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Romeo DM, Arpaia C, Lala MR, Cordaro G, Gallini F, Vento G, Mercuri E, Chiaretti A. Sleep Disorders in Low-Risk Preterm Infants and Toddlers. J Pers Med 2023; 13:1091. [PMID: 37511704 PMCID: PMC10381444 DOI: 10.3390/jpm13071091] [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: 05/10/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
Sleep disorders are particularly important in the development of children, affecting the emotional, behavioural, and cognitive spheres. The incidence of these disorders has been assessed in different types of populations, including patients with a history of premature birth, who, from the literature data, would seem to have an increased incidence of sleep disorders at school age. The aims of the present study are: (i.) to assess the presence of sleep disorders in a population of very preterm infants at 6-36 months who are at low risk of neurological impairments using the Italian version of the Sleep Disturbance Scale for Children (SDSC) adapted for this age group, and (ii.) to identify possible differences from a control group of term-born infants. A total of 217 low-risk preterm and 129 typically developing infants and toddlers were included in the study. We found no differences in the SDSC total and the factor scores between these two populations of infants. Low-risk preterm infants and toddlers showed similar incidences of sleep disorders to their term-born peers. Further clinical assessments will be needed to confirm these data at school age.
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Affiliation(s)
- Domenico M Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.argo A. Gemelli, 00168 Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Chiara Arpaia
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.argo A. Gemelli, 00168 Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Rosaria Lala
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.argo A. Gemelli, 00168 Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giorgia Cordaro
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.argo A. Gemelli, 00168 Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesca Gallini
- Neonatal Intensive Care Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
- Neonatal Intensive Care Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Vento
- Neonatal Intensive Care Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
- Neonatal Intensive Care Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.argo A. Gemelli, 00168 Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Chiaretti
- Department of Pediatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli, 00168 Rome, Italy
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Belli A, Breda M, Di Maggio C, Esposito D, Marcucci L, Bruni O. Children with neurodevelopmental disorders: how do they sleep? Curr Opin Psychiatry 2022; 35:345-351. [PMID: 35165244 DOI: 10.1097/yco.0000000000000790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW In this review we summarized the available evidence on sleep disorders in children with neurodevelopmental disorders (NDDs) in particular: intellectual disability (including some genetic conditions such as Prader-Willi Syndrome, Smith-Magenis Syndrome), Autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), Developmental Coordination Disorder, language disorders, and specific learning disorders. RECENT FINDINGS Children with NDDs frequently suffer from sleep disturbances, with a higher prevalence than that of the general pediatric population. SUMMARY These problems tend to be chronic and may cause additional cognitive and behavioral difficulties, often affecting the whole family's well-being. Sleep behaviors are also related to other important developmental skills, such as attention and listening. Investigating sleep disorders in children with NDDs is therefore crucial in clinical practice. For a systematic approach in clinical practice, we propose the use of a short and easy to remember sleep screening tool.
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Affiliation(s)
- Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Maria Breda
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Chiara Di Maggio
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
- PhD Program in Behavioral Neuroscience, Department of Psychology
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Lavinia Marcucci
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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Banaschewski T, Bruni O, Fuentes J, Hill CM, Hvolby A, Posserud MB, Schroder C. Practice Tools for Screening and Monitoring Insomnia in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:3758-3768. [PMID: 34463899 PMCID: PMC9296438 DOI: 10.1007/s10803-021-05236-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 11/24/2022]
Abstract
Between 50-80% of children with autism spectrum disorder (ASD) have insomnia, which adversely affects their mental and physical health. However, there is no consensus to-date on suitable tools for insomnia screening and monitoring in daily clinical practice. An expert panel of child neuropsychiatry and sleep specialists, with expertise in children with neurodevelopmental disabilities, recommends: (1) performing insomnia screening of all children with ASD; (2) considering discussion or referral to a sleep specialist when comorbid sleep disorders are suspected. The panel further developed structured, brief screening and monitoring tools to facilitate insomnia screening and management in daily practice, monitor treatment effectiveness and standardize and compare outcomes across clinical settings to improve care and well-being of children with ASD and their families.
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Affiliation(s)
- Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy.
| | - Joaquin Fuentes
- Service of Child and Adolescent Psychiatry, Policlínica Gipuzkoa and GAUTENA Autism Society, San Sebastián, Spain
| | - Catherine Mary Hill
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Department of Sleep Medicine, Southampton Children's Hospital, Southampton, UK
| | - Allan Hvolby
- Department of Child and Adolescent Psychiatry, Psychiatry in Region of South Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Maj-Britt Posserud
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carmen Schroder
- Department of Child and Adolescent Psychiatry & Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, Strasbourg University Hospitals & University of Strasbourg Medical School, 67000, Strasbourg, France.
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France.
- Sleep Disorders Center& International Research Center for ChronoSomnology, Strasbourg, France.
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Park KJ, Kim MJ, Yum MS, Ko TS, Kim HW. Clinical and neuropsychological characteristics of children with epilepsy and attention-deficit/hyperactivity disorder. Seizure 2021; 91:325-331. [PMID: 34274892 DOI: 10.1016/j.seizure.2021.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES This study aimed to explore the clinical and neuropsychological characteristics-cognition, behavior, parenting-related stress, and sleep-of children with epilepsy, attention-deficit/hyperactivity disorder (ADHD), or both. METHODS We retrospectively reviewed the electronic medical records of 33 children with epilepsy and ADHD, 113 with epilepsy alone, and 294 with ADHD alone. The children were required to complete the Advanced Test of Attention (ATA), and their parents completed the ADHD Rating Scale (ARS), Child Behavior Checklist (CBCL), Children's Sleep Habits Questionnaire (CSHQ), Disruptive Behavior Disorder (DBD) Scale (DBD), Social Responsiveness Scale (SRS), and Parenting Stress Index-Short Form (PSI-SF). RESULTS Auditory Commission Errors made during the ATA were higher in children with epilepsy and ADHD than in those with epilepsy alone. On the SRS, all the subscales except Social Awareness were significantly higher in children with epilepsy and ADHD or ADHD alone than in those with epilepsy alone. The Oppositional Defiant and Conduct Disorder subscales on DBD, Attention Problems, and Aggressive Behaviors on CBCL were significantly higher in children with both epilepsy and ADHD than in those with epilepsy alone. The Parent-Child Dysfunctional Interaction subscales on the PSI-SF were significantly greater in children with both epilepsy and ADHD than in those with epilepsy alone. The subscales on the CSHQ did not significantly differ between children with both epilepsy and ADHD and those with epilepsy alone. CONCLUSIONS In children with epilepsy, comorbid ADHD was associated with negative effects on response inhibition, aggressive behavior, and parenting-related stress.
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Affiliation(s)
- Kee Jeong Park
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Min-Jee Kim
- Department of Pediatric Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Mi-Sun Yum
- Department of Pediatric Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Tae-Sung Ko
- Department of Pediatric Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hyo-Won Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
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Kalashnikova TP, Anisimov GV. [Features of the organization of sleep in children with attention deficit hyperactivity disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:55-60. [PMID: 34078861 DOI: 10.17116/jnevro202112104255] [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: 11/17/2022]
Abstract
The article presents modern ideas about the clinical features of sleep in children with attention deficit hyperactivity disorder (ADHD), the macrostructure of sleep, its cyclic organization and possible common links in the pathogenesis of sleep disorders and behavioral problems in patients. The relationship between the structure of sleep and impaired executive functions, the level of social maladjustment in patients with ADHD has been proven. Typical of children with ADHD are difficulty in going to sleep and falling asleep for a long time (resistance to sleep time), increased motor activity associated with sleep, including the association of ADHD with Restless legs syndrome (RLS) and periodic leg movement syndrome (PLMS), daytime sleepiness. The presence of circadian desynchrony in children with ADHD explains the relationship between chronotype, circadian typology, and clinical manifestations of the syndrome. Multidirectional data on the representation of REM sleep by nocturnal polysomnography in children with ADHD depend on age. However, the change in the proportion of REM sleep during the night is considered as a leading factor in the pathogenesis of ADHD manifestations. Various variants of metabolic disorders of melatonin, dopamine, serotonin, aggravated by social jet lag, are considered by the conjugatedcommon pathogenetic mechanisms of sleep disturbance and ADHD. As well as changes in the concentration of iron and ferritin in the blood, which may explain the frequency of RLS and PLMS in children with ADHD. The change in the number of sleep cycles during the night in patients has been demonstrated. Possible strategies for correcting sleep disorders in children with ADHD and their impact on the manifestation of ADHD are discussed.
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Affiliation(s)
| | - G V Anisimov
- The First Medical and Pedagogical Center «Lingua Bona», Perm, Russia
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Characterization of Sleep Disturbances in Children and Adolescents with Down Syndrome and Their Relation with Cognitive and Behavioral Features. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095001. [PMID: 34065045 PMCID: PMC8125939 DOI: 10.3390/ijerph18095001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 12/29/2022]
Abstract
Despite sleep disturbances are common among youths with Down syndrome (DS), the cognitive and behavioral features associated with sleep problems have not yet been studied extensively. The present study investigated the presence of sleep disturbances in a group of children and adolescents with DS and their cognitive and behavioral correlates. Seventy-one children and adolescents with DS underwent a neuropsychological evaluation, whereas parents completed questionnaires for the screening of the child's sleep, emotional and behavioral problems. We found no association between sleep disturbances and sex, nonverbal IQ, nor adaptive abilities. However, we found that age was positively associated with disorders in initiating and maintaining sleep (DIMS) and disorders of excessive somnolence (DOES), while body mass index was related with DOES. We also detected a relationship between visual-motor integrations and DIMS, as well as multiple associations between sleep disturbances and psychopathological and behavioral problems, mainly externalizing symptoms. The present study provided a detailed characterization of sleep problems in relation to several features of youths with DS. The proper identification of sleep disturbances profile in the DS population could support the process of clinical evaluation, in particular for psychopathological aspects.
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Romeo DM, Brogna C, Belli A, Lucibello S, Cutrona C, Apicella M, Mercuri E, Mariotti P. Sleep Disorders in Autism Spectrum Disorder Pre-School Children: An Evaluation Using the Sleep Disturbance Scale for Children. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:95. [PMID: 33498988 PMCID: PMC7911676 DOI: 10.3390/medicina57020095] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/16/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022]
Abstract
Background and Objectives: Sleep disorders are common in children with Autism Spectrum Disorder (ASD). The aims of this study were to describe the incidence and characteristics of sleep disorders using a questionnaire completed by the caregiver in a sample of preschool-aged children with ASD and to identify possible differences in a control group of peers. Materials and Methods: Sleep disorders were investigated with the Sleep Disturbance Scale for Children (SDSC) in a population of pre-school-aged (3-5 years) ASD children and in a control group. The Autism Diagnostic Observation Schedule-second ed. (ADOS-2) was further used to assess autism symptom severity. A total of 84 children (69 males; mean age 3.9 ± 0.8 years) with a diagnosis of ASD and 84 healthy controls (65 males; mean age of 3.7 ± 0.8 years) that were matched for age and sex were enrolled. Results: ASD children reported significantly higher (pathological) scores than the control group on the SDSC total scores and in some of the factor scores, such as Difficulty in Initiating and Maintaining Sleep (DIMS), disorders of excessive somnolence (DOES), and sleep hyperhidrosis. A total of 18% of ASD children had a pathological SDSC total T-score, and 46% had an abnormal score on at least one sleep factor; DIMS, parasomnias, and DOES showed the highest rates among the sleep factors. Younger children (3 years) reported higher scores in DIMS and sleep hyperhidrosis than older ones (4 and 5 years). No specific correlation was found between ADOS-2 and SDSC scores. Conclusions: Pre-school children with ASD showed a high incidence of sleep disorders with different distributions of specific sleep factors according to their age. We suggest a screening assessment of sleep disorders using the SDSC in these children with a more in-depth evaluation for those reporting pathological scores on the questionnaire.
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Affiliation(s)
- Domenico M. Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (E.M.); (P.M.)
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.B.); (A.B.); (S.L.); (C.C.); (M.A.)
| | - Claudia Brogna
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.B.); (A.B.); (S.L.); (C.C.); (M.A.)
- Neuropsichiatria Infantile, ASL Avellino, 83100 Avellino, Italy
| | - Arianna Belli
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.B.); (A.B.); (S.L.); (C.C.); (M.A.)
| | - Simona Lucibello
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.B.); (A.B.); (S.L.); (C.C.); (M.A.)
| | - Costanza Cutrona
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.B.); (A.B.); (S.L.); (C.C.); (M.A.)
| | - Massimo Apicella
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.B.); (A.B.); (S.L.); (C.C.); (M.A.)
| | - Eugenio Mercuri
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (E.M.); (P.M.)
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.B.); (A.B.); (S.L.); (C.C.); (M.A.)
| | - Paolo Mariotti
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (E.M.); (P.M.)
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Romeo DM, Leo G, Lapenta L, Leone D, Turrini I, Brogna C, Gallini F, Cota F, Vento G, Mercuri E. Sleep disorders in low-risk preschool very preterm children. Sleep Med 2019; 63:137-141. [DOI: 10.1016/j.sleep.2019.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 01/09/2023]
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