1
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Wong MM, Brower KJ, Conroy DA, Craun EA. Convergence Between the Child Behavior Checklist Sleep Items, Actigraphy and Other Sleep Measures Among Children of Parents with Alcoholic Disorders and Controls. Nat Sci Sleep 2022; 14:2107-2121. [PMID: 36471754 PMCID: PMC9719267 DOI: 10.2147/nss.s324002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose The Child Behavior Checklist (CBCL) is a widely used instrument of children psychosocial functioning. CBCL sleep items have been used in both clinical settings and research. To date, few empirical studies have examined the relationships between CBCL sleep items and other sleep measures such as actigraphy and validated sleep questionnaires. This study extends the literature by examining these relationships in a group of children of parents with an alcohol use disorder (COAs) and matched controls. Participants and Methods Two hundred and forty-eight children aged 8-12 (48% COAs; 50% girls; Mean age =10.37 (Standard deviation = 1.47)), participated in this study. Data presented here were taken from Time 1 of a larger prospective study designed to understand the relationship between sleep and alcohol use. All participants were naïve to alcohol and other illicit drugs. Parents completed the Achenbach CBCL and the Pediatric Sleep Questionnaire (PSQ). Participants wore an actigraph watch on their non-dominant wrists for one week and filled out the Youth Self-Report (YSR). Results Multiple regression analyses showed that CBCL sleep items (eg, "trouble sleeping") correlated with related actigraphy (eg, shorter total sleep time and longer sleep onset latency) and Pediatrics Sleep Questionnaire (PSQ) items (eg, sleep difficulties and daytime sleepiness). Logistic regression analyses indicated that CBCL items (eg, "trouble sleeping) predicted similar items in the Youth Self Report (YSR) (eg, trouble sleeping). Structural equation modeling analyses showed that the latent variable "CBCL sleep" correlated significantly with the latent variables of actigraphy (r = -0.54, p < 0.001), PSQ (r = 0.93, p < 0.001) and YSR (r = 0.38, p < 0.01). These associations were largely the same for COAs and controls. Conclusion CBCL items were significantly associated with actigraphy variables, a validated sleep measure (PSQ) and youth report of sleep for both COAs and non-COAs.
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Affiliation(s)
- Maria M Wong
- Department of Psychology, Idaho State University, Pocatello, ID, 83209, USA
| | - Kirk J Brower
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Deirdre A Conroy
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Elizabeth A Craun
- Department of Psychology, Idaho State University, Pocatello, ID, 83209, USA
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2
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Clara MI, Clemente V, Abrantes J, Marques DR, Azevedo MHP, Allen Gomes A. Sleep-wake patterns and disturbances in Portuguese primary school children: a comparison between 1995 and 2016. Sleep Biol Rhythms 2022; 20:541-549. [PMID: 38468612 PMCID: PMC10900031 DOI: 10.1007/s41105-022-00400-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/05/2022] [Indexed: 11/25/2022]
Abstract
Purpose It is often assumed sleep duration has decreased and sleep schedules have delayed over the last decades, as society modernized. We aimed to investigate changes in the sleep patterns of school-age children over time. Methods We compared the sleep timings, durations, and disturbances of primary school-age children in 1995 and roughly two decades later, in 2016. Data from 666 children attending the 3rd and 4th grades of basic education were combined from two different cross-sectional school-based studies conducted within the same educational region of mainland Portugal using the same parent-report questionnaire (Children's Sleep-wake Patterns Questionnaire). Results Mean sleep duration did not differ significantly between the two time points (schooldays: t = .118, p = .906; free days: t = 1.310, p = .191), albeit the percentage of children sleeping the recommended number of hours decreased significantly in 2016 when compared to 1995 (schooldays: χ2 = 4.406, p = .036; free days: χ2 = 16.859, p < .001). Wake-times advanced on free days in 2016. Difficulties on settling to sleep alone and returning to sleep were more prevalent in 2016, as well as fearing the dark and needing lights on or parent's presence to fall asleep. Conclusions Sleep onset-related disturbances appear to have increased from 1995 to 2016. One possible explanation for this increase might be the change in parental practices preventing children from learning to fall asleep autonomously.
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Affiliation(s)
- Maria Inês Clara
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3000-115 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal
| | - Vanda Clemente
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3000-115 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal
- Sleep Medicine Center, University Hospital Center of Coimbra, Coimbra, Portugal
| | - Joana Abrantes
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Daniel R. Marques
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | | | - Ana Allen Gomes
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3000-115 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Coimbra, Portugal
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3
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Durmuşoğlu Saltalı N, Günay Molu N, Ateş MA. Psychometric evaluation of the Turkish Adaptation of Parent-Child Sleep Interaction Scale (PSIS) for preschoolers. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2090672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
| | - Nesibe Günay Molu
- Department of Psychiatry Nursing, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Ali Ateş
- Department of Preschool Education, Girne American University, Girne, Cyprus
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4
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Almeida F, Pires L, Bettencourt C, Almeida R, Ruivo Marques D, Leitão J, Gomes AA. Momentary emotional states in primary school children: combined effects of chronotype X time-of-day. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2081400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Filipa Almeida
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
| | - Luís Pires
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Memory, Language and Executive Functions Lab, University of Coimbra, Coimbra, Portugal
- Department of Psychology, School of Life Sciences, University of Hull, UK
| | - Catarina Bettencourt
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
| | - Rita Almeida
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
| | - Daniel Ruivo Marques
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - José Leitão
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Memory, Language and Executive Functions Lab, University of Coimbra, Coimbra, Portugal
| | - Ana Allen Gomes
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Memory, Language and Executive Functions Lab, University of Coimbra, Coimbra, Portugal
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5
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Schønning V, Sivertsen B, Hysing M, Dovran A, Askeland KG. Childhood maltreatment and sleep in children and adolescents: a systematic review and meta-analysis. Sleep Med Rev 2022; 63:101617. [DOI: 10.1016/j.smrv.2022.101617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/02/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
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6
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Chan NY, Au CT, Li SX, Wing YK. Sleep Complaints Among School Children. Sleep Med Clin 2022; 17:53-65. [PMID: 35216761 DOI: 10.1016/j.jsmc.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sleep complaints are common among children. These include both night-time and daytime symptoms, such as trouble falling asleep, problems in maintaining sleep, snoring, and unusual events during sleep and daytime functioning impairment. However, sleep complaints in children are often overlooked and undertreated in clinical practice. Untreated sleep problems may further impact on children's development and will persist into adulthood in some cases. This review summarizes the common sleep complaints and disorders in school children, and provides an overview of the epidemiology, clinical features, consequences, and treatment of the sleep problems.
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Affiliation(s)
- 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.
| | - Chun Ting Au
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The 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.
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7
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Ksinan Jiskrova G, Pikhart H, Bobák M, Klanova J, Stepanikova I. Prenatal psychosocial stress and children's sleep problems: Evidence from the ELSPAC-CZ study. J Sleep Res 2021; 31:e13531. [PMID: 34879444 DOI: 10.1111/jsr.13531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/24/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
Prenatal exposure to maternal stress may increase the risk of developing sleep problems in childhood. This study examined the association between prenatal stressful life events (PSLE) and children's sleep problems, taking into consideration their trajectory over time. Data were obtained from the Czech portion of the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ; N = 4,371 children). Mothers reported PSLE using an inventory of 42 life events and child sleep problems at five time-points (child age of 1.5, 3, 5, 7, and 11 years). The association was tested by a Poisson latent growth model, controlling for maternal and family demographics, birth characteristics, maternal depression, and alcohol use in pregnancy. The average rate of sleep problems was 2.06 (p < 0.001) at the age of 1.5 years and the rate of sleep problems decreased in a linear fashion over time (estimate = -0.118; p < 0.001). A higher number of PSLE was associated with a higher rate of sleep problems at the age of 1.5 years (incidence rate ratio [IRR] per interquartile range = 1.08, 95% confidence interval [CI] 1.05-1.12, p < 0.001) and with a reduced rate of decrease in sleep problems between the ages of 1.5 and 11 years (p < 0.001). Thus, PSLE were associated with chronicity of sleep problems in addition to their amount during early childhood. Prenatal exposure to stress may predispose individuals to the development of sleep problems in later life.
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Affiliation(s)
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.,Department of Epidemiology & Public Health, University College London, London, UK
| | - Martin Bobák
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.,Department of Epidemiology & Public Health, University College London, London, UK
| | - Jana Klanova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Irena Stepanikova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.,Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
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8
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Sun W, Kwok NTT, Chan NY, Chan JWY, Zhang J, Chan KCC, Li SX. Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children. J Clin Sleep Med 2021; 17:2107-2114. [PMID: 34606443 DOI: 10.5664/jcsm.9346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine the associations of circadian characteristics (ie, chronotype and social jetlag) with insomnia symptoms and emotional and behavioral problems among school-age children. METHODS A total of 620 primary school children (medianage = 10.06, standard deviation = 1.16, 58.7% boys) were recruited and assessed by a set of parent-report questionnaires, including Children's Sleep Habit Questionnaire for measuring sleep-wake patterns and insomnia symptoms (bedtime resistance, sleep onset delay, and night waking), Children's Chronotype Questionnaire for assessing the child's chronotype preference, and Strength and Difficulties Questionnaire for assessing emotional and behavioral problems. Linear regression models were applied to examine the associations of chronotype and social jetlag with insomnia symptoms and mental health outcomes, in which age, sex, family income, and average sleep duration were entered as covariates. RESULTS Evening chronotype was significantly associated with bedtime resistance and sleep onset delay, while social jetlag was not related to insomnia symptoms. Evening chronotype was also significantly associated with externalizing symptoms after controlling for potential confounders. CONCLUSIONS Evening chronotype, but not social jetlag, was the risk factor for insomnia symptoms, and evening chronotype was further associated with increased behavioral problems in school-age children. Our findings underscored the roles of circadian factors in relation to sleep and mental health problems in this young population. CITATION Sun W, Kwok NTT, Chan NY, et al. Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children. J Clin Sleep Med. 2021;17(10):2107-2114.
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Affiliation(s)
- Wanqi Sun
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,Department of Psychiatry, Shanghai Mental Health Center, People's Republic of China
| | - Natasha Tung Ting Kwok
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR)
| | - Ngan Yin Chan
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR
| | - Joey Wing Yan Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR.,Guang Dong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kate Ching-Ching Chan
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR
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9
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Veatch OJ, Malow BA, Lee HS, Knight A, Barrish JO, Neul JL, Lane JB, Skinner SA, Kaufmann WE, Miller JL, Driscoll DJ, Bird LM, Butler MG, Dykens EM, Gold JA, Kimonis V, Bacino CA, Tan WH, Kothare SV, Peters SU, Percy AK, Glaze DG. Evaluating Sleep Disturbances in Children With Rare Genetic Neurodevelopmental Syndromes. Pediatr Neurol 2021; 123:30-37. [PMID: 34388423 PMCID: PMC8429141 DOI: 10.1016/j.pediatrneurol.2021.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Adequate sleep is important for proper neurodevelopment and positive health outcomes. Sleep disturbances are more prevalent in children with genetically determined neurodevelopmental syndromes compared with typically developing counterparts. We characterize sleep behavior in Rett (RTT), Angelman (AS), and Prader-Willi (PWS) syndromes to identify effective approaches for treating sleep problems in these populations. We compared sleep-related symptoms across individuals with these different syndromes with each other, and with typically developing controls. METHODS Children were recruited from the Rare Diseases Clinical Research Network consortium registries; unaffected siblings were enrolled as related controls. For each participant, a parent completed multiple sleep questionnaires including Pediatric Sleep Questionnaire (Sleep-Disordered Breathing), Children's Sleep Habits Questionnaire (CSHQ), and Pediatric Daytime Sleepiness Scale. RESULTS Sleep data were analyzed from 714 participants, aged two to 18 years. Young children with AS had more reported sleep problems than children with RTT or PWS. Older children with RTT had more reported daytime sleepiness than those with AS or PWS. Finally, all individuals with RTT had more evidence of sleep-disordered breathing when compared with individuals with PWS. Notably, typically developing siblings were also reported to have sleep problems, except for sleep-related breathing disturbances, which were associated with each of the genetic syndromes. CONCLUSIONS Individuals with RTT, AS, and PWS frequently experience sleep problems, including sleep-disordered breathing. Screening for sleep problems in individuals with these and other neurogenetic disorders should be included in clinical assessment and managements. These data may also be useful in developing treatment strategies and in clinical trials.
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Affiliation(s)
- Olivia J Veatch
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas.
| | - Beth A Malow
- Departments of Pediatrics and Neurology, Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hye-Seung Lee
- Department of Pediatrics, University of South Florida, Tampa, Florida
| | - Aryn Knight
- Center for Clinical Research, Texas Heart Institute, Houston, Texas
| | - Judy O Barrish
- Departments of Pediatrics and Neurology, Baylor College of Medicine, Houston, Texas
| | - Jeffrey L Neul
- Vanderbilt Kennedy Center, Departments of Pediatrics, Pharmacology, and Special Education, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jane B Lane
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama; University of Alabama at Birmingham, Civitan International Research Center, Birmingham, Alabama
| | | | - Walter E Kaufmann
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Jennifer L Miller
- Department of Pediatrics, University of Florida, Gainesville, Florida
| | - Daniel J Driscoll
- Department of Pediatrics, University of Florida, Gainesville, Florida
| | - Lynne M Bird
- Division of Genetics and Dysmorphology, Department of Pediatrics, University of California San Diego/Rady Children's Hospital, San Diego, California
| | - Merlin G Butler
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas
| | - Elisabeth M Dykens
- Departments of Pediatrics and Special Education, Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - June-Anne Gold
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, California
| | - Virginia Kimonis
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, California
| | - Carlos A Bacino
- Departments of Pediatrics and Neurology, Baylor College of Medicine, Houston, Texas
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts
| | - Sanjeev V Kothare
- Pediatric Sleep Program, Cohen Children's Medical Center, New Hyde Park, New York
| | - Sarika U Peters
- Departments of Pediatrics and Psychiatry & Behavioral Sciences, Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alan K Percy
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama; University of Alabama at Birmingham, Civitan International Research Center, Birmingham, Alabama
| | - Daniel G Glaze
- Departments of Pediatrics and Neurology, Baylor College of Medicine, Houston, Texas
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10
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El Mlili N, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Sleep Quality and Related Disorders. Life (Basel) 2021; 11:life11020081. [PMID: 33499247 PMCID: PMC7911396 DOI: 10.3390/life11020081] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/11/2022] Open
Abstract
Cortisol is the end product of the hypothalamic-pituitary-adrenal (HPA) axis, and its production is increased mainly in stressful situations or in chronic disorders accompanied by stress enhancement. Altered cortisol concentrations have been reported in a number of neuropsychiatric diseases and sleep disorders. Cortisol concentrations have been measured using several methods, and in several matrixes, such as blood, saliva, and urine. However, lately, hair cortisol, for several reasons, has emerged as a promising biomarker of long-term retrospective HPA activation. Several experimental approaches for cortisol measurement with the corresponding concentration reference ranges and a summary of findings from scientific literature on this field are presented. There is evidence of a close relationship between HPA functional alteration and the development of neuropsychiatric disorders. Sleep disorders are the most common manifestation in several neuropsychiatric conditions, and have also been associated to cortisol alterations in both adults and children. Many studies indicate that hair cortisol constitutes a valuable tool for further contributing to existing data on salivary, plasma, or urinary cortisol concentrations in patients with sleep disorders.
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Affiliation(s)
- Nisrin El Mlili
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; (N.E.M.); (H.A.)
- Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Hanan Ahabrach
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; (N.E.M.); (H.A.)
- Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Healthy, Active and Participatory Aging, Valencia City Council, University of Valencia, 46010 Valencia, Spain
- Correspondence:
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11
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Keller SR, Mallack EJ, Rubin JP, Accardo JA, Brault JA, Corre CS, Elizondo C, Garafola J, Jackson-Garcia AC, Rhee J, Seeger E, Shullanberger KC, Tourjee A, Trovato MK, Waldman AT, Wallace JL, Wallace MR, Werner K, White A, Ess KC, Becker C, Eichler FS. Practical Approaches and Knowledge Gaps in the Care for Children With Leukodystrophies. J Child Neurol 2021; 36:65-78. [PMID: 32875938 PMCID: PMC7736398 DOI: 10.1177/0883073820946154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Leukodystrophies are a group of neurodegenerative genetic disorders that affect approximately 1 in 7500 individuals. Despite therapeutic progress in individual leukodystrophies, guidelines in neurologic care are sparse and consensus among physicians and caregivers remains a challenge. At patient advocacy meetings hosted by Hunter's Hope from 2016-2018, multidisciplinary experts and caregivers met to conduct a literature review, identify knowledge gaps and summarize best practices regarding neurologic care. Stages of severity in leukodystrophies guided recommendations to address different levels of need based on a newly defined system of disease severity. Four core neurologic domains prioritized by families were identified and became the focus of this guideline: sleep, pain, seizures/epilepsy, and language/cognition. Based on clinical severity, the following categories were used: presymptomatic, early symptomatic, intermediate symptomatic, and advanced symptomatic. Across the leukodystrophies, neurologic care should be tailored to stages of severity while accounting for unique aspects of every disease and multiple knowledge gaps present. Standardized tools and surveys can help guide treatment but should not overburden families.
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Affiliation(s)
- Stephanie R. Keller
- Department of Pediatrics, Division of Pediatric Neurology, Emory University/Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Eric J. Mallack
- Department of Pediatrics, Division of Child Neurology, Weill Cornell
Medical College/New York-Presbyterian Hospital, New York, NY, USA
| | - Jennifer P. Rubin
- Department of Pediatric Neurology, Northwestern Feinberg School of
Medicine, Chicago, IL, USA
| | - Jennifer A. Accardo
- Department of Neurology, Children’s Hospital of Richmond at VCU,
Richmond, VA, USA
| | - Jennifer A. Brault
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | - Camille S. Corre
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Camila Elizondo
- East Boston Neighborhood Health Canter, East Boston, MA, USA
| | - Jennifer Garafola
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Jullie Rhee
- Children’s National Health Systems, Washington, DC, USA
| | | | | | - Amanda Tourjee
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa K. Trovato
- Department of Physical Medicine and Rehabilitation, Kennedy Krieger Institute and Johns Hopkins University, Baltimore, MD, USA
| | - Amy T. Waldman
- Division of Neurology, The Children’s Hospital of Philadelphia,
University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Klaus Werner
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Angela White
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kevin C. Ess
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | - Catherine Becker
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Florian S. Eichler
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA,Florian S. Eichler, MD, Department of
Neurology, Massachusetts General Hospital, 175 Cambridge Street, Suite 340,
Boston, MA 02114, USA.
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12
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Leahy E, Gradisar M. Dismantling the bidirectional relationship between paediatric sleep and anxiety. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/j.1742-9552.2012.00039.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Erin Leahy
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Michael Gradisar
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
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13
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Van Meter AR, Anderson EA. Evidence Base Update on Assessing Sleep in Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 49:701-736. [PMID: 33147074 DOI: 10.1080/15374416.2020.1802735] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Sleep is vital to youth well-being and when it becomes disturbed - whether due to environmental or individual factors - mental and physical health suffer. Sleep problems can also be a symptom of underlying mental health disorders. Assessing different components of sleep, including quality and hygiene, can be useful both for identifying mental health problems and for measuring changes in well-being over time. However, there are dozens of sleep-related measures for youth and it can be difficult to determine which to select for a specific research or clinical purpose. The goal of this review was to identify sleep-related measures for clinical and/or research use in youth mental health settings, and to update the evidence base on this topic. METHOD We generated a list of candidate measures based on other reviews and searched in PubMed and PsycINFO using the terms "sleep" AND (measure OR assessment OR questionnaire) AND (psychometric OR reliability OR validity). Search results were limited to studies about children and adolescents (aged 2-17) published in English. Additional criteria for inclusion were that there had to be at least three publications reporting on the measure psychometrics in community or mental health populations. Sleep measures meeting these criteria were evaluated using the criteria set by De Los Reyes and Langer (2018). RESULTS Twenty-six measures, across four domains of sleep - insomnia, sleep hygiene, sleepiness, sleep quality - met inclusion criteria. Each measure had at least adequate clinical utility. No measure(s) emerged as superior across psychometric domains. CONCLUSION Clinicians and researchers must evaluate sleep measures for each use case, as the intended purpose will dictate which measure is best. Future research is necessary to evaluate measure performance in transdiagnostic mental health populations, including youth with serious mental illness.
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Affiliation(s)
- Anna R Van Meter
- Department of Psychiatry, Zucker Hillside Hospital.,Feinstein Institutes for Medical Research, Institute for Behavioral Science.,Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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14
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Eid B, Bou Saleh M, Melki I, Torbey PH, Najem J, Saber M, El Osta N, Rabbaa Khabbaz L. Evaluation of Chronotype Among Children and Associations With BMI, Sleep, Anxiety, and Depression. Front Neurol 2020; 11:416. [PMID: 32581995 PMCID: PMC7291378 DOI: 10.3389/fneur.2020.00416] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/20/2020] [Indexed: 12/01/2022] Open
Abstract
Objectives: To evaluate possible associations between chronotype, weight, sleep problems, anxiety, and depression among children from 6 to 12 years of age. Method: One-hundred children aged between 6 and 12 years were randomly recruited in five pediatrician clinics in the capital city of Beirut, Lebanon. The protocol was approved by the ethics committee of Saint-Joseph University and Hotel-Dieu Hospital and an informed written formal consent was obtained from one of the parents. The Sleep Disturbance Scale for Children (CCTQ), the Revised Child Anxiety and Depression Scale (RCADS)-Parent version, and the Children's Chronotype Questionnaire (CCTQ) were used. Results: The majority of the sample (47%) presented an intermediate chronotype. There was a shift toward evening chronotype with increased age and a significant association between electronic devices use and an evening chronotype. Higher sleep disturbances were also observed among children with an evening chronotype. In particular, disorders of initiating and maintaining sleep, non-restorative sleep, excessive somnolence, and total SDSC were significantly higher among evening type children in our study. Finally, major depression domain scores were significantly higher among children with an evening chronotype. Conclusions: Several findings of this study are important and explain factors associated to chronotype in children. Two important future perspectives can be highlighted: limiting electronic devices use among children in an effort to reduce circadian rhythm disturbances and identifying and treating sleep problems associated with eveningness, taking into account the possible presence of major depression among this population.
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Affiliation(s)
- Bassam Eid
- Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Pediatrics, Hôtel-Dieu de France Hospital, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Mary Bou Saleh
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Imad Melki
- Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Pediatrics, Hôtel-Dieu de France Hospital, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Paul-Henry Torbey
- Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Pediatrics, Hôtel-Dieu de France Hospital, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Joelle Najem
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Maroun Saber
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Nada El Osta
- Craniofacial Research Laboratory, Oral Health Unit, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon.,Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de qualite des medicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
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15
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Phillips SR, Johnson AH, Shirey MR, Rice M. Sleep Quality in School-Aged Children: A Concept Analysis. J Pediatr Nurs 2020; 52:54-63. [PMID: 32179378 PMCID: PMC7285623 DOI: 10.1016/j.pedn.2020.02.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Shameka R Phillips
- The University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, United States of America.
| | - Ann H Johnson
- Texas Christian University Harris College of Nursing and Health Sciences, Fort Worth, Texas, United States of America.
| | - Maria R Shirey
- The University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, United States of America.
| | - Marti Rice
- The University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, United States of America.
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16
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Abstract
Sleep has been linked to adjustment difficulties in both children and adolescents; yet little is known about the long-term impact of childhood sleep on subsequent development. This study tested whether childhood sleep problems, sleep quantity, and chronotype predicted internalizing and externalizing problems during adolescence. Latent Growth Modeling using the Czech portion of the European Longitudinal Study of Pregnancy and Childhood (N = 4393) was utilized to test the developmental trajectories of sleep characteristics (from 1.5 to 7 years) as predictors of adjustment problems trajectories (from 11 to 18 years). Findings provided evidence that children with higher levels of sleep problems at 1.5 years (and throughout childhood) reported higher levels of internalizing and externalizing problems at age 11. Additionally, greater eveningness at age 1.5 predicted a greater increase in externalizing problems from ages 11 to 18 years. The results emphasize the importance of childhood sleep problems in evaluating the risk of future adjustment difficulties.
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17
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Khazaie H, Zakiei A, Rezaei M, Komasi S, Brand S. Sleep pattern, common bedtime problems, and related factors among first-grade students: Epidemiology and predictors. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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18
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Teague MS, Hockenberry M, Kinney JL, Coleman R. Sleep Evaluation in the Assessment of Pediatric Attention Deficit Disorders. J Pediatr Health Care 2019; 33:234-241. [PMID: 30466794 DOI: 10.1016/j.pedhc.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 07/26/2018] [Accepted: 08/03/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Examining the impact of appropriate sleep evaluation on diagnosis of attention deficit disorders can improve the standard of care in pediatrics. This quality improvement project examined current practice and subsequent implementation of a validated standardized sleep evaluation tool in the assessment of children with symptoms of attention deficit. METHODS Retrospective chart review and implementation of the Children's Sleep Habits Questionnaire (CSHQ) for children 6 to 14years old with attention deficit symptoms. MEASURES Rates of sleep screening, sleep referrals, diagnosis of sleep and attention deficit disorders, Vanderbilt scores, CSHQ scores. RESULTS In the retrospective group (n = 41), 76% of patients had attention deficit disorder/attention deficit hyperactivity disorder, 19.5% had sleeping disorders. There were significant provider differences in diagnosing sleep problems (p = .007). In the intervention group (n = 5), 60% had abnormal CSHQ scores. DISCUSSION There was considerable incidence of sleeping problems in children with symptoms of attention deficit and provider variation in sleep evaluation and diagnosis, with minimal referral to specialist care. Our findings support a more comprehensive and standardized evaluation of sleep when assessing for attention deficit disorders to improve appropriate referrals, diagnosis, and treatment in pediatrics.
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19
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Linking Sleep to Externalizing Behavioral Difficulties: A Longitudinal Psychometric Survey in a Cohort of Italian School-Age Children. J Prim Prev 2019; 40:231-241. [DOI: 10.1007/s10935-019-00547-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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20
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Xanthopoulos MS, Berkowitz RI, Tapia IE. Effects of obesity therapies on sleep disorders. Metabolism 2018; 84:109-117. [PMID: 29409812 DOI: 10.1016/j.metabol.2018.01.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/18/2018] [Accepted: 01/26/2018] [Indexed: 12/21/2022]
Abstract
Obesity is a significant risk factor for obstructive sleep apnea syndrome (OSAS), and has also been linked to reductions in sleep quality and quantity. Weight loss has been shown to be an effective treatment for improving OSAS; however, there is a high degree of variability in improvements of OSAS in response to weight loss. There are three modalities of obesity therapies: 1) lifestyle modification, which includes changes in dietary intake and physical activity, along with behavioral interventions; 2) pharmacologic agents; and 3) bariatric surgery. Individuals have a highly variable response to the various obesity interventions, and maintenance of weight loss can be especially challenging. These factors influence the effect of weight loss on sleep disorders. There is still a need for large, well-controlled studies examining short- and long-term efficacy of weight loss modalities and their impact on long-term treatment of OSAS and other sleep parameters, particularly in youth. Nonetheless, given our current knowledge, weight reduction should always be encouraged for people coping with obesity, OSAS, and/or sleep disruptions and resources identified to assist patients in choosing a weight loss approach that will benefit them the most.
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Affiliation(s)
- Melissa S Xanthopoulos
- Sleep Center in the Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Robert I Berkowitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ignacio E Tapia
- Sleep Center in the Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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21
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Poznanski B, Cornacchio D, Coxe S, Pincus DB, McMakin DL, Comer JS. The Link Between Anxiety Severity and Irritability Among Anxious Youth: Evaluating the Mediating Role of Sleep Problems. Child Psychiatry Hum Dev 2018; 49:352-359. [PMID: 29222620 DOI: 10.1007/s10578-017-0769-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although recent studies have linked pediatric anxiety to irritability, research has yet to examine the mechanisms through which youth anxiety may be associated with irritability. Importantly, sleep related problems (SRPs) have been associated with both child anxiety and irritability, but research has not considered whether the link between youth anxiety and irritability may be accounted for by SRPs. The present study investigated whether SRPs mediated the relationship between anxiety severity and irritability in a large sample of treatment-seeking anxious youth (N = 435; ages 7-19 years, M = 12.7; 55.1% female). Anxiety severity, SRPs and irritability showed significant pairwise associations, and the indirect effect of youth anxiety severity on irritability, via SRPs, was positive and significant. The present analysis is the first to examine youth anxiety, irritability, and SPRs in a single model in a sample of anxious youth, and provides preliminary evidence that SRPs partially mediate links between child anxiety and irritability.
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Affiliation(s)
- Bridget Poznanski
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Danielle Cornacchio
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Stefany Coxe
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Donna B Pincus
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Studies, Boston University, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA
| | - Dana L McMakin
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA. .,Department of Psychology, The Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
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22
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Ma ZR, Shi LJ, Deng MH. Efficacy of cognitive behavioral therapy in children and adolescents with insomnia: a systematic review and meta-analysis. Braz J Med Biol Res 2018; 51:e7070. [PMID: 29791593 PMCID: PMC6002144 DOI: 10.1590/1414-431x20187070] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
Insomnia is highly prevalent in children and adolescents. However, the efficacy of cognitive behavioral therapy for insomnia (CBT-i) in children and adolescents remains controversial. Therefore, this systematic review and meta-analysis aimed to assess the efficacy of CBT-i in children and adolescents. We conducted a search of PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO to select primary studies evaluating CBT-i in children and adolescents that were primarily diagnosed through standardized diagnostic criteria. The primary outcomes of the meta-analysis included sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE%). Six randomized controlled trials and four open-label trials met all inclusion criteria. A total of 464 participants (ranging from 5-19 years of age) were included. Based on the results from sleep logs, a significant pooled effect size was observed for SOL and SE%. However, no significant pooled effect size was found for WASO or TST. Results from actigraphy were consistent with the sleep logs. A significant pooled effect size was observed for SOL and SE%, and no significant pooled effect size was found for WASO or TST. CBT-i might be effective in the treatment of children and adolescents with insomnia.
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Affiliation(s)
- Zhong-Rui Ma
- Department of Neurology, Chengdu Fifth People's Hospital,
Chengdu, China
| | - Li-Jun Shi
- Department of Hematology, Chengdu Fifth People's Hospital,
Chengdu, China
| | - Ming-Hong Deng
- Department of Neurology, Chengdu Fifth People's Hospital,
Chengdu, China
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23
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Busch V, Altenburg TM, Harmsen IA, Chinapaw MJ. Interventions that stimulate healthy sleep in school-aged children: a systematic literature review. Eur J Public Health 2018; 27:53-65. [PMID: 28177474 DOI: 10.1093/eurpub/ckw140] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Healthy sleep among children has social, physical and mental health benefits. As most of today’s children do not meet the healthy sleep recommendations, effective interventions are urgently needed. This systematic review summarizes the characteristics and effectiveness of interventions aiming to stimulate healthy sleeping in a general population of school-aged children. Methods The search engines PubMed, Embase, Web of Science, PsycInfo and the Cochrane Database Library were systematically searched up to March 2016. We included all studies evaluating interventions targeting healthy sleep duration and/or bedtime routines of children aged 4–12 years. All steps in this systematic review, i.e. search, study selection, quality assessment and data extraction, were performed following CRD Guidelines and reported according to the PRISMA Statement. Results Eleven studies were included, of which only two were of strong quality. The interventions varied in terms of targeted determinants and intervention setting. Overall, no evidence was found favoring a particular intervention strategy. One intervention that delayed school start time and two multi-behavioral interventions that targeted both the school and home setting showed promising effects in terms of increasing sleep duration. Conclusion Due to few high quality studies, evidence for the effectiveness of any particular intervention strategy to stimulate healthy sleep in children is still inconclusive. However, the more effective interventions in stimulating healthy sleep duration and adherence to regular bedtimes were mostly multi-behavioral interventions that included creating daily healthy routines and combined intervention settings (e.g. home and school). In conclusion, high-quality studies evaluating systematically developed interventions are needed to move this field forward.
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Affiliation(s)
- Vincent Busch
- Department of Epidemiology & Health Promotion, Section Youth, Municipal Health Service Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Irene A Harmsen
- Department of Epidemiology & Health Promotion, Section Youth, Municipal Health Service Amsterdam, Amsterdam, The Netherlands
| | - Mai J Chinapaw
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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24
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Forrest CB, Meltzer LJ, Marcus CL, de la Motte A, Kratchman A, Buysse DJ, Pilkonis PA, Becker BD, Bevans KB. Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks. Sleep 2018; 41:4931870. [DOI: 10.1093/sleep/zsy054] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christopher B Forrest
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, CO
| | - Carole L Marcus
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Anna de la Motte
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Amy Kratchman
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brandon D Becker
- Project Performance Site: Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA
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25
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Sakamoto N, Gozal D, Smith DL, Yang L, Morimoto N, Wada H, Maruyama K, Ikeda A, Suzuki Y, Nakayama M, Horiguchi I, Tanigawa T. Sleep Duration, Snoring Prevalence, Obesity, and Behavioral Problems in a Large Cohort of Primary School Students in Japan. Sleep 2017; 40:2980939. [PMID: 28364432 DOI: 10.1093/sleep/zsw082] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Study Objectives Poor or short sleep and the presence of snoring indicative of sleep-disordered breathing (SDB) have been associated with behavioral problems in school-aged children. We examined the relationship between SDB, sleep duration, obesity risk, and behavioral characteristics in Japanese elementary school students using a large-scale survey. Methods We conducted a cross-sectional study of children enrolled in all 46 public primary schools in Matsuyama city, Japan. The children's parents or guardians completed a questionnaire that covered sleep habits, presence of SDB risk, and behavioral characteristics. Results In total, 24 296 responses were received (90% response rate). After excluding incomplete responses, we analyzed complete datasets for 17 769 children. Mean sleep duration decreased with age, as did the prevalence of pediatric SDB. We found an increased risk for the presence of SDB and short sleep among overweight/obese children. With SDB or short sleep, we observed significantly increased odds of restless behaviors, fidgety behaviors, and poor concentration in school. Conclusions Shorter sleep duration was associated with increased risk of obesity, and in turn, obesity increased SDB risk. Both short sleep duration and SDB risk were significantly associated with behavioral problems in school.
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Affiliation(s)
- Naoko Sakamoto
- Department of Epidemiologic Research, Toho University, Tokyo, Japan
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago,Chicago, IL
| | - Dale L Smith
- Department of Health Sciences, University of Chicago, Chicago, IL
| | - Limin Yang
- Medical Support Center for Japan Environment and Children's Study, Tokyo, Japan
- National Center for Child Health and Development, Tokyo, Japan
| | - Noriko Morimoto
- National Center for Child Health and Development, Tokyo, Japan
| | - Hiroo Wada
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kotatsu Maruyama
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Ai Ikeda
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yohei Suzuki
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Meiho Nakayama
- Department of Otolaryngology and Good Sleep Center, Nagoya City University, Nagoya, Japan
| | - Itsuko Horiguchi
- Center for Relations Strategy, Nagasaki University, Nagasaki, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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26
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Conway A, Miller AL, Modrek A. Testing Reciprocal Links Between Trouble Getting to Sleep and Internalizing Behavior Problems, and Bedtime Resistance and Externalizing Behavior Problems in Toddlers. Child Psychiatry Hum Dev 2017; 48:678-689. [PMID: 27796623 DOI: 10.1007/s10578-016-0692-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sleep problems are associated with problematic adjustment in toddlers, but less is known regarding the direction of association between specific sleep problems and adjustment. To address this gap, we used data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1001) to examine reciprocal associations between sleep problems and behavior problems from 24- to 36-months. Results from cross-lagged path models suggested specificity of associations between type of sleep problem and behavior problem. Specifically, there were reciprocal associations between trouble getting to sleep and internalizing problems, and unidirectional links between externalizing problems and bedtime resistance from 24- to 36-months. Internalizing and externalizing problems at 24 months, however, predicted increases in bedtime resistance from 24- to 36-months for boys, but not girls. Findings highlight specific relations between sleep problems and internalizing and externalizing problems during toddlerhood, and the importance of examining sex differences.
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Affiliation(s)
- Anne Conway
- School of Social Work, Columbia University, New York, NY, USA. .,Columbia Population Research Center, Columbia University, New York, NY, USA.
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Anahid Modrek
- Columbia Population Research Center, Columbia University, New York, NY, USA.,Developmental Psychology, Teachers College, Columbia University, New York, NY, USA
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27
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Foley JE, Weinraub M. Sleep, Affect, and Social Competence from Preschool to Preadolescence: Distinct Pathways to Emotional and Social Adjustment for Boys and for Girls. Front Psychol 2017; 8:711. [PMID: 28588517 PMCID: PMC5440503 DOI: 10.3389/fpsyg.2017.00711] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/21/2017] [Indexed: 11/13/2022] Open
Abstract
Using a normative sample of 1,057 children studied across 4 waves over 6 years with multiple informants, we investigated transactional relations for sleep problems, anxious-depressed symptoms, and social functioning from preschool to preadolescence, assessing cumulative effects on children's emotional and social adjustment. To examine sex differences in the developmental processes, we conducted separate analyses for boys and girls. For both boys and girls, longitudinal cross-lagged panel analyses showed that preschool sleep problems directly predicted anxious-depressed symptoms 2 years later; indirect effects continued into preadolescence. For girls, early and later sleep problems directly or indirectly predicted a wide variety of preadolescent emotional and social adjustment domains (e.g., depressive symptoms, school competence, emotion regulation, risk-taking behaviors). For boys, social competence played a more important role than sleep problems in predicting preadolescent adjustment. Among the first set of findings that demonstrate longitudinal relations between sleep problems and social functioning in middle childhood and preadolescence, these results support Dahl's and Walker's neurological models of sleep and emotional functioning. We discuss these findings in light of relations between sleep and affect during pre-pubertal development and discuss differential findings for boys and girls.
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Affiliation(s)
- Joan E Foley
- Family and Children's Research Collaborative, Department of Psychology, Temple UniversityPhiladelphia, PA, USA
| | - Marsha Weinraub
- Family and Children's Research Collaborative, Department of Psychology, Temple UniversityPhiladelphia, PA, USA
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28
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Chaput JP, Gray CE, Poitras VJ, Carson V, Gruber R, Olds T, Weiss SK, Connor Gorber S, Kho ME, Sampson M, Belanger K, Eryuzlu S, Callender L, Tremblay MS. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Appl Physiol Nutr Metab 2017; 41:S266-82. [PMID: 27306433 DOI: 10.1139/apnm-2015-0627] [Citation(s) in RCA: 482] [Impact Index Per Article: 68.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5-17 years. Online databases were searched in January 2015 with no date or study design limits. Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth aged 5-17 years), intervention/exposure/comparator (various sleep durations), and outcome (adiposity, emotional regulation, cognition/academic achievement, quality of life/well-being, harms/injuries, and cardiometabolic biomarkers) criteria. Because of high levels of heterogeneity across studies, narrative syntheses were employed. A total of 141 articles (110 unique samples), including 592 215 unique participants from 40 different countries, met inclusion criteria. Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being. The evidence was mixed and/or limited for the association between sleep duration and cognition, harms/injuries, and cardiometabolic biomarkers. The quality of evidence ranged from very low to high across study designs and health indicators. In conclusion, we confirmed previous investigations showing that shorter sleep duration is associated with adverse physical and mental health outcomes. However, the available evidence relies heavily on cross-sectional studies using self-reported sleep. To better inform contemporary sleep recommendations, there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.
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Affiliation(s)
- Jean-Philippe Chaput
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Casey E Gray
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Veronica J Poitras
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Valerie Carson
- b Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Reut Gruber
- c Attention, Behavior, and Sleep Laboratory, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Timothy Olds
- d Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute of Health Research, University of South Australia, Adelaide, Australia
| | - Shelly K Weiss
- e Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Sarah Connor Gorber
- f Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Michelle E Kho
- g School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Margaret Sampson
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Kevin Belanger
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Sheniz Eryuzlu
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Laura Callender
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Mark S Tremblay
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
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Abstract
OBJECTIVE To assess the effectiveness and feasibility of behavioral sleep intervention for medicated children with ADHD. METHOD Six medicated children (five boys, one girl; aged 6-12 years) with ADHD participated in a 4-week sleep intervention program. The main behavioral strategies used were Faded Bedtime With Response Cost (FBRC) and positive reinforcement. Within a case-series design, objective measure (Sleep Disturbance Scale for Children [SDSC]) and subjective measure (sleep diaries) were used to record changes in children's sleep. RESULTS For all six children, significant decrease was found in the severity of children's sleep problems (based on SDSC data). Bedtime resistance and mean sleep onset latency were reduced following the 4-week intervention program according to sleep diaries data. Gains were generally maintained at the follow-up. Parents perceived the intervention as being helpful. CONCLUSION Based on the initial data, this intervention shows promise as an effective and feasible treatment.
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Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. J Clin Sleep Med 2016; 12:1549-1561. [PMID: 27707447 DOI: 10.5664/jcsm.6288] [Citation(s) in RCA: 355] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 12/13/2022]
Abstract
ABSTRACT Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. COMMENTARY A commentary on this article apears in this issue on page 1439.
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Affiliation(s)
| | - Lee J Brooks
- Children's Hospital of Philadelphia, Philadelphia, PA.,Liaison for the American Academy of Pediatrics
| | | | - Wendy A Hall
- University of British Columbia School of Nursing, Vancouver, BC
| | | | | | - Beth A Malow
- Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | | | | | - Merrill S Wise
- Methodist Healthcare Sleep Disorders Center, Memphis, TN
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Brown KM, Malow BA. Pediatric Insomnia. Chest 2016; 149:1332-9. [DOI: 10.1378/chest.15-0605] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 08/15/2015] [Accepted: 08/23/2015] [Indexed: 11/01/2022] Open
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Spruyt K, Alaribe CU, Nwabara OU. Daily dynamics in sleep and behavior of young African-American children: A convoluted dyad?! Int J Psychophysiol 2015; 99:57-66. [PMID: 26548618 DOI: 10.1016/j.ijpsycho.2015.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/26/2015] [Accepted: 11/04/2015] [Indexed: 12/22/2022]
Abstract
Prior research has provided evidence that in children sleep and behavior are related. We aimed to determine the association between naturalistic daily variations in sleep and behavioral functioning. African American children, 5.4±1.7years old, living on the south side of Chicago participated in a repeated measures study to assess this sleep-behavior link. Data was obtained from three separate two-week periods of 24-hour actigraphy and the parental version of the Behavioral Assessment System for Children. Canonical correlations analyses were applied to investigate the relation between individual changes in sleep and behavior. After 1-month, weekday average sleep duration primarily related to internalizing behaviors, while within-child variability of sleep related to behavioral changes which may involve internalizing and externalizing symptoms. Week-weekend differences in sleep associated with maladaptive social skills. Over a 6-week period, sleep onset latency and sleep offset latency related to behavioral symptoms and maladaptive skills. Over a period of 3-months, sleep associated with symptomatic behaviors while the adverse impact of within-child variability of sleep attenuated. Alternatively, the week-weekend differences in bedtime, wake-up time, wake after sleep onset and sleep onset latency in particular related to internalizing and externalizing behavior problems. Findings showed that poor sleep related to dysfunctional behaviors. While maladaptive at the beginning, they may develop into symptomatic behaviors with potentially internalizing characteristics. As time goes on, individual changes in sleep onset and offset might be important clinical markers of a chronic 'social dysregulation'. Continued sufficient and regular sleep may improve daytime and nighttime behavioral regulation in early childhood.
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Affiliation(s)
- Karen Spruyt
- Faculty of Psychology and Educational Sciences, Pleinlaan 2, 1050, Vrije Universiteit Brussel, Belgium; GKC-Rett Expertise Center - MHeNS, Maastricht University, PO Box 616, 6200 MD Maastricht, Netherlands; Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center affiliated with Shanghai Jiaotong University School of Medicine, 1678 Dongfang Road, Pudong, Shanghai, China.
| | - Calista U Alaribe
- College of Health Sciences, Department of Health Studies, Chicago State University, 9501 S King Dr, Chicago, IL 60628, USA
| | - Odochi U Nwabara
- College of Health Sciences, Department of Health Studies, Chicago State University, 9501 S King Dr, Chicago, IL 60628, USA
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Iwadare Y, Kamei Y, Usami M, Ushijima H, Tanaka T, Watanabe K, Kodaira M, Saito K. Behavioral symptoms and sleep problems in children with anxiety disorder. Pediatr Int 2015; 57:690-3. [PMID: 25754117 DOI: 10.1111/ped.12620] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 12/24/2014] [Accepted: 01/23/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep disorders are frequently associated with childhood behavioral problems and mental illnesses such as anxiety disorder. To identify promising behavioral targets for pediatric anxiety disorder therapy, we investigated the associations between specific sleep and behavioral problems. METHODS We conducted retrospective reviews of 105 patients aged 4-12 years who met the DSM-IV criteria for primary diagnosis of generalized anxiety disorder (n = 33), separation anxiety disorder (n = 23), social phobia (n = 21), or obsessive compulsive disorder (n = 28). Sleep problems were evaluated using the Children's Sleep Habits Questionnaire (CSHQ) and behavioral problems by the Spence Children's Anxiety Scale, Oppositional Defiant Behavior Inventory (ODBI), and Depression Self-Rating Scale for Children. RESULTS Depressive behavior was weakly correlated with CSHQ subscores for sleep onset delay and night waking but not with total sleep disturbance. Anxiety was correlated with bedtime resistance, night waking, and total sleep disturbance score. Oppositional defiance was correlated with bedtime resistance, daytime sleepiness, sleep onset delay, and most strongly with total sleep disturbance. On multiple regression analysis ODBI score had the strongest positive association with total sleep disturbance and the strongest negative association with total sleep duration. CONCLUSIONS Sleep problems in children with anxiety disorders are closely related to anxiety and oppositional defiant symptoms.
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Affiliation(s)
- Yoshitaka Iwadare
- Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Yuichi Kamei
- Department of Clinical Laboratory, National Center Hopsital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Masahide Usami
- Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Hirokage Ushijima
- Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Tetsuya Tanaka
- Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Kyota Watanabe
- Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
| | - Masaki Kodaira
- Department of Child and Adolescent Psychiatry, Aiiku Hospital, Minato, Japan
| | - Kazuhiko Saito
- Department of Child and Adolescent Psychiatry, Aiiku Hospital, Minato, Japan
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Hughes A, Gallagher S, Hannigan A. A Cluster Analysis of Reported Sleeping Patterns of 9-Month Old Infants and the Association with Maternal Health: Results from a Population Based Cohort Study. Matern Child Health J 2015; 19:1881-9. [DOI: 10.1007/s10995-015-1701-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sleep-wake patterns reported by parents in hyperactive children diagnosed according to ICD-10, as compared to paired controls. Child Psychiatry Hum Dev 2014; 45:533-43. [PMID: 24276394 DOI: 10.1007/s10578-013-0422-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study aimed primarily to compare the parent-reported sleep of children with ICD-10 hyperkinetic disorder (HKD) versus community children. Thirty children aged 5-13 years (83.3% boys) diagnosed with HKD by their child and adolescent psychiatrists took part in this study, plus 30 community children, matched for sex, age, and school year. Compared to the controls, the HKD children showed significantly later bedtimes, stronger bedtime resistance, longer sleep latency, shorter sleep; more frequent behaviors and symptoms concerning falling asleep into parents bed, needing something special to initiate sleep, nightmares, sleep talking, sleep bruxism, fear from darkness, bedwetting, and, most notably, loud snoring (26.7%); they also tended to show higher daytime somnolence. Attention deficit/hyperactivity disorder (ADHD)/HKD children may thus have more sleep-related problems than typically developing children. Alternatively, our results may reflect misdiagnoses; thus, special attention should be directed to comorbidity and differential diagnosis issues between sleep disturbances and ADHD/HKD.
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Li L, Ren J, Shi L, Jin X, Yan C, Jiang F, Shen X, Li S. Frequent nocturnal awakening in children: prevalence, risk factors, and associations with subjective sleep perception and daytime sleepiness. BMC Psychiatry 2014; 14:204. [PMID: 25079476 PMCID: PMC4261897 DOI: 10.1186/1471-244x-14-204] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 06/25/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Nocturnal awakening is the most frequent insomnia complaint in the general population. In contrast to a growing knowledge based on adults, little is known about its prevalence, correlated factors, and associations with subjective sleep perception and daytime sleepiness in children. This study was designed to assess the prevalence and the correlate factors of frequent nocturnal awakening (FNA) among Chinese school-aged children. Furthermore, the associations of FNA with subjective sleep perception and daytime sleepiness were examined. METHODS A random sample of 20,505 children aged 5.00 to 11.92 years old (boys: 49.5% vs. girls: 50.5%) participated in a cross-sectional survey, which was conducted in eight cities of China. Parent-administered questionnaires were used to collect information on children's sleep behaviors, sleep perception, and potential influential factors of FNA from six domains. Univariate and multivariate logistic regression models were performed. RESULTS The prevalence of FNA was 9.8% (10.0% for boys vs. 8.9% for girls) in our sampled children. The prominent FNA-related factors inclued biological health problems, such as overweight/obesity (OR = 1.70), chronic pain during night (OR = 2.47), and chronic respiratory condition (OR = 1.23), poor psychosocial condition, such as poor mental and emotional functioning (OR = 1.34), poor sleep hygiene, such as frequently doing exciting activities before bedtime (OR = 1.24) and bedtime resistance (OR = 1.42), and parents' history of insomnia (OR = 1.31). FNA was associated with subjective poor sleep quality (OR = 1.24), subjective insufficient sleep (OR = 1.21), and daytime sleepiness (OR = 1.35). CONCLUSION FNA was associated with poor sleep and daytime sleepiness. Compared to sleep environment and family susceptibility, chronic health problems, poor psychosocial condition, and poor sleep hygiene had greater impact on FNA, indicating childhood FNA could be partly prevented by health promotion, by psychological intervention, and by improving sleep hygiene routine.
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Affiliation(s)
- Liwen Li
- MOE - Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Kong Jiang Road No.1665, Shanghai, 200092 China ,School of Public Health, Shanghai Jiao Tong University, South Chongqing Road No.227, Shanghai, 200027 China
| | - Jiwei Ren
- Shanxi Third People’s Hospital, Shanxi Cancer research center, Zhigong New Street No.3, Taiyuan, 030013 Shanxi, China
| | - Lei Shi
- MOE - Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Kong Jiang Road No.1665, Shanghai, 200092 China
| | - Xinming Jin
- Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Dongfang Road No.1678, 2000127 Shanghai, China
| | - Chonghuai Yan
- MOE - Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Kong Jiang Road No.1665, Shanghai, 200092 China
| | - Fan Jiang
- Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Dongfang Road No.1678, 2000127 Shanghai, China
| | - Xiaoming Shen
- MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Kong Jiang Road No,1665, Shanghai 200092, China.
| | - Shenghui Li
- MOE - Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Kong Jiang Road No.1665, Shanghai, 200092 China ,School of Public Health, Shanghai Jiao Tong University, South Chongqing Road No.227, Shanghai, 200027 China
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Armstrong JM, Ruttle PL, Klein MH, Essex MJ, Benca RM. Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence. Sleep 2014; 37:901-9. [PMID: 24790268 DOI: 10.5665/sleep.3656] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. DESIGN A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. SETTING Community. PARTICIPANTS A total of 396 children (51% female). INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9-10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. CONCLUSIONS Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18.
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Affiliation(s)
- Jeffrey M Armstrong
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Paula L Ruttle
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Marjorie H Klein
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Marilyn J Essex
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Ruth M Benca
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
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Kelly Y, Kelly J, Sacker A. Changes in bedtime schedules and behavioral difficulties in 7 year old children. Pediatrics 2013; 132:e1184-93. [PMID: 24127471 DOI: 10.1542/peds.2013-1906] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Causal links between disrupted sleep and behavioral problems in nonclinical populations are far from clear. Research questions were as follows: Are bedtime schedules associated with behavioral difficulties? Do effects of bedtime schedules on behavior build up over early childhood? Are changes in bedtime schedules linked to changes in behavior? METHODS Data from 10,230 7-year-olds from the UK Millennium Cohort Study, with bedtime data collected at 3, 5, and 7 years, and behavioral difficulties scores as rated by mothers and teachers were analyzed. RESULTS Children with nonregular bedtimes had more behavioral difficulties. There was an incremental worsening in behavioral scores as exposure through early childhood to not having regular bedtimes increased: mother rated (nonregular any 1 age, β = 0.53; nonregular any 2 ages, β = 1.04; nonregular all 3 ages, β = 2.10, P < .001) and teacher rated (β = 0.22, β = 0.73, β = 1.85, P < .001). Difference in differences analysis showed that for children who changed from nonregular to regular bedtimes there were clear nontrivial, statistically significant improvements in behavioral scores: A change between age 3 and 7 corresponded to a difference of β = -0.63, and a change between age 5 and 7 corresponded to a difference of β = -1.02). For children who changed from regular to nonregular bedtimes between ages 5 and 7 there was a statistically significant worsening in scores, β = 0.42. CONCLUSIONS Having regular bedtimes during early childhood is an important influence on children's behavior. There are clear opportunities for interventions aimed at supporting family routines that could have important impacts on health throughout life.
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Affiliation(s)
- Yvonne Kelly
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
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40
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Wang G, Xu G, Liu Z, Lu N, Ma R, Zhang E. Sleep patterns and sleep disturbances among Chinese school-aged children: prevalence and associated factors. Sleep Med 2012; 14:45-52. [PMID: 23218539 DOI: 10.1016/j.sleep.2012.09.022] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 09/28/2012] [Accepted: 09/29/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The study aimed to (1) characterize sleep patterns and sleep disturbances among Chinese school-aged children, (2) determine the prevalence of their short sleep duration and sleep disturbances based on clinical cutoffs, and (3) examine possible factors (socio-demographic factors and emotional/behavioral problems) that are associated with sleep disturbances. METHODS A large representative sample of 912 children aged 6-14years was recruited from Shenzhen, China. Their parents completed the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). RESULTS The mean bedtime was 9:45pm (SD=1h 11min), mean wake-up time was 7:03am (SD=31min), mean sleep duration was 9h 14min (SD=46min), and 23.8% of the children had sleep duration <9h. Overall, 69.3% of the children suffered from global sleep disturbances (CSHQ total score >41). Bedtime resistance (22.9%), sleep anxiety (22.1%), sleep duration (21%) and daytime sleepiness (20%) were the most prevalent sleep disturbances; followed by sleep disordered breathing (12.1%), parasomnias (9.4%), sleep onset delay (6.9%), and night waking (5.2%). The prevalence of specific sleep disturbances ranged from 3.2% (falling asleep while watching television) to 81.9% (awakening by others in the morning). Correlations between most domains of sleep disturbances and emotional/behavioral problems were statistically significant (p<0.05 or p<0.01). Hierarchical multiple regression analysis revealed that gender (β=0.10, p<0.01), school grade (β=-0.09, p<0.05), co-sleeping (β=0.25, p<0.01), emotional symptoms (β=0.24, p<0.01), conduct problems (β=0.09, p<0.05), and hyperactivity (β=0.17, p<0.01) accounted for significant variance in CSHQ total score. CONCLUSIONS Short sleep duration and sleep disturbances are prevalent among Chinese school-aged children. Sleep disturbances are associated with gender, school grade, co-sleeping, emotional symptoms, conduct problems, and hyperactivity.
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Affiliation(s)
- Guanghai Wang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China.
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Calhoun SL, Fernandez-Mendoza J, Vgontzas AN, Mayes SD, Tsaoussoglou M, Rodriguez-Muñoz A, Bixler EO. Learning, attention/hyperactivity, and conduct problems as sequelae of excessive daytime sleepiness in a general population study of young children. Sleep 2012; 35:627-32. [PMID: 22547888 PMCID: PMC3321421 DOI: 10.5665/sleep.1818] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Although excessive daytime sleepiness (EDS) is a common problem in children, with estimates of 15%; few studies have investigated the sequelae of EDS in young children. We investigated the association of EDS with objective neurocognitive measures and parent reported learning, attention/hyperactivity, and conduct problems in a large general population sample of children. DESIGN Cross-sectional. SETTING Population based. PARTICIPANTS 508 children from The Penn State Child Cohort. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Children underwent a 9-h polysomnogram, comprehensive neurocognitive testing, and parent rating scales. Children were divided into 2 groups: those with and without parent-reported EDS. Structural equation modeling was used to examine whether processing speed and working memory performance would mediate the relationship between EDS and learning, attention/hyperactivity, and conduct problems. Logistic regression models suggest that parent-reported learning, attention/hyperactivity, and conduct problems, as well as objective measurement of processing speed and working memory are significant sequelae of EDS, even when controlling for AHI and objective markers of sleep. Path analysis demonstrates that processing speed and working memory performance are strong mediators of the association of EDS with learning and attention/hyperactivity problems, while to a slightly lesser degree are mediators from EDS to conduct problems. CONCLUSIONS This study suggests that in a large general population sample of young children, parent-reported EDS is associated with neurobehavioral (learning, attention/hyperactivity, conduct) problems and poorer performance in processing speed and working memory. Impairment due to EDS in daytime cognitive and behavioral functioning can have a significant impact on children's development.
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Affiliation(s)
- Susan L Calhoun
- Sleep Research and Treatment Center, Pennsylvania State University College of Medicine, Hershey, PA, USA.
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Psychometric properties of an omnibus sleep problems questionnaire for school-aged children. Sleep Med 2012; 13:390-5. [DOI: 10.1016/j.sleep.2011.12.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 12/09/2011] [Accepted: 12/29/2011] [Indexed: 11/23/2022]
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Gill AI, Schaughency E, Gray A, Galland BC. Reliability of home-based physiological sleep measurements in snoring and non-snoring 3-year olds. Sleep Breath 2012; 17:147-56. [PMID: 22327554 DOI: 10.1007/s11325-012-0663-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 01/10/2012] [Accepted: 01/30/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE To study snoring and non-snoring 3-year olds in their own homes and to establish reference values and night-to-night variability of physiological measurements taken during sleep. METHODS One hundred and sixty-six children, aged 3.2-4.0 years, identified as at high (n = 83, M/F = 1.5:1) or low (n = 83, M/F = 1.4:1) risk for persistent snoring, as rated by a parent, wore a sleep screening system (Grey Flash) for up to five consecutive nights, to measure snoring, oxygen saturation, heart rate, movement, sleep efficiency, and sleep timing. RESULTS The snoring group snored 25% of their total sleep time, while the non-snoring group snored just 7.6%. Reliability estimates were calculated, using intraclass correlations to establish the reliability of single recordings and the Spearman-Brown prophecy formula to estimate reliability over multiple recordings. Snoring (percent), turn index (number of turns per hour), and mean heart rate were adequately assessed in both groups with one recording night (all intraclass correlation coefficients (ICCs) ≥0.70). Furthermore, mean SpO(2) was measured with sufficient reliability with two recordings in non-snorers (ICC = 0.71), while five recording nights were necessary to reach reliability in snorers (ICC = 0.71). SpO(2) nadir did not reach adequate reliability in either group even after seven recording nights. CONCLUSIONS Our results showed that snoring can be measured reliably at home with just one recording night, whereas most other physiological sleep measures require two or more recordings.
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Affiliation(s)
- Amelia I Gill
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
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Carotenuto M, Esposito M, Parisi L, Gallai B, Marotta R, Pascotto A, Roccella M. Depressive symptoms and childhood sleep apnea syndrome. Neuropsychiatr Dis Treat 2012; 8:369-73. [PMID: 22977304 PMCID: PMC3430390 DOI: 10.2147/ndt.s35974] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The relationship between sleep and mood regulation is well known, and some reports suggest a key role of sleep-related breathing disorders (SRBD) in the development of the symptomatology of depression, even if no conclusive data are actually found in the clinical literature. The aim of this study was to assess the relationship between SRBD and depressive symptoms in a population of school-aged children. METHODS The study population comprised 94 children affected by SRBD and 107 healthy children. To identify the severity of SRBD, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Children Depression Inventory (CDI) to screen for the presence of depressive symptoms. RESULTS The group with SRBD showed higher CDI scores than the group without SRBD, with a positive correlation found between CDI scores, apnea-hypopnea index, and oxygen desaturation index values. Logistic regression showed that an apnea-hypopnea index ≥ 3 and an oxygen desaturation index ≥ 1 could be risk factors for development of depressive symptoms. According to receiver-operating characteristic curve analysis, the cutoff point for the apnea-hypopnea index that could cause a pathological CDI score (≥19) was >5.66, and the cutoff point for the oxygen desaturation index was >4.2. The limitations of this study are that our data are derived from one single psychometric test and not from a complete psychiatric evaluation, and our subjects came from a small group in southern Italy. CONCLUSION Our results suggest the importance of mood assessment in children affected by SRBD.
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Affiliation(s)
- Marco Carotenuto
- Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy
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GIBSON R, GANDER P, ELDER D. Factors differentiating infants identified by parents as problem sleepers, and those that are not. Sleep Biol Rhythms 2011. [DOI: 10.1111/j.1479-8425.2011.00517.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Paine S, Gradisar M. A randomised controlled trial of cognitive-behaviour therapy for behavioural insomnia of childhood in school-aged children. Behav Res Ther 2011; 49:379-88. [DOI: 10.1016/j.brat.2011.03.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 03/11/2011] [Accepted: 03/28/2011] [Indexed: 11/29/2022]
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Calhoun SL, Vgontzas AN, Fernandez-Mendoza J, Mayes SD, Tsaoussoglou M, Basta M, Bixler EO. Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep. Sleep 2011; 34:503-7. [PMID: 21461329 DOI: 10.1093/sleep/34.4.503] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES We investigated the prevalence and association of excessive daytime sleepiness (EDS) with a wide range of factors (e.g., medical complaints, obesity, objective sleep [including sleep disordered breathing], and parent-reported anxiety/depression and sleep difficulties) in a large general population sample of children. Few studies have researched the prevalence and predictors of EDS in young children, none in a general population sample of children, and the results are inconsistent. DESIGN Cross-sectional SETTING Population -based. PARTICIPANTS 508 school-aged children from the general population. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Children underwent a 9-hour polysomnogram (PSG), physical exam, and parent completed health, sleep and psychological questionnaires. Children were divided into 2 groups: those with and without parent reported EDS. The prevalence of subjective EDS was approximately 15%. Significant univariate relationships were found between children with EDS and BMI percentile, waist circumference, heartburn, asthma, and parent reported anxiety/depression, and sleep difficulties. The strongest predictors of EDS were waist circumference, asthma, and parent-reported symptoms of anxiety/depression and trouble falling asleep. All PSG sleep variables including apnea/hypopnea index, caffeine consumption, and allergies were not significantly related to EDS. CONCLUSIONS It appears that the presence of EDS is more strongly associated with obesity, asthma, parent reported anxiety/depression, and trouble falling asleep than with sleep disordered breathing (SDB) or objective sleep disruption per se. Our findings suggest that children with EDS should be thoroughly assessed for anxiety/depression, nocturnal sleep difficulties, asthma, obesity, and other metabolic factors, whereas objective sleep findings may not be as clinically useful.
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Affiliation(s)
- Susan L Calhoun
- Sleep Research and Treatment Center, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
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48
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Taanila A, Yliherva A, Kaakinen M, Moilanen I, Ebeling H. An epidemiological study on Finnish school-aged children with learning difficulties and behavioural problems. Int J Circumpolar Health 2011; 70:59-71. [PMID: 21342613 DOI: 10.3402/ijch.v70i1.17799] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate the association between learning difficulties (LDs) and behavioural and emotional problems of 8-year-old children in the Northern Finland Birth Cohort 1986 (n=9432). STUDY DESIGN A cross-sectional study. METHODS Teachers assessed children's behaviour with a Rutter scale (RB2) and assessed their learning with questions about whether a child had difficulties in reading, spelling and mathematics. RESULTS Of the children, 21.4% (n=1774) had 1 or more learning difficulties (LDs): 12.3% (n=1026) had a verbal LD, 3.0% (n=248) a mathematical LD and 6.0% (n=500) a combined LD. For boys with LDs, an adjusted odds ratio of having behavioural problems was 3.1 (95% CI 2.5-4.0) and emotional problems 3.0 (2.0-4.6), and for girls 3.9 (2.6-5.8) and 5.3 (3.6-8.1), respectively. In boys and girls, verbal difficulties were associated with behavioural and emotional problems whereas mathematical difficulties were associated with behavioural problems in boys and with emotional problems in girls. Divorced and reconstructed family types were significant risk factors for LDs and behavioural problems, whereas a lifelong one-parent family type was a risk factor for behavioural problems, but not for LDs. A child's younger age compared to that of classmates, a mother's and a father's low education level and a low family SES were risk factors for having LDs. CONCLUSION More attention should be paid to children whose families are facing adverse circumstances, especially as it affects their preschool education, in order to support their learning and school attendance.
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Affiliation(s)
- Anja Taanila
- Institute of Health Sciences, University of Oulu, 90014 University of Oulu, Finland.
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Li S, Zhu S, Jin X, Yan C, Wu S, Jiang F, Shen X. Risk factors associated with short sleep duration among Chinese school-aged children. Sleep Med 2011; 11:907-16. [PMID: 20817554 DOI: 10.1016/j.sleep.2010.03.018] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 03/17/2010] [Accepted: 03/19/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To examine risk factors regarding short sleep duration among Chinese school-aged children. METHODS A random sample of 20,778 children aged around 5-11years participated in a cross-sectional survey, which was conducted in eight cities of China in 2005. A parent-administered questionnaire was used to collect information on children's sleep duration and possible related factors from eight domains. Short sleep duration was defined as total sleep duration <9h per day. RESULTS In all, 28.3% of the sampled children slept <9h per day. The multivariate logistic regression identified, after adjusting for demographic and socioeconomic variables, factors associated with short sleep duration: more television viewing during weekdays (OR=1.21, p=0.004), more frequent computer/internet using (OR=1.17, p=0.006), earlier school starting time (OR=1.10, p=0.020), more time on homework during weekdays (OR=1.66, p<0.001) and weekends (OR=1.14, p=0.001), poor bedtime hygiene (e.g., having drinks with caffeine after 6:00PM [OR=1.22, p<0.001], doing exciting activities during bedtime [OR=1.16, p<0.001], and irregular bedtime [OR=1.55, p<0.001]), and shorter sleep duration of parents (mother: OR=1.31, p<0.001 for sleep duration <6h and OR=1.24, p=0.006 for 6-8h; father: OR=1.52, p<0.001 for <6h and OR=1.19, p<0.001 for 6-8h). CONCLUSIONS Factors associated with sleep duration covered multidimensional domains among school-aged children. Compared to sleep environments and chronic health problems, school schedules, lifestyle patterns, and parents' sleep habits had greater impact on children's sleep duration, indicating the existing chronic sleep loss in school children could be, at least partly, intervened by reducing the use of visual technologies, by changing the school schedules, by improving the sleep hygiene routine, and by regulating parents' sleep habits.
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Affiliation(s)
- Shenghui Li
- Shanghai Xin Hua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
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Pediatric sleep questionnaires as diagnostic or epidemiological tools: a review of currently available instruments. Sleep Med Rev 2010; 15:19-32. [PMID: 20934896 DOI: 10.1016/j.smrv.2010.07.005] [Citation(s) in RCA: 259] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Revised: 07/10/2010] [Accepted: 07/13/2010] [Indexed: 11/20/2022]
Abstract
An extensive list of published and unpublished instruments used to investigate or evaluate sleep issues in children was collected and assessed based on the fundamental operational principles of instrument development (11 steps). Of all the available tools identified, only a few were validated and standardized using appropriate psychometric criteria. In fact, only 2 fulfill all desirable criteria and approximately 11 instruments seem to adhere to most of the psychometric tool development requirements, and were therefore assessed in greater detail. Notwithstanding, in the rapidly developing scientific world of pediatric sleep, there are too many tools being used that have not undergone careful and methodical psychometric evaluation, and as such may be fraught with biased or invalid findings. It is hoped that this initial effort in categorizing and assessing available tools for pediatric sleep will serve as recognition of the relatively early developmental stage of our field, and provide the necessary impetus for future tool development using multicentered approaches and adequate methodologies.
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