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Children 2018, 5(2), 20;

A Sleep Questionnaire for Children with Severe Psychomotor Impairment (SNAKE)—Concordance with a Global Rating of Sleep Quality

Paediatric Palliative Care Centre, Children’s and Adolescents’ Hospital, 45711 Datteln, Germany
Department of Children’s Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
Paediatric Neurology, Psychosomatics and Pain Therapy, Center for Child, Youth and Women’s Health, Klinikum Stuttgart, Olgahospital/Frauenklinik, 70174 Stuttgart, Germany
Author to whom correspondence should be addressed.
Received: 29 November 2017 / Revised: 14 January 2018 / Accepted: 30 January 2018 / Published: 1 February 2018
(This article belongs to the Special Issue Pediatric Palliative Care)
PDF [620 KB, uploaded 1 February 2018]


Sleep problems are a common and serious issue in children with life-limiting conditions (LLCs) and severe psychomotor impairment (SPMI). The “Sleep Questionnaire for Children with Severe Psychomotor Impairment” (Schlaffragebogen für Kinder mit Neurologischen und Anderen Komplexen Erkrankungen, SNAKE) was developed for this unique patient group. In a proxy rating, the SNAKE assesses five different dimensions of sleep(-associated) problems (disturbances going to sleep, disturbances remaining asleep, arousal and breathing disorders, daytime sleepiness, and daytime behavior disorders). It has been tested with respect to construct validity and some aspects of criterion validity. The present study examined whether the five SNAKE scales are consistent with parents’ or other caregivers’ global ratings of a child’s sleep quality. Data from a comprehensive dataset of children and adolescents with LLCs and SPMI were analyzed through correlation coefficients and Mann–Whitney U testing. The results confirmed the consistency of both sources of information. The highest levels of agreements with the global rating were achieved for disturbances in terms of going to sleep and disturbances with respect to remaining asleep. The results demonstrate that the scales and therefore the SNAKE itself is well-suited for gathering information on different sleep(-associated) problems in this vulnerable population. View Full-Text
Keywords: sleep; pediatric; SNAKE; life-limiting; neurological; impairments sleep; pediatric; SNAKE; life-limiting; neurological; impairments

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Dreier, L.A.; Zernikow, B.; Blankenburg, M.; Wager, J. A Sleep Questionnaire for Children with Severe Psychomotor Impairment (SNAKE)—Concordance with a Global Rating of Sleep Quality. Children 2018, 5, 20.

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