Parental Anxiety and Sleep Disorders in Children with Congenital Heart Diseases

Abstract

Background: Sleep disorders in children can be caused by psychological disorders or birth defects such as congenital heart disease (CHD). While physiological factors associated with CHD are recognized as major factors, the environmental influences and parental mental health on sleep disorders in children are often overlooked. Objectives: This study examines the association between parental stress and anxiety and sleep disorders in children with CHD. Methods: A cross-sectional study was conducted on 147 children aged 4 to 12 years with CHD and their mothers attending Shahid Rajaee Heart Center in Tehran. Data were collected using a demographic questionnaire, the Children’s Sleep Habits Questionnaire (CSHQ), and the Depression, Anxiety, and Stress Scales-21 (DASS-21) completed by mothers. Results: In this study of 147 children with CHD (52.1% boys, 47.9% girls), 68.7% had undergone cardiac surgery, mainly open-heart (63.3%) or angioplasty (24.5%). Most families lived in urban areas (83.7%), 91.8% of parents were married, and 70.8% of mothers had a high school education or lower. The mean CSHQ score was 48.3 ± 7.2, with parental stress, anxiety, and depression (DASS-21) averaging 12.5 ± 5.4, 11.7 ± 4.8, and 10.2 ± 4.7, respectively. Parental anxiety showed the strongest association with child sleep disorders (r = 0.36, P < 0.001) and remained the only significant predictor in adjusted analysis (β = 0.36, P < 0.001). Conclusions: Parental anxiety and stress are significant predictors of sleep disorders in children with CHD. Integrating regular psychological support and mental health interventions for parents into the care of these children is essential to improve their sleep quality and overall well-being.