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Sobiech L, Dąbkowska I, Bekiesz W, Turżańska K, Blicharski T, Sarna-Boś K. Bruxism in a Child with Trisomy 21 (Down Syndrome)-Case Report. J Clin Med 2024; 13:3679. [PMID: 38999245 PMCID: PMC11242527 DOI: 10.3390/jcm13133679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
Bruxism has been defined in recent years and analyzed in detail as the repetitive activity of the muscles of the masticatory system. Both adults and children experience two different forms of bruxism: daytime and nighttime bruxism. According to the WHO, bruxism affects 5% to 50% of the world's pediatric population. The symptoms of this disease include tooth wear and fractures, temporomandibular disorders, headaches, behavioral and sleep disorders, and parafunctional habits such as nail biting. According to scientists, psychosocial factors are the most likely factors causing bruxism in children. To this day, we do not have established standards of treatment for children, especially for those with disabilities. The issue of bruxism in children with Down syndrome (DS) is still unexplained. Anatomical abnormalities in the facial skeleton, reduced muscle tone, personality traits, and sleep problems in these people may cause the symptoms of bruxism. Our study aimed to present a clinical case of a 13-year-old girl with DS and symptoms of bruxism. Diagnostics and dental examination in children with intellectual disabilities and a lack of understanding of the disease create a great challenge for the treatment team, including the dentist, physiotherapist, psychologist, and family. Creating standards for treating and preventing bruxism symptoms is demanding, among other things, due to the lack of sufficient scientific research.
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Affiliation(s)
- Lena Sobiech
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (L.S.); (T.B.)
| | - Izabela Dąbkowska
- Department of Sports Medicine, Faculty of Health Science, Medical University of Lublin, Chodźki 15, 20-093 Lublin, Poland
| | - Wojciech Bekiesz
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (L.S.); (T.B.)
| | - Karolina Turżańska
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (L.S.); (T.B.)
| | - Tomasz Blicharski
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (L.S.); (T.B.)
| | - Katarzyna Sarna-Boś
- Department of Dental Prosthetics, Medical University of Lublin, Chodźki 6, 20-093 Lublin, Poland;
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Bracci A, Lobbezoo F, Colonna A, Bender S, Conti PCR, Emodi-Perlman A, Häggman-Henrikson B, Klasser GD, Michelotti A, Lavigne GJ, Svensson P, Ahlberg J, Manfredini D. Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies. J Oral Rehabil 2024; 51:150-161. [PMID: 37191494 DOI: 10.1111/joor.13514] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND With time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged. OBJECTIVE In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management. METHODS We summarised current strategies for AB assessment and proposed a research route for improving its metrics. RESULTS Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non-instrumental or instrumental approaches. The former include self-report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology-enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake-time bruxism-type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity. CONCLUSIONS Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject-based information must be gathered in a universally accepted standardised approach.
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Affiliation(s)
- Alessandro Bracci
- Department of Neuroscience, School of Dentistry, University of Padova, Padova, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Steven Bender
- Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, Texas, USA
| | - Paulo C R Conti
- Bauru School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Telaviv, Israel
| | | | - Gary D Klasser
- Department of Diagnostic Sciences, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Ambra Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Gilles J Lavigne
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, and Universite de Montreal, Montreal, Quebec, Canada
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
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Bondopadhyay U, Diaz-Orueta U, Coogan AN. A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder. J Atten Disord 2022; 26:149-224. [PMID: 33402013 DOI: 10.1177/1087054720978556] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD. METHODS Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD. RESULTS 148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep. CONCLUSION Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.
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Affiliation(s)
- Upasana Bondopadhyay
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
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Darweesh AEDM, El Beh KA, Hashem MM, Nagy NES. Shorter rapid eye movement sleep duration in children with attention-deficit /hyperactivity disorder: the impact on quality of life. Sleep Med 2021; 87:77-84. [PMID: 34534746 DOI: 10.1016/j.sleep.2021.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The relationship of sleep with attention deficit hyperactivity disorder (ADHD) remains complex and unclear. The current study aimed to compare the subjective and objective sleep parameters among children with and without ADHD. Moreover, to address the effect of sleep parameters on the quality of life (QoL). METHODS We assessed 42 participants who were children with ADHD (aged 6-12 years), with predominant combined presentation (23), compared to 42 healthy children, who underwent a sleep study assessment subjectively (the Children's Sleep Habits Questionnaire), and objectively (one-night Polysomnographic recording). Also, parents completed the pediatric quality of life inventory (PedsQL-P). RESULTS Children with ADHD had more subjective sleep problems. ADHD patients also had a significant decrease in total sleep time and sleep efficiency, spending more time in wake and N1 sleep stages. Moreover, they had significantly lower rapid eye movement (REM)sleep duration and less duration of deep sleep stages. Multivariate regression analysis showed that REM sleep duration was the most contributing and predictive factor to QoL and school function impairment. CONCLUSION Children with ADHD have a significantly lower sleep quantity and poor sleep quality. In addition, short REM sleep duration independently contributes to further deterioration in different areas of QoL.
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Affiliation(s)
- Alaa El-Din M Darweesh
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Khaled A El Beh
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mustafa M Hashem
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Nahla El-Sayed Nagy
- Institute of Psychiatry, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
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Bulanda S, Ilczuk-Rypuła D, Nitecka-Buchta A, Nowak Z, Baron S, Postek-Stefańska L. Sleep Bruxism in Children: Etiology, Diagnosis, and Treatment-A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189544. [PMID: 34574467 PMCID: PMC8471284 DOI: 10.3390/ijerph18189544] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Bruxism, a condition characterized by grinding and involuntary clenching of the teeth, is a risk factor for the development of masticatory dysfunction. It can occur together with sleep disturbances and may be associated with abnormal body movements, breathing difficulties, increased muscle activity, and heart rate disturbances. This disorder is becoming an important dental concern in children. (2) Methods: A literature review was carried out based on a search in PubMed and Google Scholar databases for articles on bruxism in children, published between 2014 and 2021. The etiology, diagnosis, and treatment of bruxism in children were of particular interest in the study. (3) Results: A total of 40 articles were included in the review. The analyzed studies indicated that the prevalence rates of bruxism in children vary widely from 13% to 49%. The etiology of bruxism is complex and incomprehensible, and the main diagnostic criteria for this condition in children are subjective observation, clinical history, and clinical examination. The recommended therapy for sleep bruxism in children is physiotherapy and psychotherapy. (4) Conclusions: Dentists and primary care physicians should correctly diagnose bruxism in children, educate parents, prevent potential consequences for oral health, and identify possible comorbidities. Appropriate clinical guidelines for the treatment and prophylaxis of bruxism in children should also be developed.
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Affiliation(s)
- Sylwia Bulanda
- Department of Pediatric Dentistry, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (D.I.-R.); (L.P.-S.)
- Correspondence: (S.B.); (A.N.-B.)
| | - Danuta Ilczuk-Rypuła
- Department of Pediatric Dentistry, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (D.I.-R.); (L.P.-S.)
| | - Aleksandra Nitecka-Buchta
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (Z.N.); (S.B.)
- Correspondence: (S.B.); (A.N.-B.)
| | - Zuzanna Nowak
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (Z.N.); (S.B.)
| | - Stefan Baron
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (Z.N.); (S.B.)
| | - Lidia Postek-Stefańska
- Department of Pediatric Dentistry, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland; (D.I.-R.); (L.P.-S.)
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Zaccari V, Santonastaso O, Mandolesi L, De Crescenzo F, Foti F, Crescentini C, Fabbro F, Vicari S, Curcio G, Menghini D. Clinical application of mindfulness-oriented meditation in children with ADHD: a preliminary study on sleep and behavioral problems. Psychol Health 2021; 37:563-579. [PMID: 33678073 DOI: 10.1080/08870446.2021.1892110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE High incidence of sleep problems in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) has been described. Mindfulness meditation has emerged as a novel approach to sleep disturbances and insomnia remediation. This preliminary study tested the efficacy of Mindfulness-Oriented Meditation (MOM) training on sleep quality and behavioral problems in children with ADHD. DESIGN Twenty-five children with ADHD aged 7-11 years underwent two programs three times per week for eight-weeks: the MOM training (15 children) and an Active Control Condition (10 children). MAIN OUTCOME MEASURES Objective and subjective measures of sleep quality and behavioral measures were collected before and after the programs. RESULTS Positive effects on sleep and behavioral measures were found only in the MOM group. CONCLUSION Although they are preliminary, our results indicate that MOM training is a promising tool for ameliorating sleep quality and behavioral manifestations in ADHD.
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Affiliation(s)
- Vittoria Zaccari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
| | - Ornella Santonastaso
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
| | - Laura Mandolesi
- Department of Humanities, University of Naples Federico II, Napoli, Italy
| | - Franco De Crescenzo
- Department of Psychiatry, University of Oxford, Oxford, UK.,Clinical Trial Unit, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy.,Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Francesca Foti
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Cristiano Crescentini
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Franco Fabbro
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy.,Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
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Souto-Souza D, Mourão PS, Barroso HH, Douglas-de-Oliveira DW, Ramos-Jorge ML, Falci SGM, Galvão EL. Is there an association between attention deficit hyperactivity disorder in children and adolescents and the occurrence of bruxism? A systematic review and meta-analysis. Sleep Med Rev 2020; 53:101330. [PMID: 32554210 DOI: 10.1016/j.smrv.2020.101330] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 11/17/2022]
Abstract
Aim of the present systematic review was to evaluate whether children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are at greater chance of developing bruxism compared to individuals without this disorder. Observational studies that evaluated the occurrence of bruxism in children and adolescents with ADHD were included. The quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation criteria. Thirty-two studies involving a total of 2629 children/adolescents with ADHD and 1739 with bruxism (1629 with sleep bruxism and 110 with awake bruxism) were included. The prevalence of bruxism, irrespective of type, in the children/adolescents was 31% (95% CI: 0.22-0.41, I2 = 93%). ADHD was associated with an increased chance of bruxism (OR: 2.94, 95% CI: 2.12-4.07, I2 = 61%), independently of the type [sleep bruxism (OR: 2.77, 95% CI: 1.90-4.03, I2 = 66%) or awake bruxism (OR: 10.64, 95% CI: 2.41-47.03, I2 = 65%)]. The presence of signs of ADHD without a diagnostic confirmation was not associated with an increased chance of bruxism (OR: 3.26, 95% CI: 0.76-14.04, I2 = 61%). Children and adolescents with a definitive diagnosis of ADHD are at greater chance of developing sleep and awake bruxism than those without this disorder.
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Affiliation(s)
- Debora Souto-Souza
- Post-Graduate Program in Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, Minas Gerais, Brazil.
| | - Priscila S Mourão
- Post-Graduate Program in Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, Minas Gerais, Brazil
| | - Heloisa H Barroso
- Post-Graduate Program in Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, Minas Gerais, Brazil
| | - Dhelfeson W Douglas-de-Oliveira
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, Minas Gerais, Brazil
| | - Maria L Ramos-Jorge
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, Minas Gerais, Brazil
| | - Saulo G M Falci
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, Minas Gerais, Brazil
| | - Endi L Galvão
- Post-Graduate Program in Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, Minas Gerais, Brazil
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Knight FLC, Dimitriou D. Poor Sleep Has Negative Implications for Children With and Without ADHD, but in Different Ways. Behav Sleep Med 2019; 17:423-436. [PMID: 29072500 DOI: 10.1080/15402002.2017.1395335] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Sleep problems are commonly reported in attention deficit hyperactivity disorder (ADHD), and are also a familiar characteristic of typical development (TD). We sought to elucidate the relationship between sleep, ADHD trait behaviors, and cognitive inattention, and how it manifests between ADHD and TD children. Participants: Eighteen children diagnosed with ADHD and 20 age-matched TD controls aged 5 to 11 years old participated in the study. Methods: Sleep profiles were assessed using Children's Sleep Habits Questionnaire and actigraphy measures. Behavioral functioning was examined using Conners' Parent Report Scale and attention using the computerized Conners' Continuous Performance Task. Results: We found evidence of (a) poorer sleep quality in the ADHD group, despite no difference in actual sleep time, (b) poor sleep quality in TD children predicting increased ADHD-trait behaviors, despite no association with attention, and (c) a consistent trend for poor sleep quality predicting reduced attentional control in ADHD children, despite no association with behavior. Conclusions: Poor sleep quality affects developmental subgroups in different ways. For ADHD children, poor sleep worsens their predisposed attentional deficit, while for TD children it mimics ADHD behaviors. These findings have important implications for the debate on overdiagnosis of childhood ADHD, and the use of sleep-based interventions. Above all, they highlight the importance of promoting good sleep hygiene in all children.
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Affiliation(s)
- Frances Le Cornu Knight
- a Lifespan Learning and Sleep Laboratory (LiLAS) , UCL, Institute of Education , London, England
| | - Dagmara Dimitriou
- a Lifespan Learning and Sleep Laboratory (LiLAS) , UCL, Institute of Education , London, England
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9
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Cao H, Yan S, Gu C, Wang S, Ni L, Tao H, Shao T, Xu Y, Tao F. Prevalence of attention-deficit/hyperactivity disorder symptoms and their associations with sleep schedules and sleep-related problems among preschoolers in mainland China. BMC Pediatr 2018; 18:70. [PMID: 29458356 PMCID: PMC5817725 DOI: 10.1186/s12887-018-1022-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 01/29/2018] [Indexed: 12/31/2022] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) among children is an increasing public health concern. The identification of behavioral risk factors, including sleep quality, has important public health implications for prioritizing behavioral intervention strategies for ADHD. Herein, this study aimed to investigate the prevalence of high levels of ADHD symptoms and to explore the association between sleep schedules, sleep-related problems and ADHD symptoms among preschoolers aged 3 to 6 years in mainland China. Methods A cross-sectional study was conducted, comprising a large sample of 15,291 preschoolers in Ma’anshan city of Anhui Province in China. ADHD symptoms were assessed by the 10-item Chinese version of the Conners Abbreviated Symptom Questionnaire (C-ASQ). Sleep-related variables included caregivers’ responses to specific questions addressing children’s daytime and nighttime sleep schedules, as well as sleep-related behaviors. Data on other factors were also collected, such as socio-demographic characteristics, TV viewing duration on weekdays and weekends, and outdoor activities. Logistic regression models were used to analyze the relationships between sleep schedules, sleep-related problems and ADHD symptoms. Results Approximately 8.6% of the total sample of preschoolers had high levels of ADHD symptoms, with boys having higher levels than girls (9.9% vs. 7.2%). In the logistic regression analysis, after adjusting for TV viewing duration, outdoor activities, and socio-demographic characteristics, delayed bedtime was significantly associated with a risk of high levels of ADHD symptoms, with odds ratios (OR) of 2.50 [95% confidence interval (CI): 2.09 ~ 3.00] and 2.04 (95% CI: 1.72 ~ 2.42) for weekdays and weekends, respectively. Longer time falling asleep (≥ 31 min) (OR = 1.76, 95% CI: 1.47 ~ 2.11), no naps (OR = 1.57, 95% CI: 1.34 ~ 1.84) and frequent sleep-related problems (OR = 4.57, 95% CI: 3.86 ~ 5.41) were also significantly associated with an increased risk of high levels of ADHD symptoms, while longer sleep duration (> 8.5 h) was associated with a decreased risk of high levels of ADHD symptoms (OR = 0.76, 95% CI: 0.67~ 0.87). Conclusions ADHD symptoms are prevalent in preschoolers in Ma’anshan region, China. Undesirable sleep schedules and sleep-related problems among preschoolers confer a risk of ADHD symptoms, highlighting the finding that beneficial and regular sleep habits potentially attenuate ADHD symptoms among preschoolers.
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Affiliation(s)
- Hui Cao
- Ma'anshan Maternity and Child Health Care Hospital, Ma'anshan, Anhui, 243000, China
| | - Shuangqin Yan
- Ma'anshan Maternity and Child Health Care Hospital, Ma'anshan, Anhui, 243000, China
| | - Chunli Gu
- Ma'anshan Maternity and Child Health Care Hospital, Ma'anshan, Anhui, 243000, China
| | - Sumei Wang
- Ma'anshan Maternity and Child Health Care Hospital, Ma'anshan, Anhui, 243000, China
| | - Lingling Ni
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Mei Shan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Huihui Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Mei Shan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Ting Shao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Mei Shan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Yeqing Xu
- Ma'anshan Maternity and Child Health Care Hospital, Ma'anshan, Anhui, 243000, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Mei Shan Road, Hefei, Anhui, 230032, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China.
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10
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Mota-Veloso I, Celeste RK, Fonseca CP, Soares MEC, Marques LS, Ramos-Jorge ML, Ramos-Jorge J. Effects of attention deficit hyperactivity disorder signs and socio-economic status on sleep bruxism and tooth wear among schoolchildren: structural equation modelling approach. Int J Paediatr Dent 2017; 27:523-531. [PMID: 28155241 DOI: 10.1111/ipd.12291] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The prevalence of both bruxism and attention deficit hyperactivity (ADHD) has increased in recent years. AIM This study evaluated the direct and indirect effects of signs of ADHD, reported by parents/caregivers and teachers, with sleep bruxism. In addition, this study explores the effects of socio-economic status (SES) on sleep bruxism. DESIGN This cross-sectional study was performed in Diamantina, Brazil, with 851 randomly selected schoolchildren aged 6-12 years. The schoolchildren were underwent an oral examination for the evaluation of bruxism. Moreover, parents/caregivers fill out a form for the assessment of sleep bruxism and sociodemographic factors. Parents/caregivers and teachers responded to the Swanson, Nolan and Pelham scale - version IV (SNAP-IV) for the assessment of ADHD signs. The structural equation modelling approach was used, and standardized coefficients to direct, indirect and total effects were calculated. RESULTS ADHD signs had a significant moderate (SC = -0.19, P < 0.01) effect on sleep bruxism. SES had a significant indirect effect on bruxism via sucking habits. Moreover, SES had a significant direct (SC = -0.16, P = 0.01) and total effect on tooth wear (SC = -0.17, P < 0.01). CONCLUSION This study concluded that signs of ADHD and SES have a complex direct and indirect effects on sleep bruxism among schoolchildren.
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Affiliation(s)
- Isabella Mota-Veloso
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cynthia Pimenta Fonseca
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Maria Eliza Consolação Soares
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Leandro Silva Marques
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Maria Letícia Ramos-Jorge
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Joana Ramos-Jorge
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
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Bruxismo de sueño en niños y adolescentes. ACTA ACUST UNITED AC 2015; 86:373-9. [DOI: 10.1016/j.rchipe.2015.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/04/2015] [Indexed: 12/31/2022]
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Associations of sleep disturbance with ADHD: implications for treatment. ACTA ACUST UNITED AC 2014; 7:1-18. [PMID: 25127644 PMCID: PMC4340974 DOI: 10.1007/s12402-014-0151-0] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/08/2014] [Indexed: 01/08/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is commonly associated with disordered or disturbed sleep. The relationships of ADHD with sleep problems, psychiatric comorbidities and medications are complex and multidirectional. Evidence from published studies comparing sleep in individuals with ADHD with typically developing controls is most concordant for associations of ADHD with: hypopnea/apnea and peripheral limb movements in sleep or nocturnal motricity in polysomnographic studies; increased sleep onset latency and shorter sleep time in actigraphic studies; and bedtime resistance, difficulty with morning awakenings, sleep onset difficulties, sleep-disordered breathing, night awakenings and daytime sleepiness in subjective studies. ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian-rhythm sleep disorders). Psychostimulant medications are associated with disrupted or disturbed sleep, but also ‘paradoxically’ calm some patients with ADHD for sleep by alleviating their symptoms. Long-acting formulations may have insufficient duration of action, leading to symptom rebound at bedtime. Current guidelines recommend assessment of sleep disturbance during evaluation of ADHD, and before initiation of pharmacotherapy, with healthy sleep practices the first-line option for addressing sleep problems. This review aims to provide a comprehensive overview of the relationships between ADHD and sleep, and presents a conceptual model of the modes of interaction: ADHD may cause sleep problems as an intrinsic feature of the disorder; sleep problems may cause or mimic ADHD; ADHD and sleep problems may interact, with reciprocal causation and possible involvement of comorbidity; and ADHD and sleep problems may share a common underlying neurological etiology.
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