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Swisher VS, Liu S, Ricketts EJ. Bedtime Regularity and Sleep Sufficiency in Children With Tourette Syndrome. Pediatr Neurol 2024; 158:26-34. [PMID: 38945036 DOI: 10.1016/j.pediatrneurol.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 04/12/2024] [Accepted: 05/01/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Despite research demonstrating sleep disturbance in children with Tourette syndrome (TS), few studies have examined bedtime regularity and sleep sufficiency, two important sleep health dimensions. Therefore, this study examined bedtime regularity and sleep sufficiency in children with TS relative to matched healthy control subjects, and its associated demographic, clinical, and behavioral factors. METHODS Participants were 384 parents or caregivers of children aged three to 17 years, including 192 with current TS and 192 matched healthy control subjects drawn from the 2020-2021 cycle of the National Survey of Children's Health. Parents completed questions assessing demographic (i.e., age, race, sex), clinical (i.e., attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder, anxiety, depression, tic severity, behavioral or conduct problems, ADHD medication, health condition-related impairment), and behavioral (i.e., screen time) characteristics. Mann-Whitney U test and chi-square test of independence were performed to compare groups on bedtime regularity and sleep sufficiency, respectively. Ordinal regression and binary logistic regression without and with backward elimination were performed to evaluate indicators of bedtime regularity and sleep sufficiency, respectively, in children with TS. RESULTS Children with current TS had significantly poorer bedtime regularity, but not sleep sufficiency, relative to matched healthy control subjects. In children with TS, anxiety and two or more hours of daily screen time were associated with higher likelihood of poor bedtime regularity. Autism was associated with lower likelihood of insufficient sleep, and depression was associated with increased likelihood of insufficient sleep. CONCLUSIONS Findings put forth screen time, anxiety, and depression as intervention targets to optimize sleep health in children with TS.
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Affiliation(s)
- Valerie S Swisher
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | - Serene Liu
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | - Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California.
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Cooper DK, Alonzo JK, Goldson T, Jordan IR, Jatoi F, Mallozzi I, Lupini F. Black and Latiné parents' perspectives on supporting their children's emotional and physical health. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:630-648. [PMID: 38654393 DOI: 10.1111/jmft.12705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024]
Abstract
Informed by integrative models of cultural resilience, the purpose of this study was to (a) explore how parents are promoting their children's emotional and physical health, with a focus on race and ethnic-racial socialization strategies, and (b) identify the barriers and challenges parents are experiencing in supporting their children's health. Ethnically racially matched qualitative interviews were conducted with 33 parents (82% women, 64% Black, 36% Latiné). Results of thematic analysis revealed three overarching themes: (a) Strategies for Promoting Children's Physical and Emotional Health, (b) Challenges Promoting Children's Physical and Emotional Health, and (c) Impact of Racism on Parenting and Children's Health. Most parents believed that racism had an impact on their parenting decisions and their children's health; however, there were some differences in ethnic-racial socialization practices between Black and Latiné parents. Findings have implications for culturally relevant parenting approaches to support children's emotional and physical health.
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Affiliation(s)
- Daniel K Cooper
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Jayxa K Alonzo
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Tracey Goldson
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Isabel R Jordan
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Fatima Jatoi
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Isabella Mallozzi
- Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Francesca Lupini
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
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Inoue M, Nakajima S, Inada N, Oi H, Sato N, Miyazaki Y, Takashina H, Tagaya H, Adachi Y, Kuga H. Development of the Parenting Behavior Checklist to Promote Preschoolers' Sleep (PCPP). Behav Sleep Med 2024; 22:275-284. [PMID: 37545146 DOI: 10.1080/15402002.2023.2241590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
OBJECTIVES To develop the Parenting Behavior Checklist to Promote Preschoolers' sleep (PCPP), quantify sleep-promoting parenting behaviors for children, and examine the scale's reliability and validity. METHODS The PCPP was developed based on the recommendations of the ABCs of SLEEPING for children's sleep, which is strongly supported by research evidence. Its validity and reliability were evaluated using data from 140 participants. Structural validity was estimated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency was evaluated by Cronbach's α. Hypothesis testing was evaluated by analyzing the correlations between each factor of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) and the PCPP. RESULTS Regarding structural validity, EFA was conducted because CFA showed a poor model fit. The PCPP comprised one factor and six items. The JSQ-P subfactors of insomnia or circadian rhythm sleep-wake disorders, undesirable morning symptoms and behaviors, and insufficient sleep were moderately negatively correlated with the PCPP; the subfactor of undesirable daytime behaviors related to sleep problems was weakly negatively correlated with the PCPP. Thus, the sleep-promoting parenting behaviors listed in the PCPP were associated with better sleep in children. CONCLUSIONS The PCPP showed sufficient reliability and validity. Future studies should use the scale to examine more effective interventions regarding sleep-promoting parental behaviors for children.
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Affiliation(s)
- Mari Inoue
- Graduate School of Medical Science, Kitasato University, Kanagawa, Japan
| | - Shun Nakajima
- Faculty of Liberal Arts, Department of Psychology, Teikyo University, Tokyo, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoko Inada
- Faculty of Liberal Arts, Department of Psychology, Teikyo University, Tokyo, Japan
- Faculty of Psychology and Sociology, Taisho University, Tokyo, Japan
| | - Hitomi Oi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoko Sato
- Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Yuri Miyazaki
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hikari Takashina
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hirokuni Tagaya
- Graduate School of Medical Science, Kitasato University, Kanagawa, Japan
| | | | - Hironori Kuga
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
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Hartman AG, Caspero K, Bodison SC, Soehner A, Akcakaya M, DeAlmeida D, Bendixen R. Pediatric Occupational Therapists' Perspectives on Sleep: A Qualitative Descriptive Study. Am J Occup Ther 2024; 78:7803205010. [PMID: 38512128 DOI: 10.5014/ajot.2024.050352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
IMPORTANCE Insufficient sleep is common among children seeking occupational therapy services but is rarely a focus of therapy despite sleep's critical impact on health. OBJECTIVE To examine pediatric occupational therapists' experiences, views, and confidence in addressing sleep concerns in their practice as well as barriers to and supports for doing so. DESIGN A qualitative descriptive study with thematic analysis of data from 1-hr virtual interviews. Rapport building, multiple-coder analysis, and member checking were used to ensure reliability and validity. SETTING Interviews were conducted remotely at each participant's preferred time and location. PARTICIPANTS Pediatric occupational therapists (N = 20) practicing across multiple settings in the United States were recruited through emails directed to their place of work and social media posts. A goal of 20 participants was set a priori with the goal of thematic saturation. OUTCOMES AND MEASURES A semistructured interview guide. RESULTS Participants were predominately cisgender (95%), female (85%), and White, non-Hispanic (90%). Overall, they voiced the importance of sleep but reported almost never writing sleep-related goals. Reported barriers that affected the participants' ability to fully address sleep in practice included therapists' lack of confidence and knowledge and low caregiver buy-in. CONCLUSIONS AND RELEVANCE The findings identify themes on the basis of which actionable steps toward promoting occupational therapists as sleep champions can be developed. Future implications include increasing sleep education opportunities, enhancing awareness of sleep health's impact on goal areas, and facilitating discussions about occupational therapy's role within the medical system and family system in supporting sleep. Plain-Language Summary: This qualitative study identifies what helps and hinders occupational therapists in addressing the sleep health concerns of their clients. We give occupational therapy clinicians and educators key supports to seek out or barriers to address.
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Affiliation(s)
- Amy G Hartman
- Amy G. Hartman, PhD, OTR/L, is Postdoctoral Fellow, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA;
| | - Kaitlyn Caspero
- Kaitlyn Caspero, MS, OTR/L, is Occupational Therapist and Founder, OT Graphically, Frederick, MD
| | - Stefanie C Bodison
- Stefanie C. Bodison, OTD, OTR/L, FAOTA, is Assistant Professor, Department of Occupational Therapy, University of Florida, Gainesville
| | - Adriane Soehner
- Adriane Soehner, PhD, is Assistant Professor, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Murat Akcakaya
- Murat Akcakaya, PhD, is Associate Professor, Department of Engineering, University of Pittsburgh, Pittsburgh, PA
| | - Dilhari DeAlmeida
- Dilhari DeAlmeida, PhD, is Associate Professor and Program Director, Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA
| | - Roxanna Bendixen
- Roxanna Bendixen, PhD, OTR/L, FAOTA, is Associate Professor and Division Director, Department of Occupational Therapy, Medical University of South Carolina, Charleston
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Kocevska D, Trajanoska K, Mulder RH, Koopman-Verhoeff ME, Luik AI, Tiemeier H, van Someren EJW. Are some children genetically predisposed to poor sleep? A polygenic risk study in the general population. J Child Psychol Psychiatry 2024; 65:710-719. [PMID: 37936537 DOI: 10.1111/jcpp.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Twin studies show moderate heritability of sleep traits: 40% for insomnia symptoms and 46% for sleep duration. Genome-wide association studies (GWAS) have identified genetic variants involved in insomnia and sleep duration in adults, but it is unknown whether these variants affect sleep during early development. We assessed whether polygenic risk scores for insomnia (PRS-I) and sleep duration (PRS-SD) affect sleep throughout early childhood to adolescence. METHODS We included 2,458 children of European ancestry (51% girls). Insomnia-related items of the Child Behavior Checklist were reported by mothers at child's age 1.5, 3, and 6 years. At 10-15 years, the Sleep Disturbance Scale for Children and actigraphy were assessed in a subsample (N = 975). Standardized PRS-I and PRS-SD (higher scores indicate genetic susceptibility for insomnia and longer sleep duration, respectively) were computed at multiple p-value thresholds based on largest GWAS to date. RESULTS Children with higher PRS-I had more insomnia-related sleep problems between 1.5 and 15 years (BPRS-I < 0.001 = .09, 95% CI: 0.05; 0.14). PRS-SD was not associated with mother-reported sleep problems. A higher PRS-SD was in turn associated with longer actigraphically estimated sleep duration (BPRS-SD < 5e08 = .05, 95% CI: 0.001; 0.09) and more wake after sleep onset (BPRS-SD < 0.005 = .25, 95% CI: 0.04; 0.47) at 10-15 years, but these associations did not survive multiple testing correction. CONCLUSIONS Children who are genetically predisposed to insomnia have more insomnia-like sleep problems, whereas those who are genetically predisposed to longer sleep have longer sleep duration, but are also more awake during the night in adolescence. This indicates that polygenic risk for sleep traits, based on GWAS in adults, affects sleep already in children.
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Affiliation(s)
- Desana Kocevska
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Generation R Study, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Katerina Trajanoska
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rosa H Mulder
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Generation R Study, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Elisabeth Koopman-Verhoeff
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Generation R Study, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Henning Tiemeier
- The Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Eus J W van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Kiel N, Samdan G, Wienke AS, Reinelt T, Pauen S, Mathes B, Herzmann C. From co-regulation to self-regulation: Maternal soothing strategies and self-efficacy in relation to maternal reports of infant regulation at 3 and 7 months. Infant Ment Health J 2024; 45:135-152. [PMID: 38175546 DOI: 10.1002/imhj.22098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/06/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
This study, conducted in Germany, examines the role of maternal soothing strategies to explain the association of maternal self-efficacy with infant regulation (crying and sleeping behavior). Questionnaire data of 150 mothers, living in Germany, with mixed ethnic and educational backgrounds were collected when infants were 3 and 7 months old. Two types of maternal soothing strategies were distinguished: close soothing, involving close physical and emotional contact, and distant soothing, involving physical and emotional distancing from the infant. A cross-sectional SEM at 3 months indicated that maternal self-efficacy is associated with reported infant regulation through distant soothing strategies. Low maternal self-efficacy was associated with frequent maternal use of distant soothing, which in turn was related to reported infant regulation problems, that is, non-soothability and greater crying frequency. Frequent use of close soothing was associated with reported infant sleeping behavior, that is, frequent night-time awakenings. A longitudinal SEM further indicated that the effects of close soothing persisted at least until the infants' age of 7 months. The study showed how low maternal self-efficacy, increased use of distant soothing, and reported early infant regulation problems are intertwined and that, due to their persisting positive effect on infant soothability, close soothing better supports infant development.
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Affiliation(s)
- Natalie Kiel
- Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Gizem Samdan
- Human and Health Sciences, University of Bremen, Bremen, Germany
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Annika S Wienke
- Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Tilman Reinelt
- Department of Neonatology, University of Zurich, University Hospital Zurich, Zurich, Switzerland
- Leibniz Institute for Research and Information in Education, Frankfurt am Main, Germany
- Center for Individual Development and Adaptive Education of Children at Risk, Frankfurt am Main, Germany
| | - Sabina Pauen
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Birgit Mathes
- Human and Health Sciences, University of Bremen, Bremen, Germany
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Robles-Ramamurthy B, Zaki S, Sandoval JF, Dube AR, Hlozek S, Fortuna LR, Williamson AA. Improving adolescent sleep in long-term Juvenile correctional settings: case examples with clinical, research, and policy implications. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae006. [PMID: 38425455 PMCID: PMC10904105 DOI: 10.1093/sleepadvances/zpae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/30/2023] [Indexed: 03/02/2024]
Abstract
Poor sleep during adolescence is a public health concern that may be especially important to address among youth in juvenile correctional facilities, who tend to experience greater mental health challenges, substance use disorders, and traumatic stress exposure. However, evidence for addressing sleep in correctional settings is limited. Using de-identified composite clinical cases, this paper describes challenges and opportunities for addressing sleep disorders (i.e. insomnia) and promoting sleep health (i.e. improving duration, regularity, and behaviors) among adolescents in long-term juvenile correctional facilities. These clinical cases highlight common presenting problems and underscore the need for integrated sleep and mental health interventions as well as adaptations to enhance feasibility and efficacy of behavioral sleep treatment and sleep health promotion in juvenile correctional contexts. We conclude by summarizing clinical, research, and policy implications for addressing adolescent sleep problems and promoting sleep health and well-being in these contexts.
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Affiliation(s)
- Barbara Robles-Ramamurthy
- Department of Psychiatry and Behavioral Sciences, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Saadia Zaki
- Department of Psychiatry and Behavioral Sciences, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Jessica F Sandoval
- Department of Psychiatry and Behavioral Sciences, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Anish R Dube
- Department of Psychiatry, Charles R. Drew University College of Medicine and Science, Los Angeles, CA, USA
| | - Steven Hlozek
- Department of Internal Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Lisa R Fortuna
- Department of Psychiatry and Neurosciences, University of California Riverside, School of Medicine, Riverside, CA, USA
| | - Ariel A Williamson
- Ballmer Institute for Children’s Behavioral Health, University of Oregon, Portland, OR, USA
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Daniel L, Poliakova P, Stein M, Dunmyer L, Weaver-Rogers S, Garcia W, Santiago GB, Williamson AA. Maternal Perceptions of Evidence-Based Early Childhood Sleep Health Promotion Recommendations: An Explanatory Sequential Study. Behav Sleep Med 2024; 22:87-99. [PMID: 37042454 PMCID: PMC10567985 DOI: 10.1080/15402002.2023.2189723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVES The purpose of this explanatory sequential design study was to better understand caregivers' perceptions about and interest in evidence-based early childhood sleep health promotion recommendations. METHOD A purposeful sample of mothers of 20 1-5-year-old children (10 children exhibiting optimal sleep and 10 children exhibiting insufficient/fragmented sleep) attending a preschool serving a low socio-economic (SES) status metropolitan community were invited to participate in qualitative interviews. Data were coded according to a grounded theory approach and themes were identified within the optimal and suboptimal sleeper groups. RESULTS Mothers reported different approaches to managing electronics by optimal/suboptimal sleeper group, with mothers of optimal sleepers limiting access to electronics more than mothers in the suboptimal sleep group. Other themes of sleep health practices did not differ meaningfully between groups. CONCLUSIONS Maternal perspectives about early childhood sleep health were similar across optimal and suboptimal sleepers on most elements of child sleep health. Managing child sleep was contextually influenced and these results highlight the complexities of how families living in lower SES environments perceive common sleep recommendations. Thus, sleep health education efforts should be tailored to the needs and values of specific families and communities.
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Affiliation(s)
| | | | | | | | | | - Wanda Garcia
- Rutgers University, Camden
- Early Learning Research Academy, Camden, NJ
| | | | - Ariel A. Williamson
- The Children’s Hospital of Philadelphia
- University of Pennsylvania Perelman School of Medicine
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Whitney K, Felt B, Collins-Anderson A, Bonuck K. The Feasibility of Screening for Sleep Problems in Early Childhood Education Programs. Behav Sleep Med 2024; 22:28-38. [PMID: 36751036 PMCID: PMC10404644 DOI: 10.1080/15402002.2023.2177294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVES Assess the feasibility and staff experience of screening for behavioral sleep problems (BSP) and sleep disordered breathing (SDB) in early childhood education (ECE) settings; examine BSP/SDB prevalence and caregivers' knowledge/attitudes, perception of child sleep problems, and sleep health engagement in this sample. METHOD Eight staff representatives from four ECE sites involved with sleep problem screening procedures within a larger RCT on ECE sleep health, discussed their experiences in a focus group; transcript content reviewed. A random subset of caregiver-child dyads (n = 59) from the four ECE sites completed sleep problem measures (BSP: Children's Sleep Habits Questionnaire, Short form [SF-CSHQ], Tayside Children's Sleep Questionnaire [TCSQ-sleep disturbance and difficulty] and SDB: Pediatric Sleep Questionnaire [PSQ], in addition to RCT measures (Parent Knowledge/Attitude/Self-efficacy/Beliefs survey and sleep health goals). Caregiver sleep health engagement was measured by the sleep health goals set. RESULTS ECE staff reported sleep problem screening as self-explanatory and doable but sometimes administratively burdensome. BSPs were identified in 44% (SF-CSHQ) to 63% (TCSQ-sleep disturbance) of children; SDBs in 13%. Only 11% of caregivers endorsed their child having a sleep "difficulty" (TCSQ). Sleep health goals were set by 85% of caregivers; 63% employed educational materials' language. CONCLUSION Sleep problem screening in ECE is feasible, and problems are elicited. While caregivers readily engage in setting healthy sleep goals, few endorse sleep as difficult. ECE education could improve caregiver understanding/recognition of sleep problems.
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Affiliation(s)
- Kimberly Whitney
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY
| | - Barbara Felt
- University of Michigan School of Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI
| | | | - Karen Bonuck
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY
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Leung TNH, Wong KL, Chan AKC, Li AM. Common Childhood Sleep Problems and Disorders. Curr Pediatr Rev 2024; 20:27-42. [PMID: 36043722 DOI: 10.2174/1573396318666220827102018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep insufficiency and disturbances affect the physical, cognitive, and emotional well-being of children. OBJECTIVE To perform a narrative review on common sleep problems and disorders encountered in primary care for children and adolescents. METHODS A search of English literature in the Pubmed and Google Scholar databases published from 1 January 2000 till 31 October 2021 was conducted with the keywords "sleep problem" or "sleep disorder" and "child" or "adolescent". Findings in the relevant articles and cross-references were compiled. RESULTS Sleep duration and habits of children vary widely across countries with different cultural backgrounds. There is robust evidence to support the promotion of positive bedtime routines and sleep hygiene as prevention and management of sleep problems. 15-70% of parents reported their children having sleep problems or disturbances. Common sleep complaints include difficulty in initiation or maintenance of sleep, abnormal behaviors or movements, snoring or abnormal breathing, and excessive daytime sleepiness. Comprehensive sleep history and a sleep diary are the first steps for evaluation. Home video and actigraphy may be used as preliminary tools to confirm the history. Referrals to a sleep specialist for polysomnography and other tests are needed, if suspecting specific sleep disorders, such as obstructive sleep apnea and narcolepsy, needs timely intervention. Common sleep disorders in different age groups encountered in primary care are reviewed with clinical features, indications for evaluation, and treatment options summarized. CONCLUSION Screening for sleep problems shall be an integral part of each child's health care visit. It is important to evaluate the impact of common sleep problems and identify specific sleep disorders for early intervention to prevent long-term adverse outcomes.
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Affiliation(s)
- Theresa Ngan Ho Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Kin Lok Wong
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Anthony Kam Chuen Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
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Oliveira PMBD, Lima MDO, Marinho PDM, Silveira JACD, Menezes RCED, Longo-Silva G. Association between sleep duration and latency, nocturnal awakenings, and body mass index among infants. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2023058. [PMID: 38126602 PMCID: PMC10742347 DOI: 10.1590/1984-0462/2024/42/2023058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/03/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To investigate the association between sleep duration, nocturnal awakenings, and sleep latency with body mass index (BMI) at six and 12 months of age. METHODS 179 children from a birth cohort were enrolled. At six and 12 months of age, anthropometric data were obtained using standardized techniques and infants' mothers answered the Brief Infant Sleep Questionnaire for sleep data. The association of BMI with the independent variables (sleep duration, latency, and nocturnal awakenings) was assessed by linear regression models. Analyses were adjusted for potential confounders and a p-value<0.05 was adopted to define statistical significance. RESULTS For each additional hour of sleep duration, BMI was reduced by 0.15 kg/m² (95% confidence interval [CI] -0.28; -0.01; p=0.03) and each additional minute of sleep latency increased BMI by 0.01 kg/m² (95%CI -0.00; 0.03; p=0.02). These associations were independent of gestational age, child sex, birth weight, duration of exclusive breastfeeding, smoking during pregnancy, and mother's BMI, education, and marital status. Nocturnal awakenings showed no association with the outcome. CONCLUSIONS Our findings suggest that sleep duration and sleep latency time are associated with BMI in the first year of life. Insights into the influence of sleep early in life on weight status may be helpful to complement future nutritional recommendations and prevent and treat obesity.
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Sletten TL, Weaver MD, Foster RG, Gozal D, Klerman EB, Rajaratnam SMW, Roenneberg T, Takahashi JS, Turek FW, Vitiello MV, Young MW, Czeisler CA. The importance of sleep regularity: a consensus statement of the National Sleep Foundation sleep timing and variability panel. Sleep Health 2023; 9:801-820. [PMID: 37684151 DOI: 10.1016/j.sleh.2023.07.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To develop and present consensus findings of the National Sleep Foundation sleep timing and variability panel regarding the impact of sleep timing variability on health and performance. METHODS The National Sleep Foundation assembled a panel of sleep and circadian experts to evaluate the scientific evidence and conduct a formal consensus and voting procedure. A systematic literature review was conducted using the NIH National Library of Medicine PubMed database, and panelists voted on the appropriateness of 3 questions using a modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting. RESULTS The literature search and panel review identified 63 full text publications to inform consensus voting. Panelists achieved consensus on each question: (1) is daily regularity in sleep timing important for (a) health or (b) performance? and (2) when sleep is of insufficient duration during the week (or work days), is catch-up sleep on weekends (or non-work days) important for health? Based on the evidence currently available, panelists agreed to an affirmative response to all 3 questions. CONCLUSIONS Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.
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Affiliation(s)
- Tracey L Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Russell G Foster
- Sleep & Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David Gozal
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Till Roenneberg
- Institutes for Occupational, Social, and Environmental Medicine and Medical Psychology, LMU Munich, Munich, Germany
| | - Joseph S Takahashi
- Department of Neuroscience, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Howard Hughes Medical Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Fred W Turek
- Center for Sleep and Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, Illinois, USA
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Michael W Young
- Laboratory of Genetics, The Rockefeller University, New York City, New York, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
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13
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Pal E, Blackwell JE, Ball HL, Collings PJ. Sociodemographic, temporal and bedtime routine correlates of sleep timing and duration in South Asian and white children: A Born in Bradford study. Sleep Med X 2023; 5:100068. [PMID: 37033692 PMCID: PMC10074244 DOI: 10.1016/j.sleepx.2023.100068] [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: 01/05/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/16/2023] Open
Abstract
Objective The study aimed to examine sociodemographic, temporal and bedtime routine correlates of parent-reported sleep duration and timing in a biethnic sample of 18 month and 36 month old children from a disadvantaged location. Methods Between October 2010 and September 2012, parents completed a bespoke three day sleep diary when their child was approximately 18 months (n = 276) and 36 months of age (n = 262) (45.1% South Asian; 54.9% white). Parents reported their child's overnight sleep duration (h/day), the time their child fell asleep, their wake time and their child's bedtime and napping routines. Data were available at both time points for 135 children. Results In line with previous literature, South Asian children had shorter overnight sleep duration and later sleep and wake times than white children. In both ethnic groups, children slept and woke up later on weekends, and children went to bed earlier and slept longer in winter. In white children only, napping duration was associated with overnight sleep period. No significant associations were found between napping frequency and overnight sleep duration. Based on parent-reported data, children who consistently adhered to regular bedtimes and had set times for sleeping tended to go to sleep earlier, wake earlier and have longer overnight sleep. Conclusions The data showed parent-reported variation in sleep patterns between two ethnic groups within a single geographical and deprived area. It is important that researchers, clinicians and early years workers are considerate of cultural norms in sleep practices.
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Affiliation(s)
- Elizabeth Pal
- Better Start Bradford, Bradford Trident, Mayfield Centre, Broadway Ave, Bradford, UK
| | | | - Helen L. Ball
- Durham Infancy & Sleep Centre, Department of Anthropology, Durham University, UK
| | - Paul J. Collings
- Department of Health Sciences, University of York, UK
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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14
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Tougas M, Rigney G, Chambers C, Smith I, Mugford J, Keeler L, Rajda M, Corkum P. Focus Groups to Inform User-Centered Development of an eHealth Sleep Intervention for Adolescents: Perspectives of Youth with Insomnia Symptoms, with and without Pain. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1692. [PMID: 37892355 PMCID: PMC10605192 DOI: 10.3390/children10101692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
INTRODUCTION Adolescence is a developmental stage that often coincides with increasing sleep problems. Focus groups were conducted to inform development of an adolescent eHealth sleep intervention by exploring opinions about (1) healthy sleep practices, and (2) using an eHealth intervention. METHODS Adolescents 14-18 years old experiencing symptoms of insomnia based on the Insomnia Sleep Index, with and without recurrent pain, and associated stakeholders (i.e., parents, school personnel, and health care providers) were recruited. Across six online focus groups, 24 adolescents with insomnia participated (14 pain-free, 10 with recurrent pain; 10 male, 14 female). Across seven online focus groups, 22 stakeholders participated, including 8 parents, 9 school professionals, and 5 health care providers (10 male, 8 female). Using a content analysis, subthemes were induced from transcripts. RESULTS Most healthy sleep practices were perceived as reasonable for adolescents to implement, except avoiding technology before bed and using bedrooms only for sleep. Three primary barriers to sleep practices were identified, including a variable schedule due to lifestyle factors, technology at night, and academics interfering with sleep, and only in the pain group, the barrier related to pain was identified. Content addressing adolescent-specific barriers was considered important to include in a sleep intervention. Desirable eHealth components included interactive features, videos, audio, and pictures to present information. A common barrier to using an eHealth sleep intervention was the program feeling too academic, with accessibility of the sleep information and strategies as a common facilitator. CONCLUSIONS This research represents the first step in a user-centered approach to developing an adolescent eHealth sleep intervention. These results provide insights from a range of perspectives on guiding adolescents to follow healthy sleep practices. Next, these findings will be integrated in the development of an eHealth intervention for adolescents with and without recurrent pain.
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Affiliation(s)
- Michelle Tougas
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada (G.R.); (C.C.); (I.S.); (J.M.); (L.K.)
| | - Gabrielle Rigney
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada (G.R.); (C.C.); (I.S.); (J.M.); (L.K.)
- Appleton Institute, School of Health, Medical and Applied Sciences, CQUniversity, Adelaide, SA 5034, Australia
| | - Christine Chambers
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada (G.R.); (C.C.); (I.S.); (J.M.); (L.K.)
- Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Isabel Smith
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada (G.R.); (C.C.); (I.S.); (J.M.); (L.K.)
- Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Joshua Mugford
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada (G.R.); (C.C.); (I.S.); (J.M.); (L.K.)
| | - Laura Keeler
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada (G.R.); (C.C.); (I.S.); (J.M.); (L.K.)
| | - Malgorzata Rajda
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Penny Corkum
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada (G.R.); (C.C.); (I.S.); (J.M.); (L.K.)
- Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada;
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15
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D'Souza L, Cassels T. Contextual considerations in infant sleep: Offering alternative interventions to families. Sleep Health 2023; 9:618-625. [PMID: 35768320 DOI: 10.1016/j.sleh.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 10/17/2022]
Abstract
Infant sleep problems are one of the commonly reported reasons parents seek professional help, yet what constitutes a "sleep problem" depends on the models used to explain the development of infant sleep. The current models are based on research conducted in the western context where infant solitary sleeping is the norm. Parent-child co-sleeping is the norm in many cultures around the world. We argue that the primary focus of current research on parent-child interactions as the mediating context for the development of infant sleep problems has inherently made these models and ensuing interventions less sensitive and applicable to infant sleep problems in the context of co-sleeping families. When families present for help with infant sleep difficulties, extinction based behavioral interventions or interventions focused on reducing parental presence at bedtime are commonly recommended. These recommendations may not always align with cultural values and parenting practices of all families, therefore precluding these families from getting necessary help. In attempting to provide families with choices that depart from behavioral based interventions, this paper draws on research and adapts current models to propose an alternative to conceptualize perceptions of infant sleep problems that may be sensitive to and applied across various cultural and personal contexts. We attempt to provide a rationale for interventions that are inclusive and sensitive to families where reduced parental nighttime responsiveness may not be a preferred choice.
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Affiliation(s)
- Levita D'Souza
- Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia.
| | - Tracy Cassels
- Evolutionary Parenting, 116 County Rd, 16 Milford, ON, K0K 2P0, Canada
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16
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Petit D, Touchette E, Pennestri MH, Paquet J, Côté S, Tremblay RE, Boivin M, Montplaisir JY. Nocturnal sleep duration trajectories in early childhood and school performance at age 10 years. J Sleep Res 2023; 32:e13893. [PMID: 36973015 DOI: 10.1111/jsr.13893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023]
Abstract
Sleep plays a fundamental role in brain development and resultant functions. The aim was to verify whether nocturnal sleep duration during early childhood has long-term associations with academic achievement at age 10 years. The present study is part of the Quebec Longitudinal Study of Child Development, a representative cohort of infants born in 1997-1998 in the province of Quebec, Canada. Children with known neurological conditions were excluded from this cohort. Four trajectories of parent-reported nocturnal sleep duration at ages 2.5, 3, 4, 5 and 6 years were determined using a SAS procedure named PROC TRAJ. Sleep duration at age 10 years was also reported. Teachers provided data on academic performance when the children were age 10 years. These data were available for 910 children (430 boys, 480 girls; 96.6% Caucasians). Univariate and multivariable logistic regressions were performed using SPSS. Children who slept less than 8 hr per night at 2.5 years but normalized later on (Traj1) had three-five times the odds of having grades below the class average in reading, writing, mathematics and science compared with children who slept sufficiently (Traj3-4: 10-11 hr per night). Children who slept about 9 hr per night throughout childhood (Traj2) had two-three times the odds of being below the class average in mathematics and science. Sleep duration at age 10 years was not correlated with the academic performance. These results point to the presence of a very important early period during which sufficient sleep is needed to fine-tune the functions necessary for academic achievement later on.
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Affiliation(s)
- Dominique Petit
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-I'lle-de-Montréal, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
| | - Evelyne Touchette
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-I'lle-de-Montréal, Montreal, Quebec, Canada
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
- Research Unit on Children's Psychosocial Maladjustment, Laval University, Quebec City, Quebec, Canada
| | - Marie-Hélène Pennestri
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-I'lle-de-Montréal, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Hôpital en Santé Mentale Rivière-des-Prairies, CIUSSS du Nord-de-I'lle-de-Montréal, Montreal, Quebec, Canada
| | - Jean Paquet
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-I'lle-de-Montréal, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
| | - Sylvana Côté
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montreal, Quebec, Canada
| | - Richard E Tremblay
- Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
- Research Unit on Children's Psychosocial Maladjustment, Université de Montréal, Montreal, Quebec, Canada
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Michel Boivin
- Research Unit on Children's Psychosocial Maladjustment, Laval University, Quebec City, Quebec, Canada
| | - Jacques Y Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-I'lle-de-Montréal, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
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17
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Williamson AA, Amin RS, Meltzer LJ, Laposky A, Fiks AG, Tapia IE. Defining and Promoting Pediatric Pulmonary Health: Understanding Sleep and Ventilatory Health. Pediatrics 2023; 152:e2023062292D. [PMID: 37656027 PMCID: PMC10484307 DOI: 10.1542/peds.2023-062292d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 09/02/2023] Open
Abstract
Healthy sleep and optimal ventilatory control begin in early development and are crucial for positive child outcomes. This paper summarizes information presented at the Sleep and Ventilatory Control sessions of the National Heart, Lung, and Blood-sponsored 2021 Defining and Promoting Pediatric Pulmonary Health workshop. These sessions focused on pediatric sleep health, screening for sleep health and sleep disorders in primary care using the electronic health record, infant sleep and ventilatory control, and home sleep testing. Throughout this summary, we discuss key gaps in and barriers to promoting sleep and ventilatory health that were identified during the workshop sessions. We conclude with strategies to address these gaps and barriers and directions for future multidisciplinary research, patient care, and training.
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Affiliation(s)
- Ariel A. Williamson
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raouf S. Amin
- Cincinnati Children’s Medical Center, Cincinnati, Ohio
| | | | - Aaron Laposky
- National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Alexander G. Fiks
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ignacio E. Tapia
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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18
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Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med 2023; 19:1321-1336. [PMID: 36722616 PMCID: PMC10315605 DOI: 10.5664/jcsm.10476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 02/02/2023]
Abstract
STUDY OBJECTIVES This review synthesizes the pediatric behavioral sleep intervention (BSI) evidence base, summarizes challenges in translating BSIs from research to practice, and provides recommendations for integrating implementation science methods to advance pediatric BSI research. METHODS We briefly review the common behavioral sleep disturbances among youth, discuss the pediatric BSIs with well-established evidence, and identify gaps in pediatric BSI research. We then identify contributors to the dearth of research evaluating pediatric BSIs in accessible settings and present a model for applying implementation science strategies to address identified gaps across the continuum of translational research. RESULTS Relatively few BSI trials include older children and adolescents. Similarly, there is limited research evaluating BSIs among racially and ethnically minoritized children and families and/or those of lower socioeconomic status backgrounds. Access to scalable and easily disseminable tools to treat pediatric sleep disturbances early in their development is crucial for promoting positive child outcomes. To address these gaps, researchers should apply implementation science theories, models, and frameworks to design new interventions for implementation, adapt existing interventions with end users and settings in mind, conduct hybrid effectiveness-implementation trials, and test implementation strategies. CONCLUSIONS Given the prevalence and consequences of poor sleep across developmental periods, pediatric BSIs must be effective as well as adaptable, scalable, and easily disseminable. Implementation science theories, models, and frameworks can enhance access to, engagement in, and the implementation and dissemination of scalable BSIs across diverse pediatric care settings and heterogeneous populations. CITATION Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med. 2023;19(7):1321-1336.
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Affiliation(s)
- Jessica C. Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ariel A. Williamson
- Sleep Center, Division of Pulmonary and Sleep Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
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19
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Servot S, St-Amand A, Rousseau M, Simard V, Touchette E. Sleep ecology, objective sleep characteristics and behavior problems in preschoolers referred to child protection services: An exploratory study. CHILD ABUSE & NEGLECT 2023; 138:106075. [PMID: 36764173 DOI: 10.1016/j.chiabu.2023.106075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/19/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Exposure to environmental risk factors increases the negative impact maltreatment has on children's development. Sleep ecology (i.e., sleep hygiene and home sleeping conditions) can be one of these factors. Poor sleep hygiene and suboptimal home sleeping conditions can alter sleep characteristics, which in turn, may lead to behavior problems (BPs), highly prevalent in maltreated preschoolers. OBJECTIVES Describe sleep ecology in maltreated preschoolers and explore associations between their sleep ecology, objective sleep characteristics and BPs. METHOD Parents (n = 22) completed the Children's Sleep Hygiene Scale (CSHS), and a sleep environment questionnaire to document sleep ecology. Children wore an actigraph to record objective sleep characteristics. Parents completed the Behavioral Assessment Scale for Children (BASC-2) to assess children's BPs. Descriptive and correlational analyses were performed. RESULTS Most of the parents (90.5 %) reported adequate sleep hygiene. However, 20 parents (95.2 %) reported suboptimal home sleeping conditions. Better physiological and overall sleep hygiene were related to earlier sleep onset. Better emotional sleep hygiene was associated with shorter nighttime awakenings and better sleep efficiency. Later sleep onset was associated with lower anxiety, and longer 24-hour sleep duration with higher somatization. Better physiological sleep hygiene was associated with less depression, and better emotional sleep hygiene with less hyperactivity. CONCLUSION This study showed that sleep hygiene could be associated with maltreated preschoolers' sleep characteristics and BPs, and that their home sleeping conditions may be of concern. Associations between sleep ecology, objective sleep characteristics and BPs deserve to be better understood, and further explored.
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Affiliation(s)
- Sabrina Servot
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada
| | - Annick St-Amand
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada
| | - Michel Rousseau
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada
| | - Valérie Simard
- Department of Psychology, Université de Sherbrooke, Québec, Canada; Centre de recherche Charles-Le Moyne, Longueuil, Canada; Sainte-Justine University Hospital Research Center, Montréal, Canada
| | - Evelyne Touchette
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada; Research Unit on Children's Psychosocial Maladjustment, Québec, Canada.
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20
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Eysenbach G, Leung T, Yamamoto T, Fujisawa TX, Hanaie R, Hirata I, Matsumoto S, Mohri I, Taniike M. Improving Children's Sleep Habits Using an Interactive Smartphone App: Community-Based Intervention Study. JMIR Mhealth Uhealth 2023; 11:e40836. [PMID: 36641237 PMCID: PMC9960041 DOI: 10.2196/40836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/16/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Sleep problems are quite common among young children and are often a challenge for parents and a hinderance to children's development. Although behavioral therapy has proven effective in reducing sleep problems in children, a lack of access to professionals who can provide effective support is a major barrier for many caregivers. Therefore, pediatric sleep experts have begun developing apps and web-based services for caregivers. Despite the substantial influence of cultural and familial factors on children's sleep, little effort has gone into developing cultural or family-tailored interventions. OBJECTIVE This study aimed to examine the effectiveness of the interactive smartphone app "Nenne Navi," which provides culturally and family-tailored suggestions for improving sleep habits in young Japanese children through community-based long-term trials. The study also aimed to investigate the association between app-driven improvements in sleep and mental development in children. METHODS This study adopted a community-based approach to recruit individuals from the Higashi-Osaka city (Japan) who met ≥1 of the following eligibility criteria for sleep problems: sleeping after 10 PM, getting <9 hours of nighttime sleep, and experiencing frequent nighttime awakenings. A total of 87 Japanese caregivers with young children (mean 19.50, SD 0.70 months) were recruited and assigned to the app use group (intervention group) or the video-only group (control group). Both groups received educational video content regarding sleep health literacy. The caregivers in the intervention group used the app, which provides family-tailored suggestions, once per month for 1 year. RESULTS A total of 92% (33/36) of the caregivers in the app use group completed 1 year of the intervention. The participants' overall evaluation of the app was positive. The wake-up time was advanced (base mean 8:06 AM; post mean 7:48 AM; F1,65=6.769; P=.01 and sleep onset latency was decreased (base mean 34.45 minutes; post mean 20.05 minutes; F1,65=23.219; P<.001) significantly in the app use group at the 13th month compared with the video-only group. Moreover, multiple regression analysis showed that decreased social jetlag (β=-0.302; P=.03) and increased sleep onset latency SD (β=.426; P=.02) in children predicted a significant enhancement in the development of social relationships with adults. At 6 months after the completion of the app use, all the caregivers reported continuation of the new lifestyle. CONCLUSIONS The present findings suggest that the app "Nenne Navi" has high continuity in community use and can improve sleep habits in young Japanese children and that interventions for sleep habits of young children may lead to the enhancement of children's social development. Future studies must focus on the effectiveness of the app in other regions with different regional characteristics and neuroscientific investigations on how changes in sleep impact brain development.
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Affiliation(s)
| | | | - Tomoka Yamamoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Yoshida-gun, Fukui, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Ryuzo Hanaie
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Ikuko Hirata
- Department of Pediatrics, Osaka University Hospital, Suita, Osaka, Japan
| | | | - Ikuko Mohri
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Masako Taniike
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
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21
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Finkel MA, Bryan A, Partida I, Raaen L, Duong N, Goldsmith J, Woo Baidal JA. Longitudinal trends in parent-reported child sleep, physical activity, and screen use during the COVID-19 pandemic in New York City. SAGE Open Med 2023; 11:20503121221147851. [PMID: 36660110 PMCID: PMC9845847 DOI: 10.1177/20503121221147851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/09/2022] [Indexed: 01/17/2023] Open
Abstract
Objective To examine trends in child sleep, physical activity, and screen use during the COVID-19 pandemic in New York City with a prospective, longitudinal online survey of parents recruited from a large medical center. Methods Data was collected Spring 2020 ("Complete Shutdown") and Fall 2020 ("Partial Shutdown"). Outcomes were parental perceptions about changes in child sleep, physical activity, and screen time compared to before COVID-19; and contemporaneous measures of these child behaviors. We report contemporaneous responses and paired analyses to describe longitudinal changes. Results Two hundred seventy-seven participants were surveyed during Complete Shutdown and 227 (81.9%) filled out a follow-up survey during Partial Shutdown. The largest percentage of parents at both time points perceived no change in child sleep, decreases in child exercise, and increases in child screen time. In paired analyses, perceptions shifted toward less sleep, more physical activity and less screen time from Complete Shutdown to Partial Shutdown. Conclusion COVID-19 had negative impacts on child health behaviors that did not resolve over a 6-month period despite partial reopenings.
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Affiliation(s)
- Morgan A Finkel
- Department of Pediatrics, Columbia
University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Alexis Bryan
- Department of Epidemiology, Columbia
University Mailman School of Public Health, New York, NY, USA
| | - Ivette Partida
- Department of Pediatrics, Columbia
University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Laura Raaen
- Department of Nutrition, Teachers
College, Columbia University, New York, NY, USA
| | - Ngoc Duong
- Department of Pediatrics, Columbia
University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jeff Goldsmith
- Department of Biostatistics, Columbia
University Mailman School of Public Health, New York, NY, USA
| | - Jennifer A Woo Baidal
- Department of Pediatrics, Columbia
University Vagelos College of Physicians and Surgeons, New York, NY, USA,Jennifer A. Woo Baidal, Division of
Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons,
NewYork-Presbyterian, 622 West 168th St, PH-17, New York, NY 10032, USA.
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22
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Mitchell JA, Morales KH, Williamson AA, Jawahar A, Juste L, Vajravelu ME, Zemel BS, Dinges DF, Fiks AG. Promoting Sleep Duration in the Pediatric Setting Using a Mobile Health Platform: A Randomized Optimization Trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.04.23284151. [PMID: 36711634 PMCID: PMC9882437 DOI: 10.1101/2023.01.04.23284151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective Determine the optimal combination of digital health intervention component settings that increase average sleep duration by ≥30 minutes per weeknight. Methods Optimization trial using a 25 factorial design. The trial included 2 week run-in, 7 week intervention, and 2 week follow-up periods. Typically developing children aged 9-12y, with weeknight sleep duration <8.5 hours were enrolled (N=97). All received sleep monitoring and performance feedback. The five candidate intervention components (with their settings to which participants were randomized) were: 1) sleep goal (guideline-based or personalized); 2) screen time reduction messaging (inactive or active); 3) daily routine establishing messaging (inactive or active); 4) child-directed loss-framed financial incentive (inactive or active); and 5) caregiver-directed loss-framed financial incentive (inactive or active). The primary outcome was weeknight sleep duration (hours per night). The optimization criterion was: ≥30 minutes average increase in sleep duration on weeknights. Results Average baseline sleep duration was 7.7 hours per night. The highest ranked combination included the core intervention plus the following intervention components: sleep goal (either setting was effective), caregiver-directed loss-framed incentive, messaging to reduce screen time, and messaging to establish daily routines. This combination increased weeknight sleep duration by an average of 39.6 (95% CI: 36.0, 43.1) minutes during the intervention period and by 33.2 (95% CI: 28.9, 37.4) minutes during the follow-up period. Conclusions Optimal combinations of digital health intervention component settings were identified that effectively increased weeknight sleep duration. This could be a valuable remote patient monitoring approach to treat insufficient sleep in the pediatric setting.
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Affiliation(s)
- Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia
- The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia
| | - Knashawn H Morales
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ariel A Williamson
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia
| | - Abigail Jawahar
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia
| | - Lionola Juste
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia
| | - Mary Ellen Vajravelu
- Division of Pediatric Endocrinology, Diabetes and Metabolism, UPMC Children's Hospital of Pittsburgh, Pittsburgh
| | - Babette S Zemel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia
| | - David F Dinges
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Alexander G Fiks
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia
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23
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Turnbull KLP, Cubides Mateus DM, LoCasale-Crouch J, Lewin DS, Williford AP. Sleep Patterns and School Readiness of Pre-Kindergarteners from Racially and Ethnically Diverse, Low-Income Backgrounds. J Pediatr 2022; 251:178-186. [PMID: 35940290 PMCID: PMC10621568 DOI: 10.1016/j.jpeds.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To explore patterns in parent-reported child sleep health and to investigate connections between such patterns and school readiness for newly enrolled prekindergarten (PreK) attendees from racially and ethnically diverse, low-income backgrounds. STUDY DESIGN In a secondary analysis from a larger multiple-cohort longitudinal observational study of prekindergartners in low-income families, parental reports of sleep health for 351 children (mean age, 52.8 ± 3.5 months) during the first month of PreK were analyzed. Children also had completed direct assessments measuring language, literacy, mathematics, and executive functioning, and teachers rated children's social-emotional-behavioral competencies and approaches to learning at PreK entry. We performed latent class analyses to identify patterns in sleep health and used regression models to examine concurrent associations between child sleep health patterns and school readiness competencies across 6 domains: language, literacy, mathematics, executive functioning, social-emotional-behavioral, and approaches to learning. RESULTS Two classes emerged reflecting more and less desirable patterns of sleep health. Children classified in the earlier, longer, consistent sleep health class (87% of children) experienced earlier bedtimes, longer night-time sleep durations, more consistent sleep routines, less caffeine consumption ≤3 hours before bedtime, and scored higher on a direct assessment of expressive vocabulary and on teacher-reported measures of social-emotional-behavioral competencies and learning approaches than their peers in the later, shorter, inconsistent sleep health class (13% of children). CONCLUSIONS Consistent sleep routines and more optimal sleep health may serve as a protective mechanism for the language development, social-emotional-behavioral regulation, and approaches to learning of PreK from racially and ethnically diverse, low-income backgrounds. Clinician-parent discussions regarding optimal sleep health may provide key opportunities for targeted education that promotes school readiness skill development.
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Affiliation(s)
- Khara L P Turnbull
- School of Education and Human Development, Center for Advanced Study of Teaching and Learning, University of Virginia, Charlottesville, VA.
| | - Deiby Mayaris Cubides Mateus
- School of Education and Human Development, Center for Advanced Study of Teaching and Learning, University of Virginia, Charlottesville, VA
| | - Jennifer LoCasale-Crouch
- School of Education and Human Development, Center for Advanced Study of Teaching and Learning, University of Virginia, Charlottesville, VA
| | - Daniel S Lewin
- Children's National Health System, George Washington University School of Medicine, Washington, DC
| | - Amanda P Williford
- School of Education and Human Development, Center for Advanced Study of Teaching and Learning, University of Virginia, Charlottesville, VA
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24
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Pettersen Sandtrø H, Glavin K, Størksen HT, Smogli Holter MT, Drozd F. Mothers and public health nurses' experiences of sleep problems in children aged 6 months to 3 years: A qualitative study. J Clin Nurs 2022. [DOI: 10.1111/jocn.16586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Hege Pettersen Sandtrø
- Regional Centre for Child and Adolescent Mental Health (RBUP) Eastern and Southern Norway Oslo Norway
| | - Kari Glavin
- Faculty of Health VID Specialized University Oslo Norway
| | | | | | - Filip Drozd
- Regional Centre for Child and Adolescent Mental Health (RBUP) Eastern and Southern Norway Oslo Norway
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25
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Belmon LS, Van Stralen MM, Harmsen IA, Den Hertog KE, Ruiter RAC, Chinapaw MJM, Busch V. Promoting children's sleep health: Intervention Mapping meets Health in All Policies. Front Public Health 2022; 10:882384. [PMID: 36466483 PMCID: PMC9709501 DOI: 10.3389/fpubh.2022.882384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background To design a comprehensive approach to promote children's sleep health in Amsterdam, the Netherlands, we combined Intervention Mapping (IM) with the Health in All Policies (HiAP) perspective. We aimed to create an approach that fits local infrastructures and policy domains across sectors. Methods First, a needs assessment was conducted, including a systematic review, two concept mapping studies, and one cross-sectional sleep diary study (IM step 1). Subsequently, semi-structured interviews with stakeholders from policy, practice and science provided information on potential assets from all relevant social policy sectors to take into account in the program design (HiAP and IM step 1). Next, program outcomes and objectives were specified (IM step 2), with specific objectives for policy stakeholders (HiAP). This was followed by the program design (IM step 3), where potential program actions were adapted to local policy sectors and stakeholders (HiAP). Lastly, program production (IM step 4) focused on creating a multi-sector program (HiAP). An advisory panel guided the research team by providing tailored advice during all steps throughout the project. Results A blueprint was created for program development to promote children's sleep health, including a logic model of the problem, a logic model of change, an overview of the existing organizational structure of local policy and practice assets, and an overview of policy sectors, and related objectives and opportunities for promoting children's sleep health across these policy sectors. Furthermore, the program production resulted in a policy brief for the local government. Conclusions Combining IM and HiAP proved valuable for designing a blueprint for the development of an integrated multi-sector program to promote children's sleep health. Health promotion professionals focusing on other (health) behaviors can use the blueprint to develop health promotion programs that fit the local public service infrastructures, culture, and incorporate relevant policy sectors outside the public health domain.
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Affiliation(s)
- Laura S. Belmon
- Department of Public and Occupational Health, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands,Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands,Department of Healthy Living, Public Health Service (GGD), Amsterdam, Netherlands,*Correspondence: Laura S. Belmon
| | - Maartje M. Van Stralen
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Irene A. Harmsen
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands
| | - Karen E. Den Hertog
- Department of Healthy Living, Public Health Service (GGD), Amsterdam, Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Vincent Busch
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands,Vincent Busch
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26
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Topsakal S, Ekici B. Effect of illuminated musical mobile on sleep quality of children hospitalized in pediatric emergency departments. J Pediatr Nurs 2022; 67:e156-e164. [PMID: 35973878 DOI: 10.1016/j.pedn.2022.08.004] [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: 03/06/2022] [Revised: 07/27/2022] [Accepted: 08/06/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this study is to evaluate the effect of an illuminated musical mobile on the sleep quality of children hospitalized in a pediatric emergency department. DESIGN AND METHODS In this randomized controlled study, 124 children presenting to a pediatric emergency department who met the inclusion criteria were included in the study. Patients were randomized into two equal groups. In the intervention group, an illuminated musical mobile was used to help facilitate sleep. In the control group, routine sleep routines were continued. Groups were compared according to sleep quality as evaluated by mothers' observations. Evaluation was performed twice (before intervention - 1st day of hospitalization and on the intervention day - 2nd day of hospitalization). RESULTS Average age of children was 1.86 ± 0.78 years. On the intervention day, nighttime sleep duration was longer in the intervention group (p < .0001). Also, the frequency of spontaneous awakening (p < .0001), time to fall asleep after spontaneous awakening (p < .0001) and sleep time problems (p < .0001) were less in the intervention group. CONCLUSıONS: An illuminated musical mobile was used for the first time in the pediatric emergency department and was found to be effective in improving the sleep quality of hospitalized children aged between 1 and 3 years. PRACTICE IMPLICATIONS During hospitalization, children's sleep quality can be increased by using methods and objects suitable for the child's developmental level.
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Affiliation(s)
- Sinem Topsakal
- Istanbul Ministry of Health Marmara University Pendik Training and Research Hospital, Pediatric Emergency Clinic, Istanbul, Turkey
| | - Behice Ekici
- Maltepe University, School of Nursing, Pediatric Nursing Department, Istanbul, Turkey.
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27
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Magee L, Goldsmith LP, Chaudhry UAR, Donin AS, Wahlich C, Stovold E, Nightingale CM, Rudnicka AR, Owen CG. Nonpharmacological Interventions to Lengthen Sleep Duration in Healthy Children: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:1084-1097. [PMID: 36094530 PMCID: PMC9468945 DOI: 10.1001/jamapediatrics.2022.3172] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/09/2022] [Indexed: 12/15/2022]
Abstract
Importance Adequate sleep duration is necessary for many aspects of child health, development, and well-being, yet sleep durations for children are declining, and effective strategies to increase sleep in healthy children remain to be elucidated. Objective To determine whether nonpharmaceutical interventions to improve sleep duration in healthy children are effective and to identify the key components of these interventions. Data Sources CENTRAL, MEDLINE, Embase, PsycINFO, Web of Science Core collection, ClinicalTrials.gov, and WHO trials databases were searched from inception to November 15, 2021. Study Selection Randomized clinical trials of interventions to improve sleep duration in healthy children were independently screened by 2 researchers. A total of 28 478 studies were identified. Data Extraction and Synthesis Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline. Random-effects meta-analytic models were used to estimate pooled effect sizes. Main Outcomes and Measures Difference in sleep duration, measured in minutes. Results A total of 13 539 child participants from 45 randomized clinical trials were included. Of these, 6897 (50.9%) were in the intervention group and 6642 (49.1%) in the control group, and the mean age ranged from 18 months to 19 years. Pooled results indicate that sleep interventions were associated with 10.5 minutes (95% CI, 5.6-15.4) longer nocturnal sleep duration. There was substantial variation between trials. Sources of variation that were not associated with the study effect size included age group, whether the population was identified as having a sleep problem or being at a socioeconomic disadvantage (eg, coming from a low-income family or area), method of assessment of sleep duration (objective vs subjective), location of intervention delivery (home vs school), whether interventions were delivered in person or used parental involvement, whether behavioral theory was used, environmental change, or had greater or lower intensity. Interventions that included earlier bedtimes were associated with a 47-minute sleep extension (95% CI, 18.9-75.0; 3 trials) compared with remaining studies (7.4 minutes; 95% CI, 2.9-11.8; 42 trials) (P = .006 for group difference). Trials of shorter duration (6 months or less) had larger effects. Conclusions and Relevance Interventions focused on earlier bedtimes may offer a simple, pragmatic, effective way to meaningfully increase sleep duration that could have important benefits for child health.
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Affiliation(s)
- Lucia Magee
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Lucy P. Goldsmith
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Umar A. R. Chaudhry
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Angela S. Donin
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Charlotte Wahlich
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Elizabeth Stovold
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Claire M. Nightingale
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Alicja R. Rudnicka
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Christopher G. Owen
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
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28
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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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29
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Muller D, Paine SJ, Signal TL. The role of sleep in health and health inequities in early childhood in Aotearoa New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2109689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Diane Muller
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University Wellington, Wellington, New Zealand
| | - Sarah-Jane Paine
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey Leigh Signal
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University Wellington, Wellington, New Zealand
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30
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Gigliotti F, Esposito D, Basile C, Cesario S, Bruni O. Sleep terrors-A parental nightmare. Pediatr Pulmonol 2022; 57:1869-1878. [PMID: 33647192 DOI: 10.1002/ppul.25304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 11/08/2022]
Abstract
Sleep terrors (STs) are sleep disorders characterized by abrupt arousal from sleep with autonomic hyperactivity and inappropriate behavior. Though a common condition in childhood that usually affects children between 4 and 12 years of age, STs, however, may be present even in adulthood. The exact etiology of STs is not known yet, however, several hypotheses have been proposed over the years, identifying some potential genetic, neurodevelopmental, or other causes. Nevertheless, a useful pathophysiological model identified a common cascade of predisposing, priming, and precipitating factors, which could help to explain and sometimes prevent STs. Establishing a correct diagnosis is mandatory for appropriate management, as several conditions (such as other parasomnias or nocturnal seizures) may mimic STs. Furthermore, we also described some conditions which can be comorbid to STs, like some medical or psychological disorders. A number of treatment options have been proposed, ranging from only sleep hygiene practices to pharmacological therapies; we reviewed some of the most prominent ones. In spite of the fact that STs have long been considered benign disorders, which tend to reduce spontaneously over the years, they may have unexpected consequences on the child but also on the caregivers.
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Affiliation(s)
- Federica Gigliotti
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Dario Esposito
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Consuelo Basile
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Serena Cesario
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
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31
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Hoyniak CP, Bates JE, Catalina Camacho M, McQuillan ME, Whalen DJ, Staples AD, Rudasill KM, Deater-Deckard K. The physical home environment and sleep: What matters most for sleep in early childhood. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:757-769. [PMID: 35266772 PMCID: PMC9747092 DOI: 10.1037/fam0000977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The physical home environment is thought to play a crucial role in facilitating healthy sleep in young children. However, relatively little is known about how various features of the physical home environment are associated with sleep in early childhood, and some of the recommendations clinicians make for improving child sleep environments are based on limited research evidence. The present study examined how observer and parent descriptions of the child's physical home environment were associated with child sleep, measured using actigraphy and parent's reports, across a year in early childhood. The study used a machine learning approach (elastic net regression) to specify which aspects of the physical home environment were most important for predicting five aspects of child sleep, sleep duration, sleep variability, sleep timing, sleep activity, and latency to fall asleep. The study included 546 toddlers (265 females) recruited at 30 months of age and reassessed at 36 and 42 months of age. Poorer quality physical home environments were associated with later sleep schedules, more variable sleep schedules, shorter sleep durations, and more parent-reported sleep problems in young children. The most important environmental predictors of sleep were room sharing with an adult, bed sharing, and quality of both the child's sleep space and the wider home environment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Caroline P. Hoyniak
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | - John E. Bates
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA
| | - M. Catalina Camacho
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | - Maureen E. McQuillan
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA
| | - Diana J. Whalen
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | | | | | - Kirby Deater-Deckard
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, USA
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32
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Hohman EE, Savage JS, Marini ME, Anzman-Frasca S, Buxton OM, Loken E, Paul IM. Effect of the INSIGHT Firstborn Parenting Intervention on Secondborn Sleep. Pediatrics 2022; 150:188273. [PMID: 35703026 PMCID: PMC9893513 DOI: 10.1542/peds.2021-055244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention for first-time mothers improved firstborn infant sleep compared with controls. The goals of this analysis were to test intervention spillover effects on secondborn siblings and examine birth order differences in infant sleep. METHODS Secondborns (n = 117) of INSIGHT mothers were enrolled in an observational cohort, SIBSIGHT. The Brief Infant Sleep Questionnaire was collected at 3, 16, and 52 weeks. Generalized linear mixed models assessed differences among secondborns by firstborn randomization, as well as birth order differences at 16 and 52 weeks. RESULTS The RP group secondborns slept 42 minutes longer at night (95% confidence interval [95% CI]: 19-64) and 53 minutes longer total (95% CI: 17-90) than control secondborns. RP secondborns were more likely to self-soothe to sleep (odds ratio [OR] = 2.0, 95% CI: 1.1-3.7) and less likely to be fed back to sleep after waking (OR = 0.5, 95% CI: 0.3-0.9) than secondborns of control mothers. RP secondborns were more likely to have a bedtime ≤8 pm at 3 (OR = 2.9, 95% CI: 1.1-7.7) and 16 weeks (OR = 4.7, 95% CI: 2.0-11.0). Few differences in sleep parenting practices were observed when comparing siblings within families. Secondborns slept 37 minutes longer than firstborns at 16 weeks (CI: 7-67, P = .03). CONCLUSIONS The INSIGHT RP intervention for first-time mothers had a spillover effect to secondborns, positively impacting sleep duration and behaviors. Intervening with first-time mothers benefits both firstborns and subsequent children.
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Affiliation(s)
- Emily E. Hohman
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA,Nutritional Sciences, Pennsylvania State University, University Park, PA
| | - Michele E. Marini
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA
| | | | - Orfeu M. Buxton
- Biobehavioral Health, Pennsylvania State University, University Park, PA
| | - Eric Loken
- Educational Psychology, University of Connecticut, Storrs, CT
| | - Ian M. Paul
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey PA
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Primary School Children's Sleep Habits: Association with Socioeconomic Factors and Physical Activity Habits. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9070965. [PMID: 35883948 PMCID: PMC9317587 DOI: 10.3390/children9070965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
Sleep disorders have significant health impacts and affect children’s performance and wellbeing. This study aims to characterise the sleep habits of Portuguese primary school children considering socioeconomic factors, daily lifestyle, presence of electronic devices in the bedrooms, and the practice of physical and sports activity (PSA) and to identify clinical factors that may be related to a child’s insufficient sleeping time. This study involved 1438 primary students. Sleep habits and problems were assessed using the short version of the Children’s Sleep Habits Questionnaire (CSHQ). The mean sleep duration was 9 h 37 min/ per night (SD = 44 min). The prevalence of global sleep disturbances was 25.8%. The main factors we identified to be positively associated with a child’s sleep deficit (i.e., <10 h) were: being older than 7 years, living further away from school, having electronic devices in the bedroom, going to bed and eating dinner later, less daily time of PSA, and having higher scores on the sleep duration subscales. Sleeping and eating habits, electronic devices in the bedroom, and a low level of engagement with PSA are associated with children’s sleep disturbance and shorter sleep duration.
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Abstract
There is growing public health concern about the high prevalence of sleep deficiency in early childhood and the associated risk for sleep-associated poor health outcomes, including metabolic, cardiovascular, and mental health. The recent shift to conceptualize sleep health as a multidimensional construct, influenced by socioecological factors, highlights the potential role of sleep in health disparities. Understanding the development of sleep health and the emergence of sleep disorders in early life is a current priority in pediatric sleep research. Future behavioral sleep interventions should consider the multiple socioecological influences on children's sleep health and be tested using inclusive sampling methods.
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Affiliation(s)
| | - Sarah Logan
- Yale School of Nursing, PO Box 27399, West Haven, CT 06516-7399, USA
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35
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Adams EL, Master L, Buxton OM, Savage JS. Sleep parenting practices are associated with infant self-soothing behaviors when measured using actigraphy. Sleep Med 2022; 95:29-36. [DOI: 10.1016/j.sleep.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/04/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
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36
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Park J, Kim SY, Lee K. Effectiveness of behavioral sleep interventions on children's and mothers' sleep quality and maternal depression: a systematic review and meta-analysis. Sci Rep 2022; 12:4172. [PMID: 35264627 PMCID: PMC8907206 DOI: 10.1038/s41598-022-07762-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/23/2022] [Indexed: 11/29/2022] Open
Abstract
This systematic review and meta-analysis was conducted to investigate the effectiveness of behavioral sleep interventions (BSIs) on the number of child night awakenings, and maternal sleep quality and depression. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) using PubMed, CINAHL, Cochrane, and EMBASE databases and retrieved studies published until April 2021. We calculated the odds ratios (ORs) and 95% confidence intervals (CIs) for child sleep problems, and the mean differences (MD) and 95% CI for the number of child night awakenings, and maternal sleep quality and depression. Ten studies of 1628 initial searched were included in the final analysis. Two of the 10 studies were divided into two subgroups by participants and intervention type; thus, 12 subgroups were included in the meta-analysis. BSIs significantly reduced child sleep problems (OR 0.51; 95% CI 0.37–0.69) and improved maternal sleep quality (MD − 1.30; 95% CI − 1.82 to − 0.77) in the intervention group. There were no significant differences in the number of child night awakenings and maternal depression between the two groups. More RCTs to examine the effect of BSIs considering children’s age, duration of intervention, and outcome measuring time points are needed.
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Affiliation(s)
- Jeongok Park
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 616 College of Nursing, Yonsei-ro 50, Seodaemun-gu, Seoul, 03722, Korea
| | - Soo Yeon Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 616 College of Nursing, Yonsei-ro 50, Seodaemun-gu, Seoul, 03722, Korea
| | - Kyoungjin Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 616 College of Nursing, Yonsei-ro 50, Seodaemun-gu, Seoul, 03722, Korea. .,College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, 03722, Korea.
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37
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Simon SL, Kaar JL, Talker I, Reich J. Evidence-Based Behavioral Strategies in Smartphone Apps for Children's Sleep: Content Analysis. JMIR Pediatr Parent 2022; 5:e32129. [PMID: 35238787 PMCID: PMC8931643 DOI: 10.2196/32129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Empirically supported treatments for pediatric sleep problems exist, but many families turn to other sources for help with their children's sleep, such as smartphone apps. Sleep apps are easy for families to access, but little evidence exists regarding the validity of the services and information provided in the developer descriptions of the apps. OBJECTIVE The goal of this study was to examine the features and claims of developer descriptions of sleep apps for children. METHODS A search of the Apple iTunes store and Google Play was conducted using the terms "kids sleep," "child sleep," and "baby sleep." Data on the type of app, price, user rating, and number of users were collected. Apps were analyzed in comparison with evidence-based behavioral strategies and were thematically coded on the basis of claims provided in developer descriptions. RESULTS A total of 83 app descriptions were examined, of which only 2 (2.4%) offered sleep improvement strategies. The majority were sound and light apps (78%) and 19% were bedtime games or stories. Only 18 of 83 (21.6%) apps were identified as containing empirically supported behavioral sleep strategies. Despite this, many apps asserted claims that they will help children "fall asleep instantly," "cry less and sleep better," or improve child development. CONCLUSIONS A large variety of sleep apps exist for use among children, but few include evidence-based behavioral strategies according to the developer descriptions of the apps. Addressing sleep difficulties in children is important to promote physical, cognitive, and emotional development. Collaboration between sleep researchers and technology developers may be beneficial for creating evidence-supported apps to help with children's sleep in the future.
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Affiliation(s)
- Stacey L Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jill L Kaar
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ishaah Talker
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jennifer Reich
- Department of Sociology, University of Colorado Denver, Denver, CO, United States
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Williamson AA, Okoroji C, Cicalese O, Evans BC, Ayala A, Harvey B, Honore R, Kratchman A, Beidas RS, Fiks AG, Power TJ, Mindell JA. Sleep Well! An adapted behavioral sleep intervention implemented in urban primary care. J Clin Sleep Med 2021; 18:1153-1166. [PMID: 34910624 DOI: 10.5664/jcsm.9822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To describe the adaptation, feasibility, and initial outcomes of Sleep Well!, an intervention for early childhood insomnia and insufficient sleep, designed for families from lower-socioeconomic status (SES) backgrounds presenting to large metropolitan primary care sites. METHODS Fifteen caregiver-child dyads (caregivers: 92.3% mothers; 80.0% Black; 53.3% ≤125% US poverty level; children: 73.3% female; 86.7% Black; M age = 3.0 years) participated this multi-method, single-arm trial. A family advisory board of caregivers (N = 4) and a clinician advisory board of sleep experts, primary care clinicians, and psychologists (N = 13) provided intervention feedback throughout the pilot. Most adaptations were related to intervention delivery methods, with some related to sleep strategies. At post-intervention, caregivers completed surveys on intervention acceptability and cultural humility (primary outcomes) and completed semi-structured interviews. Caregivers also reported on child sleep pre- and post-intervention. RESULTS Thirteen (86.6%) families completed Sleep Well! and 12 (80.0%) completed pre- and post-intervention measures. Caregivers reported strong intervention acceptability and cultural humility. There were pre-to-post reductions in child sleep problems, bedroom electronics, sleep onset latency, and night awakening frequency and duration. Nighttime sleep duration and overall insufficient sleep also improved. Qualitative data also showed strong intervention acceptability and perceived flexibility, with few participation barriers. CONCLUSIONS A brief, early childhood behavioral sleep intervention delivered in primary care with families from primarily lower-SES and/or racially minoritized backgrounds is feasible to implement, with strong retention rates, acceptability, and perceptions of cultural humility. Child sleep improvements are positive, and warrant replication in a randomized controlled trial.
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Affiliation(s)
- Ariel A Williamson
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Amanda Ayala
- Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - Rachel Honore
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - Amy Kratchman
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - Rinad S Beidas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA.,Penn Medicine Nudge Unit, University of Pennsylvania Health System, Philadelphia, PA
| | - Alexander G Fiks
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas J Power
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jodi A Mindell
- Children's Hospital of Philadelphia, Philadelphia, PA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Saint Joseph's University, Philadelphia, PA
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39
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Larsen KL, Jordan SS. Factors associated with consistent bedtime routines and good sleep outcomes. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1981331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kristy L. Larsen
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Sara S. Jordan
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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40
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Belmon LS, Komrij NL, Busch V, Oude Geerdink E, Heemskerk DM, de Bruin EJ, Chinapaw MJM, van Stralen MM. Correlates of inadequate sleep health among primary school children. J Sleep Res 2021; 31:e13483. [PMID: 34528326 PMCID: PMC9285344 DOI: 10.1111/jsr.13483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/29/2021] [Accepted: 08/30/2021] [Indexed: 10/29/2022]
Abstract
The aim of the present study was to explore potential factors of inadequate sleep health (i.e. sleep duration, quality, and timing) of school-aged children. Data were collected among 382 primary school children (aged 4-13 years) and their parents. Personal characteristics (i.e. age, sex), individual lifestyle behaviours (i.e. screen use, sleep hygiene behaviour), social and community factors (i.e. parental sleep-related practices, parental barriers, perceived ethnicity), and living conditions (i.e. parental educational level, sleep environment) were assessed with a parental questionnaire. Sleep duration, quality, and timing were assessed with a sleep diary. Associations were analysed using linear mixed models and logistic regression analyses. In total, 332 children, with a mean (range) age of 7.5 (4-13) years, were included in the analyses. The mean sleep duration was 632 min/night, the mean sleep quality score was 40, on a scale from 10 to 50, and 25% had a bedtime that varied >40 min between weekdays. Factors negatively associated with children's sleep health included older age, perceived non-Dutch cultural background, lower parental pre-sleep emotional support, the parental barrier to get their child to bed on time when siblings have a later bedtime, high parental educational level, sleeping in a darkened bedroom, and being brought to bed after falling asleep. On average, children in the present study had adequate sleep health. The factors found to be associated with children's sleep health are useful for future healthy sleep research and intervention development.
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Affiliation(s)
- Laura S Belmon
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands
| | - Nina L Komrij
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands
| | - Vincent Busch
- Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands
| | - Esmée Oude Geerdink
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Danique M Heemskerk
- Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands.,Department of Health Science, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ed J de Bruin
- Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Maartje M van Stralen
- Department of Health Science, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
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41
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Saidi O, Rochette E, Bourdier P, Ratel S, Merlin E, Pereira B, Duché P. Sleep in children and adolescents with juvenile idiopathic arthritis: a systematic review and meta-analysis of case-control studies. Sleep 2021; 45:6370831. [PMID: 34525202 DOI: 10.1093/sleep/zsab233] [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: 03/06/2021] [Revised: 07/02/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Juvenile idiopathic arthritis (JIA) is one of the most common pediatric rheumatic disease. However, sleep alteration associated with this auto-immune disease remain unclear. We aimed in this systematic review and meta-analysis to compare sleep duration, quality, and architecture in JIA subjects with those in their healthy peers. METHODS Systematic search performed in PubMed, EMBase, Cochrane, and PsycINFO databases included 19 studies in the qualitative synthesis of which 10 met the inclusion criteria for the meta-analysis. RESULTS Pooled results from subjective methods indicated pronounced sleep disturbances and complaints in youth with JIA compared with their healthy counterparts. This was further confirmed by Increased difficulty maintaining sleep (wake after sleep onset; SMD: -0.69; CI: -1.29; -0.09, p =0.02) and a tendency to increased difficulty initiating sleep (sleep onset latency; SMD: -0.29; CI: -0.60; 0.03, p =0.07). There were no remarkable differences in sleep duration or sleep architecture between JIA patients and healthy controls. High heterogeneity was found for several outcomes. This could be explained by the different methods used as well as associated sleep disorders, medication and comorbidities. CONCLUSIONS Although included studies were methodologically diverse, the summarized results of our review and meta-analysis bring evidence that children with JIA present more fragmented sleep compared to healthy peers. Thereby, the implementation of strategies to manage and improve sleep in this population are needed and might have a beneficial effect on the symptoms and functions of JIA.
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Affiliation(s)
- Oussama Saidi
- Université Clermont Auvergne, AME2P, (EA 3533), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France.,Université de Toulon, Laboratoire IAPS, Toulon, France
| | - Emmanuelle Rochette
- Université de Toulon, Laboratoire IAPS, Toulon, France.,CHU Clermont-Ferrand, Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, Clermont-Ferrand, France
| | - Pierre Bourdier
- Université Clermont Auvergne, AME2P, (EA 3533), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France
| | - Sébastien Ratel
- Université Clermont Auvergne, AME2P, (EA 3533), Clermont-Ferrand, France.,CRNH-Auvergne, Clermont-Ferrand, France
| | - Etienne Merlin
- CHU Clermont-Ferrand, Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, Clermont-Ferrand, France.,Université Clermont Auvergne, INRA, UMR 1019 UNH, ECREIN, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation de la Recherche Clinique et Innovations, Clermont-Ferrand, France
| | - Pascale Duché
- Université de Toulon, Laboratoire IAPS, Toulon, France
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42
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Schultz LF, Mastroeni SSDBS, Rafihi-Ferreira RE, Mastroeni MF. Sleep habits and weight status in Brazilian children aged 4-6 years of age: the PREDI study. Sleep Med 2021; 87:30-37. [PMID: 34508985 DOI: 10.1016/j.sleep.2021.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/13/2021] [Accepted: 08/22/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate the association of sleep habits with the weight status of children aged 4-6 years. METHODS Data were obtained from the PREDI Study, a Brazilian birth cohort study. The current study was carried out in the homes of the participants during two follow-ups: 2016/17 and 2018. The participants were submitted to anthropometric assessment and demographic, socioeconomic and sleep data were obtained. The child's sleep habits were self-reported by the mother or caregiver on the day of the visit and included information on the following sleep habits during the past week: bedtime routine, rhythmicity, and separation affect determined with the Sleep Habits Inventory for Preschool Children and the Sleep Habits Inventory. Logistic regression and gamma-log regression analyses were used to examine the association of sleep habits with excess body weight of children in the two follow-ups according to sex. RESULTS Of the 217 and 185 children included in 2016/17 and 2018, respectively, 66 (30.6%) and 48 (25.9%) had a BMI >85th percentile at 4-6 years, respectively. The median rhythmicity score was higher in children with excess body weight (p = 0.05). Adjusted analysis showed that rhythmicity was associated with excess body weight of girls at ages 4-5 years (OR = 1.42, 95% CI: 1.09-1.86, p = 0.009) and 6 years (OR = 1.32, 95% CI: 1.06-1.65, p = 0.015), even after adjustment for other important covariates. Additionally, the sleep habit "separation affect" was inversely associated with the child's BMI in boys (β = -0.005, 95% CI: -0.010-0.000, p = 0.037). CONCLUSIONS In the present study, rhythmicity problems were associated with increased odds of girls aged 4-6 years having excess body weight. These results are important from a public health perspective since strategies aimed at preventing excess body weight in children need to consider the child's sleep quality as a potential risk factor, especially rhythmicity.
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Affiliation(s)
- Lidiane Ferreira Schultz
- Postgraduate Program in Health and Environment, University of Joinville Region, Rua Paulo Malschitzki, nº 10, Joinville, SC, CEP 89.219-710, Brazil
| | | | - Renatha El Rafihi-Ferreira
- Ambulatório de Sono (LIM-63), Instituto de Psiquiatria, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marco F Mastroeni
- Postgraduate Program in Health and Environment, University of Joinville Region, Rua Paulo Malschitzki, nº 10, Joinville, SC, CEP 89.219-710, Brazil; Health Sciences Department, University of Joinville Region - UNIVILLE, Joinville, SC, Brazil.
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43
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Branigan AR, Meyer JM. Bedtime Schedules and Sleep Regulation among Children of Incarcerated Parents. J Pediatr 2021; 236:253-259. [PMID: 33940012 PMCID: PMC8491564 DOI: 10.1016/j.jpeds.2021.04.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To investigate variation by parental incarceration history in the bedtime schedules set for elementary-age children and whether sleep was effectively regulated. STUDY DESIGN We ran multivariate regression models estimating the relationship between parental incarceration and 6 measures of bedtime schedules and sleep regulation. Our sample included 9-year-olds in the Fragile Families and Child Wellbeing Study (n = 3246), a survey of children born in large US cities between 1998 and 2000 that has an oversample of unmarried mothers. RESULTS Children's bedtime schedules did not differ at a statistically significant level by parental incarceration history, but children of ever- vs never-incarcerated fathers had lower odds of consistently adhering to a set bedtime. Children of ever-incarcerated fathers also slept for less time on average than did children of never-incarcerated fathers, and they had lower odds of obtaining sufficient sleep. Bedtime consistency partly mediated the association between paternal incarceration and total sleep duration. CONCLUSIONS Although caregivers set appropriate bedtime schedules for children of ever-incarcerated fathers, consistent adherence to those schedules may be particularly challenging given the structural hardships of paternal incarceration. Policymakers, researchers, and practitioners working to improve sleep among children of incarcerated fathers should focus on helping families to develop strategies for implementing bedtime schedules as consistently and effectively as possible.
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Affiliation(s)
- Amelia R. Branigan
- Department of Sociology, University of Maryland, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr, College Park, MD 20742
| | - Jess M. Meyer
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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44
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Fehr KK, Chambers DE, Ramasami J. The Impact of Anxiety on Behavioral Sleep Difficulties and Treatment in Young Children: A Review of the Literature. J Clin Psychol Med Settings 2021; 28:102-112. [PMID: 32112293 DOI: 10.1007/s10880-020-09703-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sleep difficulties are a common pediatric complaint, and the majority of these sleep difficulties are behavioral in nature (e.g., difficulties initiating or maintaining sleep). Although research supports behavioral interventions to improve sleep in young children with behavioral sleep difficulties, anxiety and child distress are common in this age range and these factors can impact treatment outcomes directly (e.g., increased distress and resistance at bedtime) and indirectly (e.g., poor parental compliance with behavioral strategies). Anxiety is an important aspect of treatment in adolescents and adults with behavioral sleep difficulties, but this factor is rarely considered in the literature for younger children. Thus, this manuscript reviews the literature on anxiety as it relates to behavioral sleep difficulties in young children (i.e., the preschool and surrounding age range), provides an overview of empirically supported behavioral intervention and research incorporating anxiety into behavioral sleep treatments, and provides recommendations and future directions for continuing to advance the literature and treatment in this area.
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Affiliation(s)
- Karla K Fehr
- Department of Psychology, Southern Illinois University, Life Science II - Mail Code 6502, 1125 Lincoln Drive, Carbondale, IL, 62901, USA.
| | - Danielle E Chambers
- Department of Psychology, Southern Illinois University, Life Science II - Mail Code 6502, 1125 Lincoln Drive, Carbondale, IL, 62901, USA
| | - Jennifer Ramasami
- Department of Psychology, Southern Illinois University, Life Science II - Mail Code 6502, 1125 Lincoln Drive, Carbondale, IL, 62901, USA
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45
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Allen J, Zareen Z, Doyle S, Whitla L, Afzal Z, Stack M, Franklin O, Green A, James A, Leahy TR, Quinn S, Elnazir B, Russell J, Paran S, Kiely P, Roche EF, McDonnell C, Baker L, Hensey O, Gibson L, Kelly S, McDonald D, Molloy EJ. Multi-Organ Dysfunction in Cerebral Palsy. Front Pediatr 2021; 9:668544. [PMID: 34434904 PMCID: PMC8382237 DOI: 10.3389/fped.2021.668544] [Citation(s) in RCA: 6] [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: 02/16/2021] [Accepted: 07/15/2021] [Indexed: 11/20/2022] Open
Abstract
Cerebral Palsy (CP) describes a heterogenous group of non-progressive disorders of posture or movement, causing activity limitation, due to a lesion in the developing brain. CP is an umbrella term for a heterogenous condition and is, therefore, descriptive rather than a diagnosis. Each case requires detailed consideration of etiology. Our understanding of the underlying cause of CP has developed significantly, with areas such as inflammation, epigenetics and genetic susceptibility to subsequent insults providing new insights. Alongside this, there has been increasing recognition of the multi-organ dysfunction (MOD) associated with CP, in particular in children with higher levels of motor impairment. Therefore, CP should not be seen as an unchanging disorder caused by a solitary insult but rather, as a condition which evolves over time. Assessment of multi-organ function may help to prevent complications in later childhood or adulthood. It may also contribute to an improved understanding of the etiology and thus may have an implication in prevention, interventional methods and therapies. MOD in CP has not yet been quantified and a scoring system may prove useful in allowing advanced clinical planning and follow-up of children with CP. Additionally, several biomarkers hold promise in assisting with long-term monitoring. Clinicians should be aware of the multi-system complications that are associated with CP and which may present significant diagnostic challenges given that many children with CP communicate non-verbally. A step-wise, logical, multi-system approach is required to ensure that the best care is provided to these children. This review summarizes multi-organ dysfunction in children with CP whilst highlighting emerging research and gaps in our knowledge. We identify some potential organ-specific biomarkers which may prove useful in developing guidelines for follow-up and management of these children throughout their lifespan.
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Affiliation(s)
- John Allen
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | | | - Samantha Doyle
- Department of Clinical Genetics, Birmingham Women's Hospital, Birmingham, United Kingdom
| | - Laura Whitla
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Zainab Afzal
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Maria Stack
- Children's Health Ireland at Crumlin, Dublin, Ireland
- Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Orla Franklin
- Children's Health Ireland at Crumlin, Dublin, Ireland
- Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Andrew Green
- Children's Health Ireland at Crumlin, Dublin, Ireland
- Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Adam James
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Timothy Ronan Leahy
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Shoana Quinn
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Basil Elnazir
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - John Russell
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Sri Paran
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Patrick Kiely
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Edna Frances Roche
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Ciara McDonnell
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
- Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Louise Baker
- Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | | | - Louise Gibson
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
| | - Stephanie Kelly
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Denise McDonald
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Eleanor J. Molloy
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
- Children's Health Ireland at Crumlin, Dublin, Ireland
- Department of Neonatology, The Coombe Women and Infants University Hospital, Dublin, Ireland
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46
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Shetty J, Newton AT, Reid GJ. Parenting Practices, Bedtime Routines, and Consistency: Associations with Pediatric Sleep Problems. J Pediatr Psychol 2021; 47:49-58. [PMID: 34343320 DOI: 10.1093/jpepsy/jsab072] [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: 11/06/2020] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Investigate the direct and moderating effects of daytime parenting practices on the relationship between bedtime routines and pediatric sleep problems. METHODS A community sample of 407 parents with children 2-10 years old completed measures of parenting practices (i.e., laxness and over-reactivity) and bedtime routines (i.e., consistency and reactivity to changes in routines). Sleep problems (i.e., severity and signaled night waking) were assessed by a parent-report questionnaire and sleep diaries. RESULTS Higher parenting laxness (β = .13) and less bedtime routine consistency (β = -.34) significantly predicted sleep problem severity. Laxness moderated the relationship between bedtime reactivity and sleep problem severity: when bedtime reactivity was high, higher parental laxness was associated with more severe sleep problems. CONCLUSIONS Daytime parenting practices are important to consider when children are reactive to changes in bedtime routines, as permissive or inconsistent daytime parenting practices were found to be associated with more severe sleep problems. Future research should examine the effects of parenting practices and bedtime routines on problematic signaled night waking in a clinical sample of children.
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Affiliation(s)
| | | | - Graham J Reid
- Department of Psychology.,Departments of Family Medicine and Paediatrics, Children's Health Research Institute, The University of Western Ontario, London, ON, Canada
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47
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Berg KA, Francis MW, Ross K, Spilsbury JC. Opportunities to improve sleep of children exposed to interpersonal violence: A social-ecological perspective. CHILDREN AND YOUTH SERVICES REVIEW 2021; 127:106082. [PMID: 36090582 PMCID: PMC9455662 DOI: 10.1016/j.childyouth.2021.106082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Over 25% of U.S. children are witness to traumatic intrafamilial or community violence each year, and sleep medicine and developmental research jointly suggest that trauma-exposed youth experience more sleep disturbance than their non-exposed counterparts. Sleep medicine literature emphasizes physical and social environmental factors affecting sleep, and trauma literature underscores children's seeking out physically and emotionally safe and predictable environments during trauma recovery. This study employed a hermeneutic phenomenological framing to explore the lived experiences of 65 violence-exposed children and families, and to examine how youths' social and physical sleep environments facilitated or impeded sleep in the aftermath of trauma. Children's sleep experiences following violence exposure shared two primary essences of experience: a) navigating external threats that agitated sleep after trauma; and b) exercising agency over sleep and related environments to restabilize emotional security. Clinicians and social services coordinators working with children and families are uniquely positioned to indicate sleep assessments as part of treatment following trauma, and to also facilitate identification of tangible, sleep-supportive and changeable factors in sleep environments.
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Affiliation(s)
- Kristen A. Berg
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - Meredith W. Francis
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - Kristie Ross
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - James C. Spilsbury
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
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48
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Craft AL, Perry-Jenkins M, Herman R, Spencer RMC. Parents' Nonstandard Work and Children's Sleep: The Mediating Role of Bedtime Routines. J Pediatr Psychol 2021; 46:719-728. [PMID: 33674877 PMCID: PMC8291674 DOI: 10.1093/jpepsy/jsab016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/07/2021] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The present study examined if caregivers' long work hours or shift work are related to children's sleep duration through the disruption of bedtime routines. METHOD Work hours and schedules, bedtime routines and sleep (actigraph assessments) were examined in a sample of 250 caregivers and their preschool children. RESULTS Results revealed that consistent bedtime routines mediated the relationship between caregiver's work and children's sleep, such that longer hours and shift work predicted fewer routines that, in turn, predicted less child sleep. CONCLUSION These results point to the crucial role of bedtime routines as a promising point of intervention for working parents. While caregivers may not be able to change their work hours or schedules, they can create more stable and consistent bedtime routines to mitigate the negative effects of their work on children's sleep.
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49
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McGhee K, Kidney E, Pou K, Pruyn Bouley H, Reynolds S. The Effectiveness of Bilateral Alternating Tactile Stimulation for Improving Sleep in Children with Sensory over-Responsivity. Occup Ther Health Care 2021; 35:424-441. [PMID: 34278921 DOI: 10.1080/07380577.2021.1946734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of this study was to explore the effectiveness of Touchpoints™ on improving sleep in children with sensory over-responsivity, specifically, whether wearing Touchpoints™ on the sleep setting before bed would improve children's sleep. Using three study phases (baseline, intervention, and withdrawal), eight young children with sensory over-responsivity and sleep deficits wore Touchpoints™ on their ankles before bed during the intervention phase. Data was collected using an activity tracker to measure sleep latency, sleep duration, number of nighttime awakenings and sleep efficiency as well as parent report. Results indicated that participants did not demonstrate any significant changes in sleep efficiency, sleep duration, or number of awakenings but demonstrated a significant improvement in sleep latency. Parents also reported improvement in their child's sleep quality. Results suggest Touchpoints™ before bedtime may decrease the time it takes for children with sensory over-responsivity to fall asleep and improve parental perceptions of children's sleep quality.
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Affiliation(s)
- Katherine McGhee
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Emily Kidney
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Kaelah Pou
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Heather Pruyn Bouley
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Stacey Reynolds
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA
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50
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Harper L, Ooms A, Tuffrey Wijne I. The impact of nutrition on sleep in people with an intellectual disability: An integrative literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1393-1407. [PMID: 34212459 DOI: 10.1111/jar.12911] [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: 12/05/2020] [Revised: 04/25/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with intellectual disabilities are more likely to experience sleep problems. Sleep can impact on health and well-being; therefore, evidence-based interventions are required to improve sleep in this population. METHOD An integrative literature review was conducted on the impact of nutrition on sleep in people with intellectual disabilities. Following screening of papers (n = 289), 14 papers met the inclusion criteria. RESULTS Themes related to nutrition and improved overall well-being, use of nutritional supplements, specific foods, links to health comorbidities and food fussiness. CONCLUSION This is the first comprehensive review completed on nutritional interventions to improve sleep in people with intellectual disabilities. Dietary patterns may be an important factor to improving the quality and quantity of sleep. However, the current literature regarding the benefit of improved nutrition on sleep in people with an intellectual disability needs to be interpreted with caution.
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Affiliation(s)
- Lynette Harper
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Ann Ooms
- Kingston University and St Georges University, London, UK
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