101
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Blake MJ, Snoep L, Raniti M, Schwartz O, Waloszek JM, Simmons JG, Murray G, Blake L, Landau ER, Dahl RE, Bootzin R, McMakin DL, Dudgeon P, Trinder J, Allen NB. A cognitive-behavioral and mindfulness-based group sleep intervention improves behavior problems in at-risk adolescents by improving perceived sleep quality. Behav Res Ther 2017; 99:147-156. [DOI: 10.1016/j.brat.2017.10.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 10/10/2017] [Indexed: 11/24/2022]
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102
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Implications of Psychological Morbidity on Physical Health and Behavior of Adolescents in Aligarh, India. JOURNAL OF PEDIATRICS REVIEW 2017. [DOI: 10.5812/jpr.11083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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103
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Dunbar M, Mirpuri S, Yip T. Ethnic/racial discrimination moderates the effect of sleep quality on school engagement across high school. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:527-540. [PMID: 28394166 PMCID: PMC6090546 DOI: 10.1037/cdp0000146] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Previous research has indicated that school engagement tends to decline across high school. At the same time, sleep problems and exposure to social stressors such as ethnic/racial discrimination increase. The current study uses a biopsychosocial perspective to examine the interactive and prospective effects of sleep and discrimination on trajectories of academic performance. METHOD Growth curve models were used to explore changes in 6 waves of academic outcomes in a sample of 310 ethnically and racially diverse adolescents (mean age = 14.47 years, SD = .78, and 64.1% female). Ethnic/racial discrimination was assessed at Time 1 in a single survey. Sleep quality and duration were also assessed at Time 1 with daily diary surveys. School engagement and grades were reported every 6 months for 3 years. RESULTS Higher self-reported sleep quality in the ninth grade was associated with higher levels of academic engagement at the start of high school. Ethnic/racial discrimination moderated the relationship between sleep quality and engagement such that adolescents reporting low levels of discrimination reported a steeper increase in engagement over time, whereas their peers reporting poor sleep quality and high levels of discrimination reported the worse engagement in the ninth grade and throughout high school. CONCLUSION The combination of poor sleep quality and high levels of discrimination in ninth grade has downstream consequences for adolescent academic outcomes. This study applies the biopsychosocial model to understand the development and daily experiences of diverse adolescents. (PsycINFO Database Record
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Affiliation(s)
- Margaret Dunbar
- Applied Developmental Psychology Program, Fordham University
| | - Sheena Mirpuri
- Applied Developmental Psychology Program, Fordham University
| | - Tiffany Yip
- Applied Developmental Psychology Program, Fordham University
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104
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Peltz JS, Rogge RD, Connolly H, O'Connor TG. A process-oriented model linking adolescents' sleep hygiene and psychological functioning: the moderating role of school start times. Sleep Health 2017; 3:465-471. [PMID: 29157641 DOI: 10.1016/j.sleh.2017.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/01/2017] [Accepted: 08/09/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine a mediational model linking sleep hygiene to better mental health in adolescents via the mechanism of improved sleep quality, and to test the moderating role of school start times (SST) (before 8:30 AM vs. 8:30 AM or later) on that mediation model. DESIGN Cross-sectional. SETTING Online survey for high school students across the United States. PARTICIPANTS A total of 197 adolescents aged 14-17 years old (Mage = 15.6 years, SD = 1.8; 53% female) completed a baseline survey and 7-day sleep diaries; their parents (Mage = 47.7 years, SD = 5.5; 79% female) reported on family socioeconomic status and high SST. MEASUREMENT Adolescents reported on their sleep hygiene, circadian chronotype, daily levels of sleep quality and duration (morning diaries) and their depressive/anxiety symptoms (evening diaries) for 7 days. RESULTS A moderated-mediation model suggested that baseline sleep hygiene was directly associated with lower average daily depressive/anxiety symptoms across all students, but that association was marginally stronger in students with later SST (8:30 AM or later). A mediated path emerged only for students with earlier start times, suggesting that, for those students, baseline sleep hygiene was indirectly associated with lower average daily psychological symptoms by improving average daily sleep quality. CONCLUSIONS The current study is one of the first to demonstrate that SST might serve as a critical moderator in models of adolescent sleep and daily functioning. The findings provide additional evidence in the debate on how SST may affect adolescent health.
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Affiliation(s)
- Jack S Peltz
- 4380 Main St., Daemen College, Amherst, NY 14226.
| | - Ronald D Rogge
- Department of Clinical & Social Sciences in Psychology, Box 270266, University of Rochester, Rochester, NY 14627
| | - Heidi Connolly
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY 14627
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105
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Continuity of sleep problems from adolescence to young adulthood: results from a longitudinal study. Sleep Health 2017; 3:290-295. [DOI: 10.1016/j.sleh.2017.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/28/2017] [Accepted: 04/13/2017] [Indexed: 11/21/2022]
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106
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Vernon L, Modecki KL, Barber BL. Mobile Phones in the Bedroom: Trajectories of Sleep Habits and Subsequent Adolescent Psychosocial Development. Child Dev 2017; 89:66-77. [PMID: 28556891 DOI: 10.1111/cdev.12836] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mobile phones are an essential part of an adolescent's life, leading them to text, phone, or message into the night. Longitudinal latent growth models were used to examine relations between changes in adolescent night-time mobile phone use, changes in sleep behavior, and changes in well-being (depressed mood, externalizing behavior, self-esteem, and coping) for 1,101 students (43% male) between 13 and 16 years old. Both night-time mobile phone use and poor sleep behavior underwent positive linear growth over time. Increased night-time mobile phone use was directly associated with increased externalizing behavior and decreased self-esteem and coping. Changes in sleep behavior mediated the relation between early changes in night-time mobile phone use and later increases in depressed mood and externalizing behavior and later declines in self-esteem and coping.
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Affiliation(s)
| | - Kathryn L Modecki
- Murdoch University.,Griffith University, Menzies Health Institute of Queensland
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107
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Goosby BJ, Straley E, Cheadle JE. Discrimination, Sleep, and Stress Reactivity: Pathways to African American-White Cardiometabolic Risk Inequities. POPULATION RESEARCH AND POLICY REVIEW 2017. [DOI: 10.1007/s11113-017-9439-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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108
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Schweizer A, Berchtold A, Barrense-Dias Y, Akre C, Suris JC. Adolescents with a smartphone sleep less than their peers. Eur J Pediatr 2017; 176:131-136. [PMID: 27981353 DOI: 10.1007/s00431-016-2823-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/04/2016] [Accepted: 12/07/2016] [Indexed: 12/13/2022]
Abstract
UNLABELLED Many studies have shown that the use of electronic media is related to sleep disturbance, but few have examined the impact of smartphones. The objective of this study was to assess longitudinally whether acquiring a smartphone had an effect on adolescents' sleeping duration. The study included 591 adolescents observed at baseline (T0, Spring 2012; mean age 14.3 years, 288 females) and 2 years later (T1). They were divided into owners (those owning a smartphone at T0 and T1; N = 383), new owners (those owning a smartphone at T1 but not at T0; N = 153), and non-owners (those not owning a smartphone at any time-point; N = 55). Groups were compared on sleep duration, sleep problems, and sociodemographic variables. Overall, all three groups decreased their sleeping time between T0 and T1. At T0, owners of a smartphone were found to sleep significantly less than non-owners and new-owners, especially on school days, and to report significantly more sleeping problems. At T1, new-owners and owners showed no differences on sleep duration or sleeping problems. CONCLUSION The results emphasize that owning a smartphone tends to entail sleep disturbance. Therefore, adolescents and parents should be informed about the potential consequences of smartphone use on sleep and health. What is Known: • The use of electronic media plays an important role in the life of adolescents. • Smartphone use is increasing among young people and allows them to be connected almost anytime anywhere. What is New : • Adolescents owning a smartphone sleep less hours on school days than their peers. • Smartphones seem to have an important impact on youths' sleep duration.
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Affiliation(s)
- Angélick Schweizer
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - André Berchtold
- Institute of Social Sciences and LIVES, University of Lausanne, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Christina Akre
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Joan-Carles Suris
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
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109
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Marilyn Wedge: A Disease Called Childhood: Why ADHD Became An American Epidemic. J Youth Adolesc 2016. [DOI: 10.1007/s10964-016-0546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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110
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Lunsford-Avery JR, Krystal AD, Kollins SH. Sleep disturbances in adolescents with ADHD: A systematic review and framework for future research. Clin Psychol Rev 2016; 50:159-174. [PMID: 27969004 DOI: 10.1016/j.cpr.2016.10.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/15/2016] [Accepted: 10/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Biological mechanisms underlying symptom and prognostic heterogeneity in Attention-Deficit/Hyperactivity Disorder (ADHD) are unclear. Sleep impacts neurocognition and daytime functioning and is disrupted in ADHD, yet little is known about sleep in ADHD during adolescence, a period characterized by alterations in sleep, brain structure, and environmental demands as well as diverging ADHD trajectories. METHODS A systematic review identified studies published prior to August 2016 assessing sleep in adolescents (aged 10-19years) with ADHD or participating in population-based studies measuring ADHD symptoms. RESULTS Twenty-five studies were identified (19 subjective report, 6 using actigraphy/polysomnography). Findings are mixed but overall suggest associations between sleep disturbances and 1) ADHD symptoms in the population and 2) poorer clinical, neurocognitive, and functional outcomes among adolescents with ADHD. Common limitations of studies included small or non-representative samples, non-standardized sleep measures, and cross-sectional methodology. CONCLUSIONS Current data on sleep in adolescent ADHD are sparse and limited by methodological concerns. Future studies are critical for clarifying a potential role of sleep in contributing to heterogeneity of ADHD presentation and prognosis. Potential mechanisms by which sleep disturbances during adolescence may contribute to worsened symptom severity and persistence of ADHD into adulthood and an agenda to guide future research are discussed.
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Affiliation(s)
- Jessica R Lunsford-Avery
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road Suite 300, Durham, NC 27705, United States.
| | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road Suite 300, Durham, NC 27705, United States; Departments of Psychiatry and Neurology, University of California San Francisco School of Medicine, 401 Parnassus Avenue, San Francisco, CA 94143, United States
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road Suite 300, Durham, NC 27705, United States
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111
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Effect of sleep extension on sluggish cognitive tempo symptoms and driving behavior in adolescents with chronic short sleep. Sleep Med 2016; 30:93-96. [PMID: 28215271 DOI: 10.1016/j.sleep.2016.09.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/26/2016] [Accepted: 09/29/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE/BACKGROUND Few adolescents report obtaining adequate amounts of sleep. Correlational studies have linked adolescent short sleep with driving crashes and sluggish cognitive tempo (SCT), a cluster of symptoms that include sluggishness and low persistence that are related to but distinct from inattention and sleepiness. The relationship between SCT and driving is understudied, and no study has experimentally examined the relationship between SCT and sleep. We examined the relationship between SCT and driving problems in a sample of chronically short-sleeping adolescents. We also examined whether experimentally extending sleep improved SCT and driving behaviors. PARTICIPANTS/METHODS Licensed 16- to 18-year-old adolescents who regularly obtained five to seven hours of sleep completed a five-week at-home experimental protocol: a baseline week to determine typical sleep (TYP), followed in a counterbalanced order by two-week spans in which school-night bedtimes and rise times were (a) matched to TYP or (b) modified to extend (EXT) time in bed by 1.5 h/night. Sleep was monitored by actigraphy. Self- and parent-reported SCT and inattention and self-reported driving problems were recorded at baseline and following each condition. Of the 38 eligible participants who completed the baseline session, 24 completed all five weeks of the protocol. RESULTS After controlling for inattention, only parent-reported SCT was significantly positively associated with self-reported purposeful driving violations at baseline. Adolescents reported lesser SCT during EXT than during TYP. Further, after controlling for inattention, participants who reported improvement in SCT demonstrated fewer driving problems during EXT than during TYP. CONCLUSIONS Preliminary findings suggest that extending sleep in short-sleeping adolescents may help alleviate SCT symptoms and improve driving.
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112
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Wong MM, Brower KJ, Craun EA. Insomnia symptoms and suicidality in the National Comorbidity Survey - Adolescent Supplement. J Psychiatr Res 2016; 81:1-8. [PMID: 27355426 PMCID: PMC5021568 DOI: 10.1016/j.jpsychires.2016.06.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 03/30/2016] [Accepted: 06/02/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In this paper, we examined the relationship between insomnia symptoms and suicidality in a national sample of US adolescents, while controlling for several psychiatric disorders that are known to be associated with suicidality. Additionally, we examined whether insomnia symptoms interact to affect any suicidality variables. METHODS Study participants were 10,123 adolescents between the ages of 13-18 from the National Comorbidity Survey - Adolescent Supplement (NCS-A). RESULTS In bivariate analyses, all insomnia symptoms (i.e., difficulty falling asleep, difficulty staying asleep, and early morning awakening) were associated with suicide ideation, plan and attempts. In multivariate analyses, controlling for substance use, mood and anxiety disorders, as well as important covariates, difficulties falling and staying asleep had a significant relationship with 12-month and lifetime suicide variables while early morning awakening did not. CONCLUSIONS Two of the three insomnia symptoms had a significant association with suicide thoughts and plan even after controlling for psychiatric disorders that were known to affect suicidality. Having trouble falling sleeping or staying asleep had both direct and indirect relationships (via substance use, mood and anxiety disorders) on suicidal behavior. Assessment and treatment of sleep disturbances may reduce the risk for suicidality in adolescents.
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Affiliation(s)
- Maria M Wong
- Department of Psychology, Idaho State University, USA.
| | - Kirk J Brower
- Department of Psychiatry, University of Michigan, USA
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113
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Sosnowski DW, Kliewer W, Lepore SJ. The Role of Sleep in the Relationship Between Victimization and Externalizing Problems in Adolescents. J Youth Adolesc 2016; 45:1744-54. [PMID: 27216201 PMCID: PMC5826765 DOI: 10.1007/s10964-016-0506-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
Abstract
Victimization is linked to externalizing outcomes in adolescents and recent theorizing suggests that sleep plays a role in this relationship; however, there is little evidence examining sleep as a mediator. This study examines associations between victimization experiences and changes in aggression, delinquency, and drug use. Data were obtained from three waves of a school-based study with middle-school youth (n = 785; 55 % female; 20 % African American; M = 12.32, SD = .51 years at T1), and path analyses were used to test the key hypotheses. Analyses controlling for major life events, demographic factors, and school site revealed that victimization indirectly affected delinquency and drug use, but not aggression, through its relationship with sleep problems. Further, the effects of sleep problems on drug use were specific to females. These data suggest that intervening to address sleep problems resulting from victimization may serve to reduce some forms of externalizing behavior.
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Affiliation(s)
- David W Sosnowski
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA.
| | - Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA
| | - Stephen J Lepore
- Department of Social and Behavioral Sciences, Temple University, 1301 Cecil B. Moore Ave., Philadelphia, PA, 19122, USA
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114
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Becker SP, Sidol CA, Van Dyk TR, Epstein JN, Beebe DW. Intraindividual variability of sleep/wake patterns in relation to child and adolescent functioning: A systematic review. Sleep Med Rev 2016; 34:94-121. [PMID: 27818086 DOI: 10.1016/j.smrv.2016.07.004] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 01/09/2023]
Abstract
Substantial research attention has been devoted to understanding the importance and impact of sleep in children and adolescents. Traditionally, this has focused on mean sleep variables (e.g., a child's "typical" or average sleep duration), yet research increasingly suggests that intraindividual variability (IIV) of sleep/wake patterns (sometimes referred to as sleep variability or night-to-night variability) regularly occurs and may have implications for adjustment. A systematic search of five electronic databases identified 52 empirical studies published between 2000 and 2015 that examined correlates of sleep IIV in children and adolescents, with a recent increase in the publication rate of such studies. Identified studies were often atheoretical and included post hoc analyses, though IIV in select aspects of sleep does appear to be associated with increasing age/pubertal status, non-White race, physical and neurodevelopmental conditions (e.g., attention-deficit/hyperactivity disorder; autism), psychopathology symptoms (e.g., anxiety, depression, inattention), body weight, stress, aspects of cognitive functioning, and poorer sleep functioning/habits. The limited intervention work examining sleep IIV in adolescents is promising, though studies are needed using more rigorous intervention designs. Clinical sleep recommendations may not only need to address overall sleep duration and sleep habits but also the stability of sleep duration and timing. It will be important for future research examining sleep IIV in children and adolescents to use a developmental framework in advancing theory pertaining to the causes, mechanisms, moderators, and outcomes of sleep IIV in youth, and a conceptual model is proposed to help guide such efforts.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Craig A Sidol
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Tori R Van Dyk
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jeffery N Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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115
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Examining Dark Triad traits in relation to sleep disturbances, anxiety sensitivity and intolerance of uncertainty in young adults. Compr Psychiatry 2016; 68:103-10. [PMID: 27234190 DOI: 10.1016/j.comppsych.2016.03.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/23/2016] [Accepted: 03/28/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The Dark Triad (DT) describes a set of three closely related personality traits, Machiavellianism, narcissism, and psychopathy. The aim of this study was to examine the associations between DT traits, sleep disturbances, anxiety sensitivity and intolerance of uncertainty. METHOD A total of 341 adults (M=29years) completed a series of questionnaires related to the DT traits, sleep disturbances, anxiety sensitivity, and intolerance of uncertainty. RESULTS A higher DT total score was associated with increased sleep disturbances, and higher scores for anxiety sensitivity and intolerance of uncertainty. In regression analyses Machiavellianism and psychopathy were predictors of sleep disturbances, anxiety sensitivity, and intolerance of uncertainty. CONCLUSIONS Results indicate that specific DT traits, namely Machiavellianism and psychopathy, are associated with sleep disturbances, anxiety sensitivity and intolerance of uncertainty in young adults.
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116
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Abstract
OBJECTIVE To examine the effects of stimulant medication on the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) and identify predictors of sleep problems as a side effect of taking stimulant medication. METHOD One hundred sixty-three stimulant-naïve children (72% boys) aged 7 to 11 years diagnosed with ADHD (120 with ADHD predominantly inattentive type, 43 with ADHD combined type) participated in a 4-week, randomized, double-blind, placebo-controlled trial of once-daily (long-acting) methylphenidate (MPH). Parents completed weekly side-effect ratings including an item related to sleep problems. RESULTS Ten percent of patients had parent-rated sleep problems before the initiation of medication. Rates of parent-rated sleep problems during MPH titration generally increased with increasing MPH dose (placebo: 8%; low dose: 18%; medium dose: 15%; high dose: 25%). Differences emerged between children with (n = 16) or without (n = 147) preexisting sleep problems. Although 23% of children without preexisting sleep problems went on to have sleep problems at the highest MPH dose, only 37.5% of children with preexisting sleep problems still had sleep problems at the highest MPH dose. Lower weight and lower body mass index (BMI) were associated with increased sleep problems during MPH titration. CONCLUSION This study demonstrated a general association between increased MPH dose and increased sleep problems in children with ADHD, particularly for children of lower weight/BMI. However, a substantial proportion of children with preexisting sleep difficulties no longer had sleep problems on the highest MPH dose, which may help explain mixed findings reported to date in studies examining the impact of MPH on sleep functioning in children with ADHD and suggests that MPH dose titration should not be avoided solely on the basis of a child's premorbid sleep problems. Future research is needed to replicate and extend these findings to more specific domains of sleep functioning and to identify differences between children with persistent or improved sleep functioning as a result of MPH use.
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117
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Becker SP, Garner AA, Byars KC. Sluggish cognitive tempo in children referred to a pediatric Sleep Disorders Center: Examining possible overlap with sleep problems and associations with impairment. J Psychiatr Res 2016; 77:116-24. [PMID: 27017288 PMCID: PMC4826847 DOI: 10.1016/j.jpsychires.2016.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/29/2016] [Accepted: 03/14/2016] [Indexed: 11/18/2022]
Abstract
Research supports the distinctness of sluggish cognitive tempo (SCT) (e.g., mental confusion and slowed behavior/thinking) from other psychopathologies. However, the relation between SCT and sleep functioning has not been adequately studied. We examined the association between SCT and sleep functioning in 325 children (62% male) ages 6-10 years referred to a pulmonary-based, accredited Sleep Disorders Center. Correlations between caregiver ratings of SCT, other psychopathologies (i.e., inattention/hyperactivity, oppositionality, depression, anxiety), sleep functioning (both behavioral and organic symptoms), as well as sleep disorder diagnoses, were examined. Unique effects of SCT and other psychopathologies on sleep problem severity controlling for child demographics were assessed using regressions. Regression analyses were also conducted to examine the unique effects of SCT on impairment (i.e., academic difficulties, parenting stress, and other psychopathologies) controlling for child demographics, sleep problem severity, and other psychopathology symptoms. SCT was weakly to moderately correlated with most measures of sleep (rs = .07-.39) and moderately to strongly correlated with measures of daytime sleepiness (rs = .33 and .53). In the regression analyses, SCT was uniquely associated with greater sleep functioning severity and impairment in academic functioning. SCT was also uniquely associated with higher levels of depression and inattention/hyperactivity, but not anxiety, and negatively associated with oppositionality. Finally, SCT symptoms were uniquely associated with greater parent-child dysfunctional interaction. Findings demonstrate that SCT is related to, but not redundant with, sleep problems and daytime sleepiness specifically. Further, SCT remained associated with several domains of functional impairment in sleep-disordered children after controlling for clinically-relevant variables, highlighting the potential value in assessing SCT symptoms in children with sleep problems.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 10006, Cincinnati, OH 45056, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave., MLC 10006, Cincinnati, OH 45056, USA.
| | - Annie A Garner
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd., St. Louis, Missouri 63108, USA
| | - Kelly C Byars
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 10006, Cincinnati, OH 45056, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave., MLC 10006, Cincinnati, OH 45056, USA; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45056, USA
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118
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Chen YIL, Gau SSF. Sleep problems and internet addiction among children and adolescents: a longitudinal study. J Sleep Res 2016; 25:458-65. [DOI: 10.1111/jsr.12388] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/12/2015] [Indexed: 11/29/2022]
Affiliation(s)
- YI-Lung Chen
- Department of Psychiatry; National Taiwan University Hospital and College of Medicine; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry; National Taiwan University Hospital and College of Medicine; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
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119
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Becker SP, Pfiffner LJ, Stein MA, Burns GL, McBurnett K. Sleep habits in children with attention-deficit/hyperactivity disorder predominantly inattentive type and associations with comorbid psychopathology symptoms. Sleep Med 2015; 21:151-9. [PMID: 26922623 DOI: 10.1016/j.sleep.2015.11.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/17/2015] [Accepted: 11/16/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Much of what is currently known about the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) is based on samples of children with ADHD combined type, and no study to date has examined the association between sluggish cognitive tempo (SCT) and sleep functioning in children diagnosed with ADHD. Accordingly, the objectives of this study were to (1) describe the sleep habits of children diagnosed with ADHD predominantly inattentive type (ADHD-I) and (2) examine whether comorbid internalizing, oppositional, and/or SCT symptoms are associated with poorer sleep functioning in children with ADHD-I. This study extends the current literature by using a large, clinical sample of children with ADHD-I to examine the association between SCT and other psychopathology symptoms with children's sleep functioning. METHODS Participants included 147 children (age: 6-11, 59% male, 55% White) diagnosed with ADHD-I using a semi-structured diagnostic interview. Parents completed measures assessing their child's sleep habits as well as comorbid anxiety, depression, oppositionality, and SCT symptoms. RESULTS Fourteen percent of children with ADHD-I obtain less sleep than recommended and 31% have a sleep onset latency of greater than 20 minutes. The few children taking medication for ADHD had a longer sleep onset latency than those without medication. Twenty-seven percent of parents indicated that it is "difficult" to get their child out of bed on school days and 41% of parents indicated that their child needs to catch-up on sleep on the weekend "at least a little". Regression analyses found anxiety and SCT sleepy/tired symptoms to be the most consistent dimensions of psychopathology associated with sleep functioning, with little support for depression or oppositionality being associated with sleep. CONCLUSIONS A sizeable minority of children with ADHD-I experience impaired sleep. In addition to SCT sleepy/tired symptoms, comorbid anxiety was most consistently associated with poorer sleep functioning in children with ADHD-I. SCT daydreaming and working memory symptoms were unassociated with sleep functioning, and the size of the effects between SCT sleepy/tired and sleep functioning indicates that these are not overlapping constructs. Longitudinal studies are needed to evaluate the interrelations of sleep problems and comorbid psychopathology symptoms and their impact on the daytime functioning of children with ADHD-I.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Linda J Pfiffner
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Mark A Stein
- Department of Psychiatry and Behavioral Medicine, University of Washington, Seattle, WA, USA
| | - G Leonard Burns
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Keith McBurnett
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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