Young Children Undergoing Nighttime Bracing for Clubfoot Have No Differences in Sleep Metrics Compared to Age-matched Controls.

Background: The potential for impaired sleep due to pain or discomfort can be a concern for adherence to nighttime bracing when treating clubfoot. The primary aim of our study was to compare sleep efficiency in young children wearing a nighttime foot abduction orthosis (FAO) to that of a matched control group. Secondary aims included the comparison of total sleep time, number of night wakings, and number of parental interventions between groups. Methods: Autovideosomnography using the Nanit infant monitor (Nanit, Inc, New York, NY) was utilized to measure sleep/wake patterns. Clubfoot patients aged 12-36 months at time of enrollment (November 2019 to March 2024, inclusive) undergoing nighttime FAO treatment, with a home Wi-Fi network and who were sleeping alone in a crib, were eligible for inclusion.Sleep metrics from 7 days for 25 children with clubfoot sleeping with nighttime FAO were compared to data from 100 age- and geographically matched controls within Nanit's database. Shapiro-Wilk tests were performed to assess normality. Mann-Whitney U tests were used to assess differences in all sleep metrics and age between cohorts. Statistical significance was set at P < .05. Results: There were no significant differences in sleep efficiency, total sleep time, or number of night wakings. There were slightly more nighttime interventions for parents of children with clubfeet compared to controls. Conclusions: Sleep metrics of young children undergoing Ponseti-style FAO bracing are not significantly different from those of matched controls. Key Concepts: (1)Autovideosomnography using the Nanit infant monitor was utilized to measure sleep/wake patterns in 25 clubfoot patients undergoing Ponseti-style boots and bar treatment and 75 matched controls.(2)Clubfoot patients undergoing Ponseti-style boots and bar treatment did not have any significant differences across sleep efficiency, total sleep time, total time awake or number of night wakings compared to controls.(3)As brace tolerance and consistent adherence to a nighttime bracing regimen are essential to prevent recurrent clubfoot, caregivers and physicians may be reassured that clubfoot bracing will not significantly impact a child's sleep. Level of Evidence: Level II.