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Balthazar FM, Moraes WADS, Hunter JR, Prado GFD, Carvalho LBCD. Interaction between apolipoprotein E genotypes, excessive daytime sleepiness, and cognitive function in obstructive sleep apnea patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1104-1111. [PMID: 36577409 PMCID: PMC9797275 DOI: 10.1055/s-0042-1758399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Some studies show an association between the apolipoprotein E ε4 allele (ApoEε4) and obstructive sleep apnea syndrome (OSAS), and other studies, an association between ApoEε4 and excessive daytime sleepiness (EDS), but there are no data in the literature on the interaction between EDS, cognitive function, and ApoEε4 in patients with OSA. OBJECTIVE To examine the cognitive function of adults with and without EDS and with and without ApoEε4. METHODS A total of 21 male and female patients aged between 33 and 79 years, underwent a clinical interview, ApoE genotyping, neuropsychological evaluation, polysomnography, and the application of the Epworth Sleepiness Scale. RESULTS Excessive daytime sleepiness was associated with lower intelligence quotient (IQ; total performance) and worse immediate visual memory, regardless of the ApoE genotype. Patients carrying the ApoEε3/ε4 genotype had a worse performance in divided attention, constructional praxis, perceptual organization, and cognitive flexibility. A combination of the ε4 allele and EDS potentiates the negative effect on cognition, except for immediate visual memory. In this case, patients had a worse performance in terms of processing speed, selective attention, and visuomotor coordination. CONCLUSIONS Excessive daytime sleepiness and the ApoEε3/ε4 genotype are associated with worse cognitive performance in OSA patients. The combination of EDS and ε4 allele potentiates cognitive impairment.
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Affiliation(s)
- Fernanda Maurer Balthazar
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
| | - Walter André dos Santos Moraes
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
| | - James Richard Hunter
- Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Infectologia, São Paulo SP, Brazil.
| | - Gilmar Fernandes do Prado
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
| | - Luciane Bizari Coin de Carvalho
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
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Li Y, Xiao X, Wang L, Wang Q, Liang R, Zheng C, Yang J, Ming D. Comparison effects of chronic sleep deprivation on juvenile and young adult mice. J Sleep Res 2021; 31:e13399. [PMID: 34137107 DOI: 10.1111/jsr.13399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/04/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
Sleeplessness leads to a spectrum of neuropsychiatric disorders, affecting both juveniles and young adults. Studies have shown different sleep patterns at different stages of development. However, the molecular mechanisms underlying the effects of the same chronic sleep deprivation (CSD) on behaviours of juveniles and young adults remain elusive. Here, we aimed to evaluate the effects of CSD (6 days, 19 h per day) on anxiety-like behaviour, cognitive performance and molecular alterations in juvenile and young adult mice. Change in body weight suggested impaired physical development in CSD animals, specifically juveniles gaining weight at a lower rate and young adults losing weight. Behavioural performance indicated that CSD had little effect on spatial memory, but induced analogous anxiety-like phenotypes in both juveniles and young adults, as evidenced by no significant difference in the Y-maze experiment (Y-M) or the Morris water maze experiment (MWM), as well as the decreased open-arm distance percentage in the elevated plus maze experiment (EPM). In addition, CSD reduced the N-methyl-D-aspartic receptor subunit 2B (NR2B) and postsynaptic density protein 95 (PSD95) levels in juveniles, but these were increased in young adults. In conclusion, our results suggested that although CSD resulted in analogous anxiety-like behaviours in both juvenile and young adult mice, the underlying mechanisms might be different, which was indicated by the opposite change of synaptic proteins under CSD. These findings may help to better understand the important role of sleep and have constructive significance for human health.
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Affiliation(s)
- Yaqing Li
- Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Xi Xiao
- Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Ling Wang
- School of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin, China
| | - Qian Wang
- Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Rong Liang
- Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Chenguang Zheng
- Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.,School of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin, China
| | - Jiajia Yang
- Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.,School of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin, China
| | - Dong Ming
- Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.,School of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin, China
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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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de Almeida GMF, Nunes ML. Sleep characteristics in Brazilian children and adolescents: a population-based study. Sleep Med X 2019; 1:100007. [PMID: 33870166 PMCID: PMC8041111 DOI: 10.1016/j.sleepx.2019.100007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 11/30/2022] Open
Abstract
Objective/background To evaluate sleep characteristics in Brazilian children and adolescents aged 0–19 years and determine the prevalence of sleep disturbances (SDs) and their association with regional differences and socioeconomic status (SES). Patients/methods The target population was divided into three age groups: 0–3 years, 4–12 years, and 13–19 years. An online questionnaire based on Brazilian versions of instruments for sleep assessment was made available to participants from 2014 to 2017. Sleep habits were characterized following the recommendations of the instruments and of the National Sleep Foundation. Data were evaluated by bivariate analyses and logistic regression analyses (p ≤ 0.05). Results A total of 1180 respondents were included, representative of all Brazilian regions and SES levels. Inadequate bedtime habits and total sleep time below the recommended levels were observed in all age groups. Overall SD prevalence was 25.5%. Increased risk of SDs was associated with a current health problem in children aged 0–3 years, with hospitalization after birth and sleeping in parents' bed in children aged 4–12 years, and with medication use and playing video games/using the cell phone before sleep in adolescents. There was no significant difference in SD rates between the regions. There was an increased risk of SDs in children with low SES (0–3 years), lower middle SES (4–12 years), and high SES (13–19 years). Conclusions Brazilian children and adolescents overall present inadequate sleep habits and sleep duration lower than recommended. SDs increased with age, reaching a peak in adolescence, with an influence of SES on these disturbances. Brazilian children and adolescents overall present inadequate sleep habits. Sleep duration is lower than recommended in children and adolescents. Low socioeconomic status increased the risk of sleep disturbances in children. High socioeconomic status increased the risk of sleep disturbances in adolescents. Co-sleeping was found in 38.8% and inadequate sleep position in 68.8% of infants.
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Fernandes MDBL, Salgueiro AGNS, Bighetti EJB, Trindade-Suedam IK, Trindade IEK. Symptoms of Obstructive Sleep Apnea, Nasal Obstruction, and Enuresis in Children With Nonsyndromic Cleft Lip and Palate: A Prevalence Study. Cleft Palate Craniofac J 2018; 56:307-313. [PMID: 29775557 DOI: 10.1177/1055665618776074] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of symptoms of obstructive sleep apnea (OSA), nasal obstruction, and enuresis in children with nonsyndromic unilateral cleft lip and palate. DESIGN Prospective cross-sectional study. SETTING Referral care center. PARTICIPANTS One hundred seventy-four children aged 6 to 12 years of both genders. INTERVENTIONS Symptoms of OSA and nasal obstruction were investigated by analysis of scores obtained by the Sleep Disturbance Scale for Children (SDSC) and Congestion Quantifier (CQ-5). Enuresis was considered as present when urinary loss was reported during sleep (at least 1 episode/month, last 3 months). To characterize the enuresis as mono- or polysymptomatic, symptoms of dysfunction of the lower urinary tract (DLUT) were investigated by the Dysfunctional Voiding Scoring System (DVSS). Statistical analysis was performed at a 5% level of significance. RESULTS Positive SDSC scores for OSA were observed in 60 (34%) children; positive CQ-5 scores for nasal obstruction in 45 (26%), positive DVSS scores for DLUT in 30 (17%), and enuresis was reported by 29 (17%), being categorized as primary in 66% and polysymptomatic in 72% of the children. Compared to the pediatric population, OSA, nasal obstruction, and enuresis prevalence ratios were up to 7 (95% confidence interval [CI] 5-9), 2 (95% CI 2-3), and 3 times (95% CI 2-5) higher, respectively. There was a positive/moderate correlation between symptoms of OSA and nasal obstruction ( P = .0001). No correlation was seen between symptoms of OSA and enuresis. CONCLUSIONS Children with nonsyndromic cleft lip and palate have high prevalence of nasal obstruction and enuresis and are at risk of OSA.
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Affiliation(s)
| | | | - Eliete Janaína Bueno Bighetti
- 1 Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru-SP, Brazil
| | - Ivy Kiemle Trindade-Suedam
- 2 Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru-SP, Brazil
| | - Inge Elly Kiemle Trindade
- 2 Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru-SP, Brazil
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Abstract
Sleep issues are common in preschoolers, defined in this article as ages 3 to 5 years. Sleep deprivation can cause behavioral and cognitive issues. Sleep issues seen in the preschool years include insomnia, obstructive sleep apnea, parasomnias, and restless legs syndrome. Sleep issues seem to exacerbate mood and attention disturbances. Conversely, children with psychiatric disorders are likely to have sleep problems. Treatment of sleep issues is important for long-term mental health and optimization of functioning.
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Affiliation(s)
- Amy Licis
- Department of Neurology, Washington University School of Medicine, Campus Box 8111, 660 South Euclid Avenue, St Louis, MO 63110, USA.
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Leite Filho CA, Silva FFD, Pradella-Hallinan M, Xavier SD, Miranda MC, Pereira LD. Auditory behavior and auditory temporal resolution in children with sleep-disordered breathing. Sleep Med 2017; 34:90-95. [PMID: 28522104 DOI: 10.1016/j.sleep.2017.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 02/26/2017] [Accepted: 03/04/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Intermittent hypoxia caused by obstructive sleep apnea syndrome (OSAS) may lead to damage in brain areas associated to auditory processing. The aim of this study was to compare children with OSAS or primary snoring (PS) to children without sleep-disordered breathing with regard to their performance on the Gaps-in-Noise (GIN) test and the Scale of Auditory Behaviors (SAB) questionnaire. METHODS Thirty-seven children (6-12 years old) were submitted to sleep anamnesis and in-lab night-long polysomnography. Three groups were organized according to clinical criteria: OSAS group (13 children), PS group (13 children), and control group (11 children). They were submitted to the GIN test and parents answered SAB questionnaire. The Kruskal-Wallis statistical test was used to compare the groups; p < 0.05 was considered statistically significant. RESULTS The OSAS group performed significantly worse than PS (p = 0.011) and Control (p = 0.029) groups on gap detection percentage, while PS and Control groups showed no significant differences. The three groups showed similar gap detection thresholds. Regarding SAB questionnaire, PS group had significantly worse scores when compared to Control (p = 0.011), but not to OSAS (p = 0.101) groups. No statistical difference between OSAS and Control groups were found. CONCLUSION Children with OSAS showed worse performance on GIN test in comparison to children with PS and children without sleep-disordered breathing. PS negatively affected auditory behavior in children. These findings suggest that sleep-disordered breathing may lead to auditory behavior impairment.
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Affiliation(s)
- Carlos Alberto Leite Filho
- Department of Speech, Language and Hearing Sciences, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.
| | | | | | - Sandra Doria Xavier
- Department of Otorhinolaryngology, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | | | - Liliane Desgualdo Pereira
- Department of Speech, Language and Hearing Sciences, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
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Ward CP, Wooden JI, Kieltyka R. Effects of Sleep Deprivation on Spatial Learning and Memory in Juvenile and Young Adult Rats. ACTA ACUST UNITED AC 2017; 10:109-116. [PMID: 28959381 DOI: 10.1037/pne0000075] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sleepiness is commonly seen in adolescents and can negatively impact school performance. Little research has investigated the impact of sleepiness in juvenile animals on spatial learning. Sprague-Dawley juvenile (<30 days) and young adult (>60 days) rats were sleep deprived for 24 hours and tested, along with controls, in a water maze task. Sleep deprived juveniles were slower to learn the location of the hidden platform than controls; however, adult performance was not impaired. Sleep deprivation did not impair recall during a probe trial for either age group. Sleep deprivation prior to testing slowed spatial learning in juveniles but not adults.
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Gruber R, Somerville G, Bergmame L, Fontil L, Paquin S. School-based sleep education program improves sleep and academic performance of school-age children. Sleep Med 2016; 21:93-100. [PMID: 27448478 DOI: 10.1016/j.sleep.2016.01.012] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 11/28/2022]
Abstract
STUDY OBJECTIVE The objective of this study was to develop and evaluate the effectiveness of a school-based sleep education program aimed at improving the sleep and academic performance of school-age children. METHODS Using a community-based participatory research approach, we created a school-based sleep education program, "Sleep for Success"™ (SFS), composed of four distinct modules that addressed the children, their family and community, the school staff, and decision makers within the school setting. Implementation was carried out in three elementary schools. Seventy-one students participated in the evaluation of the program. The effectiveness of the SFS program was evaluated using non-randomized controlled before-and-after study groups (intervention and control) assessed over two time points (pre- and post-program implementation). Before (baseline) and after implementation, sleep and academic performance were measured using actigraphy and report card marks, respectively. RESULTS In the intervention group, true sleep was extended by 18.2 min per night, sleep efficiency improved by 2.3%, and sleep latency was shortened by 2.3 min, and report card grades in mathematics and English improved significantly. No changes were noted in the control group. CONCLUSION Participation in the sleep education program was associated with significant improvements in children's sleep and academic performance.
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Affiliation(s)
- Reut Gruber
- Department of Psychiatry, McGill University, Montréal, QC, Canada; Attention, Behavior and Sleep Laboratory, Research Centre of the Douglas Mental Health University Institute, Montréal, QC, Canada.
| | | | - Lana Bergmame
- Attention, Behavior and Sleep Laboratory, Research Centre of the Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Laura Fontil
- Attention, Behavior and Sleep Laboratory, Research Centre of the Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Soukaina Paquin
- Attention, Behavior and Sleep Laboratory, Research Centre of the Douglas Mental Health University Institute, Montréal, QC, Canada
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The family role in children׳s sleep disturbances: Results from a cross-sectional study in a Portuguese Urban pediatric population. ACTA ACUST UNITED AC 2016; 8:108-14. [PMID: 26779316 PMCID: PMC4688587 DOI: 10.1016/j.slsci.2015.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 09/11/2015] [Accepted: 09/23/2015] [Indexed: 11/28/2022]
Abstract
Background Sleep Disorders (SlD) are frequently undervalued complaints in childhood. Several factors influence sleep, particularly socio-cultural environment and medical conditions such as breathing disorders. Poor sleep hygiene has physical, educational and social consequences. In Portugal, there are few published studies about children׳s sleep habits and rarely based on validated questionnaires. Aim To study the prevalence of SlD and associated factors, in an outpatient pediatric population of a Primary Health Care Center (PHCC). Methods Cross-sectional study of children admitted to a PHCC on a suburban area of Lisbon. Children Sleep Habits Questionnaire, validated for the Portuguese population (CSHQ-PT) for the screening of SlD (cut-off=44), was applied to parents, as well as a demographic inquiry. Body mass index z-score was evaluated. Children scoring 44 or above were sent to Pediatric Sleep Disorders consultation (PSDC). Parametric and non-parametric tests were used whenever appropriate. Results From 128 children, 57.8% were male; the median age was 6.0 years (P25=5.0; P75=8.0). The median of cohabitants per family was 4.0 (P25=3.0; P75=5.0); 21.1% lived in a single-parent family. From CSHQ-PT, 59.4% (76) scored above the cut-off. Data showed that children from a single-parent family have more SlD (p=0.048), particularly parasomnia (p=0.019). Children with sleep disordered breathing (SDB) suffer more daytime sleepiness (p=0.034). From 63 children sent to PSDC, 33 attended. Regarding these children, a difference was found between BMI z-scores of those with and without SDB (p=0.06). Conclusion Family structure plays a non-negligible role in children’s sleep habits. Daily performance of children with SDB may become compromised.
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Key Words
- BMI, body mass index
- BTR, bedtime resistance
- CSHQ-PT, Portuguese Children Sleep Habits Questionnaire
- Children Sleep Habits Questionnaire
- DTS, daytime sleepiness
- Family
- NW, night awakenings
- OSA, obstructive sleep apnea
- PHCC, Primary Health Care Center
- PS, parasomnia
- PSG, polysomnography
- Pediatric Sleep Disorder
- SA, sleep anxiety
- SDB, sleep disordered breathing
- SDur, sleep duration
- SOD, sleep onset delay
- SlD, Sleep Disorders
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Galland B, Spruyt K, Dawes P, McDowall PS, Elder D, Schaughency E. Sleep Disordered Breathing and Academic Performance: A Meta-analysis. Pediatrics 2015; 136:e934-46. [PMID: 26347434 DOI: 10.1542/peds.2015-1677] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/21/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Sleep-disordered breathing (SDB) in children is associated with daytime functioning decrements in cognitive performance and behavioral regulation. Studies addressing academic achievement are underrepresented. This study aimed to evaluate the strength of the relationships between SDB and achievement in core domains and general school performance. METHODS Data sources included PubMed, Web of Science, CINAHL, and PsycINFO. Studies of school-aged children investigating the relationships between SDB and academic achievement were selected for inclusion in a systematic literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extracted were converted into standardized mean differences; effect sizes (ES) and statistics were calculated by using random-effects models. Heterogeneity tests (I(2)) were conducted. RESULTS Of 488 studies, 16 met eligibility criteria. SDB was significantly associated with poorer academic performance for core academic domains related to language arts (ES -0.31; P < .001; I(2) = 74%), math (ES -0.33; P < .001; I(2) = 55%), and science (ES -0.29; P = .001; I(2) = 0%), and with unsatisfactory progress/learning problems (ES -0.23; P < .001; I(2) = 0%) but not general school performance. CONCLUSIONS Variable definitions of both academic performance and SDB likely contributed to the heterogeneity among published investigations. Clear links between SDB and poorer academic performance in school-age children are demonstrated. ES statistics were in the small to medium range, but nevertheless the findings serve to highlight to parents, teachers, and clinicians that SDB in children may contribute to academic difficulties some children face.
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Affiliation(s)
| | - Karen Spruyt
- Department of Developmental and Behavioral Pediatrics, Jiao Tong University School of Medicine, Shanghai, China; Faculty of Psychology, Vrije Universiteit Brussel and School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands
| | - Patrick Dawes
- Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Philippa S McDowall
- Department of Paediatrics and Child Health, Wellington School of Medicine, University of Otago, Wellington, New Zealand; and
| | - Dawn Elder
- Department of Paediatrics and Child Health, Wellington School of Medicine, University of Otago, Wellington, New Zealand; and
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Leite JMRS, Ferreira VR, do Prado LF, do Prado GF, de Morais JF, de Carvalho LBC. TuCASA questionnaire for assessment of children with obstructive sleep apnea: validation. Sleep Med 2015; 16:265-9. [PMID: 25576135 DOI: 10.1016/j.sleep.2014.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/08/2014] [Accepted: 09/15/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of the present study was to validate The Tucson Children's Assessment of Sleep Apnea Study (TuCASA) questionnaire for use in the Brazilian population. METHODS Of the total 62 children who participated in the present study (27 girls), aged 4 to 11 years, 45 (72.6%) had sleep-disordered breathing (SDB) diagnosed by polysomnography, while 17 (27.4%) had no sleep disorders. Translation, back-translation, and pretesting were previously performed. The final Portuguese-language version of TuCASA was administered to the participants from May 2012 to August 2013. The interviewer was blinded to presence or absence of SDB. Cronbach's alpha for the overall scale (with 95% CI) and the effect of excluding any items were evaluated. RESULTS There was no difference among TuCASA items/score and the presence of SDB with either age or gender. The TuCASA had a Cronbach's alpha coefficient of 0.726 (95% CI 0.614 to 0.817), which denotes satisfactory internal consistency - a finding reinforced by evaluation of the effect of item exclusion on the questionnaire. Convergent validity was also satisfactory, in as much as most correlations were positive and significant. CONCLUSION The translated version of the TuCASA questionnaire was validated for Brazilian populations and proved to be a reliable, validated instrument that can be used in clinical practice for evaluation of children with symptoms of SDB.
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Affiliation(s)
| | | | | | | | | | - Luciane Bizari Coin de Carvalho
- Department of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Department of Neurology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Gruber R, Somerville G, Enros P, Paquin S, Kestler M, Gillies-Poitras E. Sleep efficiency (but not sleep duration) of healthy school-age children is associated with grades in math and languages. Sleep Med 2014; 15:1517-25. [PMID: 25441747 DOI: 10.1016/j.sleep.2014.08.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/21/2014] [Accepted: 08/23/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this study was to examine the associations between objective measures of sleep duration and sleep efficiency with the grades obtained by healthy typically developing children in math, language, science, and art while controlling for the potential confounding effects of socioeconomic status (SES), age, and gender. STUDY DESIGN We studied healthy typically developing children between 7 and 11 years of age. Sleep was assessed for five week nights using actigraphy, and parents provided their child's most recent report card. RESULTS Higher sleep efficiency (but not sleep duration) was associated with better grades in math, English language, and French as a second language, above and beyond the contributions of age, gender, and SES. CONCLUSION Sleep efficiency, but not sleep duration, is associated with academic performance as measured by report-card grades in typically developing school-aged children. The integration of strategies to improve sleep efficiency might represent a successful approach for improving children's readiness and/or performance in math and languages.
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Affiliation(s)
- Reut Gruber
- Attention, Behavior, and Sleep Laboratory, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Verdun, Québec H4H 1R3, Canada; Department of Psychiatry, McGill University, Québec, Canada.
| | - Gail Somerville
- Riverside School Board, 7525 Chemin de Chambly, Saint-Hubert, Québec J3Y 0N7, Canada
| | - Paul Enros
- Riverside School Board, 7525 Chemin de Chambly, Saint-Hubert, Québec J3Y 0N7, Canada
| | - Soukaina Paquin
- Attention, Behavior, and Sleep Laboratory, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Verdun, Québec H4H 1R3, Canada
| | - Myra Kestler
- Riverside School Board, 7525 Chemin de Chambly, Saint-Hubert, Québec J3Y 0N7, Canada
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