Assessment & Research

Understanding the dynamic association between sleep quality and mood in children and adolescents with cerebral palsy.

Sanguino et al. (2026) · Research in developmental disabilities 2026
★ The Verdict

For teens with CP, nightly sleep quality—not duration—drives next-day mood, so target sleep-hygiene rather than just hours.

✓ Read this if BCBAs working with teens with CP in clinic, school, or home settings
✗ Skip if Practitioners serving only adult or ASD populations without CP

01Research in Context

01

What this study did

The team tracked sleep and mood in youth with cerebral palsy for many nights. Each morning the teens rated how they felt.

They looked at both sleep quality and sleep length. Then they asked, 'Which one predicts next-day mood?'

02

What they found

Better sleep quality lifted mood the next day. This happened for the whole group and for each teen alone.

Sleep duration made no difference. Eight hours of poor sleep still led to a grumpy morning.

03

How this fits with other research

Rana et al. (2024) saw the same link, but used parent reports of anxiety and depression. The new study shows the effect shows up day-by-day inside the teen.

Chu et al. (2009) found child sleep problems hurt mothers' mood. Together the papers say: fix the child's sleep and two people feel better.

Storch et al. (2012) linked shorter sleep to lower IQ in young kids with ASD. The new work moves the focus from 'how long' to 'how good' the night was.

04

Why it matters

Stop counting hours. Start checking quality. Ask about noise, pain, position, and night waking. Add a quick sleep-hygiene checklist to your CP behavior plan. A calm night can give you a calmer client the next session.

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→ Action — try this Monday

Add one sleep-quality question to your daily check-in and adjust demands on low-quality mornings.

02At a glance

Intervention
not applicable
Design
other
Sample size
32
Population
developmental delay
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: Cerebral palsy (CP) is one of the most prevalent long-term childhood conditions. Children and adolescents with CP are at elevated risk for mental health difficulties, which contribute to reduced quality of life and daily functioning. Sleep difficulties are a well-established risk factor for mental health. Poor sleep quality has been linked to worse mood in youth with and without neurodevelopmental disabilities. However, most studies in youth with CP have focused on average sleep metrics over time, rather than examining intraindividual variability (IIV) using daily assessments, which may reduce retrospective reporting biases. This study examined the dynamic and bidirectional association between sleep quality, sleep duration, and mood in youth with CP. METHODS: Thirty-two youth with CP (aged 11-17 years; 45.5 % girls) were recruited from health and community agencies. Youth completed daily diaries over seven consecutive days. Each day, youth rated their sleep quality, sleep duration, and levels of daily mood (operationalized as positive and negative affect using the Positive and Negative Affect Scale [PANAS]). Multilevel models examined bidirectional associations between sleep quality, sleep duration, and mood, controlling for gender, age, and GMFCS level. RESULTS: At the between-person level, higher previous-day sleep quality was significantly associated with greater next-day positive mood and lower negative mood, and higher negative mood was associated with poorer sleep quality the following night. At the within-person level, increases in sleep quality were associated with higher next-day positive mood only. Sleep duration was not significantly associated with next-day mood at either level. CONCLUSION: Findings highlight both between-person and within-person associations between sleep quality and mood in youth with CP, with bidirectional associations observed at the between-person level and unidirectional associations at the within-person level.

Research in developmental disabilities, 2026 · doi:10.1016/j.ridd.2026.105257