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McLay L, Hunter J, Ballam K, Marie Emerson L, Day AS, Vandeleur M, Dalton S, Radcliffe Z, Woodford E. An evaluation of psychosocial sleep interventions for children with chronic health conditions: A systematic review. Sleep Med Rev 2024; 77:101962. [PMID: 38870551 DOI: 10.1016/j.smrv.2024.101962] [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: 04/10/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
Chronic health conditions (CHC; e.g., cystic fibrosis, type 1 diabetes) in children are associated with disease-specific physical symptoms that contribute to a high prevalence of sleep problems. Sleep problems exacerbate other health-related sequelae and can impede therapeutic response to health treatments, increasing the overall complexity of symptom management. Psychosocial sleep interventions (PSI) improve sleep in children with typical development and neurodevelopmental conditions. Yet, the effectiveness of PSI for children with CHC has scarcely been investigated. This systematic review appraises the literature examining the effectiveness and acceptability of PSI for children with CHC. A search identified 20 studies that met inclusion criteria. Data related to participant characteristics, sleep targets, research design and methods, measures, sleep outcomes and collateral effects were extracted. Study rigor was then evaluated. Most studies evaluated youth-directed Cognitive Behavioral Therapy for Insomnia or parent-implemented behavioral sleep interventions. Twelve studies demonstrated positive sleep treatment effects and four demonstrated mixed effects. Collateral improvements were reported in child mental health and parental health and well-being, though physical health benefits for children were not consistently reported. One, five and 14 studies were rated as having strong, adequate, and weak methodological rigor respectively. Recommendations for clinical practice and future research are made.
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Affiliation(s)
- Laurie McLay
- The Child Well-being Research Institute and Faculty of Health, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, New Zealand.
| | - Jolene Hunter
- Faculty of Health, Te Whare Wānanga o Waitaha University of Canterbury, Christchurch, New Zealand
| | - Kimberly Ballam
- Faculty of Health, Te Whare Wānanga o Waitaha University of Canterbury, Christchurch, New Zealand
| | - Lisa Marie Emerson
- Faculty of Health, Te Whare Wānanga o Waitaha University of Canterbury, Christchurch, New Zealand
| | - Andrew S Day
- Department of Pediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Moya Vandeleur
- The Royal Children's Hospital, Melbourne, Murdoch Children's Research Institute (MCRI), Australia
| | - Samuel Dalton
- Child Health Services, Waitaha Canterbury, Health New Zealand Te Whatu Ora, Christchurch, New Zealand
| | - Zoe Radcliffe
- Faculty of Health, Te Whare Wānanga o Waitaha University of Canterbury, Christchurch, New Zealand
| | - Emma Woodford
- Faculty of Health, Te Whare Wānanga o Waitaha University of Canterbury, Christchurch, New Zealand
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McPhee PG, Vaccarino AL, Naska S, Nylen K, Santisteban JA, Chepesiuk R, Andrade A, Georgiades S, Behan B, Iaboni A, Wan F, Aimola S, Cheema H, Gorter JW. Harmonizing data on correlates of sleep in children within and across neurodevelopmental disorders: lessons learned from an Ontario Brain Institute cross-program collaboration. Front Neuroinform 2024; 18:1385526. [PMID: 38828185 PMCID: PMC11141168 DOI: 10.3389/fninf.2024.1385526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/19/2024] [Indexed: 06/05/2024] Open
Abstract
There is an increasing desire to study neurodevelopmental disorders (NDDs) together to understand commonalities to develop generic health promotion strategies and improve clinical treatment. Common data elements (CDEs) collected across studies involving children with NDDs afford an opportunity to answer clinically meaningful questions. We undertook a retrospective, secondary analysis of data pertaining to sleep in children with different NDDs collected through various research studies. The objective of this paper is to share lessons learned for data management, collation, and harmonization from a sleep study in children within and across NDDs from large, collaborative research networks in the Ontario Brain Institute (OBI). Three collaborative research networks contributed demographic data and data pertaining to sleep, internalizing symptoms, health-related quality of life, and severity of disorder for children with six different NDDs: autism spectrum disorder; attention deficit/hyperactivity disorder; obsessive compulsive disorder; intellectual disability; cerebral palsy; and epilepsy. Procedures for data harmonization, derivations, and merging were shared and examples pertaining to severity of disorder and sleep disturbances were described in detail. Important lessons emerged from data harmonizing procedures: prioritizing the collection of CDEs to ensure data completeness; ensuring unprocessed data are uploaded for harmonization in order to facilitate timely analytic procedures; the value of maintaining variable naming that is consistent with data dictionaries at time of project validation; and the value of regular meetings with the research networks to discuss and overcome challenges with data harmonization. Buy-in from all research networks involved at study inception and oversight from a centralized infrastructure (OBI) identified the importance of collaboration to collect CDEs and facilitate data harmonization to improve outcomes for children with NDDs.
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Affiliation(s)
- Patrick G. McPhee
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Sibel Naska
- Ontario Brain Institute, Toronto, ON, Canada
| | - Kirk Nylen
- Ontario Brain Institute, Toronto, ON, Canada
| | - Jose Arturo Santisteban
- Ontario Brain Institute, Toronto, ON, Canada
- The Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Andrea Andrade
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Alana Iaboni
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Flora Wan
- Ontario Brain Institute, Toronto, ON, Canada
| | | | | | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
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Lumertz MS, Friedrich FO, Loch LB, Pinto LA. Sleep and quality of life characteristics in a pediatric population with chronic obstructive respiratory diseases. Sleep Breath 2024; 28:945-949. [PMID: 38062225 DOI: 10.1007/s11325-023-02960-8] [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: 02/07/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 05/31/2024]
Abstract
PURPOSE To describe sleep and quality of life of pediatric patients with chronic obstructive respiratory diseases and to ascertain whether or not sleep quality correlates with quality of life in this population. METHODS Participants aged 5 to 18 years with cystic fibrosis (CF), severe asthma, or postinfectious bronchiolitis obliterans (PIBO) receiving regular follow-up at a pediatric respiratory medicine center were recruited. Two questionnaires were used: the Brazilian version of the Sleep Disturbance Scale for Children (SDSC) and the Pediatric Quality of Life Inventory (Peds-QL). RESULTS A total of 46 individuals were included: 30 with CF, 9 with severe asthma, and 7 with PIBO. Almost two-thirds of the patients and their parents or guardians scored at least 39 points on the SDSC, suggesting poor sleep quality. Significantly higher overall median scores were observed in those with severe asthma. Patients and their parents or guardians scored a median of 77 and 80 points respectively on the Peds-QL, with parents of patients with CF scoring higher than any other group. There was a moderate inverse correlation between sleep disorders and quality of life (r = - 0.532 for patients and r = - 0.606 for parents; p < 0.001). CONCLUSION Children and adolescents with chronic obstructive respiratory diseases experience impairment in their sleep quality and quality of life. Sleep disorders and quality of life have a moderate negative correlation.
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Affiliation(s)
- Magali Santos Lumertz
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil.
| | - Frederico Orlando Friedrich
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil
| | - Letícia Bortolini Loch
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil
| | - Leonardo Araújo Pinto
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil
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Thompson L, Baker A, Almeida I, Slavish D, Blumenthal H. Disengagement coping and sleep problems among trauma-exposed adolescents. ANXIETY, STRESS, AND COPING 2024; 37:379-393. [PMID: 38093577 PMCID: PMC10990797 DOI: 10.1080/10615806.2023.2292180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/03/2023] [Indexed: 04/05/2024]
Abstract
BACKGROUND The formation of healthy sleep patterns is a critical component of positive adolescent development. Dysregulated sleep habits can put youth at risk for the development of a multitude of inimical outcomes, particularly among those who are exposed to a traumatic event. DESIGN AND METHODS The present study investigated the links between voluntary disengagement coping (e.g., avoidance, denial, wishful thinking) and sleep outcomes among 86 trauma-exposed and non-exposed adolescents between the ages of 12-17 (Mage = 15.44, SD = 1.51; 41.9% female). RESULTS The relationship between voluntary disengagement coping and sleep outcomes was significant only among trauma-exposed adolescents, such that greater use of voluntary disengagement strategies was associated with greater sleep disturbances and greater daytime dysfunction. CONCLUSIONS Targeting disengagement coping may be an important strategy to improve sleep health among trauma-exposed adolescents. Continued efforts in improving the efficacy of trauma-exposed adolescent intervention strategies are needed.
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Affiliation(s)
- Linda Thompson
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Alexandria Baker
- University of Rochester, Department of Psychology, Rochester, NY, United States
| | - Isamar Almeida
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Danica Slavish
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Heidemarie Blumenthal
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
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Baddam SKR, Canapari CA, Van de Grift J, McGirr C, Nasser AY, Crowley MJ. Screening and Evaluation of Sleep Disturbances and Sleep Disorders in Children and Adolescents. Psychiatr Clin North Am 2024; 47:65-86. [PMID: 38302214 DOI: 10.1016/j.psc.2023.06.005] [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
Sleep disturbances and sleep disorders are prevalent in children/adolescents and have a bidirectional relationship with pediatric medical and mental health disorders. Screening tools and mechanisms for the evaluation and treatment of sleep disturbances and sleep disorders in the pediatric mental health clinic are less well-known; hence, sleep disturbances and disorders are under-recognized in the pediatric clinics. We present specific, validated screening and evaluation tools to identify sleep disturbances and sleep disorders in children/adolescents. We offer guidance related to the use of consumer wearables for sleep assessments and use of sleep telemedicine in pediatric mental health and primary care clinics.
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Affiliation(s)
- Suman K R Baddam
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA.
| | - Craig A Canapari
- Pediatric Pulmonology, Allergy, Immunology & Sleep Medicine, PO Box 208064, New Haven, CT, 06520-8064, USA
| | - Jenna Van de Grift
- Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
| | - Christopher McGirr
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
| | | | - Michael J Crowley
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
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Ciappina S, Roccia E, Concas D, Faretta E, Fernandez I, Quarello P, Zucchetti G, Fagioli F. EMDR in pediatric hospital setting: a case report of an adolescent with cancer. Front Psychol 2024; 15:1347822. [PMID: 38586287 PMCID: PMC10996851 DOI: 10.3389/fpsyg.2024.1347822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/12/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Childhood cancer is rare, but it is the most frequent serious event with a high risk of traumatization for children, adolescents, parents and siblings. EMDR is widely studied as clinical intervention that addressed cancer-related stressors among cancer adult population, but to our knowledge, no researches have been conducted among children and adolescent with cancer. Methods The purpose of this case study is to describe for the first time the application of the EMDR protocol in a pediatric hospital setting with a 17-years-old Italian adolescent who received a diagnosis of leukemia. He accessed the psychological support service complaining of feelings of anxiety and general discomfort. EMDR protocol started after the diagnosis and ended after the usual eight phases. The Impact of Event Scale-Revised (IES-R) was used to assess stress disorders symptoms as outcome at the baseline (before the First Phase) and at the end of the EMDR protocol (after the Eight Phase). Results By using EMDR protocol the patient reported a decrease of emotional activation after a few EMDR sessions. Conclusion EMDR protocol may be effective for pediatric cancer patients in treating stress disorders symptoms and it can be proposed immediately after diagnosis as a standard care also in pediatric hospital setting.
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Affiliation(s)
- Sabrina Ciappina
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Elvia Roccia
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Deborah Concas
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | | | | | - Paola Quarello
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Giulia Zucchetti
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
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Junghans-Rutelonis A, Sim L, Harbeck-Weber C, Dresher E, Timm W, Weiss KE. Feasibility of wearable activity tracking devices to measure physical activity and sleep change among adolescents with chronic pain-a pilot nonrandomized treatment study. FRONTIERS IN PAIN RESEARCH 2024; 4:1325270. [PMID: 38333189 PMCID: PMC10850299 DOI: 10.3389/fpain.2023.1325270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/20/2023] [Indexed: 02/10/2024] Open
Abstract
Purpose Personal informatics devices are being used to measure engagement in health behaviors in adults with chronic pain and may be appropriate for adolescent use. The aim of this study was to evaluate the utilization of a wearable activity tracking device to measure physical activity and sleep among adolescents attending a three-week, intensive interdisciplinary pain treatment (IIPT) program. We also assessed changes in physical activity and sleep from baseline to the treatment phase. Methods Participants (57.1% female, average age 15.88, SD = 1.27) wore an activity tracking device three weeks prior to starting and during the treatment program. Results Of 129 participants contacted, 47 (36.4%) agreed to participate. However, only 30 (64%) complied with the instructions for using the device prior to programming and during program participation. Preliminary analyses comparing averages from 3-weeks pre-treatment to 3-weeks during treatment indicated increases in daily overall activity minutes, daily step counts, and minutes of moderate to vigorous physical activity (by 353%), as well as a corresponding decrease in sedentary minutes. There was more missing data for sleep than anticipated. Conclusions Wearable activity tracking devices can be successfully used to measure adolescent physical activity in-person, with more difficulty obtaining this information remotely. Adolescents with chronic pain experience improvements in objective measurements of physical activity over the course of a 3-week IIPT program. Future studies may want to spend more time working with pediatric patients on their understanding of how to use trackers for sleep and physical activity.
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Affiliation(s)
- Ashley Junghans-Rutelonis
- AJR & Co Consulting and Mental Health, St. Paul, MN, United States
- Department of Psychiatry & Psychology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Leslie Sim
- Department of Psychiatry & Psychology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Cynthia Harbeck-Weber
- Department of Psychiatry & Psychology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Emily Dresher
- Department of Nursing, Mayo Clinic, Rochester, MN, United States
| | - Wendy Timm
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States
| | - Karen E. Weiss
- Department of Psychiatry & Psychology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, MN, United States
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Huhn AS, Ellis JD. Promoting sleep health to mitigate the risk of nonmedical opioid use and opioid-related adverse events. Sleep 2023; 46:zsad153. [PMID: 37246569 PMCID: PMC10485563 DOI: 10.1093/sleep/zsad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Indexed: 05/30/2023] Open
Affiliation(s)
- Andrew S Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer D Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med 2023; 19:1321-1336. [PMID: 36722616 PMCID: PMC10315605 DOI: 10.5664/jcsm.10476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 02/02/2023]
Abstract
STUDY OBJECTIVES This review synthesizes the pediatric behavioral sleep intervention (BSI) evidence base, summarizes challenges in translating BSIs from research to practice, and provides recommendations for integrating implementation science methods to advance pediatric BSI research. METHODS We briefly review the common behavioral sleep disturbances among youth, discuss the pediatric BSIs with well-established evidence, and identify gaps in pediatric BSI research. We then identify contributors to the dearth of research evaluating pediatric BSIs in accessible settings and present a model for applying implementation science strategies to address identified gaps across the continuum of translational research. RESULTS Relatively few BSI trials include older children and adolescents. Similarly, there is limited research evaluating BSIs among racially and ethnically minoritized children and families and/or those of lower socioeconomic status backgrounds. Access to scalable and easily disseminable tools to treat pediatric sleep disturbances early in their development is crucial for promoting positive child outcomes. To address these gaps, researchers should apply implementation science theories, models, and frameworks to design new interventions for implementation, adapt existing interventions with end users and settings in mind, conduct hybrid effectiveness-implementation trials, and test implementation strategies. CONCLUSIONS Given the prevalence and consequences of poor sleep across developmental periods, pediatric BSIs must be effective as well as adaptable, scalable, and easily disseminable. Implementation science theories, models, and frameworks can enhance access to, engagement in, and the implementation and dissemination of scalable BSIs across diverse pediatric care settings and heterogeneous populations. CITATION Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med. 2023;19(7):1321-1336.
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Affiliation(s)
- Jessica C. Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ariel A. Williamson
- Sleep Center, Division of Pulmonary and Sleep Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
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Owiredua C, Flink I, Boersma K. Prevalence and risk factors for pain-specific school absenteeism in adolescents with recurrent pain: A prospective population-based design. Eur J Pain 2023; 27:390-400. [PMID: 36478020 DOI: 10.1002/ejp.2065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/16/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adolescents with recurrent pain miss out from school more often than pain-free peers. Research has so far used cross-sectional designs, focusing on non-specific absenteeism in clinical samples. Hence, it is unknown whether estimates of absenteeism are specifically linked to the pain itself or reflects the characteristics of clinical samples. OBJECTIVES This study aimed to prospectively explore pain-related school absenteeism in a non-clinical sample, its variance and potential risk factors. METHODS This prospective study followed a cohort of 1300 Sweden-based adolescents (mean age = 16.9; 17.2% immigrants; 62.7% girls) with recurrent pain (headache, abdominal and/or musculoskeletal pain) through self-reports at two assessment points 12 months apart. RESULTS Overall, 64.2% reported any absenteeism at follow-up and about half of these (26.2%) reported frequent absenteeism. Adolescents who indicated missing school were more often girls, slightly older and had a higher overall pain burden and stressor levels. Yet, after adjusting for previous absenteeism, independent predictors were age, pain intensity, medication use and stress associated with school attendance. Further to this, immigrant status predicted frequent absenteeism. CONCLUSIONS Many adolescents with pain frequently miss out from school due to pain. Identified risk factors points at pain characteristics and coping, stressors associated with participation and advancing age. Taken together, the burden of pain and its correlates emerge earlier and escalate with increasing age hence, early interventions targeting broader domains are needed. SIGNIFICANCE This study adds substantially to the field by estimating the prevalence of pain-specific school absenteeism in a large sample of adolescents with recurrent pain in the general population using a prospective design. Furthermore, it identifies risk factors of pain-specific absenteeism from a broader context of the adolescent's life with independent predictors being the previous history of absenteeism, age, immigrant status, pain intensity, medication use and stress related to school attendance.
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Affiliation(s)
- Christiana Owiredua
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Ida Flink
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Katja Boersma
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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Tokatly Latzer I, Tauman R, Senderowich N, Markovitz R, Bachar-Zipori A, Klein A, Meirson H, Fattal-Valevski A, Hausman-Kedem M. Sleep Disturbances in Adolescents With Idiopathic Intracranial Hypertension. Pediatr Neurol 2023; 142:39-46. [PMID: 36905761 DOI: 10.1016/j.pediatrneurol.2023.02.006] [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] [Received: 06/14/2022] [Revised: 09/19/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND We aimed to assess the presence of sleep disturbances in adolescents with idiopathic intracranial hypertension (IIH) and to determine whether demographic, anthropometric, and clinical factors are associated with disrupted sleep. METHODS Sleep disturbances and patterns were evaluated in a cohort of adolescents (aged 12 to 18 years) with ongoing IIH and compared with a healthy age- and sex-matched control group. All participants responded to three self-rating questionnaires: the School Sleep Habits Survey (SSHS), the Pediatric Sleep Questionnaire (PSQ), and the Depression, Anxiety, and Stress Scale. The study group's demographic, clinical, laboratory, and radiological data were documented, and their association with sleep patterns was examined. RESULTS Thirty-three adolescents with ongoing IIH and 71 healthy controls were included. There was a significantly higher prevalence of sleep disturbances in the IIH group compared with the controls (SSHS, P < 0.001 and PSQ, P < 0.001), as well as of their independent subscales: sleep-related breathing disorders (P = 0.006), daytime sleepiness (P = 0.04), sleep/wake disruptions (P < 0.001), and sleep-related depressive tendencies (P < 0.001). According to subgroup analyses, these differences were also present between the normal-weight adolescents but not between the overweight IIH and control adolescents. No differences were found in the demographic, anthropometric, and IIH disease-related clinical measures between individuals with IIH with disrupted and normal sleep patterns. CONCLUSIONS Sleep disturbances are common among adolescents with ongoing IIH, irrespective of their weight and disease-related characteristics. Screening adolescents with IIH for sleep disturbances is recommended as part of their multidisciplinary management.
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Affiliation(s)
- Itay Tokatly Latzer
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Riva Tauman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sleep Disorders Center, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Noam Senderowich
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Raviv Markovitz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Bachar-Zipori
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Ophthalmology Department, Neuro-Ophthalmology Unit, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Ainat Klein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Ophthalmology Department, Neuro-Ophthalmology Unit, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Hadas Meirson
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviva Fattal-Valevski
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moran Hausman-Kedem
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Tiongco RFP, Dane JM, Owens MA, Cemaj SL, Puthumana JS, Ross ES, Redett RJ, Hultman CS, Caffrey JA, Lerman SF. A Systematic Review and Meta-analysis of Sleep Disturbances in Pediatric Burn Survivors. CURRENT SLEEP MEDICINE REPORTS 2022. [DOI: 10.1007/s40675-022-00231-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Werner S, Doerfel C, Biedermann R, Lorenz M, Rasche M, Proquitté H, Newman L, Vilser D. The CSHQ-DE Questionnaire Uncovers Relevant Sleep Disorders in Children and Adolescents with Long COVID. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1419. [PMID: 36138727 PMCID: PMC9497557 DOI: 10.3390/children9091419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/19/2022]
Abstract
Acute SARS-CoV-2 infections in children and adolescents are usually mild. However, they can suffer from ongoing symptoms, generally referred to as long COVID. Sleep disorders are one of the most frequent complaints in long COVID although precise data are missing. We assessed the sleep behavior of children and adolescents who presented at our outpatient clinic between January 2021 and May 2022 with the Children's Sleep Habits Questionnaire (CSHQ-DE). We compared the sleep behavior at three different time points: pre-COVID-19; post-COVID-19 at the initial presentation; and post-COVID-19 at re-presentation. Data from 45 patients were analyzed. Of those, 64% were female and the median age was 10 years (range: 0-18 years). Asymptomatic or mild COVID-19 disease was experienced in 89% of patients; 11% experienced moderate disease. The initial presentation occurred at a median of 20.4 weeks (6 weeks-14 months) after the infection. The CSHQ-DE score increased significantly from pre-COVID-19 (45.82 ± 8.7 points) to post-COVID-19 (49.40 ± 8.3 points; p ≤ 0.01). The score then normalized at re-presentation (46.98 ± 7.8; p = 0.1). The greatest changes were seen in the CSHQ-DE subscale score "daytime sleepiness". Our data showed that children and adolescents with long COVID often suffer from sleep disturbances. For most children and adolescents, these sleep disorders decreased over time without any further medical intervention aside from a basic sleep consultation.
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Affiliation(s)
- Sarah Werner
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Claus Doerfel
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Richard Biedermann
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Michael Lorenz
- Respiratory, Allergy and Cystic Fibrosis Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Marius Rasche
- Respiratory, Allergy and Cystic Fibrosis Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Hans Proquitté
- Neonatal and Pediatric Intensive Care Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Lars Newman
- Cardiology Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
| | - Daniel Vilser
- Cardiology Section, Department of Child and Adolescent Medicine, University Hospital Jena, 07747 Jena, Germany
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14
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Evans C, Fidler A, Baker D, Wagner M, Fedele D. Sleep and asthma management in youth with poorly-controlled asthma and their caregivers: a qualitative approach. J Asthma 2022; 59:1131-1138. [PMID: 33827372 PMCID: PMC10072859 DOI: 10.1080/02770903.2021.1914650] [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: 02/05/2023]
Abstract
OBJECTIVE Youth with poorly-controlled asthma are at increased risk for sleep disturbances caused by nocturnal symptoms like coughing. Asthma-related sleep disturbances can have downstream consequences for youth with asthma and their families. This study aims to describe (1) sleep disturbances in adolescents with poorly-controlled asthma and their caregivers and (2) the relationship between sleep and asthma management. METHODS Adolescents with poorly-controlled asthma and their caregivers completed the Family Asthma Management System Scale (FAMSS), a semi-structured interview that assesses youth asthma management within the family context. Interviews were audio-recorded and transcribed. Two authors coded each transcript for sleep-related data in NVivo using descriptive content analysis. RESULTS Thirty-three adolescents ages 12-15 years old (M = 13.2, SD = 1.2) with poorly-controlled asthma and their caregivers participated in this study. Four main themes emerged: sleep difficulties, sleep environment, sleep and self-management, and fatigue and self-management. 42% of youth and caregivers reported worse nocturnal asthma symptoms (e.g. coughing) that caused frequent nighttime awakening. Approximately 27% of caregivers expressed distress over their child's nocturnal asthma and described their management strategies (e.g. co-sleeping, nighttime symptom monitoring). Adolescents described sleepiness as a barrier to asthma self-management tasks (e.g. medication adherence, response to exacerbation). CONCLUSION Interview responses demonstrated the considerable interrelationship of sleep and asthma management in adolescents with poorly-controlled asthma. Asthma providers should consider discussing sleep difficulties with their adolescent patients and their families. Addressing these difficulties may help adolescents improve their asthma self-management and help caregivers better cope with their child's disease.
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Affiliation(s)
- Corinne Evans
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea Fidler
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Dawn Baker
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - Mary Wagner
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - David Fedele
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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15
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Venta A, Alfano C. Sleep Duration Buffers The Effects of Adversity on Mental Health Among Recently Immigrated Latinx Adolescents. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:235-247. [PMID: 35600519 PMCID: PMC9120277 DOI: 10.1007/s40653-021-00374-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 06/03/2023]
Abstract
The rate of Latinx migration to the U.S. has risen rapidly over the last several decades. Recognizing that Latinx migrant youth are exposed to a high rate of adverse events and that sleep has potential buffering effects on mental health, the current study aimed to examine sleep duration as a moderator of the link between childhood adversity and emotional and behavioral symptoms among Latinx migrant youth. One hundred and twelve first-generation migrants of Latinx ethnicity (and 46 caregivers) participated in this study; the average age was 19 (SD = 2). Participants self-reported demographics: 59.8% of participants were male, with the racial breakdown as follows: 38.8% white, 6.1% black, 4.1% mixed race, and 51% marked "other." Data were collected from a public high school for immigrant youth in the Southwestern U.S. and included average sleep duration, Adverse Childhood Experiences; the Child PTSD Symptoms Scale and the Child Behavior Checklist. Findings indicated experiences of neglect in childhood were associated with youth-reported mental health symptoms, but this relation was significantly moderated by sleep duration such that the relation was weakened in the presence of high sleep duration. Both effects were statistically significant and of medium size. Caregiver reports supported the buffering effects of sleep; medium or large interactions between sleep and all three adversity variables (abuse, neglect, and household dysfunction) were noted in multivariate analyses. The current study takes an important first step in identifying that short sleep duration is prevalent among Central American immigrant youth. Findings suggest that sleep duration has important public health potential as a means of buffering the effects of childhood adversity on mental health in a vulnerable group.
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Affiliation(s)
- Amanda Venta
- Department of Psychology, University of Houston, Houston, Texas USA
| | - Candice Alfano
- Department of Psychology, University of Houston, Houston, Texas USA
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16
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Lah S, Bogdanov S, Brookes N, Epps A, Teng A, Ocampo IMB, Naismith S. Convergent validity of the child behavior checklist sleep items in children with moderate to severe traumatic brain injury. Brain Inj 2022; 36:750-758. [PMID: 35622928 DOI: 10.1080/02699052.2022.2077444] [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: 11/02/2022]
Abstract
AIM The Child Behavior Checklist (CBCL) includes several sleep items. We aimed to examine the convergent validity of CBCL sleep scores with validated sleep measures, and to explore their functional correlates. METHODS This cross-sectional study included 44 children with moderate to severe TBI, aged 6-15 years. Parents completed the CBCL and Sleep Disturbance Scale for Children (SDSC), and children wore actigraphy watches. RESULTS We found significant, albeit differential, associations between CBCL and SDSC sleep scores. Specifically: (i) "trouble sleeping" with SDSC total score, (ii) "trouble sleeping" and "nightmares" with SDSC initiating and maintaining sleep, (iii) "talks/walks in sleep" with SDSC arousal, and (iv) "overtired," "sleeps more" and CBCL sleep composite with SDSC excessive somnolence. The CBCL item "sleeps less" was the only significant predictor of functioning; children who slept less had lower social competence. No associations were found between CBCL sleep scores and actigraphy. CONCLUSIONS The CBCL does not provide a comprehensive assessment of sleep disturbances in children with moderate to severe TBI. Nevertheless, certain CBCL sleep items demonstrate initial convergent validity with subscales of the SDSC assessing select types of sleep disturbances. The CBCL may be useful in research and clinical situations when administration of more comprehensive assessment sleep tools is not viable.
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Affiliation(s)
- Suncica Lah
- School of Psychology, The University of Sydney, Camperdown, New South Wales, Australia
| | - Stefan Bogdanov
- School of Psychology, The University of Sydney, Camperdown, New South Wales, Australia
| | - Naomi Brookes
- Rehab2Kids, Rehabilitation Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Adrienne Epps
- Rehab2Kids, Rehabilitation Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Arthur Teng
- Department of Sleep Medicine, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Paediatrics and Women's Health, University of New South Wales, Kensington, New South Wales, Australia
| | | | - Sharon Naismith
- School of Psychology, The University of Sydney, Camperdown, New South Wales, Australia.,Brain and Mind Centre, and Charles Perkins Centre, The University of Sydney, New South Wales, Australia
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17
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Implications of Disability Severity on 24-Hour Movement Guideline Adherence Among Children With Neurodevelopmental Disorders in the United States. J Phys Act Health 2021; 18:1325-1331. [PMID: 34548417 DOI: 10.1123/jpah.2021-0282] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/04/2021] [Accepted: 06/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Research has established beneficial associations between 24-hour movement guideline adherence and several health outcomes in typically developing (TD) children, but these relationships are poorly understood in children with neurodevelopmental disorders (NDD). This study examined (1) 24-hour movement guideline adherence, (2) the influence of disability severity, and (3) associations between guideline adherence and health outcomes of TD children and children with NDD. METHODS This cross-sectional study used data from the 2018 and 2019 cycles of the US National Survey of Children's Health. Parental/caregiver reports of movement behaviors (physical activity, screen time, and sleep), disability severity (limitations to daily activities), and health outcomes (general health status, anxiety, and depression) were provided for 8554 children with NDD and 19,669 TD children aged 6-17 years. RESULTS Children with NDD had significantly lower odds of meeting each movement behavior guideline compared to TD children; these effects were most pronounced for those who experienced consistent limitations to daily activities. Meeting at least 2 guidelines significantly lowered the odds for anxiety and depression, and increased the odds for better general health for children with NDD. DISCUSSION These findings suggest that degree of disability severity has a strong influence on adherence to 24-hour movement guidelines among children with NDD.
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18
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Rose S, Boucher SE, Galland BC, Wiltshire EJ, Stanley J, Smith C, de Bock MI, Rayns JA, MacKenzie KE, Wheeler BJ. Impact of high-risk glycemic control on habitual sleep patterns and sleep quality among youth (13-20 years) with type 1 diabetes mellitus compared to controls without diabetes. Pediatr Diabetes 2021; 22:823-831. [PMID: 33880853 DOI: 10.1111/pedi.13215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/28/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In type 1 diabetes mellitus (T1D), glycemic control and sleep have a bidirectional relationship, with unhealthy glycemic control impacting sleep, and inadequate sleep impacting diabetes management. Youth are at risk for poor quality sleep; however, little is known about sleep among youth with high-risk glycemic control. OBJECTIVE To assess differences in habitual sleep timing, duration, and quality among youth with T1D and controls. SUBJECTS Two-hundred-thirty youth (13-20 years): 64 with T1D (mean age 16.6 ± 2.1 years, 48% female, diabetes duration 7.5 ± 3.8 years, HbA1c 96 ± 18.0 mmol/mol [10.9 ± 1.7%]), and 166 controls (mean age 15.3 ± 1.5, 58% female). METHODS Comparison of data from two concurrent studies (from the same community) using subjective and objective methods to assess sleep in youth: Pittsburgh Sleep Quality Index evaluating sleep timing and quality; 7-day actigraphy measuring habitual sleep patterns. Regression analyses were used to compare groups. RESULTS When adjusted for various confounding factors, youth with T1D reported later bedtimes (+36 min; p < 0.05) and shorter sleep duration (-53 min; p < 0.05) than controls, and were more likely to rate subjective sleep duration (OR 3.57; 95% CI 1.41-9.01), efficiency (OR 4.03; 95% CI 1.43-11.40), and quality (OR 2.59; 95% CI 1.16-5.76) as "poor" (p < 0.05). However, objectively measured sleep patterns were similar between the two groups. CONCLUSIONS Youth with high-risk T1D experience sleep difficulties, with later bedtimes contributing to sleep deficit. Despite a lack of objective differences, they perceive their sleep quality to be worse than peers without diabetes.
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Affiliation(s)
- Shelley Rose
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of Pediatrics and Child Health, University of Otago Wellington, Wellington, New Zealand
| | - Sara E Boucher
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Esko J Wiltshire
- Department of Pediatrics and Child Health, University of Otago Wellington, Wellington, New Zealand.,Pediatric Department, Capital and Coast District Health Board, Wellington, New Zealand
| | - James Stanley
- Biostatistical Group, Dean's Department, University of Otago Wellington, Wellington, New Zealand
| | - Claire Smith
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Martin I de Bock
- Department of Paediatrics, University of Otago, Christchurch, New Zealand.,Pediatric Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Jenny A Rayns
- Endocrinology Department, Southern District Health Board, Dunedin, New Zealand
| | - Karen E MacKenzie
- Department of Paediatrics, University of Otago, Christchurch, New Zealand.,Pediatric Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Benjamin J Wheeler
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Pediatric Department, Southern District Health Board, Dunedin, New Zealand
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19
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Sleep Assessment for Sleep Problems in Children. Nurs Clin North Am 2021; 56:299-309. [PMID: 34023123 DOI: 10.1016/j.cnur.2021.02.008] [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: 11/21/2022]
Abstract
The breadth of childhood sleep problems is broad and can be associated with biologic, psychiatric, behavioral, social, and environmental processes. Unrecognized childhood sleep problems may threaten daytime behaviors and negatively impact school and psychosocial functioning. Left unattended, overall child biopsychosocial development may be impaired. Thus, identifying and addressing sleep problems has potential to optimize childhood health, development, and overall well-being. Nurses need to be cognizant of detrimental impacts of child sleep deprivation and advocate for appropriate sleep assessments while offering sleep education to parents and children.
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20
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Differences of Craniofacial Characteristics in Oral Breathing and Pediatric Obstructive Sleep Apnea. J Craniofac Surg 2021; 32:564-568. [PMID: 33704981 DOI: 10.1097/scs.0000000000006957] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Oral breathing (OB) was considered associated with specific craniofacial structures and same for pediatric obstructive sleep apnea (OSA). This study aimed to investigate the differences of craniofacial structures between OB and OSA. METHODS In this retrospective study, 317 children under age 18 years were recruited and divided into OB group, OSA group, and control group. OSA group (15 boys, 4 girls) were referred from qualified sleep center and diagnosed as pediatric OSA with full-night polysomnography. OB group (10 boys, 10 girls) were mostly referral from pediatric or ENT department, some of whom undertook polysomnography and were not OSA. Control group consisted of orthodontic patients within the same period. Lateral cephalograms were obtained in all groups and their parameters were compared with Chinese normal values and each other. RESULTS R-PNS of OB group (18.04 ± 2.49 mm) was greater than OSA group (14.27 ± 4.36 mm) and even control group (16.22 ± 3.91 mm) (P < 0.01). U1-NA was also the greatest in OB group (7.15 ± 2.92 mm), followed by OSA group (4.88 ± 2.66 mm), while control group was the smallest (5.71 ± 2.94 mm) (P < 0.05). In addition, OB group presented the smallest adenoids and tonsils among three groups. Bony nasopharynx development, mandibular length and growth direction of mandible of OB group were all better than OSA group. CONCLUSION Despite of oral breathing, anatomical morphology (well-developed dentoalveolar structures; mild adenotonsillar hypertrophy) might protect children from developing OSA.
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21
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Baddam SKR, Canapari CA, Van de Grift J, McGirr C, Nasser AY, Crowley MJ. Screening and Evaluation of Sleep Disturbances and Sleep Disorders in Children and Adolescents. Child Adolesc Psychiatr Clin N Am 2021; 30:65-84. [PMID: 33223069 DOI: 10.1016/j.chc.2020.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sleep disturbances and sleep disorders are prevalent in children/adolescents and have a bidirectional relationship with pediatric medical and mental health disorders. Screening tools and mechanisms for the evaluation and treatment of sleep disturbances and sleep disorders in the pediatric mental health clinic are less well-known; hence, sleep disturbances and disorders are under-recognized in the pediatric clinics. We present specific, validated screening and evaluation tools to identify sleep disturbances and sleep disorders in children/adolescents. We offer guidance related to the use of consumer wearables for sleep assessments and use of sleep telemedicine in pediatric mental health and primary care clinics.
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Affiliation(s)
- Suman K R Baddam
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA.
| | - Craig A Canapari
- Pediatric Pulmonology, Allergy, Immunology & Sleep Medicine, PO Box 208064, New Haven, CT, 06520-8064, USA
| | - Jenna Van de Grift
- Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
| | - Christopher McGirr
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
| | | | - Michael J Crowley
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
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22
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Loades ME, Rimes KA, Chalder T. Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort. Clin Child Psychol Psychiatry 2020; 25:816-832. [PMID: 32441119 PMCID: PMC7116133 DOI: 10.1177/1359104520918364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sleep problems have a negative impact on a range of outcomes and are very common in adolescents with chronic fatigue syndrome (CFS). We aimed to (a) establish whether adolescents with CFS have more self-reported sleep problems than illness controls as well as healthy controls, (b) investigate changes in sleep problems and (c) explore the extent to which sleep problems at baseline predict fatigue and functioning at follow-up in adolescents with CFS. The Insomnia Scale was completed by 121 adolescents with CFS, 78 healthy adolescents and 27 adolescents with asthma. Eighty (66%) treatment-naïve adolescents with CFS completed questionnaires approximately 3 months later. Adolescents with CFS reported increased sleep problems compared to healthy controls and adolescents with asthma. In CFS, there was no significant change in sleep problems without treatment over a 3-month follow-up. Sleep problems at baseline predicted a significant proportion of the variance in sleep problems at follow-up. Sleep problems should be targeted in treatment. Regulating the 'body clock' via the regulation of sleep could influence outcomes not assessed in this study such as school attainment.
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Affiliation(s)
- Maria Elizabeth Loades
- Department of Psychology, University of Bath, UK.,Bristol Medical School, University of Bristol, UK
| | - Katharine A Rimes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,South London & Maudsley NHS Foundation Trust, UK
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23
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Delaruelle K, Dierckens M, Vandendriessche A, Deforche B, Poppe L. Adolescents' sleep quality in relation to peer, family and school factors: findings from the 2017/2018 HBSC study in Flanders. Qual Life Res 2020; 30:55-65. [PMID: 32865698 DOI: 10.1007/s11136-020-02614-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE While a multitude of studies focused on biological and behavioral determinants of adolescents' sleep quality, a paucity of research examined the impact of social factors. The current study therefore examines the relationship between adolescents' sleep quality and peer, family and school factors. METHODS Data of Flemish participants in the 2017/2018 Health Behavior in School-aged Children survey (HBSC) were used, which is representative of the adolescent population (11-18 years) in Flanders. Adolescents' sleep quality was linked to individual-level data on peer relationships (i.e., peer support), family relationships (i.e., family support, perceived family wealth, caregiving responsibilities) and school relationships (i.e., teacher support, school support, school pressure) and contextual-level data on the school culture. Three-level multilevel models were fitted to account for the clustering of individuals (N = 8153) within classes (N = 769) and classes within schools (N = 177). RESULTS The individual-level results indicated that adolescents' sleep quality was positively related to family support, teacher support, student support and perceived family wealth. In contrast, adolescents' sleep quality was negatively related to caregiving responsibilities and school pressure. In addition, the contextual-level results pointed out that adolescents tended to report better sleep quality in less-demanding schools. CONCLUSION These findings highlight the need to consider social factors in promoting better sleep in adolescence.
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Affiliation(s)
- Katrijn Delaruelle
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. .,Health Promotion Unit, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Maxim Dierckens
- Health Promotion Unit, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Ann Vandendriessche
- Health Promotion Unit, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Benedicte Deforche
- Health Promotion Unit, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Movement and Nutrition for Health and Performance Research Group, Faculty of Physical Education and Physiotherapy, Pleinlaan 2, 1050, Elsene, Belgium
| | - Louise Poppe
- Health Promotion Unit, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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24
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Meltzer LJ, Forrest CB, de la Motte A, Bevans KB. Clinical Validity of the PROMIS Pediatric Sleep Measures across Populations of Children with Chronic Illnesses and Neurodevelopment Disorders. J Pediatr Psychol 2020; 45:319-327. [PMID: 31764969 PMCID: PMC7081937 DOI: 10.1093/jpepsy/jsz088] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine the clinical validity of the Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Sleep Disturbance (SD) and Sleep-Related Impairment (SRI) short forms. METHODS Youth (8-17 years) from clinical populations with known SDs (sleep clinic n = 126, autism n = 276, asthma n = 82, asthma + eczema n = 68) and the general population (n = 902) completed the PROMIS Pediatric SD and SRI 8-item short forms, along with established measures of sleep (Children's Report of Sleep Patterns, Sleep Habits Survey), PROMIS Pediatric Fatigue, and parent-reported clinical indicators (does child have sleep problem, use melatonin, use prescription sleep medication). RESULTS Confirmatory factor analyses demonstrated factorial invariance for all clinical groups. Significant differences between the general population and clinical groups were found for SD and SRI (medium to large effect sizes). Convergent validity was demonstrated through separate hierarchical regression models that showed significant associations between parent-reported clinical indicators and SD and SRI, above and beyond clinical group, as well as moderate to strong correlations between the PROMIS sleep measures and both established measures of sleep and fatigue. CONCLUSIONS The PROMIS Pediatric SD and SRI short forms provide clinicians and researchers a brief, accurate, and valid way to measure patient-reported sleep outcomes in pediatric populations.
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Affiliation(s)
| | - Christopher B Forrest
- Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - Anna de la Motte
- Applied Clinical Research Center, Children’s Hospital of Philadelphia
| | - Katherine B Bevans
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University
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25
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Slim M, Westmacott R, Toutounji S, Singh J, Narang I, Weiss S, Krishnan P, Grbac E, Surmava AM, Andres K, MacGregor D, deVeber G, Moharir M, Dlamini N. Obstructive sleep apnea syndrome and neuropsychological function in pediatric stroke. Eur J Paediatr Neurol 2020; 25:82-89. [PMID: 31787553 DOI: 10.1016/j.ejpn.2019.11.006] [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] [Received: 01/07/2019] [Revised: 06/04/2019] [Accepted: 11/17/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the prevalence of obstructive sleep apnea syndrome (OSAS) in children with arterial ischemic stroke (AIS) and to evaluate its association with neuropsychological outcomes. METHODS We conducted a cross-sectional study of sleep health and neuropsychological outcome in children with AIS. A consecutive cohort of children attending a stroke clinic were assessed using a standardized pediatric sleep questionnaire (PSQ) and standardized measures of pediatric stroke outcome and intellectual, executive and adaptive function. High risk for OSAS was defined as PSQ score ≥0.33. RESULTS Overall, 102 children were included (55% males, median age: 9 years [interquartile-range [IQR]: 6-14]). The prevalence of OSAS in children with AIS was significantly higher compared to published normative prevalence rate (25.5% vs 5%, p < 0.001). Children with OSAS were more likely to have infarcts affecting both the anterior and posterior circulation (37.5% vs 9.5%, p = 0.021). In addition, children with OSAS had significantly higher median Pediatric Stroke Outcome Measure (PSOM) scores (2 [IQR: 0-2] vs 1 [IQR: 1-3.5], p = 0.01) and were more likely to be prescribed concomitant medications affecting sleep architecture (50% vs 22.4%, p = 0.007). OSAS was associated with significantly lower scores on intellectual, memory, cognitive, behavioral, attention, executive and adaptive function scales. The association between PSQ and intellectual ability and working memory remained statistically significant upon controlling for potential confounding factors including stroke related characteristics (neurologic impairment and arterial territory). CONCLUSIONS The prevalence of OSAS in children with AIS compared to healthy controls is significantly elevated and is associated with poor neuropsychological outcomes. We highlight the importance of regular screening for OSAS - a modifiable risk factor - in children with AIS. The specific risk factors for OSAS and the potential benefits of therapeutic interventions in this patient population warrant further investigation.
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Affiliation(s)
- Mahmoud Slim
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Robyn Westmacott
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
| | - Sandra Toutounji
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Jaspal Singh
- Department of Neurology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Indra Narang
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Shelly Weiss
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Pradeep Krishnan
- Division of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Elena Grbac
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Ann-Marie Surmava
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Kathleen Andres
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Daune MacGregor
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Gabrielle deVeber
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | | | - Nomazulu Dlamini
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada.
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26
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Meentken MG, van der Mheen M, van Beynum IM, Aendekerk EWC, Legerstee JS, van der Ende J, Del Canho R, Lindauer RJL, Hillegers MHJ, Moll HA, Helbing WA, Utens EMWJ. EMDR for children with medically related subthreshold PTSD: short-term effects on PTSD, blood-injection-injury phobia, depression and sleep. Eur J Psychotraumatol 2020; 11:1705598. [PMID: 32002140 PMCID: PMC6968501 DOI: 10.1080/20008198.2019.1705598] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/29/2019] [Accepted: 12/02/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Paediatric illness, injury and medical procedures are potentially traumatic experiences with a range of possible negative psychosocial consequences. To prevent psychosocial impairment and improve medical adherence, evidence-based psychotherapy should be offered if indicated. Eye movement desensitization and reprocessing (EMDR) has been found to reduce symptoms of posttraumatic stress disorder (PTSD) in adults. The evidence for the use with children is promising. Furthermore, recent studies indicate its effectiveness for the treatment of other psychological symptomatology. However, the effectiveness of EMDR in children with subthreshold PTSD after medically related trauma has not yet been investigated. Objective: Investigating the short-term effectiveness of EMDR on posttraumatic stress, anxiety, depression and sleep problems in children with subthreshold PTSD after hospitalization through a randomized controlled trial (RCT). Method: Following baseline screening of 420 children from various Dutch hospitals, 74 children (4-15 years old) with medically related subthreshold PTSD were randomized to EMDR (n = 37) or care-as-usual (CAU; n = 37). Follow-up assessment took place after M = 9.7 weeks. Generalized Estimating Equation (GEE) analyses were performed to examine the effectiveness of EMDR compared to CAU. Results: Children in both groups improved significantly over time on all outcomes. However, the EMDR group improved significantly more as to child-reported symptoms of blood-injection-injury (BII) phobia and depression, and child-, and parent-reported sleep problems of the child. There was no superior effect of EMDR compared to CAU on subthreshold PTSD symptom reduction. Conclusions: EMDR did not perform better than CAU in reducing PTSD symptoms in a paediatric sample of children with subthreshold PTSD after hospitalization. However, the study results indicate that EMDR might be superior in reducing symptoms of blood-injection-injury phobia, depression and sleep problems.
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Affiliation(s)
- Maya G Meentken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Malindi van der Mheen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ingrid M van Beynum
- Department of Pediatrics, division of Cardiology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Elisabeth W C Aendekerk
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Riwka Del Canho
- Department of Pediatrics, Maasstad hospital, Rotterdam, The Netherlands
| | - Ramón J L Lindauer
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands.,Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Henriette A Moll
- Department of Pediatrics, division of Pediatrics, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Wim A Helbing
- Department of Pediatrics, division of Cardiology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Pediatrics, division of Cardiology, Radboud UMC - Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Elisabeth M W J Utens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.,De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands.,Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, The Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
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27
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Gutierrez-Colina AM, Quast LF, Eaton CK, LaMotte J, Stolz MG, Mee L, George R, Lee J, Reed B, Rich KL, Blount RL. Sleep quality is associated with psychosocial functioning and health-related quality of life in pediatric transplant recipients. Pediatr Transplant 2019; 23:e13577. [PMID: 31512800 DOI: 10.1111/petr.13577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/12/2019] [Accepted: 08/13/2019] [Indexed: 12/24/2022]
Abstract
This study examined patient-reported sleep quality in a single-center cross-sectional sample of adolescents with solid organ transplants and evaluated associations between sleep quality, psychosocial functioning (ie, depression/anxiety symptoms), and HRQOL. Health disparities associated with minority race/ethnicity and socioeconomic variables were also examined. Sixty-nine adolescents (M = 16.51 years; SD = 1.63) who received a solid organ transplant (kidney: n = 25; liver: n = 24; heart: n = 20) completed self-report measures of sleep quality, psychosocial functioning, and HRQOL. Adolescent transplant recipients endorsed significantly lower levels of sleep quality (ie, falling asleep) compared with previously published norms of healthy peers (t = -3.60; P ≤ .001). Higher sleep quality was significantly associated with fewer anxiety and depressive symptoms (r = -.31 to -.40), and higher physical and psychosocial HRQOL (r = .33-.43). Adolescents from minority backgrounds had significantly worse sleep quality compared with non-Hispanic Whites. Adolescent transplant recipients, particularly those from minority backgrounds, may be at increased risk for experiencing poor sleep quality. Suboptimal sleep is a risk factor for higher levels of anxiety and depressive symptoms, as well as lower levels of physical and psychosocial HRQOL. Sleep is an important modifiable factor that, if improved, may contribute to lower anxiety/depressive symptoms and better HRQOL in adolescent transplant recipients.
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Affiliation(s)
| | - Lauren F Quast
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Cyd K Eaton
- Division of Pulmonary & Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Julia LaMotte
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Mary G Stolz
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Laura Mee
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Roshan George
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Jennifer Lee
- Children's Healthcare of Atlanta, Atlanta, Georgia.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Bonney Reed
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Kristin Loiselle Rich
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Ronald L Blount
- Department of Psychology, University of Georgia, Athens, Georgia
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28
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Tsai SY, Lee WT, Lee CC, Jeng SF, Weng WC. Behavioral-educational sleep interventions for pediatric epilepsy: a randomized controlled trial. Sleep 2019; 43:5573595. [DOI: 10.1093/sleep/zsz211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/22/2019] [Indexed: 01/02/2023] Open
Abstract
AbstractStudy ObjectivesTo evaluate the effect of a clinic-based, behavioral-educational sleep intervention on sleep of children with epilepsy, maternal knowledge about childhood sleep, and maternal sleep quality.MethodsA total of 100 toddlers and preschool-age children with epilepsy (1.5–6 years, 55% boys) and their parents were randomized to receive sleep intervention (n = 50) or usual care with attention (n = 50). Outcomes were assessed at baseline, 3, 6, and 12 months after intervention with the use of objective actigraphy, Children’s Sleep Habits Questionnaire, Parents’ Sleep Knowledge Inventory, and Pittsburgh Sleep Quality Index. Intervention effects were examined using general linear models for repeated measurements to compare the mean change in outcomes from baseline to 12 months post-intervention between the two groups.ResultsSleep intervention resulted in children having greater sleep efficiency by 2.03% compared with the usual care group (95% CI = 0.20% to 3.86%; p = .03). Children in the intervention group also had significantly longer total nighttime sleep as objectively assessed by actigraphy than did those in the usual care group, with an adjusted mean difference of 16.13 minutes (95% CI = 0.24% to 32.03%; p = .04). No intervention effects were observed for maternal knowledge about childhood sleep, and maternal sleep quality.ConclusionSleep intervention provided during routine neurologic visits results in significant, measurable, and sustained benefits in sleep quality and quantity in children with epilepsy. Future trials are warranted to evaluate whether improvements in sleep could impact health-related quality of life or other aspects of functioning in children with epilepsy.Clinical TrialThis trial has been registered at www.clinicaltrials.gov (trial name: Sleep Intervention for Pediatric Epilepsy; registration number: NCT02514291).
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Affiliation(s)
- Shao-Yu Tsai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wang-Tso Lee
- Department of Pediatric Neurology, National Taiwan University Children’s Hospital, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Suh-Fang Jeng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Chin Weng
- Department of Pediatric Neurology, National Taiwan University Children’s Hospital, Taipei, Taiwan
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29
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Course and Predictors of Sleep and Co-occurring Problems in Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:2101-2115. [PMID: 30684086 DOI: 10.1007/s10803-019-03894-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The chronicity of sleep disturbance and its relation to co-occurring symptoms in children with autism spectrum disorder (ASD) are not well understood. The current study examined longitudinal relations among sleep and co-occurring symptoms in a large well-characterized sample of 437 children with ASD assessed at baseline and follow-up (M = 3.8 years later). Twenty-three percent experienced worsening sleep problems over time, while 31.5% showed improvement. Path analysis indicated that sleep problems at baseline predicted later development of ADHD symptoms in younger children and somatic complaints in older children. For younger children, sensory over-responsivity predicted future sleep problems. Findings suggest that sensory over-reactivity may contribute to sleep problems in some children with ASD, and that sleep problems may result in poor daytime functioning.
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30
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Gutierrez-Colina AM, Cushman GK, Eaton CK, Quast LF, Lee J, Rich KL, Reed-Knight B, Mee L, Romero R, Mao CY, George R, Blount RL. A preliminary investigation of sleep quality and patient-reported outcomes in pediatric solid organ transplant candidates. Pediatr Transplant 2019; 23:e13348. [PMID: 30604516 PMCID: PMC6488931 DOI: 10.1111/petr.13348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/06/2018] [Accepted: 12/10/2018] [Indexed: 11/30/2022]
Abstract
The current cross-sectional, single-center study aimed to examine sleep quality in a sample of adolescents awaiting solid organ transplantation and to explore associations between sleep quality and both health-related quality of life and barriers to adherence. Thirty adolescents between the ages of 12 and 18 years (M age = 15.26, SD = 1.89) who were awaiting transplantation participated in this study. Participants completed measures of sleep quality, health-related quality of life, and barriers to adherence. T test and correlational analyses were performed to examine study aims. Adolescents awaiting transplantation had significantly lower levels of overall sleep quality compared to published norms of healthy peers. Domains of sleep quality were positively related to emotional and psychosocial health-related quality of life. Sleep quality domains were also negatively related to adherence barriers. This study provides preliminary evidence demonstrating that sleep quality among transplant candidates is compromised, and that poor sleep quality is related to adolescents' functioning across a number of domains during the pretransplant period. Results highlight the clinical importance of assessing and targeting sleep functioning in adolescents awaiting transplantation in order to reduce the negative influence of suboptimal sleep on functioning during this vulnerable period.
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Affiliation(s)
| | - Grace K. Cushman
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Cyd K. Eaton
- Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lauren F. Quast
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Jennifer Lee
- Children’s Healthcare of Atlanta, Atlanta, Georgia,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Kristin Loiselle Rich
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Bonney Reed-Knight
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Laura Mee
- Children’s Healthcare of Atlanta, Atlanta, Georgia,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Rene Romero
- Children’s Healthcare of Atlanta, Atlanta, Georgia,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Chad Y. Mao
- Children’s Healthcare of Atlanta, Atlanta, Georgia,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Roshan George
- Children’s Healthcare of Atlanta, Atlanta, Georgia,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Ronald L. Blount
- Department of Psychology, University of Georgia, Athens, Georgia
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31
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Lawless C, Turner EM, LeFave E, Koinis-Mitchell D, Fedele DA. Sleep hygiene in adolescents with asthma. J Asthma 2018; 57:62-70. [PMID: 30543140 DOI: 10.1080/02770903.2018.1553049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Youth with asthma are at-risk for sleep difficulties due to nocturnal asthma symptoms. Sleep hygiene, or the ability to practice consistent sleep behaviors and habits, impacts youth sleep quality and may, as a result, influence daytime cognitive functioning. The current study sought to examine the impact sleep hygiene has on sleep quality, health-related quality of life (HRQL) and sustained attention among adolescents with asthma. It was hypothesized that worse sleep hygiene would be associated with poorer sleep quality, lower school-related and overall HRQL and worse sustained attention. Methods: Participants included 41 adolescents with persistent asthma (Mage = 14.83, SD = 1.28; 51.2% male) recruited from a pediatric pulmonology clinic. Participants completed the adolescent sleep hygiene scale (ASHS), Adolescent Sleep Wake Scale (ASWS) and the Pediatric Quality of Life Index 4.0 generic core scales (PedsQL). Participants also completed the psychomotor vigilance task (PVT), an objective test of sustained attention. Results: Higher sleep hygiene scores were related to higher reported sleep quality (β = 0.377, p = 0.015, f2 = 0.166), higher reported school-related HRQL (β = 0.321, p = 0.040, f2 = 0.115) and better sustained attention (β = 0.327, p = 0.045, f2 = 0.120). Conclusions: Sleep hygiene may be an important factor in sleep quality and deficits in daytime dysfunction including sustained attention and school-related quality of life. As adolescents with asthma are at heightened risk for these outcomes associated with disturbed sleep, sleep hygiene may serve as an important domain for clinical intervention.
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Affiliation(s)
- Casey Lawless
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Elise M Turner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Elizabeth LeFave
- Pediatric Pulmonary and Allergy Division, University of Florida, Gainesville, FL, USA
| | | | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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32
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Pétrin J, Fiander M, Doss PMIA, Yeh EA. A Scoping Review of Modifiable Risk Factors in Pediatric Onset Multiple Sclerosis: Building for the Future. CHILDREN-BASEL 2018; 5:children5110146. [PMID: 30373215 PMCID: PMC6262383 DOI: 10.3390/children5110146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/20/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022]
Abstract
Knowledge of the effect of modifiable lifestyle factors in the pediatric multiple sclerosis (MS) population is limited. We therefore conducted a scoping review, following the framework provided by Arksey and O’Malley. Four databases were searched for pediatric MS and modifiable lifestyle factors using index terms and keywords, from inception to May 2018. All quantitative and qualitative primary articles were included and limited to English and full text. Of the 7202 articles identified and screened, 25 full-text articles were relevant to our objective and were included. These articles focused on diet obesity, physical activity, and sleep. In cross-sectional analyses, these lifestyle factors were associated with increased risk of pediatric onset MS (POMS), and increased disease activity. Diet, particularly vitamin D and vegetable intake, was associated with reduced relapse rate. Obesity was linked to increased risk of POMS, and physical activity was associated with reduced relapse rate and sleep/rest fatigue. Thus, available studies of lifestyle related outcomes in pediatric MS suggest specific lifestyle related factors, including obesity, higher vitamin D levels, and higher physical activity may associate with lower disease burden in POMS. Studies reviewed are limited by their observational designs. Future studies with longitudinal and experimental designs may further clarify the role of modifiable lifestyle factors in this population.
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Affiliation(s)
- Julie Pétrin
- Department of Rehabilitation Sciences, School of Rehabilitation Therapy, Queen's University, Louise D Acton Building, 31 George St, Kingston, ON K7L 3N6, Canada.
| | - Max Fiander
- Faculty of Medicine, Dalhousie University, Sir Charles Tupper Building, 5850 College Street, Halifax, NS B3H 4R2, Canada.
| | - Prenitha Mercy Ignatius Arokia Doss
- Department of Neurosciences, Faculty of Medicine, Université Laval, Pavillon Ferdinand Vandry, 1050, Medecine Avenue, Quebec City, QC G1V 0A6, Canada.
| | - E Ann Yeh
- Hospital for Sick Children, Division of Neurology, SickKids Research Institute, Neurosciences and Mental Health, University of Toronto, 27 King's College Cir, Toronto, ON M5S 3H7, Canada.
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33
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Choi YK, Demiris G, Lin SY, Iribarren SJ, Landis CA, Thompson HJ, McCurry SM, Heitkemper MM, Ward TM. Smartphone Applications to Support Sleep Self-Management: Review and Evaluation. J Clin Sleep Med 2018; 14:1783-1790. [PMID: 30353814 DOI: 10.5664/jcsm.7396] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/01/2018] [Indexed: 12/16/2022]
Abstract
STUDY OBJECTIVES Mobile health (mHealth) tools such as smartphone applications (apps) have potential to support sleep self-management. The objective of this review was to identify the status of available consumer mHealth apps targeted toward supporting sleep self-management and assess their functionalities. METHODS We searched four mobile app stores (iTunes Appstore, Android Google Play, Amazon Appstore, and Microsoft Appstore) using the terms "sleep", "sleep management," "sleep monitoring," and "sleep tracking." Apps were evaluated using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scores. RESULTS We identified 2,431 potentially relevant apps, of which 73 met inclusion criteria. Most apps were excluded because they were unrelated to sleep self-management, simply provided alarm service, or solely played relaxation sounds in an attempt to improve sleep. The median overall MARS score was 3.1 out of 5, and more than half of apps (42/73, 58%) had a minimum acceptability score of 3.0. The apps had on average 7 functions based on the IMS functionality criteria (range 2 to 11). A record function was present in all apps but only eight had the function to intervene. About half of the apps (33/73, 45%) collected data automatically using embedded sensors, 27 apps allowed the user to manually enter sleep data, and 14 apps supported both types of data recording. CONCLUSIONS The findings suggest that few apps meet prespecified criteria for quality, content, and functionality for sleep self-management. Despite the rapid evolution of sleep self-management apps, lack of validation studies is a significant concern that limits the clinical value of these apps.
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Affiliation(s)
- Yong K Choi
- School of Nursing, University of Washington, Seattle, Washington
| | - George Demiris
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shih-Yin Lin
- School of Nursing, University of Washington, Seattle, Washington
| | | | - Carol A Landis
- School of Nursing, University of Washington, Seattle, Washington
| | | | - Susan M McCurry
- School of Nursing, University of Washington, Seattle, Washington
| | | | - Teresa M Ward
- School of Nursing, University of Washington, Seattle, Washington
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34
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Sleep and its relationship to health-related quality of life in children and adolescents with inactive juvenile idiopathic arthritis. EGYPTIAN RHEUMATOLOGIST 2018. [DOI: 10.1016/j.ejr.2017.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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35
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Maeda K, Hasegawa D, Urayama KY, Tsujimoto S, Azami Y, Ozawa M, Manabe A. Risk factors for psychological and psychosomatic symptoms among children with malignancies. J Paediatr Child Health 2018; 54:411-415. [PMID: 29105206 DOI: 10.1111/jpc.13771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/07/2017] [Accepted: 09/16/2017] [Indexed: 11/28/2022]
Abstract
AIM With increasing survival rates in paediatric malignancies, the quality-of-life of children during hospitalisation should be given more attention. We aimed to identify factors associated with psychological and psychosomatic symptoms (PPS) that required medication among children hospitalised for treatment of malignancies. METHODS We retrospectively analysed data of 190 patients aged 2-18 years old. They were diagnosed with malignant diseases and admitted for treatment at St. Luke's International Hospital between 2003 and 2013. Patients were considered as having PPS if they were prescribed psychotropic agents during hospitalisation. RESULTS Of the 190 patients, 56 (30%) were prescribed psychotropic agents for PPS. Types of PPS included insomnia in 21 (38%), anxiety in 11 (20%), and others conditions (psychogenetic nausea, agitation, delirium, depression). The most prescribed psychotropic agents were etizolam for 34 cases (61%), followed by diazepam and risperidone. The multivariable analyses confirmed statistically significant independent associations for haematopoietic stem cell transplantation (HSCT) (odds ratio (OR), 5.21; 95% confidence interval (CI), 1.77-15.35), older age (12-18 years vs. 2-5 years, OR, 3.74; 95% CI, 1.04-10.00), and opioid use (OR, 7.15; 95% CI, 2.36-21.69). CONCLUSIONS Older age at admission, undergoing HSCT, and those given opioids were found to be risk factors for PPS among children with malignancies. Appropriate preventive measures against PPS may be warranted for patients with these risk factors.
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Affiliation(s)
- Kenichi Maeda
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Kevin Y Urayama
- Center for Clinical Epidemiology, St. Luke's International University, Tokyo, Japan
| | - Shinichi Tsujimoto
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Yuriko Azami
- Child Development and Family Support, St. Luke's International Hospital, Tokyo, Japan
| | - Miwa Ozawa
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Atsushi Manabe
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
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36
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Forrest CB, Meltzer LJ, Marcus CL, de la Motte A, Kratchman A, Buysse DJ, Pilkonis PA, Becker BD, Bevans KB. Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks. Sleep 2018; 41:4931870. [DOI: 10.1093/sleep/zsy054] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christopher B Forrest
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, CO
| | - Carole L Marcus
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Anna de la Motte
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Amy Kratchman
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brandon D Becker
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
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Abstract
Sleep has an important role in maintaining health and wellbeing; this relationship is becoming increasingly recognised for adolescents and young adults. Many physicians will encounter young people who present with complaints or conditions that have some relation to poor sleep. This review article looks at why sleep matters within this population group, how it can impact on longer term health consequences and discusses some tools to help enable the clinician to evaluate and address sleep within clinical practice.
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Affiliation(s)
- Ellen S Bruce
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Laura Lunt
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester and NIHR Manchester Biomedical Research Centre, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Janet E McDonagh
- Central Manchester University Hospitals NHS Foundation Trust, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, University of Manchester and NIHR Manchester Biomedical Research Centre, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Evans S, Djilas V, Seidman LC, Zeltzer LK, Tsao JCI. Sleep Quality, Affect, Pain, and Disability in Children With Chronic Pain: Is Affect a Mediator or Moderator? THE JOURNAL OF PAIN 2017; 18:1087-1095. [PMID: 28479208 PMCID: PMC5581256 DOI: 10.1016/j.jpain.2017.04.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/18/2017] [Accepted: 04/20/2017] [Indexed: 10/19/2022]
Abstract
Sleep problems have been identified as a potential antecedent of chronic pain and pain-related disability in pediatric populations. In adult studies, affect has been implicated in these relationships. This study sought to better understand the relationships between sleep quality, negative and positive affect, and pain and functioning in children with chronic pain. Participants included 213 children and adolescents (aged 7-17 years) presenting to a tertiary pain clinic with chronic pain. Children completed questionnaires measuring sleep quality, positive and negative affect, pain intensity, and functional disability. Results indicated that 74% of children reported disordered sleeping and that poor sleep quality was significantly associated with increased pain, disability, negative affect, and decreased positive affect. Our hypotheses were partially supported, with negative affect (but not positive affect) mediating the relationship between poor sleep and increased pain; and positive as well as negative affect mediating the relationship between poor sleep and increased functional disability. There was no evidence for affect as a moderator. This study adds to the growing literature demonstrating the effect of poor sleep quality on children's pain and functioning, highlighting the need to develop further longitudinal research to confirm the causal roles of these variables. PERSPECTIVE This article examines the relationship between poor sleep quality, affect (negative as well as positive), pain, and disability in children with chronic pain. The findings have the potential to better understand the processes involved in how poor sleep may lead to increased pain and pain-related disability.
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Affiliation(s)
- Subhadra Evans
- School of Psychology, Deakin University, Geelong, Australia.
| | - Vesna Djilas
- School of Psychology, Deakin University, Geelong, Australia
| | - Laura C Seidman
- UCLA Pediatric Pain and Palliative Care Program, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Lonnie K Zeltzer
- UCLA Pediatric Pain and Palliative Care Program, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Jennie C I Tsao
- UCLA Pediatric Pain and Palliative Care Program, David Geffen School of Medicine at University of California, Los Angeles, California
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39
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Jung J, Lee EH, Yang YJ, Jang BY. Sleep Pattern and Factors Causing Sleep Disturbance in Adolescents with Cancer before and after Hospital Admission. ASIAN ONCOLOGY NURSING 2017. [DOI: 10.5388/aon.2017.17.3.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jin Jung
- Department of Nursing, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea
| | - Eun-Hye Lee
- Department of Nursing, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea
| | - You-Jin Yang
- Department of Nursing, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea
| | - Bo-Yoon Jang
- Department of Nursing, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea
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40
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Merz EL, Tomfohr-Madsen L. Sleep Disruption in Pediatric Cancer Survivors: Conceptual Framework and Opportunities for Clinical Assessment and Behavioral Treatment. Am J Lifestyle Med 2016; 12:311-323. [PMID: 32063816 DOI: 10.1177/1559827616681725] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 10/31/2016] [Accepted: 11/09/2016] [Indexed: 12/18/2022] Open
Abstract
Sleep disruption is a commonly reported consequence of cancer and its treatment in pediatric patients and survivors. This review summarizes common sleep concerns in this population and introduces a multidimensional framework of risk factors specific to childhood cancer that may interact to develop and maintain disrupted sleep. Based on the extant literature, parameters of the cancer and its treatment, physical and social environmental conditions both during and after treatment, changes to family behavior and norms, psychological factors and traumatic stress, and reduced physical activity are hypothesized to be the most pertinent risk factors for disrupted sleep in this population. Potential clinical assessment strategies and behavioral interventions relevant to these considerations are discussed, with reference to the behavioral model of insomnia. The review concludes by offering directions for research and clinical practice, including developing and testing comprehensive assessment tools, intervention effectiveness studies in both oncology and primary care clinics, and efforts to increase patient-provider communication about sleep in pediatric oncology.
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Affiliation(s)
- Erin L Merz
- Department of Psychology, California State University, Dominguez Hills, Carson, California (ELM).,Department of Psychology, University of Calgary and Department of Pediatrics, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada (LTM)
| | - Lianne Tomfohr-Madsen
- Department of Psychology, California State University, Dominguez Hills, Carson, California (ELM).,Department of Psychology, University of Calgary and Department of Pediatrics, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada (LTM)
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41
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Banasiak NC. Understanding the Relationship Between Asthma and Sleep in the Pediatric Population. J Pediatr Health Care 2016; 30:546-550. [PMID: 26774954 DOI: 10.1016/j.pedhc.2015.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/12/2015] [Accepted: 11/30/2015] [Indexed: 11/18/2022]
Abstract
The Centers for Disease Control and Prevention reports that 9.5% of children have been diagnosed with asthma. Sleep disturbances affect 20% to 30% of the pediatric population. The prevalence of nocturnal symptoms of asthma is high, and most children regularly experience nighttime symptoms. Sleep is important for growth and development, and untreated sleep disturbances have adverse effects on school performance, mental health, physical health, and functioning. This review will explore the relationship between asthma and sleep disturbances. Clinicians need to assess children with asthma for sleep disturbance.
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42
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Allen JM, Graef DM, Ehrentraut JH, Tynes BL, Crabtree VM. Sleep and Pain in Pediatric Illness: A Conceptual Review. CNS Neurosci Ther 2016; 22:880-893. [PMID: 27421251 PMCID: PMC6492850 DOI: 10.1111/cns.12583] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sleep disruption is a common comorbidity of pediatric pain. Consequences of pain and disrupted sleep, evidence for the pain-sleep relation, and how aspects of illness, treatment, and pharmacological pain management may contribute to or exacerbate these issues are presented. AIMS This conceptual review explored the relation between pain and sleep in children diagnosed with chronic medical or developmental conditions. The goal of this review is to expand upon the literature by examining common themes in sleep disturbances associated with painful conditions across multiple pediatric illnesses. Populations reviewed include youth with intellectual and developmental disabilities (IDD), migraines, cystic fibrosis (CF), sickle cell disease (SCD), cancer, juvenile idiopathic arthritis (JIA), juvenile fibromyalgia (JFM), and functional gastrointestinal disorders (FGIDs). RESULTS Consistent evidence demonstrates that children with medical or developmental conditions are more vulnerable to experiencing pain and subjective sleep complaints than healthy peers. Objective sleep concerns are common but often under-studied. Evidence of the pain-sleep relationship exists, particularly in pediatric SCD, IDD, and JIA, with a dearth of studies directly examining this relation in pediatric cancer, JFM, CF, and FGIDs. Findings suggest that assessing and treating pain and sleep disruption is important when optimizing functional outcomes. CONCLUSION It is essential that research further examine objective sleep, elucidate the pain-sleep relationship, consider physiological and psychosocial mechanisms of this relationship, and investigate nonpharmacological interventions aimed at improving pain and sleep in vulnerable pediatric populations.
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Affiliation(s)
- Jennifer M Allen
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Danielle M Graef
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Brooklee L Tynes
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Valerie M Crabtree
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.
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43
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Palmer CA, Alfano CA. Sleep Architecture Relates to Daytime Affect and Somatic Complaints in Clinically Anxious but Not Healthy Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 46:175-187. [PMID: 27610927 DOI: 10.1080/15374416.2016.1188704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
It is increasingly clear that seminal sleep-affective relationships begin to take root in childhood, yet studies exploring how nighttime sleep characteristics relate to daytime affective symptoms, both in clinical and healthy populations of children, are lacking. The current study sought to explore these relationships by investigating whether trait-like and/or daily reports of affective and somatic symptoms of children with generalized anxiety disorder and matched controls relate to sleep architecture. Sixty-six children (ages 7-11; 54.4% female; 56.1% Caucasian; 18.2% biracial; 6.1% African American; 3% Asian; 16.7% Hispanic) participated including 29 with primary generalized anxiety disorder (without comorbid depression) and 37 healthy controls matched on age and race/ethnicity. Participants underwent structured diagnostic assessments including child-report measures and subsequently reported on their negative affect and somatic symptoms over the course of 1 week. Children also completed 1 night of polysomnography. Among children with generalized anxiety disorder only, greater amounts of slow wave sleep corresponded with less negative affect, and greater amounts of rapid eye movement sleep was related to more somatic complaints across the week. Similarly, for trait-like measures, more rapid eye movement sleep and shorter latency to rapid eye movement sleep were related to greater depressive symptoms in the anxious group only. The current findings suggest that physiologic sleep characteristics may contribute in direct ways to the symptom profiles of clinically anxious children. The functional relevance of such findings (e.g., how specific sleep characteristics serve to either increase or reduce long-term risk) is a vital direction for future research.
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Affiliation(s)
- Cara A Palmer
- a Sleep and Anxiety Center of Houston , University of Houston
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44
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Setoyama A, Ikeda M, Kamibeppu K. Objective assessment of sleep status and its correlates in hospitalized children with cancer: Exploratory study. Pediatr Int 2016; 58:842-9. [PMID: 26767328 DOI: 10.1111/ped.12927] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/04/2015] [Accepted: 01/13/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children with cancer are known to have sleep problems. Although hospitalization and psychosocial factors are considered to be the factors affecting children's sleep, few studies have confirmed these effects. The aims of this study were to describe the sleep status of hospitalized children with cancer and to explore the correlates. METHODS The sleep status of 11 hospitalized children (aged 2-12 years) with cancer was measured using actigraph and sleep diary during hospitalization and a short home stay. Possible correlates were assessed using a questionnaire. RESULTS The participants had significantly longer sleep onset latency, earlier bedtime, and poorer self-evaluated sleep quality during hospitalization than the short home stay. They had shorter total sleep time, longer wake time after sleep onset, and less sleep efficiency at home, compared with healthy historical controls. Children's age, symptoms, hospitalization period, Cognitive Fatigue, Procedural Anxiety, Treatment Anxiety, Social Anxiety, and Separation Anxiety, as well as caregiver anxiety, Receptive and Focused Attitude, and Regimented Attitude were significantly correlated with sleep variables. CONCLUSIONS Hospitalization decreased self-evaluated sleep quality, and difficulty falling asleep. The sleep of the participants at home was disturbed compared with that of healthy children. Hospitalization, patient characteristics, disease-related, and some psychosocial factors were associated with sleep variables. Medical professionals should develop a favorable environment for falling asleep in hospital for individual children. Children with cancer in the early period of hospitalization need increased care to facilitate good sleep.
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Affiliation(s)
- Ami Setoyama
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Mari Ikeda
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
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45
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Krietsch KN, Lawless C, Fedele DA, McCrae CS, Janicke DM. Influence of asthma status on sleep variability in overweight/obese youth. J Asthma 2016; 54:383-391. [PMID: 27485318 DOI: 10.1080/02770903.2016.1218010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Pediatric asthma and overweight/obesity (OV/OB) frequently co-occur and youth with both conditions exhibit poor sleep/bedtime habits. This study assessed differences in week-to-weekend bedtime/wake time variability among OV/OB youth with/without comorbid asthma, and tested whether variability predicted weekday sleep. METHODS OV/OB youth (n = 142; 28% comorbid asthma; 7-12 years) wore an Accelerometer for 5 days (2 weekend days), providing estimates of week-to-weekend bedtime/wake-time variability, weekday Total Sleep Time (TST), weekday time in bed (TIB), and weekday wake after sleep onset (WASO). RESULTS There were no demographic differences between groups beyond lower family income for the OV/OB+asthma group. The OV/OB+asthma group exhibited later weekday (mean OV/OB+asthma = 10:39 pm, mean OV/OB only = 10:30pm) and weekend (mean OV/OB+asthma = 11:41 pm, mean OV/OB only = 11:17pm) bedtimes, earlier weekday waketimes (mean OV/OB+asthma = 6:40 am, mean OV/OB only = 6:51 am), and similar weekend waketimes (mean OV/OB+asthma = 7:54 pm, mean OV/OB only = 7:52 pm. Univariate MANOVA follow-ups indicated a main effect of asthma group for week-to-weekend bedtime and waketime variability, with the OV/OB+asthma group evidencing approximately 30 minutes greater bedtime (OV/OB+asthma mean = 90 minutes) and waketime (OV/OB+asthma mean = 108 minutes) variability. Within the OV/OB+asthma group, greater waketime variability predicted fewer minutes of weekday TIB and WASO. Within the OV/OB only group, wake time variability predicted fewer minutes of weekday TIB. CONCLUSION Findings suggest that asthma status confers risk for more week-to-weekend variability among currently OV/OB youth, and that greater variability shortens the weekday sleep period. Further research on reasons for greater week-to-weekend sleep variability in asthma is needed.
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Affiliation(s)
- Kendra N Krietsch
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | - Casey Lawless
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | - David A Fedele
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | - Christina S McCrae
- b Department of Health Psychology , University of Missouri , Columbia , MO , USA
| | - David M Janicke
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
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46
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Stabouli S, Papadimitriou E, Printza N, Dotis J, Papachristou F. Sleep disorders in pediatric chronic kidney disease patients. Pediatr Nephrol 2016; 31:1221-9. [PMID: 26482250 DOI: 10.1007/s00467-015-3237-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/26/2015] [Accepted: 09/28/2015] [Indexed: 11/28/2022]
Abstract
The prevalence of sleep disorders during childhood has been estimated to range from 25 to 43 %. The aim of this review is to determine the prevalence of sleep disorders and possible associations with chronic kidney disease (CKD)-related factors and health-related quality of life (HRQOL) in children with CKD. An electronic systematic literature search for sleep disorders in children with CKD in Pubmed, Embase and the Cochrane Library Databases identified seven relevant articles for review, all of which reported an increased prevalence of sleep disorders in children with CKD. Five studies included children with CKD undergoing dialysis, and two studies included only non-dialysis patients. In all studies the presence of sleep disturbances was assessed by questionnaires; only one study compared the results of a validated questionnaire with laboratory-based polysomnography. The prevalence of any sleep disorder ranged from 77 to 85 % in dialysis patients, to 32-50 % in transplanted patients and 40-50 % in non-dialysis patients. The most commonly studied disorder was restless legs syndrome, which presented at a prevalence of 10-35 %. Three studies showed significant associations between presence of sleep disorders and HRQOL. We found consistent evidence of an increased prevalence of sleep disturbances in children with CKD, and these seemed to play a critical role in HRQOL.
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Affiliation(s)
- Stella Stabouli
- Pediatric Nephrology Unit, 1st Pediatric Department, Hippokration Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece.
| | - Eleni Papadimitriou
- Pediatric Nephrology Unit, 1st Pediatric Department, Hippokration Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece
| | - Nikoleta Printza
- Pediatric Nephrology Unit, 1st Pediatric Department, Hippokration Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece
| | - John Dotis
- Pediatric Nephrology Unit, 1st Pediatric Department, Hippokration Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece
| | - Fotios Papachristou
- Pediatric Nephrology Unit, 1st Pediatric Department, Hippokration Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece
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47
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Fradkin C, Huynh C. Commentary: Are Children Like Werewolves? Full Moon and Its Association with Sleep and Activity Behaviors in an International Sample of Children. Front Pediatr 2016; 4:61. [PMID: 27377694 PMCID: PMC4899436 DOI: 10.3389/fped.2016.00061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/26/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Christophe Huynh
- Centre de réadaptation en dépendance de Montréal – Institut universitaire, Montreal, QC, Canada
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48
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Murray CB, Kirsch AC, Palermo TM, Holmbeck GN, Kolbuck V, Psihogios A, Pigott T. Developmental Course and Determinants of Sleep Disturbances in Adolescents With Spina Bifida. J Pediatr Psychol 2016; 41:631-42. [PMID: 27118272 DOI: 10.1093/jpepsy/jsw021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 02/29/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To examine (1) trajectories of sleep disturbances in adolescents with spina bifida (SB) compared with a typically developing (TD) group over a 10-year period and (2) individual, family, and socioeconomic determinants of changes in sleep disturbances. METHODS Participants were 68 families of youth with SB and 68 families of TD youth. Parent-report of adolescent sleep was collected every 2 years at 6 time points (T1: ages 8-9; T6: ages 18-19). Multiple informants and measures were used to examine internalizing, externalizing, and inattention symptoms, dyadic/family conflict, socioeconomic status (SES), and family income. RESULTS Sleep disturbances increased over the 10-year period. Youth with SB had greater sleep disturbances during early adolescence. Greater preadolescent externalizing symptoms, greater parent-child and marital conflict, and lower SES predicted increased sleep disturbances. CONCLUSIONS Sleep disturbances are common and persistent in adolescents with SB. Sleep assessment and management are important clinical and research priorities in this population.
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49
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Meltzer LJ, Booster GD. Sleep Disturbance in Caregivers of Children With Respiratory and Atopic Disease. J Pediatr Psychol 2016; 41:643-50. [PMID: 27017428 DOI: 10.1093/jpepsy/jsw016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 02/19/2016] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To examine sleep patterns and sleep disturbances in caregivers of children with chronic illness. METHODS Caregivers of children with atopic dermatitis (AD, n = 35), asthma (AS, n = 27), atopic dermatitis and asthma (AD + AS, n = 57), ventilator assistance (VENT, n = 61), or typically developing (HEALTHY, n = 63) completed the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and three items examining reasons for parent sleep disruption. RESULTS Compared with healthy families, caregivers of children with chronic illness reported poorer sleep quality, more symptoms of insomnia, and chronic partial sleep deprivation. VENT and AD caregivers had higher rates of sleep disruptions due to caregiving, whereas AS caregivers reported more sleep disruptions from stress about the child's health. CONCLUSIONS Deficient and poor-quality sleep in caregivers of children with chronic illness may have a significant impact on their health and well-being, as well as caregiving responsibilities. These data provide important information for pediatric psychologists working with these families.
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Affiliation(s)
- Lisa J Meltzer
- Division of Behavioral Health, Department of Pediatrics, National Jewish Health
| | - Genery D Booster
- Division of Behavioral Health, Department of Pediatrics, National Jewish Health
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50
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Yuwen W, Chen ML, Cain KC, Ringold S, Wallace CA, Ward TM. Daily Sleep Patterns, Sleep Quality, and Sleep Hygiene Among Parent-Child Dyads of Young Children Newly Diagnosed With Juvenile Idiopathic Arthritis and Typically Developing Children. J Pediatr Psychol 2016; 41:651-60. [PMID: 26994855 DOI: 10.1093/jpepsy/jsw007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 01/23/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Describe daily sleep patterns, sleep quality, and sleep hygiene in 2-5-year-old children newly diagnosed with juvenile idiopathic arthritis (JIA) and their parents in comparison with typically developing (TD) children and parents. METHODS Participants (13 JIA, 16 TD parent-child dyads) wore actigraphs for 10 days. Parents completed sleep diaries and sleep hygiene survey. RESULTS Children with JIA had significantly less total sleep time, lower sleep efficiency (SE), and longer naps than TD children. Parents of children with JIA had significantly earlier bedtimes, more wake after sleep onset (WASO) and lower SE than TD parents. Parent-child SE and WASO were interrelated in JIA dyads. Sleep hygiene practices were inconsistent in both groups of children. CONCLUSIONS Inadequate amounts of sleep and poor sleep quality were common in parent-child dyads. Early interventions to improve sleep duration and promote sleep hygiene practices may alleviate future sleep problems and improve parent and child well-being.
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Affiliation(s)
| | - Maida Lynn Chen
- Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, Department of Pediatrics, School of Medicine, University of Washington, and
| | | | - Sarah Ringold
- Department of Pediatrics, School of Medicine, University of Washington, and Division of Rheumatology, Seattle Children's Hospital
| | - Carol A Wallace
- Department of Pediatrics, School of Medicine, University of Washington, and Division of Rheumatology, Seattle Children's Hospital
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