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Bruni O, Angriman M, Miano S, DelRosso LM, Spruyt K, Mogavero MP, Ferri R. Individualized approaches to pediatric chronic insomnia: Advancing precision medicine in sleep disorders. Sleep Med Rev 2024; 76:101946. [PMID: 38735089 DOI: 10.1016/j.smrv.2024.101946] [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: 12/27/2023] [Revised: 02/25/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
The manifestations of chronic insomnia undergo age-related changes. In younger infants and children, behavioral insomnia emerges as the most prevalent form and typically responds to behavioral interventions. However, distinct clusters of clinical presentations suggest the presence of various phenotypes, potentially implicating the primary involvement of specific neurotransmitters. These conceptualizations, coupled with genetic studies on pleiotropy and polygenicity, may aid in identifying individuals at risk of persistent insomnia into adulthood and shed light on novel treatment options. In school-age children, the predominant presentation is sleep-onset insomnia, often linked with nighttime fears, anxiety symptoms, poor sleep hygiene, limit-setting issues, and inadequate sleep duration. The manifestations of insomnia in adolescence correlate with the profound changes occurring in sleep architecture, circadian rhythms, and homeostatic processes. The primary symptoms during adolescence include delayed sleep onset, sleep misperception, persistent negative thoughts about sleep, and physiological hyperarousal-paralleling features observed in adult insomnia. An approach centered on distinct presentations may provide a framework for precision-based treatment options. Enhanced comprehension of insomnia's manifestations across diverse developmental stages can facilitate accurate assessment. Efforts to subtype insomnia in childhood align with this objective, potentially guiding the selection of appropriate treatments tailored to individual neurobiological, clinical, and familial features.
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Affiliation(s)
- Oliviero Bruni
- Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
| | - Marco Angriman
- Child Neurology and Neurorehabilitation Unit, Bolzano Hospital, Via Guncina 54, 39100, Bolzano, Italy
| | - Silvia Miano
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Via Tesserete 46, 6900, Lugano, Switzerland
| | - Lourdes M DelRosso
- University of California San Francisco, Fresno, 2625 E. Divisadero St. Fresno, CA, 93721, USA
| | - Karen Spruyt
- Université de Paris, NeuroDiderot Inserm, Academic Hospital Robert Debré Ap-Hp in the Building Bingen, 48 Bd Sérurier, 75019, Paris, France
| | - Maria P Mogavero
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Via C. Ruggero 73, 94018, Troina, Italy
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Yang M, Chuang SYC, Kennedy SE. Sleep disturbances in children and adolescents after kidney transplantation. Pediatr Nephrol 2024; 39:1577-1585. [PMID: 38082092 DOI: 10.1007/s00467-023-06204-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 03/16/2024]
Abstract
BACKGROUND Disturbances of sleep are prevalent among children with chronic kidney disease. However, the aetiology of sleep disorders in children particularly after kidney transplantation is not clear. We sought to ascertain the prevalence and type of sleep disturbances in paediatric kidney transplant recipients and to identify predictors of sleep disturbances in this population. METHODS Caregivers of kidney transplant recipients completed online questionnaires about their child's sleep. The questionnaires utilised were the Sleep Disturbance Scale for Children (SDSC), the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), questions about sleep hygiene, and questions about restless leg syndrome. Demographic and clinical details were collected from medical records. RESULTS Thirty-five children were included in the study, with a median (IQR) age of 14.1 years (9.5-16.1) and median years (IQR) since transplant of 3.7 (0.7-8.7) years, and 72.0% were identified to have at least one category of sleep disturbance according to scores on the SDSC. The most common sleep disturbances reported were disorders of initiating and maintaining sleep (DIMS) (40.0%) and disorders of excessive somnolence (DOES) (31.4%). Statistically significant predictors of sleep disturbances include low estimated glomerular filtration rate and increased age. Among children who screened positive for DIMS and DOES, the majority indicated use of electronic devices in 1 h before bed. CONCLUSIONS A high prevalence of sleep disturbances has been identified in children after kidney transplants, and some risk factors may be modifiable. Further studies are required to understand whether there are other readily modifiable predictors of sleep disturbances.
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Affiliation(s)
- Mian Yang
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia.
| | - Sandra Ya-Chu Chuang
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Respiratory Department, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Sean E Kennedy
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Nephrology Department, Sydney Children's Hospital, Randwick, NSW, Australia
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Fellman V, Heppell PJ, Rao S. Afraid and Awake: The Interaction Between Trauma and Sleep in Children and Adolescents. Psychiatr Clin North Am 2024; 47:229-253. [PMID: 38302209 DOI: 10.1016/j.psc.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Traumatic experiences and sleep disturbances are both common in children and adolescents. Because of the reciprocal relationship between sleep complaints and trauma, a mental health evaluation should include not only an assessment of posttraumatic stress disorder and other trauma symptoms but also a specific evaluation of sleep-related complaints. Similarly, if a history of both trauma and sleep complaints is identified, an effective trauma-informed intervention, whether psychological, psychopharmacologic, or a combination of the two, should directly address sleep issues.
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Affiliation(s)
- Veronica Fellman
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, Child Study Center, One Park Avenue, 7th Floor, New York City, NY 10016, USA.
| | - Patrick J Heppell
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, Child Study Center, One Park Avenue, 7th Floor, New York City, NY 10016, USA
| | - Suchet Rao
- Psychiatry and Behavioral Health, NYC Administration for Children's Services, 150 William Street, 11th Floor, New York City, NY 10038, USA
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Xavier WDS, Abreu MP, Nunes MDR, Silva-Rodrigues FM, da Silva LF, de Araújo BBM, De Bortoli PS, Neris RR, Nascimento LC. The Sleep Patterns of Children and Adolescents with Chronic Conditions and Their Families: An Integrative Literature Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:207. [PMID: 38397320 PMCID: PMC10887388 DOI: 10.3390/children11020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Sleep is of vital necessity for health, and it has a restorative and protective function for children and adolescents with chronic conditions and their families. The purpose of this study was to identify the scientific production on sleep patterns in children and adolescents with chronic conditions and their families. This integrative review was conducted between March and June 2022 using the databases of MEDLINE, Web of Science, CINAHL and PsycINFO. The articles included were original papers published between January 2007 and mid-2022. Excluded were review studies that did not evaluate sleep and whose participants did not have chronic conditions or were not children, adolescents and/or their families. The searches returned 814 abstracts. After exclusions, 47 studies were selected to be read in full; of these, 29 were selected and were grouped empirically into four categories: major alterations in the sleep patterns of children and adolescents with chronic conditions; the relationship between sleep disorders and symptoms in children and adolescents with chronic conditions; the impaired sleep patterns of families of children and adolescents with chronic conditions; and sleep alterations and their relationship with other problems in families of children and adolescents with chronic conditions. All studies showed sleep pattern impairment in children and adolescents with chronic conditions as well as their families.
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Affiliation(s)
- Welker da Silva Xavier
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Madalena Paulos Abreu
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Michelle Darezzo Rodrigues Nunes
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Fernanda Machado Silva-Rodrigues
- Maternal-Infant and Psychiatric Nursing Department, School of Nursing, University of Sao Paulo, São Paulo 05403-000, SP, Brazil;
| | - Liliane Faria da Silva
- Maternal-Infant and Psychiatric Nursing Department, Aurora de Afonso Costa School of Nursing, Fluminense Federal University, Niteroi 22020-091, RJ, Brazil;
| | - Barbara Bertolossi Marta de Araújo
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Paula Saud De Bortoli
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
| | - Rhyquelle Rhibna Neris
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
| | - Lucila Castanheira Nascimento
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
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Yelov L, Reiter J, Meira E Cruz M, Gileles-Hillel A. The association of obstructive sleep apnea and behavioral insomnia in children ages 10 and under. J Clin Sleep Med 2024; 20:245-251. [PMID: 37772702 PMCID: PMC10835786 DOI: 10.5664/jcsm.10834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
STUDY OBJECTIVES Behavioral insomnia of childhood (BIC) and obstructive sleep apnea (OSA) are highly prevalent conditions affecting 10%-20% and 1%-5% of children, respectively. Studies in adults and adolescents have suggested that comorbid insomnia and OSA may have distinct clinical characteristics. The association between the two conditions in the pediatric population has not been thoroughly investigated. This study aimed to examine the association between BIC and OSA in young children. METHODS Children, 6 months to 10 years old, referred to a sleep specialist and polysomnography at the Hadassah Medical Center between 2018 and 2021 were included in this retrospective analysis. We excluded children with chromosomal and craniofacial abnormalities, posttonsillectomy, or neurological impairment. BIC diagnosis was extracted from the electronic health records in accordance with the International Classification of Sleep Disorders, third edition criteria. OSA was diagnosed by polysomnography (apnea-hypopnea index > 2 events/h). RESULTS Of 312 children (age 4.42 ± 2.42 years), 126 (40.4%) were non-OSA non-BIC, 125 (40.1%) OSA non-BIC, 34 (10.9%) BIC non-OSA, and 27 (8.7%) comorbid insomnia and OSA. OSA and non-OSA children had a similar prevalence of BIC. Children in the comorbid insomnia and OSA group were significantly younger (2.22 ± 1.21 years). Younger age at polysomnography, premature birth, and increased periodic leg movements on polysomnography were independently associated with OSA in a multivariable analysis. Lower body mass index, regardless of OSA, was associated with BIC. CONCLUSIONS Current findings do not support an association between behavioral insomnia of childhood and obstructive sleep apnea in children. Healthcare providers should consider each of these sleep disorders in children presenting with sleep difficulties since each has distinct diagnostic and therapeutic options. CITATION Yelov L, Reiter J, Meira E Cruz M, Gileles-Hillel A. The association of obstructive sleep apnea and behavioral insomnia in children ages 10 and under. J Clin Sleep Med. 2024;20(2):245-251.
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Affiliation(s)
- Leila Yelov
- Faculty of Medicine, The Hebrew University, Jerusalem, Israel
- Department of Military Medicine and “Tzameret,” Faculty of Medicine, Hebrew, The University of Jerusalem, and Medical Corps, Israel Defense Forces, Israel
| | - Joel Reiter
- Faculty of Medicine, The Hebrew University, Jerusalem, Israel
- Pediatric Pulmonology and Sleep Unit, Hadassah Medical Center, Jerusalem, Israel
| | - Miguel Meira E Cruz
- Sleep Unit, Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal
- International Center on Clinical Sleep Medicine and Research, Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Alex Gileles-Hillel
- Faculty of Medicine, The Hebrew University, Jerusalem, Israel
- Pediatric Pulmonology and Sleep Unit, Hadassah Medical Center, Jerusalem, Israel
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Zhao J, Wang X, Xu S, Yan W, Wang J, Wang E, Liu T, Hao M. The influence of lifestyle habits on levels of depression among rural middle school students in Northeastern China. Front Public Health 2024; 12:1293445. [PMID: 38347930 PMCID: PMC10859412 DOI: 10.3389/fpubh.2024.1293445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
Background Depression rates among adolescents have risen dramatically over the past decade. Therefore, preventing depression among adolescents is particularly important. Differences in lifestyle habits may play a role in depression. Purpose This study aimed to explore the influence of living habits on depression levels among rural middle school students in Northeast China and to provide a theoretical basis for developing interventions to reduce depression levels in middle school students. Methods A total of 296 middle school students aged 13-15 years from Benxi City, Northeast China completed the anthropometric measurements, Physical Activity Scale-3 (PARS-3), and the Self-Rating Depression Scale (SDS). Their average screen time in the most recent week, parents' education level, and monthly family income were collected through a questionnaire. Results Females had higher depression scores than males (41.0 ± 6.9 vs. 37.9 ± 8.0). Physical activity (β = -0.38, t = -7.06, P < 0.01), family income (β = -0.20, t = -4.07, P < 0.01), screen time (β = 0.16, t = 3.34, P < 0.01), age (β = 0.15, t = 3.16, P < 0.01), sex (β = -0.13, t = -2.74, P < 0.01), and sleep quality (β = -0.08, t = -1.87, P < 0.01) are important factors related to depression levels. Conclusion The preliminary analysis results showed that among middle school students in rural Northeast China, the depression level of females was significantly higher than that of males. Poor quality sleep, low levels of physical activity, low household income, and long screen time were positively associated with depression. Therefore, strengthening physical activity, improving sleep quality, and reducing screen time are of clinical relevance in preventing and reducing depression.
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Affiliation(s)
- JunCheng Zhao
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiaoyin Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Shiliang Xu
- College of Electronics and Information Engineering, Liaoning Institute of Science and Technology, Benxi, Liaoning, China
| | - Wenjing Yan
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Jingzhe Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Ende Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Tao Liu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Ming Hao
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
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Denis I, Turcotte S, Morin CM, Belleville G, Foldes-Busque G. A preliminary validation of the pediatric adaptation of the Insomnia Severity Index. L'ENCEPHALE 2023; 49:474-480. [PMID: 36244838 DOI: 10.1016/j.encep.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/03/2022] [Accepted: 05/12/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The prevalence of insomnia in children aged 5 to 12 years old is 20% to 31%. Currently, there is no well-validated questionnaire assessing all the components of insomnia in school-aged children. The present study aims to introduce an adaptation of the Insomnia Severity Index for this purpose. METHOD Fifty-nine children aged 8- to 12-years-old with at least one anxiety disorder were recruited from youth mental health care settings. Their parents completed the pediatric adaptation of the Insomnia Severity Index which includes two scales used to report insomnia symptoms in children and their impact on the child (ISI-Child) and parents (ISI-Parent), My Child's Sleep Habits questionnaire, and the Child Behavior Checklist. RESULTS Both the ISI-Child and the ISI-Parent scales presented adequate factorial structure (RMSEA ≤ 0.05) and internal consistency (ISI-Child: α=0.87; ISI-Parent: α=0.88). Furthermore, the results of the two scales were strongly correlated (r=0.91, P<0.001). The convergent validity was assessed using the Waking During the Night scale of the My Child's Sleep Habits questionnaire and was adequate for the ISI-Child (r=0.52, P<0.001) and the ISI-Parent (r=0.53, P<0.001). Finally, the Rule-Breaking Behavior (r ≤ 0.26, P ≥ 0.05) and Aggressive Behavior (r ≤ 0.19, P ≥ 0.19) scales of the Child Behavior Checklist showed small correlations with both subscales, indicating good divergent validity. CONCLUSION The pediatric adaptation of the Insomnia Severity Index is a potentially reliable and valid measure for screening and assessing insomnia in children.
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Affiliation(s)
- I Denis
- School of Psychology, Université Laval, G1V 0A6 Québec City, Canada; Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada; Centre de recherche universitaire sur les jeunes familles, G1C 3S2 Québec City, Canada.
| | - S Turcotte
- Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada
| | - C M Morin
- Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada; Centre d'étude des troubles du sommeil, centre de recherche, institut universitaire en santé mentale, G1J 2G3 Québec City, Canada
| | - G Belleville
- Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada
| | - G Foldes-Busque
- School of Psychology, Université Laval, G1V 0A6 Québec City, Canada; Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada; Research Centre, Quebec Heart and Lung Institute, G1V 4G5 Québec City, Canada
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Muskens JB, Ester WA, Klip H, Zinkstok J, van Dongen-Boomsma M, Staal WG. Novel Insights into Somatic Comorbidities in Children and Adolescents Across Psychiatric Diagnoses: An Explorative Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01587-w. [PMID: 37656290 DOI: 10.1007/s10578-023-01587-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/02/2023]
Abstract
Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6-18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.
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Affiliation(s)
- Jet B Muskens
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands.
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands.
| | - Wietske A Ester
- Sarr Autism Rotterdam, Youz Child and Adolescence Psychiatry, Dynamostraat 18, Rotterdam, 3083 AK, The Netherlands
- Parnassia Psychiatric Institute, Kiwistraat 30, The Hague, 2552 DH, The Netherlands
- Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Endegeesterstraatweg 27, Oegstgeest, 2342 AK, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - Janneke Zinkstok
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martine van Dongen-Boomsma
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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Suanrueang P, Peltzer K, Lkhamsuren Z, Yap LK. The association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents. Sci Rep 2023; 13:12589. [PMID: 37537238 PMCID: PMC10400538 DOI: 10.1038/s41598-023-39452-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023] Open
Abstract
The purpose of this study is to investigate the association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents. This cross-sectional study was conducted by investigating the 2018 Bolivia global school-based student health survey (GSHS). The total number of students who participated in this survey was 7931, and the final sample was 7377. The mean age of the participants was 15.3 years (SD = 1.4). Psychological distress was assessed with a 2-item screener (loneliness and worry induced sleep disturbance). In all 22.3% of participants reported experiencing psychological distress, with 18.1% among adolescent males and 26.2% among adolescent females. In adjusted logistic regression analysis (AOR, 95% CI), there are two significant directions of association. One is the negative association, such as parental involvement as a protective factor. School adolescents who had more parental involvement were less likely to experience psychological distress. Parents understand problems or worries (0.64, 0.54-0.75, p < .001) and parents disregard privacy (0.69, 0.58-0.82, p < .001). On the other hand, many psycho-social factors are significantly positively associated with psychological distress. School adolescents who experience more psychosocial factors are more likely to experience psychological distress. Physical assault in the previous year (1.83, 1.59-2.11, p < .001), being bullied at school (1.27, 1.07-1.52, p < .01), being bullied outside of school (1.36, 1.15-1.61, p < .001), and being cyberbullied (1.60, 1.37-1.88, p < .001), were all significantly associated with psychological distress. Healthy relationships in a family, and interventions to reduce violence and bullying, should be encouraged and promoted.
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Affiliation(s)
- Passakorn Suanrueang
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Ratchathewi, Bangkok, Thailand.
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Zuchi Lkhamsuren
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Lyen Krenz Yap
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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10
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Amagai M, Ozone M, Utsumi T, Hotchi A, Iwashita M, Yamadera W, Shigeta M. Effect of a short video on patients' motivation for dose reduction or cessation of hypnotics. Sleep Biol Rhythms 2023; 21:299-308. [PMID: 38469082 PMCID: PMC10900041 DOI: 10.1007/s41105-023-00446-4] [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: 06/21/2022] [Accepted: 01/08/2023] [Indexed: 01/28/2023]
Abstract
Recently, addiction to regular doses of hypnotics has become a problem. While many patients report a desire to reduce their dosage, many do not agree with their physicians' suggestions for reduction. In this study, we created an online short video targeting patient motivation to reduce hypnotics usage and examined its efficacy and factors associated with the intention to reduce medication. We created a 10 min video that included "sleep education," "guidance for reducing the use of hypnotics," and "systematic motivation for reducing the use of hypnotics" and posted it on our website. For 1 year, we conducted a questionnaire survey to determine the effectiveness of the video and factors associated with the intention to reduce hypnotics use. Of 4548 viewers, 609 (13.4%) completed the questionnaire, 369 (67.9%) of whom used hypnotics. Most respondents were older adults. The intention to reduce medication use was significantly strengthened after watching the video in 37.7% of medication users (effect size 0.404). In the group that was not inclined toward medication reduction before viewing, 85.2% of patients had stronger intentions to reduce medication use after watching the video (effect size 0.818). "Memorable content about side effects" was extracted as a factor related to reinforcement of the intention to reduce medication use, suggesting that prescribing physicians' descriptions of current insomnia treatment is inadequate in explaining side effects to patients. A short informational video can have beneficial effects on patients' motivation for dose reduction or cessation of hypnotics. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00446-4.
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Affiliation(s)
- Misato Amagai
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Motohiro Ozone
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-Machi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Tomohiro Utsumi
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Ayana Hotchi
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Masayuki Iwashita
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Wataru Yamadera
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Masahiro Shigeta
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
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11
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Fucà E, Costanzo F, Celestini L, Galassi P, Villani A, Valentini D, Vicari S. Sleep and behavioral problems in Down syndrome: differences between school age and adolescence. Front Psychiatry 2023; 14:1193176. [PMID: 37363163 PMCID: PMC10288521 DOI: 10.3389/fpsyt.2023.1193176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Background Individuals with Down syndrome (DS) are at risk of developing sleep problems. In spite of the well-established knowledge on the presence of sleep difficulties in DS individuals and the associated emotional and behavioral problems, less is known about the possible differences in the kind of associations between sleep and emotional/behavioral problems across different age ranges. Methods In this retrospective study, we included 289 participants with DS aged 6-18 years with the aims to explore differences in the distribution of sleep problems between specific age groups (school age vs. adolescence) and to identify specific age-based associations between sleep problems and emotional/behavioral problems. Results Some differences in the distribution of sleep problems have emerged between age groups. Moreover, differences in the patterns of association between emotional/behavioral difficulties and sleep problems-in particular, sleep-related breathing difficulties and parasomnias-have been observed. However, sleep-wake transition disorders and excessive daily somnolence appear to be related to emotional and behavioral problems (both internalizing and externalizing), in general, across school age and adolescence. Discussion These results remark the importance of appropriate neuropsychiatric and psychological evaluation taking into account the age-specific needs and features of individuals with DS.
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Affiliation(s)
- Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Laura Celestini
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Galassi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Villani
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Diletta Valentini
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
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12
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Breda M, Belli A, Esposito D, Di Pilla A, Melegari MG, DelRosso L, Malorgio E, Doria M, Ferri R, Bruni O. Sleep habits and sleep disorders in Italian children and adolescents: a cross-sectional survey. J Clin Sleep Med 2023; 19:659-672. [PMID: 36661089 PMCID: PMC10071380 DOI: 10.5664/jcsm.10400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 01/21/2023]
Abstract
STUDY OBJECTIVES The aim was to describe sleep habits and epidemiology of the most common sleep disorders in Italian children and adolescents. METHODS This was a cross-sectional study in which parents of typically developing children and adolescents (1-18 years) completed an online survey available in Italy, gathering retrospective information focusing on sleep habits and disorders. RESULTS Respondents were 4,321 typically developing individuals (48.6% females). Most of our sample did not meet the age-specific National Sleep Foundation recommendations for total sleep duration (31.9% of toddlers, 71.5% of preschoolers, 61.6% of school-age children, and 41.3% of adolescents). Napping was described in 92.6% of toddlers and in 35.2% of preschoolers. Regarding geographical differences, children and adolescents of northern Italy showed more frequent earlier bedtimes and rise times than their peers of central and southern Italy. The most frequently reported sleep disorder in our sample was restless sleep (35.6%), followed by difficulties falling asleep (16.8%), > 2 night awakenings (9.9%), and bruxism (9.6%). Data also suggest that longer screen time is associated with later bedtimes on weekdays in all age groups. CONCLUSIONS The current study shows that Italian children are at risk of sleep disorders, particularly insufficient sleep, restless sleep, and difficulty falling asleep. The study also provides normative sleep data by age group in a large cohort of typically developing Italian children, emphasizing the importance of the developmentally, ecologically, and culturally based evaluation of sleep habits and disorders. CITATION Breda M, Belli A, Esposito D, et al. Sleep habits and sleep disorders in Italian children and adolescents: a cross-sectional survey. J Clin Sleep Med. 2023;19(4):659-672.
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Affiliation(s)
- Maria Breda
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Andrea Di Pilla
- Life Sciences and Public Health Department, Hygiene Section, Medicine and Surgery “A. Gemelli”—Catholic University of Sacred Heart, Rome, Italy
| | - Maria Grazia Melegari
- Department of Social and Developmental Psychology, Sapienza University of Roma, Rome, Italy
| | - Lourdes DelRosso
- Pulmonary and Sleep Medicine, University of Washington, Seattle Children’s Hospital, Seattle, Washington
| | - Emanuela Malorgio
- Italian Federation of Primary Care Pediatricians (Federazione Italiana Medici Pediatri [FIMP]), Torino, Italy
| | - Mattia Doria
- Italian Federation of Primary Care Pediatricians (Federazione Italiana Medici Pediatri [FIMP]), Venice, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute—IRCCS, Troina, Italy
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University of Roma, Rome, Italy
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13
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López-Gil JF, Smith L, Victoria-Montesinos D, Gutiérrez-Espinoza H, Tárraga-López PJ, Mesas AE. Mediterranean Dietary Patterns Related to Sleep Duration and Sleep-Related Problems among Adolescents: The EHDLA Study. Nutrients 2023; 15:665. [PMID: 36771375 PMCID: PMC9919059 DOI: 10.3390/nu15030665] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
PURPOSE The aim of the present study was to examine the association of adherence to the Mediterranean Diet (MD) and its specific components with both sleep duration and sleep-related disorders in a sample of adolescents from the Valle de Ricote (Region of Murcia, Spain). METHODS This cross-sectional study included a sample of 847 Spanish adolescents (55.3% girls) aged 12-17 years. Adherence to the MD was assessed by the Mediterranean Diet Quality Index for Children and Teenagers. Sleep duration was reported by adolescents for weekdays and weekend days separately. The BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing) screening was used to evaluate issues related to sleep, which include difficulties at bedtime, excessive drowsiness during the day, waking up frequently during the night, irregularity, length of sleep, and breathing issues while sleeping. RESULTS Adolescents who presented a high adherence to the MD were more likely to meet the sleep recommendations (OR = 1.52, 95% CI 1.12-2.06, p = 0.008) and less likely to report at least one sleep-related problem (OR = 0.56, 95% CI 0.43-0.72, p < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, waist circumference, energy intake, physical activity, and sedentary behavior, indicating a significant association of adherence to the MD with sleep outcomes (meeting sleep recommendations: OR = 1.40, 95% CI 1.00-1.96, p = 0.050; sleep-related problems: OR = 0.68, 95% CI 0.50-0.92, p = 0.012). CONCLUSIONS Adolescents with high adherence to the MD were more likely to report optimal sleep duration and fewer sleep-related problems. This association was more clearly observed for specific MD components, such as fruits, pulses, fish, having breakfast, dairies, sweets, and baked goods/pastries.
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Affiliation(s)
- José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | | | | | - Pedro J. Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Castilla-La Mancha, 02008 Albacete, Spain
| | - Arthur Eumann Mesas
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina 86057-970, Brazil
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14
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Belli A, Breda M, Di Maggio C, Esposito D, Marcucci L, Bruni O. Children with neurodevelopmental disorders: how do they sleep? Curr Opin Psychiatry 2022; 35:345-351. [PMID: 35165244 DOI: 10.1097/yco.0000000000000790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW In this review we summarized the available evidence on sleep disorders in children with neurodevelopmental disorders (NDDs) in particular: intellectual disability (including some genetic conditions such as Prader-Willi Syndrome, Smith-Magenis Syndrome), Autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), Developmental Coordination Disorder, language disorders, and specific learning disorders. RECENT FINDINGS Children with NDDs frequently suffer from sleep disturbances, with a higher prevalence than that of the general pediatric population. SUMMARY These problems tend to be chronic and may cause additional cognitive and behavioral difficulties, often affecting the whole family's well-being. Sleep behaviors are also related to other important developmental skills, such as attention and listening. Investigating sleep disorders in children with NDDs is therefore crucial in clinical practice. For a systematic approach in clinical practice, we propose the use of a short and easy to remember sleep screening tool.
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Affiliation(s)
- Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Maria Breda
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Chiara Di Maggio
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
- PhD Program in Behavioral Neuroscience, Department of Psychology
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Lavinia Marcucci
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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15
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Fonseca CL, Peterle CF, de Freitas BHBM, Gaíva MAM, Diogo PMJ, Bortolini J. Brazilian adolescents' lifestyle in the COVID-19 pandemic: a mixed-methods study. World J Pediatr 2022; 18:553-557. [PMID: 35606629 PMCID: PMC9126433 DOI: 10.1007/s12519-022-00561-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Caroline Lima Fonseca
- Federal University of Mato Grosso, 2367 Fernando Corrêa da Costa Av, Boa Esperança, Cuiabá, MT, 78060-900, Brazil
| | - Carolina Ferreira Peterle
- Federal University of Mato Grosso, 2367 Fernando Corrêa da Costa Av, Boa Esperança, Cuiabá, MT, 78060-900, Brazil
| | | | - Maria Aparecida Munhoz Gaíva
- Federal University of Mato Grosso, 2367 Fernando Corrêa da Costa Av, Boa Esperança, Cuiabá, MT, 78060-900, Brazil
| | | | - Juliano Bortolini
- Federal University of Mato Grosso, 2367 Fernando Corrêa da Costa Av, Boa Esperança, Cuiabá, MT, 78060-900, Brazil
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16
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Qi X, Ye J, Wen Y, Liu L, Cheng B, Cheng S, Yao Y, Zhang F. Evaluating the Effects of Diet-Gut Microbiota Interactions on Sleep Traits Using the UK Biobank Cohort. Nutrients 2022; 14:1134. [PMID: 35334789 PMCID: PMC8951611 DOI: 10.3390/nu14061134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/11/2022] Open
Abstract
Previous studies showed that diet and gut microbiota had a correlation with sleep. However, the potential interaction effects of diet and gut microbiota on sleep are still unclear. The phenotypic data of insomnia (including 374,505 subjects) and sleep duration (including 372,805 subjects) were obtained from the UK Biobank cohort. The Single Nucleotide Polymorphisms (SNPs) associated with 114 gut microbiota, 84 dietary habits, and 4 dietary compositions were derived from the published Genome-wide Association Study (GWAS). We used Linkage Disequilibrium Score Regression (LDSC) to estimate the genetic correlation and colocalization analysis to assess whether dietary habits and insomnia/sleep duration shared a causal variant in a region of the genome. Using UK Biobank genotype data, the polygenetic risk score of gut microbiota, dietary habits, and dietary compositions were calculated for each subject. Logistic regression and linear regression models were used to assess the potential effects of diet-gut microbiota interactions on sleep phenotypes, including insomnia and sleep duration. Insomnia and sleep duration were used as dependent variables, and sex, age, the Townsend Deprivation Index scores, and smoking and drinking habits were selected as covariates in the regression analysis. All statistical analyses were conducted using R-3.5.1 software. Significant genetic correlations were discovered between insomnia/sleep duration and dietary habits. Further, we found several significant dietary compositions-gut microbiota interactions associated with sleep, such as fat × G_Collinsella_RNT (p = 1.843 × 10-2) and protein × G_Collinsella_HB (p = 7.11 × 10-3). Besides, multiple dietary habits-gut microbiota interactions were identified for sleep, such as overall beef intake × G_Desulfovibrio_RNT (p = 3.26 × 10-4), cups of coffee per day × G_Escherichia_Shigella_RNT (p = 1.14 × 10-3), and pieces of dried fruit per day × G_Bifidobacterium_RNT (p = 5.80 × 10-3). This study reported multiple diet-gut microbiota interactions associated with sleep, which may provide insights into the biological mechanisms of diet and gut microbiota affecting sleep.
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Affiliation(s)
- Xin Qi
- Precision Medicine Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China;
| | - Jing Ye
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Yao Yao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
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17
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Bueno APR, Savi FM, Alves IA, Bandeira VAC. Regulatory aspects and evidences of melatonin use for sleep disorders and insomnia: an integrative review. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:732-742. [PMID: 34550191 DOI: 10.1590/0004-282x-anp-2020-0379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/22/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Insomnia is a sleep disorder characterized by difficulty of falling asleep or maintaining sleep, which affects different age groups. Currently, melatonin is used as a therapeutic treatment in cases of insomnia in children, adults, and elderly people. OBJECTIVE To evaluate the effectiveness of melatonin in sleep disorders, its dosage, potential adverse effects, as well as labeling laws and regulations in Brazil. METHODS This integrative review was carried out using the Cochrane Library, Medline (Pubmed), and Science Direct databases. Twenty-five articles and three documents available on the Brazilian Society of Endocrinology and Metabology (SBEM) and National Health Surveillance Agency (ANVISA) websites published between 2015 and 2020 were selected to be evaluated in full. RESULTS It was found that in most of the selected articles the use of melatonin reduces sleep latency. The effective melatonin doses varied according to each age group, from 0.5 to 3 mg in children, 3 to 5 mg in adolescents, 1 to 5 mg in adults, and 1 to 6 mg in elderly people. Side effects are mild when taking usual doses. In Brazil, no registered drug and current regulation on the use and marketing of melatonin has been identified. CONCLUSION The use of melatonin is an alternative therapy that can be used for sleeping disorders. According to the evidences found, it did not demonstrate toxicity or severe side effects, nor dependence even when administered at high doses, suggesting that it is a safe medication to treat patients of different ages suffering from sleeping disorders.
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Affiliation(s)
- Ana Paula Rosinski Bueno
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Departamento de Ciências da Vida, Ijuí RS, Brazil
| | - Flávia Medeiros Savi
- Queensland University of Technology, Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Kelvin Grove, Australia
| | - Izabel Almeida Alves
- Universidade Federal da Bahia, Faculdade de Farmácia, Departamento do Medicamento, Salvador BA, Brazil
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Zhai S, Phillips S, Ward TM. Sleep Deficiency and Pediatric Chronic Pain. Nurs Clin North Am 2021; 56:311-323. [PMID: 34023124 DOI: 10.1016/j.cnur.2021.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sleep deficiency in children is a public health concern, and it is highly comorbid in pediatric chronic pain conditions. Children may be particularly vulnerable to the deleterious effects of sleep deficiency, because comorbid sleep deficiency in chronic pain may further exacerbate already existent symptoms of pain, anxiety, depressions, daytime function, and increase health care use. Sleep deficiency is modifiable and integrating human-centered approaches into the development of sleep interventions is a pragmatic approach to partner with parents and children to provide them with the knowledge, motivation, and skills for setting and achieving goals, adapting to setbacks, and problem solving.
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Affiliation(s)
- Shumenghui Zhai
- University of Washington School of Nursing, Box 357266, Seattle, WA 98195, USA.
| | - Shameka Phillips
- UAB Nutrition and Obesity Research Center (NORC), University of Alabama at Birmingham, School of Nursing, 1720 University Boulevard, Birmingham, AL 35294, USA
| | - Teresa M Ward
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Box 357262, Seattle, WA 98195, USA
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The Role of Sleep in the Transition from Acute to Chronic Musculoskeletal Pain in Youth-A Narrative Review. CHILDREN-BASEL 2021; 8:children8030241. [PMID: 33804741 PMCID: PMC8003935 DOI: 10.3390/children8030241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 12/16/2022]
Abstract
Musculoskeletal pain is common in the general pediatric population and is a challenge to youth, their parents, and society. The majority of children experiencing musculoskeletal pain will recover; however, a small subgroup of youth develops chronic pain. There is limited understanding of the factors that affect the transition from acute to chronic pain in youth. This review introduces sleep deficiency in the acute to chronic pain transition, exploring the potential mediational or mechanistic role and pathways of sleep in this process, including the interaction with sensory, psychological, and social components of pain and highlighting new avenues for treatment. Biological mechanisms include the increased production of inflammatory mediators and the effect on the hypothalamus-pituitary-adrenal (HPA) axis and on the dopaminergic signaling. Psychological and social components include the effect of sleep on the emotional-affective and behavioral components of pain, the negative impact on daily and social activities and coping strategies and on the reward system, increased pain catastrophizing, fear of pain, pain-related anxiety, hypervigilance, and social isolation. Future longitudinal studies are needed to elucidate these mechanistic pathways of the effect of sleep on the transition from acute to chronic pain, which may lead to the development of new treatment targets to prevent this transition.
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20
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Cassanello P, Ruiz-Botia I, Díez-Izquierdo A, Cartanyà-Hueso À, Martínez-Sanchez JM, Balaguer A. How do infants and toddlers sleep in Spain? A cross-sectional study. Eur J Pediatr 2021; 180:775-782. [PMID: 32827061 DOI: 10.1007/s00431-020-03786-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 01/17/2023]
Abstract
There is limited information on sleep patterns among infants and toddlers in Spain. The aim of this study was to assess sleep patterns in children three to 36 months of age in Spain. A cross-sectional study was conducted between February 2017 and February 2018. Sociodemographic data and sleep variables were collected using an expanded version of the validated Spanish version of the brief infant sleep questionnaire. A total of 1,404 parental reports on children (725 males; 679 females) with a mean age of 18.8 ± 9.5 months were collected. Parents who perceived their child's sleep as problematic (39% of our sample) reported fewer sleep hours (median 9 versus 10 h), more night awakenings (median 2 versus 1), and longer periods of nocturnal awakenings (median 0.5 versus 0.08 min) (p < 0.001). Parental presence at the time of sleep onset and later and irregular bedtime routines were significantly associated with a reduction in total sleep time, longer sleep latency, and disruptive night awakenings (p < 0.001). These findings highlight the need for further studies to assess how to improve sleep patterns as a relevant modifiable lifestyle factor.Conclusion: A substantial percentage of the population perceived that their children slept poorly, which was evident in a variety of sleep patterns, including sleep duration and sleep quality. What is known: • Previous research has established that sleep difficulties among pediatric population affect up to 30% of all children and up to 20-30% of infants and toddlers. • A positive relationship between less parental bedtime involvement and sleep consolidation in infants and toddlers has been established. What is new: • More than a third of Spanish parents perceived their infants and toddlers sleep as problematic and their children reportedly have shorter night sleep hours, more night awakenings, and longer periods of nocturnal awakenings. • Later and irregular parental bedtime routines were associated with worst infants and toddlers sleep.
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Affiliation(s)
- Pia Cassanello
- Pediatric Division, Hospital Universitari General de Catalunya, Barcelona, Spain. .,Universitat Internacional de Catalunya, Barcelona, Spain. .,AdSalutem Institute Sleep Medicine Barcelona, Barcelona, Spain.
| | | | - Ana Díez-Izquierdo
- Pediatric Division, Hospital Universitari General de Catalunya, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Albert Balaguer
- Pediatric Division, Hospital Universitari General de Catalunya, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
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Fellman V, Heppell PJ, Rao S. Afraid and Awake: The Interaction Between Trauma and Sleep in Children and Adolescents. Child Adolesc Psychiatr Clin N Am 2021; 30:225-249. [PMID: 33223064 DOI: 10.1016/j.chc.2020.09.002] [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] [Indexed: 11/26/2022]
Abstract
Traumatic experiences and sleep disturbances are both common in children and adolescents. Because of the reciprocal relationship between sleep complaints and trauma, a mental health evaluation should include not only an assessment of posttraumatic stress disorder and other trauma symptoms but also a specific evaluation of sleep-related complaints. Similarly, if a history of both trauma and sleep complaints is identified, an effective trauma-informed intervention, whether psychological, psychopharmacologic, or a combination of the two, should directly address sleep issues.
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Affiliation(s)
- Veronica Fellman
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, Child Study Center, One Park Avenue, 7th Floor, New York City, NY 10016, USA.
| | - Patrick J Heppell
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, Child Study Center, One Park Avenue, 7th Floor, New York City, NY 10016, USA
| | - Suchet Rao
- Psychiatry and Behavioral Health, NYC Administration for Children's Services, 150 William Street, 11th Floor, New York City, NY 10038, USA
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22
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Tekcan P, ÇaliŞkan Z, KocaÖz S. Sleep Quality and Related Factors in Turkish High School Adolescents. J Pediatr Nurs 2020; 55:120-125. [PMID: 32949851 DOI: 10.1016/j.pedn.2020.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/25/2020] [Accepted: 07/31/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of the study was to determine the sleep quality and related risk factors in high school adolescents. DESIGNS AND METHODS This descriptive and cross-sectional study was conducted with 400 adolescents. Data collection was with the 'Data Collection Form' and the 'Pittsburgh Sleep Quality Index' (PSQI). RESULTS More than half of the adolescents had poor sleep quality (53.0%). PSQI scores were found to be associated with age, sex, poor school success, chronic disease, exposure to domestic verbal violence, inability to participate in sports, and feeling tired. PRACTICE IMPLICATIONS Adolescents should be supported by educational and informative programs about sleep hygiene.
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Affiliation(s)
| | - Zehra ÇaliŞkan
- Department of Pediatric Nursing, Nursing Department, Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir Hacı Bektaş Veli University, Turkey.
| | - Semra KocaÖz
- Department of Obstetrics and Gynecology Nursing, Nursing Department, Niğde Zübeyde Hanım School of Health, Niğde Ömer Halisdemir University, Turkey
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Andreucci A, Lund Straszek C, Skovdal Rathleff M, Guldhammer C, de la Vega R, Palermo TM. Translation, validity and reliability of the Danish version of the Adolescent Insomnia Questionnaire. F1000Res 2020; 9:1029. [PMID: 35528204 PMCID: PMC9069172 DOI: 10.12688/f1000research.25832.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/20/2022] Open
Abstract
Background: The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of Danish adolescents. Methods: The AIQ underwent a process of forward-backward translation and pilot testing. Subsequently, data were collected at baseline and two-week follow-up from adolescents aged 11-19, who completed both the AIQ and an available adult measure of insomnia (the Athens Insomnia Scale, AIS). The internal consistency, test-retest reliability and convergent validity were assessed. Exploratory factor analysis was conducted to identify the latent factors underlying the questionnaire. Results: At baseline 185 adolescents (18% males and 82% females, mean age 16.0 years) and 102 (55.1%) at two-week follow-up completed the questionnaires. The AIQ showed excellent internal consistency for the total score (Cronbach's a: 0.88) and good convergent validity with the AIS total score (Pearson's correlation value= 0.86, P<0.001). The test-retest reliability at two weeks was very satisfactory (ICC coefficient = 0.89; 95% CI 0.84, 0.92). Results from the exploratory factor analysis identified a three-model solution corresponding to the same three-model solution identified within the original development sample. Conclusions: The Danish version of the AIQ demonstrated satisfactory psychometric properties in terms of internal consistency, test-retest reliability and validity, which supports its use as a screening tool for the identification of insomnia symptoms in adolescents, including Danish-speaking adolescents.
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Affiliation(s)
| | - Christian Lund Straszek
- Center for General Practice, Aalborg University, Aalborg, 9220, Denmark
- Department of Physiotherapy, University College of Northern Jutland (UCN), Aalborg, 9000, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, 9000, Denmark
| | - Michael Skovdal Rathleff
- Center for General Practice, Aalborg University, Aalborg, 9220, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, 9000, Denmark
| | - Clara Guldhammer
- Center for General Practice, Aalborg University, Aalborg, 9220, Denmark
| | - Rocio de la Vega
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, 98101, USA
| | - Tonya M. Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, 98101, USA
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, 98101, USA
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24
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Andreucci A, Lund Straszek C, Skovdal Rathleff M, Guldhammer C, de la Vega R, Palermo TM. Translation, validity and reliability of the Danish version of the Adolescent Insomnia Questionnaire. F1000Res 2020; 9:1029. [PMID: 35528204 PMCID: PMC9069172 DOI: 10.12688/f1000research.25832.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 09/17/2023] Open
Abstract
Background: The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of Danish adolescents. Methods: The AIQ underwent a process of forward-backward translation and pilot testing. Subsequently, data were collected at baseline and two-week follow-up from adolescents aged 11-19, who completed both the AIQ and an available adult measure of insomnia (the Athens Insomnia Scale, AIS). The internal consistency, test-retest reliability and convergent validity were assessed. Exploratory factor analysis was conducted to identify the latent factors underlying the questionnaire. Results: At baseline 185 adolescents (18% males and 82% females, mean age 16.0 years) and 102 (55.1%) at two-week follow-up completed the questionnaires. The AIQ showed excellent internal consistency for the total score (Cronbach's a: 0.88) and good convergent validity with the AIS total score (Pearson's correlation value= 0.86, P<0.001). The test-retest reliability at two weeks was very satisfactory (ICC coefficient = 0.89; 95% CI 0.84, 0.92). Results from the exploratory factor analysis identified a three-model solution corresponding to the same three-model solution identified within the original development sample. Conclusions: The Danish version of the AIQ demonstrated satisfactory psychometric properties in terms of internal consistency, test-retest reliability and validity, which supports its use as a screening tool for the identification of insomnia symptoms in adolescents, including Danish-speaking adolescents.
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Affiliation(s)
| | - Christian Lund Straszek
- Center for General Practice, Aalborg University, Aalborg, 9220, Denmark
- Department of Physiotherapy, University College of Northern Jutland (UCN), Aalborg, 9000, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, 9000, Denmark
| | - Michael Skovdal Rathleff
- Center for General Practice, Aalborg University, Aalborg, 9220, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, 9000, Denmark
| | - Clara Guldhammer
- Center for General Practice, Aalborg University, Aalborg, 9220, Denmark
| | - Rocio de la Vega
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, 98101, USA
| | - Tonya M. Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, 98101, USA
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, 98101, USA
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25
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Eid B, Bou Saleh M, Melki I, Torbey PH, Najem J, Saber M, El Osta N, Rabbaa Khabbaz L. Evaluation of Chronotype Among Children and Associations With BMI, Sleep, Anxiety, and Depression. Front Neurol 2020; 11:416. [PMID: 32581995 PMCID: PMC7291378 DOI: 10.3389/fneur.2020.00416] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/20/2020] [Indexed: 12/01/2022] Open
Abstract
Objectives: To evaluate possible associations between chronotype, weight, sleep problems, anxiety, and depression among children from 6 to 12 years of age. Method: One-hundred children aged between 6 and 12 years were randomly recruited in five pediatrician clinics in the capital city of Beirut, Lebanon. The protocol was approved by the ethics committee of Saint-Joseph University and Hotel-Dieu Hospital and an informed written formal consent was obtained from one of the parents. The Sleep Disturbance Scale for Children (CCTQ), the Revised Child Anxiety and Depression Scale (RCADS)-Parent version, and the Children's Chronotype Questionnaire (CCTQ) were used. Results: The majority of the sample (47%) presented an intermediate chronotype. There was a shift toward evening chronotype with increased age and a significant association between electronic devices use and an evening chronotype. Higher sleep disturbances were also observed among children with an evening chronotype. In particular, disorders of initiating and maintaining sleep, non-restorative sleep, excessive somnolence, and total SDSC were significantly higher among evening type children in our study. Finally, major depression domain scores were significantly higher among children with an evening chronotype. Conclusions: Several findings of this study are important and explain factors associated to chronotype in children. Two important future perspectives can be highlighted: limiting electronic devices use among children in an effort to reduce circadian rhythm disturbances and identifying and treating sleep problems associated with eveningness, taking into account the possible presence of major depression among this population.
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Affiliation(s)
- Bassam Eid
- Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Pediatrics, Hôtel-Dieu de France Hospital, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Mary Bou Saleh
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Imad Melki
- Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Pediatrics, Hôtel-Dieu de France Hospital, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Paul-Henry Torbey
- Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Pediatrics, Hôtel-Dieu de France Hospital, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Joelle Najem
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Maroun Saber
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Nada El Osta
- Craniofacial Research Laboratory, Oral Health Unit, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon.,Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
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26
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Owens JA, Babcock D, Weiss M. Evaluation and Treatment of Children and Adolescents With Excessive Daytime Sleepiness. Clin Pediatr (Phila) 2020; 59:340-351. [PMID: 32167377 PMCID: PMC7160754 DOI: 10.1177/0009922820903434] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Judith A. Owens
- Boston Children’s Hospital, Harvard
Medical School, Waltham, MA, USA,Judith A. Owens, Division of Neurology,
Boston Children’s Hospital, 333 Longwood Avenue, Boston, MA 02115, USA.
| | - Debra Babcock
- Packard Children’s Health Alliance,
Stanford Children’s Health, Los Altos, CA, USA
| | - Miriam Weiss
- Children’s National Health System,
Washington, DC, USA
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27
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Sleeping disorders in children. MANUELLE MEDIZIN 2020. [DOI: 10.1007/s00337-020-00670-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractIn children with sensorimotor dysfunction (SMD), a history of sleeping disorder can be regularly recorded. Many children describe the following sleeping disorders: they need light or at least an open door. Additionally, a parent is needed. They often use soft toys, which are built around them like a wall in order to have close physical contact. In the dark they are afraid because they feel ghosts, a presence or simply a monster under the bed or in the room. Sensorimotor dysfunction (SMD) is a functional disorder of the movement system caused by reversible segmental dysfunctions, mostly in several sensory regions. The SMD is manifested not only through gross and fine motor weaknesses but also through behavioral problems. The SMD is diagnosed using the motocybernetic test (MCT). The symptom of behavioral sleeping disorder is highlighted, especially since it is a general problem both in healthy children and in children with behavioral problems, such as SMD, attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders (ASD). As a therapeutic alternative, the possibilities of manual medicine are emphasized, especially atlas therapy according to Arlen, since the complaints will disappear completely after just a few treatment sessions.
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28
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Narasimhan U, Anitha FS, Battula M. Specific Learning Disability Unmasked by Psychophysiological Insomnia. Cureus 2020; 12:e7480. [PMID: 32351858 PMCID: PMC7188449 DOI: 10.7759/cureus.7480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Sleep is essential for good cognition and academic performance. Children with deficits in learning and cognition thus have various sleep disturbances. Learning disabilities in dyslexia are exaggerated with associated sleep problems which also impact the daily routine. Although it is essential to rule out organic etiologies in insomnia, it should also be borne in mind to probe the child's functional performance in school. Psychophysiological insomnia should be considered in perpetuating stressful conditions. Any scholastic difficulty in a child has to be seriously evaluated to estimate the underlying condition. We report a rare case of psychophysiological insomnia diagnosed in a child with specific learning disability. Awareness of the associated sleep difficulties in dyslexia helps in improved assessment and treatment of such children.
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Affiliation(s)
- Udayakumar Narasimhan
- Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Fatima Shirly Anitha
- Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Monika Battula
- Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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29
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Difficulties in Getting to Sleep and their Association with Emotional and Behavioural Problems in Adolescents: Does the Sleeping Duration Influence this Association? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051691. [PMID: 32150909 PMCID: PMC7084249 DOI: 10.3390/ijerph17051691] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 01/22/2023]
Abstract
Sleep problems are common in adolescence with a negative impact on the mental health and functioning of adolescents. However, the roles of different sleep problems in relation to emotional and behavioural problems (EBPs), classified according to the 10th version of the International Classification of Diseases as emotional, conduct, hyperactivity and social functioning disorders, are not clear. The first aim of the study was to investigate the association between difficulties in getting to sleep and EBPs in adolescents. The second aim was to explore the role of sleep duration in this association. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2018 in Slovakia. Presented are results for specific age groups of 13-year-old (N = 1909) and 15-year-old (N = 1293) adolescents. Subjective measures of sleep variables were used. Binary logistic regression models adjusted for age and gender were used to assess associations between difficulties in getting to sleep, sleep duration and EBPs measured using the Strengths and Difficulties Questionnaire. Modification of the association between difficulties in getting to sleep and EBPs by sleep duration was also explored. We found that difficulties in getting to sleep at least once a week as well as insufficient sleep (less than 8 h) increased the probability of EBPs. Interactions of sleep duration with difficulties in getting to sleep on EBPs were found to be non-significant. The results suggest that caregivers and clinicians should screen and intervene for both sleep quality and quantity problems in adolescents as they might indicate and promote EBPs.
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30
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Lecuelle F, Gustin MP, Leslie W, Mindell JA, Franco P, Putois B. French validation of the sleep disturbance scale for children (SDSC) in young children (aged 6 months to 4 years). Sleep Med 2020; 67:56-65. [DOI: 10.1016/j.sleep.2019.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 11/15/2022]
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31
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A Systematic Review of Sleep-Wake Disturbances in Childhood Traumatic Brain Injury: Relationship with Fatigue, Depression, and Quality of Life. J Head Trauma Rehabil 2019; 34:241-256. [DOI: 10.1097/htr.0000000000000446] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Pharmacologic Treatment of Insomnia in Children and Adolescents with Chronic Pain Conditions. CURRENT ANESTHESIOLOGY REPORTS 2019. [DOI: 10.1007/s40140-019-00316-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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33
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Brietzke E, Vazquez GH, Kang MJY, Soares CN. Pharmacological treatment for insomnia in patients with major depressive disorder. Expert Opin Pharmacother 2019; 20:1341-1349. [PMID: 31046480 DOI: 10.1080/14656566.2019.1614562] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Insomnia in Major Depressive Disorder (MDD) is highly prevalent and associated with increased suffering and functional impairment. Effective, evidence-based treatments for insomnia in MDD are an unmet need in clinical practice. AREAS COVERED Herein, the authors provide a review of the clinical correlates, putative neurobiological mechanisms and treatment options for the management of insomnia in individuals with MDD. EXPERT OPINION Sleep disturbances in MDD should be recognized as at least one of the following: (1) a domain of depressive psychopathology; (2) a consequence of rhythm disruptions; (3) a manifestation of comorbidities of sleep disturbances; (4) a manifestation of the influence of sex hormones in the brain in MDD; (5) a general medical comorbidity; and (6) a side effect of antidepressant medications. Assessment of insomnia in clinical practices is routinely performed with the use of non-structured interviews. Other methods such as standardized questionnaires and sleep diaries, along with complementary methods such as actigraphy and polysomnography are more scarcely applied. Smartphones and personal devices offer a promising strategy with the use of passive, long lasting, and ecologically valid assessments despite the lack of studies specifically targeting insomnia in individuals with MDD. New therapeutic approaches are essential, including novel targets such as orexins/hypocretins and the endocannabinoid system.
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Affiliation(s)
- Elisa Brietzke
- a Department of Psychiatry , Queen's University School of Medicine , Kingston , ON , Canada.,b Mood Disorders Outpatient Unit, Department of Psychiatry , Providence Care Hospital , Kingston , ON , Canada
| | - Gustavo H Vazquez
- a Department of Psychiatry , Queen's University School of Medicine , Kingston , ON , Canada.,b Mood Disorders Outpatient Unit, Department of Psychiatry , Providence Care Hospital , Kingston , ON , Canada
| | - Melody J Y Kang
- c Center of Neuroscience Studies (CNS) , Queen's University , Kingston , ON , Canada
| | - Claudio N Soares
- a Department of Psychiatry , Queen's University School of Medicine , Kingston , ON , Canada.,b Mood Disorders Outpatient Unit, Department of Psychiatry , Providence Care Hospital , Kingston , ON , Canada.,c Center of Neuroscience Studies (CNS) , Queen's University , Kingston , ON , Canada
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34
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35
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Botchway EN, Godfrey C, Anderson V, Nicholas CL, Catroppa C. Outcomes of Subjective Sleep–Wake Disturbances Twenty Years after Traumatic Brain Injury in Childhood. J Neurotrauma 2019; 36:669-678. [DOI: 10.1089/neu.2018.5743] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Edith N. Botchway
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Christian L. Nicholas
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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36
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El Halal CDS, Nunes ML. Sleep and weight-height development. J Pediatr (Rio J) 2019; 95 Suppl 1:2-9. [PMID: 30528567 DOI: 10.1016/j.jped.2018.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/08/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To describe the association between sleep duration and weight-height development in children and adolescents. SOURCE OF DATA A non-systematic search in the MEDLINE database was performed using the terms anthropometry, body composition, overweight, obesity, body mass index, growth, length, short stature, sleep, children, and infants and adolescents, limited to the last 5 years. The references cited in the revised articles were also reviewed, when relevant. SYNTHESIS OF DATA Sleep disorders are prevalent in the pediatric population. Among them, insomnia, which leads to a reduction in total sleep time, is the most prevalent disorder. Evidence found in the current literature allows the conclusion that sleep time reduction has a role in the current pandemic of overweight and obesity. Studies associating sleep deprivation and deficit in height growth are still insufficient. CONCLUSIONS The association between shorter sleep duration and risk of overweight and obesity is well established for all pediatric age groups. However, more evidence is needed to establish an association between insufficient sleep duration and height growth deficit. Pediatricians should include the encouragement of healthy sleep habits in their routine guidelines as an adjuvant in the prevention and management of excess weight.
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Affiliation(s)
| | - Magda Lahorgue Nunes
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Medicina, Departamento de Neurociências, Porto Alegre, RS, Brazil; Instituto do Cérebro do Rio Grande do Sul (InsCer), Porto Alegre, RS, Brazil.
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37
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Cassanello P, Díez-Izquierdo A, Gorina N, Matilla-Santander N, Martínez-Sanchez JM, Balaguer A. Adaptation and study of the measurement properties of a sleep questionnaire for infants and pre-school children. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.anpede.2017.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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38
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de Zambotti M, Goldstone A, Colrain IM, Baker FC. Insomnia disorder in adolescence: Diagnosis, impact, and treatment. Sleep Med Rev 2018; 39:12-24. [PMID: 28974427 PMCID: PMC5931364 DOI: 10.1016/j.smrv.2017.06.009] [Citation(s) in RCA: 193] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/20/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
Abstract
Insomnia disorder is very common in adolescents; it is particularly manifest in older adolescents and girls, with a prevalence comparable to that of other major psychiatric disorders (e.g., depressive disorders). However, insomnia disorder in adolescence is poorly characterized, under-recognized, under-diagnosed, and under-treated, and the reason for the female preponderance for insomnia that emerges after puberty is largely unknown. Insomnia disorder goes beyond an individual complaint of poor sleep or a sleep state misperception, and there is emerging evidence supporting the association of insomnia symptoms in adolescents with alterations in several bio-systems including functional cortical alterations and systemic inflammation. Insomnia disorder is associated with depression and other psychiatric disorders, and is an independent risk factor for suicidality and substance use in adolescents, raising the possibility that treating insomnia symptoms in early adolescence may reduce risk for these adverse outcomes. Cognitive behavioral treatments have proven efficacy for adolescent insomnia and online methods seem to offer promising cost-effective options. Current evidence indicates that insomnia in adolescence is an independent entity that warrants attention as a public health concern in its own right.
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Affiliation(s)
| | - Aimee Goldstone
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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39
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Ma ZR, Shi LJ, Deng MH. Efficacy of cognitive behavioral therapy in children and adolescents with insomnia: a systematic review and meta-analysis. Braz J Med Biol Res 2018; 51:e7070. [PMID: 29791593 PMCID: PMC6002144 DOI: 10.1590/1414-431x20187070] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
Insomnia is highly prevalent in children and adolescents. However, the efficacy of cognitive behavioral therapy for insomnia (CBT-i) in children and adolescents remains controversial. Therefore, this systematic review and meta-analysis aimed to assess the efficacy of CBT-i in children and adolescents. We conducted a search of PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO to select primary studies evaluating CBT-i in children and adolescents that were primarily diagnosed through standardized diagnostic criteria. The primary outcomes of the meta-analysis included sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE%). Six randomized controlled trials and four open-label trials met all inclusion criteria. A total of 464 participants (ranging from 5-19 years of age) were included. Based on the results from sleep logs, a significant pooled effect size was observed for SOL and SE%. However, no significant pooled effect size was found for WASO or TST. Results from actigraphy were consistent with the sleep logs. A significant pooled effect size was observed for SOL and SE%, and no significant pooled effect size was found for WASO or TST. CBT-i might be effective in the treatment of children and adolescents with insomnia.
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Affiliation(s)
- Zhong-Rui Ma
- Department of Neurology, Chengdu Fifth People's Hospital,
Chengdu, China
| | - Li-Jun Shi
- Department of Hematology, Chengdu Fifth People's Hospital,
Chengdu, China
| | - Ming-Hong Deng
- Department of Neurology, Chengdu Fifth People's Hospital,
Chengdu, China
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40
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Cassanello P, Díez-Izquierdo A, Gorina N, Matilla-Santander N, Martínez-Sanchez JM, Balaguer A. [Adaptation and study of the measurement properties of a sleep questionnaire for infants and pre-school children]. An Pediatr (Barc) 2018; 89:230-237. [PMID: 29317179 DOI: 10.1016/j.anpedi.2017.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/02/2017] [Accepted: 12/07/2017] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Although sleep disturbances in infants and toddlers are common, there is no suitable validated tool in Spanish to evaluate sleep disorders. The Brief Infant Sleep Questionnaire (BISQ) is a well-established multidimensional questionnaire widely used internationally. OBJECTIVES To adapt the BISQ questionnaire to Spanish and analyse its reliability and validity. To explore its feasibility, both in the clinical context, and in epidemiological research. METHODS Participants were parents of children between 3 and 30 months of age. The adaptation to Spanish (BISQ-E) was achieved by using both back translation and consensus, following the international guidelines.Reliability was determined by means of test-retest and measurement of agreement (Kappa value) between 2forms of administration of the questionnaire (self-administration and clinical interview). Construct validity was established by analysing its correlation with a sleep diary. RESULTS A total of 87 families/children participated. The test-retest reliability undertaken in 60 subjects was excellent; r = 0.848 (P<0.001). The kappa value was 0.939 (95% CI: 0.858-1.00, P<0.001).The agreement between BISQ-E and the sleep diary was analysed in 27 families/children, with statistically significant values being obtained for the following variables: bedtime (r = 0.731), hours of night sleep (r = 0.726), hours of daytime sleep (r = 0.867), and number of nocturnal awakenings (r = 0.888) (P < 0.001). CONCLUSIONS The Spanish adaptation of the BISQ shows overall adequate validity and reliability for the evaluation of sleep in infants and pre-school children. Its use as a clinical tool, or for clinical-epidemiological research studies, is feasible.
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Affiliation(s)
- Pia Cassanello
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Ana Díez-Izquierdo
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Nuria Gorina
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Nuria Matilla-Santander
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Jose M Martínez-Sanchez
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Albert Balaguer
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España.
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Guo L, Xu Y, Deng J, Huang J, Huang G, Gao X, Li P, Wu H, Pan S, Zhang WH, Lu C. Association between sleep duration, suicidal ideation, and suicidal attempts among Chinese adolescents: The moderating role of depressive symptoms. J Affect Disord 2017; 208:355-362. [PMID: 27810718 DOI: 10.1016/j.jad.2016.10.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/28/2016] [Accepted: 10/16/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicidal ideation and attempts are still currently serious problems among adolescents worldwide, and there is evidence that sleep problem may be associated with increased rates of mental disorder. This study aimed to examine the associations between sleep duration and suicidal ideation and attempts among adolescents and to test whether depressive symptoms have moderating effects on the associations. METHODS A 3-stage, stratified cluster, random sampling method was used to collect data from 20,130 high school students in southeast China. RESULTS The weighted prevalence of short sleep among Chinese adolescents was 5.6% (95% CI, 5.3-6.0%), and the weighted prevalence of long sleep was 2.7% (95% CI, 2.5-3.0%). The final results demonstrated that short sleep was positively associated with suicidal ideation (AOR=2.28, 95% CI=1.96-2.66) and suicidal attempts (AOR=3.20, 95% CI=2.46-4.16), and long sleep was only significantly associated with suicidal attempts (AOR=2.47, 95% CI=1.70-3.58). Stratification analyses conducted separately for students with and without depressive symptoms demonstrated that depressive symptoms may have moderating effects on the associations between sleep duration and suicidality. LIMITATIONS Our study sample only included school students, and causal inference could not be examined due to the cross-sectional design. CONCLUSIONS Sleep duration was associated with suicidal ideation and attempts, and the association between sleep duration and suicidal attempts was U-shaped. These findings support that proper treatments services with the potential to restore adolescent normal sleep would be helpful in preventing suicidality among adolescents.
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Affiliation(s)
- Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
| | - Yan Xu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Jianxiong Deng
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Jinghui Huang
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Xue Gao
- Center for ADR monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Pengsheng Li
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Hong Wu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Siyuan Pan
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Wei-Hong Zhang
- Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
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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: 70] [Impact Index Per Article: 8.8] [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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A Comparative Randomized Controlled Clinical Trial on the Effectiveness, Safety, and Tolerability of a Homeopathic Medicinal Product in Children with Sleep Disorders and Restlessness. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:9539030. [PMID: 27242915 PMCID: PMC4875989 DOI: 10.1155/2016/9539030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/05/2016] [Indexed: 11/18/2022]
Abstract
A prospective, multicenter, randomized, open-label, controlled clinical trial was performed to evaluate the effectiveness and safety of the homeopathic product ZinCyp-3-02 in children with sleep disorders for ≥ one month compared to glycine. Children ≤ six years old received either ZinCyp-3-02 (N = 89) or comparator glycine (N = 90). After treatment for 28 days, total sleep-disorder-associated complaints severity scores decreased in both groups from median 7.0 (out of maximum 11.0) points to 2.0 (ZinCyp-3-02) and 4.0 (glycine) points, respectively, with overall higher odds of showing improvement for ZinCyp-3-02 (odds ratio: 4.45 (95% CI: 2.77-7.14), p < 0.0001, POM overall treatment related effect). Absence of individual complaints (time to sleep onset, difficulties maintaining sleep, sleep duration, troubled sleep (somniloquism), physical inactivity after awakening, restlessness for unknown reason, and sleep disorders frequency) at study end were significantly higher with ZinCyp-3-02 (all p values < 0.05). More children with ZinCyp-3-02 were totally free of complaints (p = 0.0258). Treatment effectiveness (p < 0.0001) and satisfaction assessments (p < 0.0001) were more favorable for ZinCyp-3-02. Few nonserious adverse drug reactions were reported (ZinCyp-3-02: N = 2, glycine: N = 1) and both treatments were well tolerated. Treatment with the homeopathic product ZinCyp-3-02 was found to be safe and superior to the comparator glycine in the treatment of sleep disorders in children.
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Cawkwell P, Lawler A, Maneta E, Coffey BJ. Staying Up at Night: Overlapping Bipolar and Obsessive-Compulsive Disorder Symptoms in an Adolescent with Autism Spectrum Disorder. J Child Adolesc Psychopharmacol 2016; 26:74-7. [PMID: 26881860 DOI: 10.1089/cap.2016.29100.bjc] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Philip Cawkwell
- 1 Department of Psychiatry, New York University School of Medicine , New York, New York
| | - Ashley Lawler
- 2 Department of Psychiatry, Harvard Medical School, Boston Children's Hospital , Boston, Massachusetts
| | - Eleni Maneta
- 2 Department of Psychiatry, Harvard Medical School, Boston Children's Hospital , Boston, Massachusetts
| | - Barbara J Coffey
- 3 Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, New York
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