1
|
Yu MWL, Au CT, Yuen HM, Chan NY, Chan JW, Wing YK, Li AM, Chan KCC. Effects of childhood obstructive sleep apnea with and without daytime sleepiness on behaviors and emotions. Sleep Med 2024; 115:93-99. [PMID: 38350308 DOI: 10.1016/j.sleep.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE To investigate the relationship between obstructive sleep apnea (OSA) with and without excessive daytime sleepiness (EDS) and behavioral and emotional outcomes in non-obese prepubertal children. METHODS This was a retrospective analysis of children aged 5-11 years who presented to our unit for assessment of their sleep-related complaints. All children underwent polysomnography (PSG). They also completed the Pediatric Daytime Sleepiness Scale (PDSS) and a sleep diary. OSA was diagnosed if the obstructive apnea-hypopnea index (OAHI) was ≥1 event/hour. EDS was defined as PDSS >15. Behavioral and emotional outcomes were assessed using the Child Behavioral Checklist (CBCL). RESULTS Data from 391 children (mean age of 8.6 ± 1.7 years; 67 % male) were analyzed. Seventy children did not have OSA or EDS, 137 had OSA, 50 had reported having EDS but without OSA, and 134 children had both OSA and EDS. There were significantly higher CBCL total problems score in the combined group (61 ± 9) compared to the non-OSA/EDS group (54 ± 10), and the OSA-only group (54 ± 10) (p < 0.001). The presence of EDS was significantly associated with higher CBCL T score and higher odds for clinically significant behavioral problems (T score ≥65) after adjusting for age, sex, BMI z-score and average sleep duration (p < 0.001). CONCLUSION Excessive daytime sleepiness is an important contributory factor associated with suboptimal behavioral and emotional outcomes in children with OSA.
Collapse
Affiliation(s)
- Michelle Wai-Ling Yu
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chun-Ting Au
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China; Translational Medicine, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hoi-Man Yuen
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ngan-Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joey Wy Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Albert Martin Li
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China; Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kate Ching-Ching Chan
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China; Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
2
|
Zhang X, Smits M, Curfs L, Spruyt K. Sleep and the Social Profiles of Individuals With Rett Syndrome. Pediatr Neurol 2024; 152:153-161. [PMID: 38290182 DOI: 10.1016/j.pediatrneurol.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND This study investigates the distinctive social behaviors observed in individuals with Rett syndrome (RTT), characterized by the loss of spoken language, impaired eye gaze communication, gait abnormalities, and sleep issues. The research aims to identify social profiles in RTT and explore their correlation with sleep, sleep-disordered breathing (SDB), and daytime sleepiness. METHODS Standard overnight sleep macrostructure and respiratory parameters were assessed. Extracting 25 social-related items and one for daytime sleepiness from the Rett Syndrome Behavioral Questionnaire, factor analysis was applied to establish latent social profiles. These profiles were then correlated with sleep parameters. The nonparametric Mann-Whitney U test compared social profiles based on the presence of SDB (defined by an apnea-hypopnea index greater than one per hour) and daytime sleepiness. RESULTS The study involved 12 female subjects with confirmed RTT diagnoses and MECP2 mutations, aged 8.54 ± 5.30 years. The Rett Syndrome Behavioral Questionnaire revealed a total average score of 25.83 ± 12.34, indicating varying degrees of social impairments. Comprising 25 social-related items, factor analysis yielded four social profiles: "interactive motricity," "mood change," "anxiety/agitation," and "gazing." Longer sleep onset latency correlated with increased socio-behavioral impairments, particularly in interactive motricity reduction. Conversely, higher rapid eye movement sleep was associated with fewer interactive socio-motor behaviors. No significant differences in social profiles were found concerning the presence of SDB or daytime sleepiness. CONCLUSIONS The findings suggest four distinct social profiles in RTT individuals, hinting at shared disrupted circuits between sensorimotor functioning and sleep-related neuronal pathways. Despite the absence of differences in SDB or daytime sleepiness, the study highlights the relationship between sleep parameters, such as sleep onset latency and rapid eye movement sleep, and socio-behavioral outcomes in RTT with MECP2 mutations.
Collapse
Affiliation(s)
- Xinyan Zhang
- Université Paris Cité, NeuroDiderot - INSERM, Paris, France
| | - Marcel Smits
- Department of Sleep-Wake Disorders and Chronobiology, Hospital Gelderse Vallei Ede, Ede, Netherlands; Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Leopold Curfs
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Karen Spruyt
- Université Paris Cité, NeuroDiderot - INSERM, Paris, France.
| |
Collapse
|
3
|
Liu J, Ji X, Pitt S, Wang G, Rovit E, Lipman T, Jiang F. Childhood sleep: physical, cognitive, and behavioral consequences and implications. World J Pediatr 2024; 20:122-132. [PMID: 36418660 PMCID: PMC9685105 DOI: 10.1007/s12519-022-00647-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sleep problems in children have been increasingly recognized as a major public health issue. Previous research has extensively studied and presented many risk factors and potential mechanisms for children's sleep problems. In this paper, we aimed to identify and summarize the consequences and implications of child sleep problems. DATA SOURCES A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info published in the past two decades. Both relevant data-based articles and systematic reviews are included. RESULTS Many adverse consequences are associated with child sleep deficiency and other sleep problems, including physical outcomes (e.g., obesity), neurocognitive outcomes (e.g., memory and attention, intelligence, academic performance), and emotional and behavioral outcomes (e.g., internalizing/externalizing behaviors, behavioral disorders). Current prevention and intervention approaches to address childhood sleep problems include nutrition, exercise, cognitive-behavioral therapy for insomnia, aromatherapy, acupressure, and mindfulness. These interventions may be particularly important in the context of coronavirus disease 2019. Specific research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of treatments. CONCLUSIONS Given the increasing prevalence of child sleep problems, which have been shown to affect children's physical and neurobehavioral wellbeing, understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention, thus improving sleep-related child development and health.
Collapse
Affiliation(s)
- Jianghong Liu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 424, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Xiaopeng Ji
- College of Health Sciences, University of Delaware, Newark, DE, 19716, USA
| | - Susannah Pitt
- Geisinger Commonwealth School of Medicine, Scranton, PA, 18510, USA
| | - Guanghai Wang
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Elizabeth Rovit
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 424, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
| | - Terri Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 424, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
| | - Fan Jiang
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
4
|
Zhang W, Shen Y, Ou X, Wang H, Liu S. Sleep disordered breathing and neurobehavioral deficits in children and adolescents: a systematic review and meta-analysis. BMC Pediatr 2024; 24:70. [PMID: 38245707 PMCID: PMC10799548 DOI: 10.1186/s12887-023-04511-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) is broadly recognized to be associated with neurobehavioral deficits, which have significant impacts on developing-aged children and adolescents. Therefore, our study aimed to quantify the proportion of neurobehavioral impairments attributed to SDB in general children and adolescents by population attributable fraction (PAF). METHODS The study was registered at PROSPERO (ID: CRD42023388143). We collected two types of literature on the prevalence of SDB and the risk of SDB-related neurobehavioral deficits from ten electronic databases and registers, respectively. The pooled effect sizes (Pe, Pc, RR) by random-effects meta-analysis were separately substituted into Levin's formula and Miettinen's formula to calculate PAFs. RESULTS Three prevalence literature and 2 risk literature, all with moderate/high quality, were included in the quantitative analysis individually. The prevalence of SDB was 11% (95%CI 2%-20%) in children and adolescents (Pe), while the SDB prevalence was 25% (95%CI 7%-42%) in neurobehavioral patients (Pc). SDB diagnosis at baseline was probably associated with about threefold subsequent incidence of neurobehavioral deficits (pooled RR 3.24, 95%CI 1.25-8.41), after multi-adjustment for key confounders. Up to 19.8% or 17.3% of neurobehavioral consequences may be attributed to SDB from Levin's formula and Miettinen's formula, respectively. CONCLUSIONS A certain number of neurobehavioral consequences may be attributable to SDB. It is essential for clinicians to identify and treat SDB timely, as well as screen for SDB in patients with neurobehavioral impairments. More longitudinal studies of SDB and neurobehavioral deficits are needed in the future to further certify the association between them.
Collapse
Affiliation(s)
- Weiyu Zhang
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Yubin Shen
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Xiwen Ou
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Hongwei Wang
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Song Liu
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
| |
Collapse
|
5
|
Jungbauer WN, Zhang K, Melvin CL, Nietert PJ, Ford ME, Pecha PP. Identifying barriers to obstructive sleep-disordered breathing care: Parental perspectives. Int J Pediatr Otorhinolaryngol 2023; 171:111621. [PMID: 37300964 PMCID: PMC10526645 DOI: 10.1016/j.ijporl.2023.111621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/11/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Despite established clinical practice guidelines for pediatric obstructive sleep-disordered breathing (SDB), disparities persist for this common condition. Few studies have investigated parental experiences about challenges faced in obtaining SDB evaluation and tonsillectomy for their children. To better understand parent-perceived barriers to treatment of childhood SDB, we administered a survey to assess parental knowledge of this condition. MATERIALS & METHODS A cross-sectional survey was designed to be completed by parents of children diagnosed with SDB. Two validated surveys were administered: 1) Barriers to Care Questionnaire and 2) Obstructive Sleep-Disordered Breathing and Adenotonsillectomy Knowledge Scale for Parents. Logistic regression modeling was performed to assess for predictors of parental barriers to SDB care and knowledge. RESULTS Eighty parents completed the survey. Mean patient age was 7.4 ± 4.6 years, and 48 (60%) patients were male. The survey response rate was 51%. Patient racial/ethnic categories included 48 (60.0%) non-Hispanic White, 18 (22.5%) non-Hispanic Black, and 14 (17.5%) Other. Parents reported challenges in the 'Pragmatic' domain, including appointment availability and cost of healthcare, as the most frequently described barrier to care. Adjusting for age, sex, race, and education, parents in the middle-income bracket ($26,500 - $79,500) had higher odds of reporting greater barriers to care than parents in the highest (>$79,500) income tier (OR 5.536, 95% CI 1.312-23.359, P = 0.020) and lowest income tier (<$26,500) (OR 3.920, 95% CI 1.096-14.020). Parents whose children had tonsillectomy (n = 40) answered only a mean 55.7% ± 13.3% of questions correctly on the knowledge scale. CONCLUSION Pragmatic challenges were the most encountered barrier that parents reported in accessing SDB care. Families in the middle-income tier experienced the greatest barriers to SDB care compared to lower and higher income families. In general, parental knowledge of SDB and tonsillectomy was relatively low. These findings represent potential areas of improvement to target interventions to promote equitable care for SDB.
Collapse
Affiliation(s)
- W Nicholas Jungbauer
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kathy Zhang
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Cathy L Melvin
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Paul J Nietert
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Marvella E Ford
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Phayvanh P Pecha
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
| |
Collapse
|
6
|
Lin Y, Gao Y, Sun X, Wang J, Ye S, Wu IXY, Xiao F. Long-term exposure to ambient air pollutants and their interaction with physical activity on insomnia: A prospective cohort study. ENVIRONMENTAL RESEARCH 2023; 224:115495. [PMID: 36813065 DOI: 10.1016/j.envres.2023.115495] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Exposure to air pollution or lack of physical activity (PA) increases the risk of insomnia. However, evidence on joint exposure to air pollutants is limited, and the interaction of joint air pollutants and PA on insomnia is unknown. This prospective cohort study included 40,315 participants with related data from the UK Biobank, which recruited participants from 2006 to 2010. Insomnia was assessed by self-reported symptoms. The annual average air pollutant concentrations of particulate matter (PM2.5, PM10), nitrogen oxides (NO2, NOX), sulfur dioxide (SO2) and carbon monoxide (CO) were calculated based on participants' addresses. We applied a weighted Cox regression model to evaluate the correlation between air pollutants and insomnia and newly proposed an air pollution score to assess joint air pollutants effect using a weighted concentration summation after obtaining the weights of each pollutant in the Weighted-quantile sum regression. With a median follow-up of 8.7 years, 8511 participants developed insomnia. For each 10 μg/m³ increase in NO2, NOX, PM10, SO2, the average hazard ratios (AHRs) and 95% confidence interval (CI) of insomnia were 1.10 (1.06, 1.14), 1.06 (1.04, 1.08), 1.35 (1.25, 1.45) and 2.58 (2.31, 2.89), respectively; For each 5 μg/m³ increase in PM2.5 and each 1 mg/m³ increase in CO, the corresponding AHRs (95%CI) were 1.27 (1.21, 1.34) and 1.83 (1.10, 3.04), respectively. The AHR (95%CI) for insomnia associated with per interquartile range (IQR) increase in air pollution scores were 1.20 (1.15, 1.23). In addition, potential interactions were examined by setting cross-product terms of air pollution score with PA in the models. We observed an interaction between air pollution scores and PA (P = 0.032). The associations between joint air pollutants and insomnia were attenuated among participants with higher PA. Our study provides evidence on developing strategies for improving healthy sleep by promoting PA and reducing air pollution.
Collapse
Affiliation(s)
- Yijuan Lin
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Jiali Wang
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Shuzi Ye
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China
| | - Fang Xiao
- Xiangya School of Public Health, Central South University, Changsha, 410078, PR China.
| |
Collapse
|
7
|
Han SC, Yang SK, Han SY, Rhee CS, Choi Y, Shin CH, Lee YJ, Han DH. Investigating factors influencing post-operative growth in pre-pubertal children after adenotonsillectomy. Eur Arch Otorhinolaryngol 2023; 280:2841-2848. [PMID: 36656426 DOI: 10.1007/s00405-022-07817-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE To check the change in growth-for-age after adenotonsillectomy in pre-pubertal children and investigate the affecting factors. METHODS Two hundred and six pediatric patients who underwent adenotonsillectomy by a single surgeon between January 2011 and December 2014 were included for the retrospective cohort study. The z-scores of height-, weight-, and body mass index (BMI)-for-age were measured before adenotonsillectomy and 1 year after the operation. The Korean version of the obstructive sleep apnea-18 questionnaire (OSA-18), symptom questionnaire, physical examinations, demographic data, and pre-operative z-scores were used to analyze the factors affecting z-score change. RESULTS Among 206 pediatric patients, 167 patients were normal growth; 19 were undergrowth; and 20 were obese. After the operation, height, weight, and BMI z-scores all increased both in 167 normal-growth patients and 19 undergrowth patients (p value < 0.05). However, in 20 obese patients, only height z-score significantly increased (p value = 0.028). The multiple regression test showed that the sleep disturbance domain of OSA-18 was positively correlated with height z-score change (p value = 0.041), and age was negatively correlated with weight z-score change (p value = 0.016). Pre-operative BMI z-score was negatively correlated (p value = 0.019) and adenoid grade was positively correlated (p value = 0.023) with BMI z-score change. CONCLUSIONS These findings suggest that adenotonsillectomy may positively affect growth in pre-pubertal children, without undesirable weight gain. Additionally, the sleep disturbance domain of OSA-18 may play a role in predicting post-operative height increase in pre-pubertal children.
Collapse
Affiliation(s)
- Seung Cheol Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Seung Koo Yang
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Sang-Yoon Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.,Graduate School of Immunology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Allergy and Clinical Immunology and Sensory Organ Research Institute, Seoul National University Biomedical Research Center, Seoul, Korea
| | - Yunhee Choi
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Yun Jeong Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.
| | - Doo Hee Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.
| |
Collapse
|
8
|
Fredrick JW, Cook TE, Langberg JM, Becker SP. Prospective association between evening circadian preference and academic functioning in adolescents: the role of daytime sleepiness. J Child Psychol Psychiatry 2023; 64:175-184. [PMID: 35953260 PMCID: PMC10087522 DOI: 10.1111/jcpp.13683] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is growing evidence for the role of circadian factors in adolescents' sleep and academic adjustment, with greater evening preference being linked to poorer academic functioning. However, studies have yet to evaluate this association prospectively in adolescence, nor have studies examined daytime sleepiness as a putative mechanism linking evening preference to poor academic functioning. The current study used a multi-informant design to test the prospective association of evening circadian preference, daytime sleepiness, and academic functioning (e.g., global academic impairment and grades) across 2 years in adolescence. As evening circadian preference, sleepiness, and academic problems are elevated in adolescents with ADHD, we used a sample enriched for adolescents with ADHD and explored whether ADHD moderated effects. METHOD Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD). In the fall of eighth grade, adolescents reported on their circadian preference, and in the fall of ninth grade, adolescents and parents completed ratings of daytime sleepiness. In the middle of 10th grade, parents and teachers reported on adolescents' academic impairment and at the end of 10th grade, adolescents' grade point average (GPA) was obtained from school records. RESULTS Above and beyond covariates (e.g., adolescent sex, ADHD status, medication, sleep duration) and baseline academic impairment, greater self-reported evening preference in 8th grade predicted increased parent ratings of academic impairment in 10th grade indirectly via adolescent and parent ratings of daytime sleepiness in 9th grade. Furthermore, evening preference in 8th grade predicted greater teacher ratings of academic impairment and lower average GPA in 10th grade via parent ratings of daytime sleepiness in 9th grade, controlling for covariates and baseline GPA. ADHD status did not moderate indirect effects. CONCLUSION Findings underscore daytime sleepiness as a possible intervening mechanism linking evening preference to poor academic functioning across adolescence. Intervention studies are needed to evaluate whether targeting circadian preference and sleepiness improves academic functioning in adolescents.
Collapse
Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Taryn E Cook
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Joshua M Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
9
|
Dai Y, Trout KK, Liu J. Perinatal Physiological and Psychological Risk Factors and Childhood Sleep Outcomes: A Systematic Review and Meta-analysis. J Dev Behav Pediatr 2022; 43:e629-e644. [PMID: 36067425 PMCID: PMC10002289 DOI: 10.1097/dbp.0000000000001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 07/06/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the influence of maternal physiological and psychological factors during pregnancy and after birth on infant and children's sleep outcomes. METHODS Six databases were searched from inception to April 2021. Longitudinal studies that investigated the association of risk factors during and after pregnancy and children's sleep-related outcomes were included. Hedge's g and odds ratio were pooled as effect size with random effects model. RESULTS A total of 32 articles were included. Both prenatal maternal alcohol use (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.04-3.28) and tobacco smoking (OR = 1.28, 95% CI: 1.01-1.62) were associated with shorter child sleep duration. Prenatal and postnatal maternal depression symptoms were associated with increased child sleep problems at age 6 months (OR = 1.97, 95% CI: 1.19-3.24, and 2.05, 95% CI: 1.37-3.07, respectively). Prenatal and postnatal maternal major depression disorders were associated with shorter sleep duration (Hedge's g = -0.97, 95% CI: -1.57 to -0.37) and lower sleep efficiency (Hedge's g = -1.44, 95% CI: -1.93 to -0.95). Prenatal anxiety had no impact on child sleep problems (OR = 1.34, 95% CI: 0.86-2.10). CONCLUSION Maternal pregnancy and obstetric factors and psychological factors are potential risk factors of poor child sleep health. Future research is warranted to better understand the impact of these risk factors on long-term child sleep outcomes and their potential mediating mechanisms.
Collapse
Affiliation(s)
- Ying Dai
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
10
|
Zhang L, Yang Y, Luo Y, Liu ZZ, Jia CX, Liu X. A Longitudinal Study of Insomnia, Daytime Sleepiness, and Academic Performance in Chinese Adolescents. Behav Sleep Med 2022; 20:798-808. [PMID: 34994248 DOI: 10.1080/15402002.2021.2021202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Longitudinal data on the associations between sleep disturbances, daytime sleepiness, and daily functioning are limited in the general adolescent population. This study examined the cross-sectional and longitudinal associations between insomnia, excessive daytime sleepiness (EDS), and subject-specific academic performance in a large sample of Chinese adolescents. METHOD Data were derived from the Shandong Adolescent Behavior and Health Cohort (n = 7,072) study. A self-administered questionnaire was used to assess insomnia, EDS, academic performance (overall, Chinese, mathematics, and English), behavioral and emotional problems, and family demographics. The cross-sectional analysis was conducted with baseline data while the longitudinal analysis was conducted with both baseline and 1-year follow-up data. Logistic regression analyses and mediation models were performed to examine the associations between insomnia, EDS, and academic performance. RESULTS Logistic regression analyses revealed that insomnia and EDS had significant cross-sectional associations with overall performance and mathematics performance after controlling for age, gender, ever smoking, ever alcohol drinking, frequent snore, sleep duration, chronic disease, anxious/depressive symptoms, parents' education, parents' occupation, and family economic status. Both insomnia (OR = 1.20, 95% CI: 1.00-1.45) and EDS (OR = 1.22, 95% CI: 1.03-1.45) at baseline were significantly associated with poor mathematics performance 1 year later. The effect of insomnia at baseline on poor academic performance 1 year later was mediated by EDS except for the Chinese subject after controlling for the covariates. CONCLUSIONS Insomnia and daytime sleepiness are significantly associated with poor academic performance, particularly in mathematics. EDS mediates the association between insomnia and poor academic performance. Further research is warranted to investigate the effects of sleep disturbance and daytime sleepiness on the learning process and performance across academic subjects.
Collapse
Affiliation(s)
- Liying Zhang
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Yachen Luo
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,School of Psychology, Northeast Normal University, Changchun, Jilin, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
11
|
Associations of Sleep-Related Outcomes with Behavioral and Emotional Functioning in Children with Overweight/Obesity. J Pediatr 2022; 246:170-178.e2. [PMID: 35278412 DOI: 10.1016/j.jpeds.2022.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and device-assessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/obesity. STUDY DESIGN A total of 109 children with overweight/obesity (mean age, 10.0 ± 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). RESULTS SDB was positively associated with all clinical scale variables (all β > 0.197, P ≤ .041) and with lower adaptability and leadership (all β < -0.226, P < .021). Specifically, the PSQ subscale relating to daytime sleepiness was associated with higher attention problems, depression, anxiety, and retreat (all β > 0.196, P ≤ .045) and lower adaptability (β = -0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all β > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. CONCLUSIONS Our study suggests that SDB symptoms, but not device-assessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability.
Collapse
|
12
|
Zhan N, Zhang Y, Xie D, Geng F. The associations of parental COVID-19 related worries, lifestyles, and insomnia with child insomnia during the COVID-19 outbreak. J Sleep Res 2022; 31:e13590. [PMID: 35362217 PMCID: PMC9115149 DOI: 10.1111/jsr.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/13/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022]
Abstract
The impacts of the Coronavirus Disease 2019 (COVID‐19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID‐19 pandemic on insomnia in both adults and children, and to explore whether parental COVID‐19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent–child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID‐19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID‐19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID‐19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID‐19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.
Collapse
Affiliation(s)
- Nalan Zhan
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Yeqing Zhang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Dongjie Xie
- Hangzhou College of Preschool Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Fulei Geng
- School of Psychology, Jiangxi Normal University, Nanchang, China
| |
Collapse
|
13
|
Nosetti L, Zaffanello M, Katz ES, Vitali M, Agosti M, Ferrante G, Cilluffo G, Piacentini G, Grutta SL. Twenty-year follow-up of children with obstructive sleep apnea. J Clin Sleep Med 2022; 18:1573-1581. [PMID: 35164899 DOI: 10.5664/jcsm.9922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) in children is associated with acute metabolic, cardiovascular, and neuro-cognitive abnormalities. The long-term outcomes of childhood OSA into adulthood has not been established. We performed a 20-year follow-up of patients with polysomnographically documented OSA in childhood compared to a healthy control group to evaluate the long-term anthropometric, sleep, cognitive, and cardiovascular outcomes. METHODS Children diagnosed to have severe OSA between the ages of 1 - 17 years (4.87 ± 2.77) were prospectively contacted by telephone as young adults after approximately 20 years. Data collected included reported anthropometric, educational level, health history, and the Berlin questionnaire. RESULTS Young adults with confirmed severe OSA in childhood had significantly higher adulthood BMI (p=0.038), lower academic degrees (p<0.001), and more snoring (p=0.045) compared to controls. The AHI during childhood trended towards predicting cardiovascular outcomes and the Berlin questionnaire in adulthood. CONCLUSIONS Adults with history of severe childhood OSA have a high risk of having snoring, elevated BMI, and lower academic achievement in adulthood. Thus, children with severe OSA may be at increased risk of chronic diseases later in life. The intervening COVID-19 pandemic has introduced considerable additional neurobehavioral morbidity complicating the identification of the full long-term consequences of childhood OSA.
Collapse
Affiliation(s)
- Luana Nosetti
- Pediatric Sleep Disorders Center, Department of Pediatrics, F. Del Ponte Hospital, Insubria University, Varese, Italy
| | | | - Eliot S Katz
- Division of Respiratory Diseases, Department of Medicine, Boston Children's Hospital, Boston MA.,Harvard Medical School, Boston, MA
| | - Maddalena Vitali
- Pediatric Sleep Disorders Center, Department of Pediatrics, F. Del Ponte Hospital, Insubria University, Varese, Italy
| | - Massimo Agosti
- Pediatric Sleep Disorders Center, Department of Pediatrics, F. Del Ponte Hospital, Insubria University, Varese, Italy
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giovanna Cilluffo
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | | | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| |
Collapse
|
14
|
An epidemiologic study of sleep-disordered breathing in a large sample of Chinese adolescents. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
15
|
Torres-Lopez LV, Cadenas-Sanchez C, Migueles JH, Esteban-Cornejo I, Molina-Garcia P, H. Hillman C, Catena A, Ortega FB. Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity? Eur J Pediatr 2022; 181:2055-2065. [PMID: 35142932 PMCID: PMC9056447 DOI: 10.1007/s00431-022-04403-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/01/2022]
Abstract
UNLABELLED Approximately 4-11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8-12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β < -0.188, P > 0.065) or brain volumes (all P > 0.05). CONCLUSION Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone. WHAT IS KNOWN • Sleep-disordered breathing (SDB) may affect brain structure and academic performance in children. • Children with overweight/obesity are at higher risk for the development of SDB, yet the comorbid obesity-SDB relationship with brain health has not been investigated thus far. WHAT IS NEW • To our knowledge, this is the first study examining the associations of comorbid obesity-SDB severity with brain volumes and academic performance in children. • SDB symptoms may adversely affect academic performance at school in children with overweight/obesity, beyond the effects of weight status alone.
Collapse
Affiliation(s)
- Lucia V. Torres-Lopez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Cristina Cadenas-Sanchez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Institute for Innovation and Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Jairo H. Migueles
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden ,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, 14183 Sweden
| | - Irene Esteban-Cornejo
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Pablo Molina-Garcia
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Charles H. Hillman
- Center for Cognitive and Brain Health, Department of Psychology, Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA USA
| | - Andres Catena
- School of Psychology, University of Granada, Granada, Spain
| | - Francisco B. Ortega
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, 14183 Sweden ,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
16
|
Liu SJ, Liu ZZ, Wang ZY, Liu BP, Cheng S, Liu X, Jia CX. Sleep disordered breathing symptoms are associated with depressive symptoms: A longitudinal study of Chinese adolescents. J Affect Disord 2021; 293:492-501. [PMID: 34329858 DOI: 10.1016/j.jad.2021.05.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/04/2021] [Accepted: 05/30/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little is known about the prospective association between sleep disordered breathing (SDB) and depressive symptoms in Chinese adolescents. This study examined the independent predictive role of SDB symptoms in depressive symptoms in a large sample of adolescents. METHODS A total of 11831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort and 7072 adolescents who were resurveyed 1 year later were included for the analyses. Adolescents completed a self-administered questionnaire about demographics, mental health, sleep problems, and family environment. SDB symptoms were assessed by 3 items about loud snoring, breathing pauses, and snorting/gasping. The Chinese Youth Self-Report anxious/depressed subscale was used to assess depressive symptoms. RESULTS In the cross-sectional analyses, 11.8% adolescents had depressive symptoms, and elevated frequency of SDB symptoms were significantly associated with depressive symptoms. In the longitudinal study, 4.5% of adolescents had persistent depressive symptoms, the incidence rate of depressive symptoms at 1-year follow-up was 6.5%, and elevated frequency of any SDB symptoms (often: OR=2.23, 95%CI:1.50-3.32) at baseline was significantly associated with incident depressive symptoms after adjusting for potential confounders. The associations between SDB symptoms and depressive symptoms were similar for boys and girls. LIMITATION SDB symptoms and depressive symptoms were measured by self-report. CONCLUSION SDB symptoms are an independent and significant predictor of depressive symptoms in adolescents. Further research is needed to understand the biological mechanisms between SDB and mood dysregulation in adolescents.
Collapse
Affiliation(s)
- Shu-Juan Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Ze-Ying Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Shuo Cheng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Xianchen Liu
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
| |
Collapse
|
17
|
Cho SW, Yang SK. What Does the Microbiome in the Tonsil Tell Us? Clin Exp Otorhinolaryngol 2021; 14:247-248. [PMID: 34407367 PMCID: PMC8373843 DOI: 10.21053/ceo.2021.01074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/23/2021] [Indexed: 01/02/2023] Open
Affiliation(s)
- Sung-Woo Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Koo Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
18
|
Dai Y, Liu J. Omega-3 long-chain polyunsaturated fatty acid and sleep: a systematic review and meta-analysis of randomized controlled trials and longitudinal studies. Nutr Rev 2021; 79:847-868. [PMID: 33382879 PMCID: PMC8262633 DOI: 10.1093/nutrit/nuaa103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Omega-3, a long-chain polyunsaturated fatty acid (LC-PUFA), may help promote healthy sleep outcomes. However, evidence from randomized controlled trials are inconclusive. OBJECTIVE The objective of this systematic review and meta-analysis was to explore the impact of omega-3 LC-PUFA supplementation and related dietary intervention in clinical trials as well as omega-3 LC-PUFA exposure in longitudinal studies on human's sleep-related outcome. DATA SOURCES The PubMed, EMBASE, Cochrane Library, CINAHL, and AMED databases were searched from inception to November 2019. Randomized controlled trials, clinical trials that included a control group, and longitudinal studies that reported the intake of omega-3 LC-PUFA and sleep-related outcomes were included. STUDY SELECTION A total of 20 studies with 12 clinical trials and 8 longitudinal studies were identified for inclusion. DATA EXTRACTION Participant characteristics, study location, intervention information, and sleep-related outcome measurements were reported. Included studies were appraised with Cochrane risk-of-bias tools and the Newcastle-Ottawa Scale. Weighted mean differences (WMDs) and 95%CIs were pooled with fixed or random effect models. RESULTS Omega-3 LC-PUFA may improve infants' sleep organization and maturity. It reduced the percentage of infants' active sleep (WMD = -8.40%; 95%CI, -14.50 to -2.29), sleep-wake transition (WMD = -1.15%; 95%CI, -2.09 to -0.20), and enhanced the percentage of wakefulness (WMD = 9.06%; 95%CI, 1.53-16.59) but had no effect on quiet sleep. Omega-3 reduced children's total sleep disturbance score for those with clinical-level sleep problems (WMD = -1.81; 95%CI, -3.38 to -0.23) but had no effect on healthy children's total sleep duration, sleep latency, or sleep efficiency. No effectiveness was found in adults' total sleep duration, sleep latency, sleep efficiency, sleep quality, or insomnia severity. CONCLUSION Omega-3 LC-PUFA may improve certain aspects of sleep health throughout childhood. Additional robust studies are warranted to confirm the relationship between omega-3 LC-PUFA and sleep.
Collapse
Affiliation(s)
- Ying Dai
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
19
|
Liu J, Glenn AL, Cui N, Raine A. Longitudinal bidirectional association between sleep and behavior problems at age 6 and 11 years. Sleep Med 2021; 83:290-298. [PMID: 34091178 PMCID: PMC10117417 DOI: 10.1016/j.sleep.2021.04.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although a growing number of longitudinal studies have found that sleep problems precede behavior problems, few have examined potential bidirectional relationships longitudinally. The present study examined prospective associations between sleep problems and internalizing, externalizing, and attention problems over the course of childhood. METHODS Participants included 775 children from the China Jintan Cohort Study. Sleep problems were rated by mothers at ages six and 11.5, as well as self-reported by children at age 11.5. Behavior problems were rated by mothers and teachers at ages six and 11.5, and self-reported by children at age 11.5. RESULTS At age six, 15.0% of children were reported to have sleep problems as rated by mothers. At age 11, this prevalence was 12% as rated by mothers and 20% as rated by youth. Bidirectional relationships between sleep problems and behavior problems were observed. Mother-reported sleep problems at age six were predictive of self-reported internalizing and attention problems at age 11.5, even after controlling for baseline behavioral problems. At age six, teacher-reported externalizing, internalizing, and attention problems, and mother-rated internalizing and externalizing problems were all related to sleep problems at age 11.5, even after controlling for baseline sleep problems. Other sociodemographic covariates including child sex, age, and parental education were controlled for. CONCLUSIONS Findings provide further support for the reciprocal relationship between sleep problems and behavior problems. Early interventions that target both types of problems may be especially effective in preventing this aggravating health-behavior cycle.
Collapse
Affiliation(s)
- Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
| | - Andrea L Glenn
- University of Alabama, Center for Youth Development and Intervention, Department of Psychology, Tuscaloosa, AL, USA
| | - Naixue Cui
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA; Shandong University School of Nursing and Rehabilitation, Jinan, Shandong Province, China
| | - Adrian Raine
- University of Pennsylvania, Departments of Criminology, Psychiatry, and Psychology, Philadelphia, PA, USA
| |
Collapse
|
20
|
Harding R, Schaughency E, Haszard JJ, Gill AI, Luo R, Lobb C, Dawes P, Galland B. Sleep-Related Breathing Problem Trajectories Across Early Childhood and Academic Achievement-Related Performance at Age Eight. Front Psychol 2021; 12:661156. [PMID: 34267700 PMCID: PMC8276242 DOI: 10.3389/fpsyg.2021.661156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Childhood sleep disordered breathing (SDB) has been linked to poorer academic performance; however, research has not investigated the extent improvement in SDB may alter outcomes across key academic skills. This study aimed to investigate if children's early SDB status could predict later academic outcomes, and if an improvement in SDB status across the early childhood years would coincide with better, later performance in key academic skills related to reading, numeracy, and listening comprehension. Methods: Eighty five case children with an SDB symptom score >25 (maximum 77) were matched to 85 control children (score <12) at recruitment (age 3). SDB severity (symptom history and clinical assessment) was evaluated at ages 3, 4, 6, and 8 years and performance on individually-administered academic skills assessed at age 8 (91% retention from age 3). Case children were categorized into “improved” or “not-improved” groups based on SDB trajectories over the 5 years. Contributions of SDB status and trajectory group to academic performance were determined using regression analysis adjusted for demographic variables. Results: History of SDB from age 3 predicted significantly poorer performance on some key academic skills (oral reading and listening skills) at age 8. Children whose SDB improved (45%) performed better in oral reading fluency than those whose SDB did not improve, but difficulties with specific tasks involving oral language (listening retell) remained when compared to controls. Conclusion: Findings support links between early SDB and worse academic outcomes and suggest key academic areas of concern around oral language. Findings highlight the need for child mental health professionals to be aware of children's sleep problems, particularly SDB (past and present), when assessing potential barriers to children's achievement, to assist with appropriate and timely referrals for evaluation of children's sleep difficulties and collaborative evaluation of response to intervention for sleep difficulties.
Collapse
Affiliation(s)
- Rebecca Harding
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.,Department of Psychology, University of Otago, Dunedin, New Zealand
| | | | - Jillian J Haszard
- The Centre for Biostatistics, University of Otago, Dunedin, New Zealand
| | - Amelia I Gill
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.,Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Rebekah Luo
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.,Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Carmen Lobb
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Patrick Dawes
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Barbara Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| |
Collapse
|
21
|
Liu J, Wu L, Um P, Wang J, Kral TVE, Hanlon A, Shi Z. Breakfast Consumption Habits at Age 6 and Cognitive Ability at Age 12: A Longitudinal Cohort Study. Nutrients 2021; 13:nu13062080. [PMID: 34204553 PMCID: PMC8234310 DOI: 10.3390/nu13062080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 01/13/2023] Open
Abstract
This study aimed to assess the relationship between breakfast composition and long-term regular breakfast consumption and cognitive function. Participants included 835 children from the China Jintan Cohort Study for the cross-sectional study and 511 children for the longitudinal study. Breakfast consumption was assessed at ages 6 and 12 through parental and self-administered questionnaires. Cognitive ability was measured as a composition of IQ at age 6 and 12 and academic achievement at age 12, which were assessed by the Chinese versions of the Wechsler Intelligence Scales and standardized school reports, respectively. Multivariable general linear and mixed models were used to evaluate the relationships between breakfast consumption, breakfast composition and cognitive performance. In the longitudinal analyses, 94.7% of participants consumed breakfast ≥ 4 days per week. Controlling for nine covariates, multivariate mixed models reported that compared to infrequent breakfast consumption, regular breakfast intake was associated with an increase of 5.54 points for verbal and 4.35 points for full IQ scores (p < 0.05). In our cross-sectional analyses at age 12, consuming grain/rice or meat/egg 6-7 days per week was significantly associated with higher verbal, performance, and full-scale IQs, by 3.56, 3.69, and 4.56 points, respectively (p < 0.05), compared with consuming grain/rice 0-2 days per week. Regular meat/egg consumption appeared to facilitate academic achievement (mean difference = 0.232, p = 0.043). No association was found between fruit/vegetable and dairy consumption and cognitive ability. In this 6-year longitudinal study, regular breakfast habits are associated with higher IQ. Frequent grain/rice and meat/egg consumption during breakfast may be linked with improved cognitive function in youth.
Collapse
Affiliation(s)
- Jianghong Liu
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (P.U.); (J.W.); (T.V.E.K.)
- Correspondence: ; Tel.: +1-(215)-898-8293
| | - Lezhou Wu
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - Phoebe Um
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (P.U.); (J.W.); (T.V.E.K.)
| | - Jessica Wang
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (P.U.); (J.W.); (T.V.E.K.)
| | - Tanja V. E. Kral
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (P.U.); (J.W.); (T.V.E.K.)
| | - Alexandra Hanlon
- Center for Biostatistics and Health Data Science, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar;
| |
Collapse
|
22
|
Liu J, Ghastine L, Um P, Rovit E, Wu T. Environmental exposures and sleep outcomes: A review of evidence, potential mechanisms, and implications. ENVIRONMENTAL RESEARCH 2021; 196:110406. [PMID: 33130170 PMCID: PMC8081760 DOI: 10.1016/j.envres.2020.110406] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 06/02/2023]
Abstract
Environmental exposures and poor sleep outcomes are known to have consequential effects on human health. This integrative review first seeks to present and synthesize existing literature investigating the relationship between exposure to various environmental factors and sleep health. We then present potential mechanisms of action as well as implications for policy and future research for each environmental exposure. Broadly, although studies are still emerging, empirical evidence has begun to show a positive association between adverse effects of heavy metal, noise pollution, light pollution, second-hand smoke, and air pollution exposures and various sleep problems. Specifically, these negative sleep outcomes range from subjective sleep manifestations, such as general sleep quality, sleep duration, daytime dysfunction, and daytime sleepiness, as well as objective sleep measures, including difficulties with sleep onset and maintenance, sleep stage or circadian rhythm interference, sleep arousal, REM activity, and sleep disordered breathing. However, the association between light exposure and sleep is less clear. Potential toxicological mechanisms are thought to include the direct effect of various environmental toxicants on the nervous, respiratory, and cardiovascular systems, oxidative stress, and inflammation. Nevertheless, future research is required to tease out the exact pathways of action to explain the associations between each environmental factor and sleep, to inform possible therapies to negate the detrimental effects, and to increase efforts in decreasing exposure to these harmful environmental factors to improve health.
Collapse
Affiliation(s)
- Jianghong Liu
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA.
| | - Lea Ghastine
- Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
| | - Phoebe Um
- Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
| | - Elizabeth Rovit
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Tina Wu
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| |
Collapse
|
23
|
Hu T, Wang Y, Lin L, Tang W. The mediating role of daytime sleepiness between problematic smartphone use and post-traumatic symptoms in COVID-19 home-refined adolescents. CHILDREN AND YOUTH SERVICES REVIEW 2021; 126:106012. [PMID: 33846662 PMCID: PMC8028598 DOI: 10.1016/j.childyouth.2021.106012] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/23/2021] [Accepted: 04/06/2021] [Indexed: 02/08/2023]
Abstract
Background COVID-19 was first recognized in late 2019 in China, at which time school closures forced most students to isolate at home or maintain social distance, both of which increased smartphone use, daytime sleepiness and post traumatic disorder (PTSD) risks. However, to date, no research has fully explored these behavioral risks or the consequences. Methods Two thousand and ninety home-confined students from two Chinese high schools participated in an online-based questionnaire battery that assessed their sociodemographic characteristics, COVID-19 related exposures, daytime sleepiness, problematic smartphone use, and PTSD. The subsequent data were subjected to mediation analysis, and structural equation models (SEM) were employed to explore the variable relationships. Results The problematic smartphone use, daytime sleepiness and PTSD prevalence were respectively 16.4%, 20.2% and 6.9%. The number of COVID-19 related exposure was directly associated with problematic smartphone use and PTSD symptoms. Problematic smartphone use was found to be a mediator between COVID-19 related exposure and PTSD symptoms, and daytime sleepiness was found to partially mediate the associations between problematic smartphone use and PTSD. Conclusions The more exposure associated with the pandemic, the more psychological and behavioral problems the adolescents had. The relatively high rate of problematic smartphone use in home isolated adolescents possibly increased the risk of daytime sleepiness and psychological problems. Therefore, targeted improvements are needed to reduce the risk of psychological problems and daytime sleepiness in adolescents.
Collapse
Affiliation(s)
- Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Ying Wang
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Ling Lin
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.,Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
24
|
Mun IK, Yoo SH, Mo JH. Long-term outcome of concurrent coblator turbinoplasty with adenotonsillectomy in children with allergic rhinitis. Acta Otolaryngol 2021; 141:286-292. [PMID: 33315481 DOI: 10.1080/00016489.2020.1846782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is one of the most prevalent chronic diseases in children. Patients with AR tend to have more persistent symptoms after adenotonsillectomy (T&A). OBJECTIVES This study was aimed to evaluate the outcome of additional concurrent coblation-assisted turbinoplasty with adenotonsillectomy (T&A + T) in patients with AR. MATERIAL AND METHODS This study included 104 children who underwent T&A, and 67 who underwent T&A + T. All patients were diagnosed as AR and were aged < 12 years at the time of surgery. Symptoms (snoring, mouth breathing, nasal obstruction, rhinorrhea, itching, and sneezing) were evaluated preoperatively and postoperatively via a questionnaire and a telephone survey. RESULTS None of the six symptoms investigated differed significantly between the two groups preoperatively, and all evaluated symptoms exhibited dramatic improvements after the surgery in both groups. The T&A + T group showed significantly greater difference of improvement in mouth breathing and nasal obstruction than T&A group. There were no significant difference of improvements in snoring, rhinorrhea, itching and sneezing postoperatively between two groups. In multiple regression analysis, postoperative obstructive symptoms including mouth breathing and nasal obstruction were significantly associated with concurrent turbinoplasty. CONCLUSION Concurrent turbinoplasty should be considered especially in patients who have AR and adenotonsillar hypertrophy to improve obstructive symptoms.
Collapse
Affiliation(s)
- In Kwon Mun
- Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea
| | - Shin Hyuk Yoo
- Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea
| | - Ji-Hun Mo
- Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea
| |
Collapse
|
25
|
Mohammed D, Park V, Bogaardt H, Docking K. The impact of childhood obstructive sleep apnea on speech and oral language development: a systematic review. Sleep Med 2021; 81:144-153. [PMID: 33677253 DOI: 10.1016/j.sleep.2021.02.015] [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: 11/10/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this systematic review was to review and synthesize the current evidence on speech and language outcomes of children with Obstructive Sleep Apnea (OSA), or more broadly sleep-disordered breathing. METHOD A comprehensive literature search was conducted across 5 databases. Studies were selected based on the following criteria: 1) peer-reviewed research published between 2000 and 2020, 2) available in English or accessible non-English data, 3) children aged 2-13 years diagnosed with Sleep Disordered Breathing (SDB) or OSA, and 4) speech and language outcomes examined within research. RESULTS Studies were appraised using PEDro-P and the overall certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Six studies met the current review selection criteria: one paper examined speech outcomes and the remaining five examined receptive and expressive language outcomes. The overall quality of the body of evidence was rated as very low, with methodological weaknesses present in study designs and sample sizes. CONCLUSION Speech and language difficulties are common in children with OSA/SDB, in addition to neurocognitive and/or neurobehavioral issues. Further investigation of specific speech and language skills, which are compromised in this population, is needed to guide clinical practice and decision making, with particular involvement from speech-language pathologists.
Collapse
Affiliation(s)
- Dania Mohammed
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
| | - Veronica Park
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Hans Bogaardt
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Kimberley Docking
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| |
Collapse
|
26
|
Shi X, Zhu Y, Wang S, Wang A, Chen X, Li Y, Jiang L. The prospective associations between different types of sleep disturbance and suicidal behavior in a large sample of chinese college students. J Affect Disord 2021; 279:380-387. [PMID: 33099053 DOI: 10.1016/j.jad.2020.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sleep disturbance can be an important predictor associated with suicide behaviors. However, to date, few studies have examined the prospective relationships between different types of sleep disturbance and suicidal behaviors. The current study examined which sleep disturbance types were independent risk factors for subsequent suicidal behaviors in a large sample of Chinese college students. METHODS Data came from a large-scale health-related cohort study in Guangdong, China. Participants were 11,740 college students initially assessed in March and April in 2019 and reassessed six month later. Self-administered structured questionnaires were used to assess suicidal behaviors, insomnia, nightmares, sleep disordered breathing (SDB) symptoms, restless legs syndrome (RLS) symptoms, depression, substance abuse and demographic characteristics. A series of logistic regression analyses were conducted to examine the associations between different types of sleep disturbance and suicidal behaviors. RESULTS Overall, 12.2% and 1.2% of college students reported suicidal ideation and attempts at baseline, and 8.6% and 2.4% reported similar behavior at follow-up. After adjustment for key covariates and prior suicidal behaviors, frequent nightmares (AORs = 1.35-1.69) and RLS symptoms (AOR = 1.37) at baseline predicted subsequent suicidal ideation, and only frequent nightmares (AOR = 2.40) at baseline predicted subsequent suicidal attempts. LIMITATIONS All measures were based on self-report instead of objective assessments or clinical diagnostic evaluations. CONCLUSIONS Frequent nightmares and RLS symptoms were independently associated subsequent suicidal ideation or attempts. Screening and managing sleep disturbance may be helpful for reducing the risk of suicidal behaviors among college students.
Collapse
Affiliation(s)
- Xuliang Shi
- College of Education, Hebei University, Hebei, China.
| | - Ya Zhu
- Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, China
| | - Shuo Wang
- College of Education, Hebei University, Hebei, China
| | - Anqi Wang
- College of Education, Hebei University, Hebei, China
| | - Xiaoyan Chen
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yuanyuan Li
- School of Psychology, South China Normal University, Guangzhou, China
| | - Lin Jiang
- College of Education, Hebei University, Hebei, China
| |
Collapse
|
27
|
Macchitella L, Marinelli CV, Signore F, Ciavolino E, Angelelli P. Sleepiness, Neuropsychological Skills, and Scholastic Learning in Children. Brain Sci 2020; 10:brainsci10080529. [PMID: 32784660 PMCID: PMC7464965 DOI: 10.3390/brainsci10080529] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/03/2020] [Accepted: 08/03/2020] [Indexed: 12/25/2022] Open
Abstract
Excessive daytime sleepiness is a frequent condition among children and adolescents that may lead to several and significant daytime consequences, including impaired neurocognitive skills and scholastic performance. Here, we evaluated in one hundred and ninety-one unselected primary school children, the relationship between sleepiness and a wide range of cognitive and academic skills through a standardized neuropsychological test battery. In order to assess the statistical relationship, we performed a partial least squares path modelling, a non-parametrical approach which combined a model of paths between latent variables and the coefficients between indicators and dimensions. Results were validated through the bootstrap approach and suggest that sleepiness is not associated with all cognitive and scholastic abilities, but only with those relying on verbal abilities and complex cognitive functions (i.e., reading comprehension, oral/syntactic comprehension, spelling, and mathematic skills). Our data suggest the idea that sleepiness in children is associated mostly with “higher” (mainly verbal) cognitive function(s), while the visuospatial domain was not affected.
Collapse
|
28
|
Maternal emotions during the pre/postnatal periods and children's sleep behaviors: The mediating role of children's behavior. J Affect Disord 2020; 273:138-145. [PMID: 32421594 PMCID: PMC7993531 DOI: 10.1016/j.jad.2020.03.178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 02/27/2020] [Accepted: 03/29/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND We aimed to investigate the association of mother's perceived levels of depression and happiness across all trimesters of pregnancy and after delivery on their children's sleep problems, as well as examine the possible mediating effect of children's behavioral problems. METHODS Participants included 1257 children (54% boys, mean age = 5.74 ± 0.48 years). Pre- and postnatal maternal emotions were self-reported using a 5-point scale for happiness and a 3-point scale for depressive emotions. Children reported sleep and behavioral problems using the Child Behavior Checklist. RESULTS Adjusted models showed that children of women reporting depressive emotions during either the postnatal period (β = 3.07, p = 0.01) or both prenatal and postnatal periods (β = 2.91, p = 0.01) were more likely to report sleep disturbances. By contrast, children of women reporting higher levels of happiness in the second (β = -1.91, p = 0.04) and third (β = -2.27, p = 0.001) trimesters were less likely to report sleep problems. LIMITATIONS Differences in maternal-report of children's behaviors could reflect memory and recall bias, and maternal emotions were assessed by researcher-designed single item measures. All measures were completed by a single reporter. Other associated factors should be considered in clarifying the complex associations. CONCLUSIONS Maternal depressive emotions during pre- and postnatal periods were associated with an increase in children's sleep problems, while increased happiness during pregnancy was associated with a decrease in children's sleep problems. Children's behavioral problems significantly mediated these relationships. To our knowledge, this is the first study to examine the relationship between maternal pre- and postnatal emotions and children's sleep behavior in an Asian sample.
Collapse
|
29
|
Liu J, Wu T, Liu Q, Wu S, Chen JC. Air pollution exposure and adverse sleep health across the life course: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 262:114263. [PMID: 32443219 PMCID: PMC7877449 DOI: 10.1016/j.envpol.2020.114263] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 05/07/2023]
Abstract
An increasing number of epidemiological studies have examined air pollution as a possible contributor to adverse sleep health, but results are mixed. The aims of this systematic review are to investigate and summarize the associations between exposures to air pollutants and various sleep measures across the lifespan. PubMed, CINAHL, Cochrane, Scopus, Web of Science, and PsycInfo were searched through October 2019 to identify original data-based research examining direct epidemiological associations between ambient and indoor air pollution exposures and various sleep health measures, including sleep quality, sleep duration, sleep disturbances, and daytime sleepiness. Twenty-two articles from 2010 to 2019 were selected for inclusion in this review, including a wide range of study populations (from early childhood to elderly) and locations (10 Asian, 4 North American, 3 European, 5 other). Due to variation in both exposure and outcome assessments, conducting a meta-analysis was not plausible. Twenty-one studies reported a generally positive association between exposure and poor sleep quality. While most studies focused on ambient air pollutants, five assessed the specific effect of indoor exposure. In children and adolescents, increased exposure to both ambient and indoor pollutants is associated with increased respiratory sleep problems and a variety of additional adverse sleep outcomes. In adults, air pollution exposure was most notably related to sleep disordered breathing. Existing literature generally shows a negative relationship between exposures to air pollution and sleep health in populations across different age groups, countries, and measures. While many associations between air pollution and sleep outcomes have been investigated, the mixed study methods and use of subjective air pollution and sleep measures result in a wide range of specific associations. Plausible toxicological mechanisms remain inconclusive. Future studies utilizing objective sleep measures and controlling for all air pollution exposures and individual encounters may help ameliorate variability in the results reported by current published literature.
Collapse
Affiliation(s)
- Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
| | - Tina Wu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Qisijing Liu
- Peking University School of Public Health, Beijing, China
| | - Shaowei Wu
- Peking University School of Public Health, Beijing, China
| | - Jiu-Chiuan Chen
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| |
Collapse
|
30
|
Wang G, Takahashi M, Wu R, Liu Z, Adachi M, Saito M, Nakamura K, Jiang F. Association between Sleep Disturbances and Emotional/Behavioral Problems in Chinese and Japanese Preschoolers. Behav Sleep Med 2020; 18:420-431. [PMID: 31063001 DOI: 10.1080/15402002.2019.1605995] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: Sleep disturbances are often associated with emotional/behavioral problems in young children, but whether the association differs among Asian countries remains unknown. This study aimed to investigate the association between sleep disturbances and emotional/behavioral problems in Chinese and Japanese preschoolers and to explore potential differences.Methods: Participants were 1,020 Chinese preschoolers from 10 cities and 438 Japanese preschoolers from 1 city aged 4 to 5 years. Parents filled out the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ).Results: Chinese children with sleep disturbances (defined as total CSHQ score >41) demonstrated more peer problems than children without, while there was no such difference in Japanese preschoolers. Domains of sleep disturbances associated with emotional/behavioral problems in Chinese children were sleep disordered breathing and daytime sleepiness, yet in Japanese children were sleep anxiety and night wakings. Children with a higher score of sleep anxiety showed more emotional problems in Japan, but fewer conduct problems in China.Conclusions: Sleep disturbances were associated with emotional/behavioral problems in preschoolers with differences between China and Japan, indicating subcultural differences in preschoolers' sleep within Asian countries.Abbreviations: CSHQ: Children's Sleep Habits Questionnaire; SDQ: Strengths and Difficulties Questionnaire; ANCOVA: analysis of covariance; SD: standard deviation; CI: confidence interval.
Collapse
Affiliation(s)
- Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Micho Takahashi
- Research Center for Child Mental Development, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Ran Wu
- Counseling and Psychological Services Center, East China Normal University, Shanghai, China
| | - Zhijun Liu
- Department of Applied Psychology, School of Management, Zunyi Medical University, Zunyi, China
| | - Masaki Adachi
- Research Center for Child Mental Development, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Manabu Saito
- Department of Neuropsychiatry, Graduate school of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Kazuhiko Nakamura
- Research Center for Child Mental Development, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan.,Department of Neuropsychiatry, Graduate school of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
31
|
Wu J, Gui Q, Wang J, Ye J, Xia Z, Wang S, Liu F, Kong F, Zhong L. Oxycodone preemptive analgesia after endoscopic plasma total adenotonsillectomy in children: A randomized controlled trial. Medicine (Baltimore) 2020; 99:e19004. [PMID: 32028411 PMCID: PMC7015576 DOI: 10.1097/md.0000000000019004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Endoscopic tonsillectomy is associated with postoperative pain. Postoperative pain management remains to be improved in children. We aimed to investigate oxycodone preemptive analgesia in children undergoing endoscopic plasma total adenotonsillectomy. METHODS 166 children with adenotonsillar hypertrophy were recruited at Wuhan Children's Hospital between 08/2016 and 03/2017. They were randomly assigned to receive SPOA (postoperative sufentanil), SPEA+SPOA (preemptive sufentanil and postoperative sufentanil), and OPEA+SPOA (preemptive oxycodone and postoperative sufentanil). The primary endpoint was serum c-fos levels. The secondary endpoints were the response entropy (RE) value, Pediatric Anesthesia Emergence Delirium (PAED) score, FLACC score, and adverse events. RESULTS c-fos mRNA levels were increased significantly after surgery in the SPOA and SPEA+SPOA groups (P < .05). Postoperatively, c-fos mRNA levels were higher in the SPOA group compared with the OPEA+SPOA group (P = .044). The RE values increased in all groups after surgery (P < .05). At extubation, RE values were higher in the SPOA group compared with the SPEA+SPOA and OPEA+SPOA groups (P < .05). The PAED scores were higher in the SPOA group compared with the OPEA+SPOA group (P = .045). In the SPOA group, the FLACC scores were decreased at 24 h after surgery vs 4 hours (P = .044). Prediction probability (Pk) values indicated that RE and c-fos mRNA levels were quantitative predictors for early postoperative stress reaction after surgery. CONCLUSIONS The subanalgesic dose of oxycodone (0.1 mg/kg) as preemptive analgesia could improve pain after endoscopic plasma total adenotonsillectomy in children.
Collapse
Affiliation(s)
| | - Qi Gui
- Department of Otolaryngology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | | | | | - Zhongfang Xia
- Department of Otolaryngology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Shufen Wang
- Department of Otolaryngology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | | | | | | |
Collapse
|
32
|
Ji X, Cui N, Liu J. Using propensity score matching with doses in observational studies: An example from a child physical abuse and sleep quality study. Res Nurs Health 2019; 42:436-445. [PMID: 31674676 DOI: 10.1002/nur.21991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 10/03/2019] [Indexed: 01/20/2023]
Abstract
Both physical abuse and poor sleep quality are public health concerns among adolescents, particularly in mainland China, but examining any causal effect of physical abuse on adolescents' sleep quality using a randomized controlled trial is not possible for obvious ethical reasons. Researchers have proposed the use of propensity score matching with doses to minimize overt bias and estimate the effect of multidose treatments or varying degrees of risk exposure in observational studies. In this paper, we demonstrate the propensity score methods with a focus on matching with doses in an examination of the relationship between physical abuse levels (frequency and number of perpetrators) and self-reported sleep quality among adolescents. Secondary analyses were conducted using data from the China Jintan Child Cohort. The sample comprised 707 adolescents (13.16 ± 0.90 years old) who had complete data on physical abuse, sleep, and covariates. Propensity scores were computed from eight covariates and used to carry out pair matching, matching with the frequency of abusive experience, and matching with the number of perpetrators. The standardized differences of covariates suggested an acceptable balance between groups after matching. The results derived from matching sets consistently indicated that adolescents being physically abused by parent(s) have worse sleep quality. Despite its inherent limitations, propensity score matching with doses provides a useful tool for nurse researchers analyzing observational data.
Collapse
Affiliation(s)
- Xiaopeng Ji
- School of Nursing, College of Health Sciences, University of Delaware, Newark
| | - Naixue Cui
- School of Nursing, Shandong University, Jinan, China
| | - Jianghong Liu
- Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia
| |
Collapse
|
33
|
Liu J, Feng R, Ji X, Cui N, Raine A, Mednick SC. Midday napping in children: associations between nap frequency and duration across cognitive, positive psychological well-being, behavioral, and metabolic health outcomes. Sleep 2019; 42:5499200. [PMID: 31135911 PMCID: PMC6735910 DOI: 10.1093/sleep/zsz126] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 05/02/2019] [Indexed: 12/14/2022] Open
Abstract
STUDY OBJECTIVES Poor sleep and daytime sleepiness in children and adolescents have short- and long-term consequences on various aspects of health. Midday napping may be a useful strategy to reduce such negative impacts. The effect of habitual napping on a wide spectrum of cognitive, behavioral, psychological, and metabolic outcomes has not been systematically investigated. METHODS This study characterized midday napping habits in 3819 elementary school children from the China Jintan Cohort Study. In 2011, weekly nap frequency and average duration were collected once from students at grades 4-6. Prior to their completion of elementary school at grade 6 (in 2011-2013 respective to each grade), the following outcomes were collected once: behavioral and academic achievement evaluated by teachers, and self-reported positive psychology measures including grit, self-control, and happiness. IQ tests were conducted on a subgroup. Metabolic indices, including body mass index and fasting glucose concentration, were measured through physical exams. For the whole sample, we assessed associations between napping and each outcome, adjusted for sex, grade, school location, parental education, and time in bed at night. We also conducted stratified analyses on grade 6 (cross-sectional), grade 4 (2-year gap), and grade 5 (1-year gap) data. RESULTS Overall, napping was significantly associated with higher happiness, grit, and self-control, reduced internalizing behavior problem, higher verbal IQs, and better academic achievement, although specific patterns varied across frequency and duration for different outcomes. More limited significant associations were found for decreased externalizing behavior problems, compared to non-nappers, while no significant associations were found for performance IQ and metabolic outcomes. CONCLUSIONS Results indicate benefits of regular napping across a wide range of adolescent outcomes, including better cognition, better psychological wellness, and reduced emotional/behavioral problems. The current study underscores the need for further large-scale intervention studies to establish causal effects.
Collapse
Affiliation(s)
- Jianghong Liu
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Rui Feng
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Xiaopeng Ji
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA.,College of Health Sciences, University of Delaware School of Nursing, Newark, DE
| | - Naixue Cui
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA.,Shandong University School of Nursing, Shandong, China
| | - Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, Philadelphia, PA
| | - Sara C Mednick
- Department of Cognitive Sciences, University of California Irvine, Irvine, CA
| |
Collapse
|
34
|
Habitual Snoring at Age 3 Years: Links with Parent-Rated Remembering in Daily Life and Academic Achievement at Age 7 Years. J Dev Behav Pediatr 2019; 39:144-153. [PMID: 29120885 DOI: 10.1097/dbp.0000000000000524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Habitual snoring in school-aged children is well known to link with poorer cognitive functioning and academic performance, but few studies have explored later developmental outcomes related to snoring initiated in early childhood. The aims of this study were to examine whether habitual snoring at age 3 years predicted perceived memory and academic functioning at age 7 years. METHODS Parents (n = 460) of children aged 7 years 2 ± 5 months completed a community follow-up survey about their perceptions of their child's sleep and health, memory in daily activities, and academic performance relevant to numeracy and literacy skills. The first survey was completed by 839 parents 4 years prior when children were aged 3 years (54.8% response rate at age 7 years). Parents rated their child's academic performance twice. First, they rated performance based on teachers' feedback relative to national standard ratings for numeracy and literacy, and second, based on their own observations. RESULTS Children reported to snore habitually at age 3 years received lower memory and academic composite score ratings at age 7 years. Age 3 years habitual snoring history predicted small but significant unique variation in age 7 years memory (p = 0.005), literacy (p < 0.001), and overall achievement ratings (p = 0.016) in regressions controlling for covariates, with evidence suggesting that memory may mediate links between snoring history and academic performance. CONCLUSION The findings suggest that habitual snoring in early childhood may adversely affect success in beginning schooling. More research is still needed to determine the best time for treatment so that longer-term consequences of sleep-disordered breathing may be prevented.
Collapse
|
35
|
Senbanjo IO, Salisu MA, Oshikoya KA, Adediji UO, Akinola AO. Nigerian sleep study found that children slept less and had more problems than children in other countries. Acta Paediatr 2018. [PMID: 29527732 DOI: 10.1111/apa.14313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM We studied sleep patterns, sleep problems and associated socio-demographic factors among children aged one year to 12 years in Lagos, Nigeria. METHODS This prospective hospital-based study involved 432 children (55% males) who came for routine paediatric care at the Lagos State University Teaching Hospital. Information on socio-demographics, sleeping patterns and specific sleep disorders was obtained. RESULTS The mean age of the subjects was 5.4 ± 3.3 years. Night sleep duration decreased significantly with age from 9.6 ± 1.3 hours at one to four years to 8.7 ± 1.0 hours at nine years to 12 years (p < 0.001). There was no significant gender difference in bedtimes (p = 0.057), rise times (p = 0.095) and night sleep duration (p = 0.191). Most (70%) napped during the day, and 26% of these did so on a regular basis. The most common sleep problems were enuresis (42%), afraid of sleeping alone (38%), snoring (28%) and sleep talking (24%). There was no significant association between sleep duration (p > 0.05), sleep problems (p > 0.05) and socio-demographic characteristics. Comparisons with other studies showed that the children had shorter sleep duration than peers in other countries and regions and a higher prevalence of sleep disorders. CONCLUSION Children in Nigeria had shorter sleep duration and more sleep problems than children in other international studies.
Collapse
Affiliation(s)
- Idowu O. Senbanjo
- Department of Paediatrics and Child Health; Lagos State University College of Medicine; Ikeja Lagos Nigeria
| | - Mohammed A. Salisu
- Department of Paediatrics and Child Health; Lagos State University College of Medicine; Ikeja Lagos Nigeria
| | - Kazeem A. Oshikoya
- Department of Pharmacology and Therapeutics; Lagos State University College of Medicine; Ikeja Lagos Nigeria
| | - Uchechukwu O. Adediji
- Department of Paediatrics and Child Health; Lagos State University Teaching Hospital, GRA; Ikeja Lagos Nigeria
| | - Ayodeji O. Akinola
- Department of Paediatrics and Child Health; Lagos State University Teaching Hospital, GRA; Ikeja Lagos Nigeria
| |
Collapse
|
36
|
Liu J, Wang G, Ji X, Cui N, Liu X. Agreement between parent-reports and child self-reports of sleep problems in Chinese children. Sleep Biol Rhythms 2018; 16:283-291. [PMID: 37786879 PMCID: PMC10544765 DOI: 10.1007/s41105-018-0152-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 02/06/2018] [Indexed: 10/18/2022]
Abstract
Sleep problems are major concerns for parents, health professionals, and children and youths themselves. For assessing sleep problems, both parent and child reports are important, with each having its unique features. However, little is known about the correlates of the agreement between parent and child self-reports. This study evaluated the agreement between the youth self-report sleep questionnaire (YSRSQ) and the parent-reported children's sleep habits questionnaire (CSHQ) and assessed the associated sociodemographic factors, as well as the underlying discrepancies. The participants included 3143 pairs of Chinese preadolescents (mean age = 11.03, SD = 0.98) and parents. Sleep-disordered breathing (SDB), daytime sleepiness, and parasomnia were assessed by both the YSRSQ and CSHQ. Significant but low correlations were present between parent report and preadolescent self-report items on SDB problems, daytime sleepiness, and parasomnias. Although the agreement between SDB symptoms and parasomnias was stronger for girls than for boys, the degree of concordance between SDB symptoms and parasomnia increased with preadolescent age, with the highest agreement achieved among preadolescents aged 12 years or older for SDB problems and 11 years or older for parasomnias. Findings underscore the importance of utilizing both parental and preadolescent self-reports in accurately assessing and diagnosing sleep impairment in pediatric samples.
Collapse
Affiliation(s)
- Jianghong Liu
- University of Pennsylvania Schools of Nursing and Medicine, Philadelphia, PA, USA
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Xiaopeng Ji
- University of Pennsylvania Schools of Nursing and Medicine, Philadelphia, PA, USA
- University of Delaware School of Nursing, Newark, DE, USA
| | - Naixue Cui
- University of Pennsylvania Schools of Nursing and Medicine, Philadelphia, PA, USA
- Shandong University School of Nursing, Jinan, China
| | - Xianchen Liu
- Shandong University School of Public Health, Jinan, China
| |
Collapse
|
37
|
Liu J, Cui Y, Li L, Wu L, Hanlon A, Pinto-Martin J, Raine A, Hibbeln JR. The mediating role of sleep in the fish consumption - cognitive functioning relationship: a cohort study. Sci Rep 2017; 7:17961. [PMID: 29269884 PMCID: PMC5740156 DOI: 10.1038/s41598-017-17520-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 11/24/2017] [Indexed: 11/09/2022] Open
Abstract
Greater fish consumption is associated with improved cognition among children, but the mediating pathways have not been well delineated. Improved sleep could be a candidate mediator of the fish-cognition relationship. This study assesses whether 1) more frequent fish consumption is associated with less sleep disturbances and higher IQ scores in schoolchildren, 2) such relationships are not accounted for by social and economic confounds, and 3) sleep quality mediates the fish-IQ relationship. In this cohort study of 541 Chinese schoolchildren, fish consumption and sleep quality were assessed at age 9-11 years, while IQ was assessed at age 12. Frequent fish consumption was related to both fewer sleep problems and higher IQ scores. A dose-response relationship indicated higher IQ scores in children who always (4.80 points) or sometimes (3.31 points) consumed fish, compared to those who rarely ate fish (all p < 0.05). Sleep quality partially mediated the relationship between fish consumption and verbal, but not performance, IQ. Findings were robust after controlling for multiple sociodemographic covariates. To our knowledge, this is the first study to indicate that frequent fish consumption may help reduce sleep problems (better sleep quality), which may in turn benefit long-term cognitive functioning in children.
Collapse
Affiliation(s)
- Jianghong Liu
- University of Pennsylvania Schools of Nursing and Medicine, 418 Curie Blvd., Claire M. Fagin Hall, Room 426, Philadelphia, PA, 19104, USA.
| | - Ying Cui
- University of Pennsylvania Schools of Nursing and Medicine, 418 Curie Blvd., Claire M. Fagin Hall, Room 426, Philadelphia, PA, 19104, USA
| | - Linda Li
- Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Lezhou Wu
- University of Pennsylvania Schools of Nursing and Medicine, 418 Curie Blvd., Claire M. Fagin Hall, Room 426, Philadelphia, PA, 19104, USA
| | - Alexandra Hanlon
- University of Pennsylvania Schools of Nursing and Medicine, 418 Curie Blvd., Claire M. Fagin Hall, Room 426, Philadelphia, PA, 19104, USA
| | - Jennifer Pinto-Martin
- University of Pennsylvania Schools of Nursing and Medicine, 418 Curie Blvd., Claire M. Fagin Hall, Room 426, Philadelphia, PA, 19104, USA
| | - Adrian Raine
- University of Pennsylvania School of Arts and Sciences, 483 McNeil Building 3718 Locust Walk, Philadelphia, PA, USA
| | - Joseph R Hibbeln
- Acting Chief, Section on Nutritional Neurosciences LMBB, NIAAA, NIH, 5625 Fishers Lane, Rm 3N-07, MSC 9410, Bethesda, MD, 20892, USA
| |
Collapse
|
38
|
Magee CA, Robinson L, Keane C. Sleep quality subtypes predict health-related quality of life in children. Sleep Med 2017; 35:67-73. [DOI: 10.1016/j.sleep.2017.04.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/17/2017] [Accepted: 04/15/2017] [Indexed: 10/19/2022]
|