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.
Key Findings
Results
At the between-person level, higher previous-day sleep quality was significantly associated with greater next-day positive mood in youth with cerebral palsy.
Study recruited 32 youth with CP aged 11-17 years (45.5% girls) from health and community agencies
Youth completed daily diaries over seven consecutive days rating sleep quality, sleep duration, and mood
Mood was operationalized as positive and negative affect using the Positive and Negative Affect Scale (PANAS)
Multilevel models controlled for gender, age, and GMFCS level
This between-person association was statistically significant
Results
At the between-person level, higher previous-day sleep quality was significantly associated with lower next-day negative mood in youth with cerebral palsy.
This finding was observed at the between-person level, reflecting differences across individuals rather than within-individual day-to-day fluctuations
The association was bidirectional at the between-person level
Models controlled for gender, age, and GMFCS level
Results
At the between-person level, higher negative mood was significantly associated with poorer sleep quality the following night, indicating a bidirectional relationship.
This bidirectional association was observed only at the between-person level, not within-person
The finding suggests that youth who report higher negative mood on average also tend to experience worse subsequent sleep quality
This was one component of the bidirectional between-person associations identified in the study
Results
At the within-person level, increases in sleep quality were associated with higher next-day positive mood only, representing a unidirectional association.
Within-person associations reflect day-to-day fluctuations within individual children rather than average differences between children
The within-person association was unidirectional: sleep quality predicted positive mood but the reverse was not significant
No significant within-person association was found between sleep quality and negative mood
This contrasts with the bidirectional pattern observed at the between-person level
Results
Sleep duration was not significantly associated with next-day mood at either the between-person or within-person level.
Sleep duration was assessed daily via self-report diary over seven days
Neither positive nor negative mood outcomes were significantly predicted by sleep duration
This contrasts with sleep quality, which showed significant associations with mood at both levels
The finding suggests sleep quality may be more relevant than sleep duration for mood in this population
Background
Children and adolescents with cerebral palsy are at elevated risk for mental health difficulties, and most prior studies have relied on average sleep metrics rather than daily assessments.
Cerebral palsy is described as 'one of the most prevalent long-term childhood conditions'
Mental health difficulties in youth with CP contribute to reduced quality of life and daily functioning
The authors note that focusing on average sleep metrics 'rather than examining intraindividual variability (IIV) using daily assessments' may introduce retrospective reporting biases
This study used daily diary methodology specifically to address this limitation
What This Means
This research suggests that sleep quality and mood are closely linked in children and adolescents with cerebral palsy (CP), a common long-term childhood condition. Using a daily diary approach over seven consecutive days, 32 young people aged 11-17 with CP reported their sleep quality, how long they slept, and how they felt each day. This method was designed to capture real-time experiences rather than relying on memory-based summaries, which can be less accurate.
The study found that sleeping better on one night was associated with feeling more positive the next day, and this held true both when comparing different children to each other and when looking at day-to-day changes within the same child. However, the relationship between sleep and negative mood was more complex: across children, those who generally had poorer sleep also tended to have worse moods—and vice versa, meaning worse moods were also linked to poorer sleep the following night. Notably, how long children slept did not appear to matter as much as how well they slept—sleep duration showed no significant relationship with mood in any of the analyses.
This research suggests that sleep quality, rather than sleep duration alone, may be an important factor in the emotional well-being of young people with CP. The findings point to a cyclical relationship where poor sleep and negative mood can reinforce each other over time, at least at the level of differences between individuals. For those working with or caring for children with CP, these results highlight the potential importance of monitoring and supporting sleep quality as part of broader mental health care.
Sanguino H, Clark C, Brunton L, Condliffe E, Kopala-Sibley D, Noel M, et al.. (2026). Understanding the dynamic association between sleep quality and mood in children and adolescents with cerebral palsy.. Research in developmental disabilities. https://doi.org/10.1016/j.ridd.2026.105257