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Pizzo A, Sandstrom A, Drobinin V, Propper L, Uher R, Pavlova B. Parental Overprotection and Sleep Problems in Young Children. Child Psychiatry Hum Dev 2022; 53:1340-1348. [PMID: 34191190 DOI: 10.1007/s10578-021-01199-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 12/26/2022]
Abstract
Poor sleep in children predicts mental and physical disorders later in life. Identifying and changing modifiable factors associated with sleep problems in young children may improve their health trajectory. Our aim was to establish whether overprotective parenting was associated with problems sleeping in children. Parents of children aged 2-6 years completed questionnaires about their own anxiety, parenting style, and about their children's sleep. We obtained 307 reports on 197 children from 240 parents. Using mixed-effects linear regression, we found that maternal (beta = 0.26, 95% CI 0.11 to 0.41, p = 0.001) and paternal (beta = 0.35, 95% CI 0.17 to 0.53, p < 0.001) overprotection were associated with impaired sleep in children. This relationship remained unchanged when controlling for parental anxiety. Decreasing parents' overprotection may improve children's sleep, and reduce the risk of physical and mental disorders later in their life.
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Affiliation(s)
- Alex Pizzo
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Andrea Sandstrom
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Vladislav Drobinin
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Lukas Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
- Nova Scotia Health Authority, Halifax, NS, Canada.
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Tang YW, Teoh SL, Yeo JHH, Ngim CF, Lai NM, Durrant SJ, Lee SWH. Music-based Intervention for Improving Sleep Quality of Adults without Sleep Disorder: A Systematic Review and Meta-analysis. Behav Sleep Med 2022; 20:241-259. [PMID: 33896299 DOI: 10.1080/15402002.2021.1915787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Listening to music is often used as a self-help intervention to improve sleep quality, but its efficacy among individuals without sleep disorder remains unclear. METHODS A search was performed on five databases to identify for studies that examined the use of music-based intervention to improve sleep quality among individuals without sleep disorder. Random-effects meta-analysis was performed, and the certainty of evidence was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation). RESULTS Twenty-two articles which recruited 1,514 participants were included for review. Meta-analysis of six studies including 424 participants did not find an improvement in sleep quality among recipients of music-based intervention compared to those with standard care (mean difference: -0.80; 95% CI: -2.15 to 0.54, low-quality evidence). Subgroup analysis showed a clear improvement in sleep quality when interventions were administered for at least 3 weeks (-2.09; -3.84 to -0.34, n = 3). No difference in terms of sleep onset latency (standardized mean difference (SMD) -0.32; 95% CI -0.88 to 0.25, n = 4, very-low quality evidence) and sleep efficiency (SMD: -0.59; 95% CI -3.15 to 1.97, n = 2, very-low quality evidence) were observed. The effect of music-based intervention on anxiety, depression and quality of life were mixed with suggestions of possible benefits. CONCLUSION Music-based intervention in addition to standard care appears to be a promising strategy to improve sleep quality when delivered for 3 week or longer. However, effects are inconsistent across studies and larger randomized controlled studies reporting long-term outcomes are needed before it can be recommended for routine use. PROSPERO REGISTRATION CRD42018081193.
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Affiliation(s)
- Yee Woon Tang
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.,Hospital Dutchess of Kent, Sandakan
| | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Julie Hsiao Hui Yeo
- School of Medicine, Taylor's University Lakeside Campus, Subang Jaya, Malaysia.,Hospital Sultanah Bahiyah,Ministry of Health, Alor Setar, Malaysia
| | - Chin Fang Ngim
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University Lakeside Campus, Subang Jaya, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Simon James Durrant
- Lincoln Sleep Research Centre and School of Psychology, University of Lincoln, Lincoln, UK
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.,School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
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3
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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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4
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Abstract
OBJECTIVE The primary objective was to identify the characteristics of parents and infants and parenting practices associated with delayed responsiveness to infant crying during the first year of infant life. A secondary objective was to evaluate, in a subsample of maternal-infant pairs, the associations between delayed responsiveness to infant crying and observational measures of maternal-infant interaction and infant-maternal attachment. METHOD This is a secondary analysis of the data from a community sample of pregnant women recruited to the Alberta Pregnancy Outcomes and Nutrition study. Mothers completed questionnaires during the first year of infant life (n = 1826), and a convenience subsample of maternal-infant pairs (n = 137) participated in laboratory assessments of maternal-infant interaction at 6 months of age and infant-maternal attachment at 20 months. RESULTS Parental use of "cry out" as a strategy to deal with a crying infant was associated with parental characteristics (being white and having a relatively higher income), infant characteristics (higher problematic behavior at 3 months and reduced problematic behavior at 12 months), sleep ecology (infants sleeping alone), and parental soothing strategies (less frequently taking the infant into the parent's bed, cuddling, or carrying the crying infant). Cry out was not associated with observational measures of maternal sensitivity or infant-maternal attachment. CONCLUSION When used selectively and in response to the specific needs and characteristics of the infant, delayed responsiveness may reduce problematic behavior and does not harm the infant's socioemotional development.
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Kuhn BR, LaBrot ZC, Ford R, Roane BM. Promoting Independent Sleep Onset in Young Children: Examination of the Excuse Me Drill. Behav Sleep Med 2020; 18:730-745. [PMID: 31621416 DOI: 10.1080/15402002.2019.1674852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: There is compelling evidence to support behavioral interventions as the first-line approach for bedtime resistance in young children. Among the behavioral treatment options, extinction ("cry it out") has the most extensive empirical support and tends to produce the most rapid gains. There are well known problems with the use of extinction, however, including side effects (extinction burst, spontaneous recovery) and poor acceptance, not to mention that extinction fails to teach children appropriate replacement behaviors (what "to do"). This study introduces a new behavioral sleep intervention, the Excuse Me Drill, designed to address some of the limitations of extinction. The EMD was formally evaluated for the first time using a multiple-baseline research design across four participants with sleep disturbance.Participants: Participants included four children who were clinically referred to outpatient pediatric psychology clinics for the treatment of behavioral insomnia of childhood, and included one 2-year-old female, two 7-year-old females, and one 7-year-old male. All participants had a history of dependent sleep onset at bedtime (i.e., parents remained in the child's bedroom upon sleep onset). Methods: A non-concurrent multiple baseline design across participants was used to experimentally evaluate the effectiveness of the EMD. During baseline, parents collected data on independent sleep onset and disruptive bedtime behaviors, but conducted the bedtime routine as usual. Immediately following baseline, parents implemented the EMD protocol until data indicated that children were consistently initiating sleep independently. Follow-up data were collected to determine the extent to which children continued to initiate sleep independently at bedtime in absence of the EMD. Results: Outcomes were promising as the EMD successfully taught all four children to initiate sleep independently and produced notable decreases in disruptive bedtime behavior. Results were maintained at follow-up for three of four participants. In addition, parents rated the EMD to be a socially acceptable procedure for their children. Conclusions: Results of this study indicate that the EMD was effective in promoting independent sleep onset and reducing disruptive bedtime behavior that maintained over time. The EMD should be considered to be a viable alternative to traditional extinction procedures for pediatric sleep disturbance. Implications for practice, limitations, and direction for future research are discussed.
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Affiliation(s)
- Brett R Kuhn
- Department of Psychology, University of Nebraska Medical Center/Munroe-Meyer Institute , Omaha, NE
| | - Zachary C LaBrot
- Department of Psychology, University of Nebraska Medical Center/Munroe-Meyer Institute , Omaha, NE
| | - Ryan Ford
- Tidal Integrated Health, NOVA Behavioral Healthcare Corporation , Golsboro
| | - Brandy M Roane
- Department of Physiology and Anatomy, University of North Texas Health Science Center , Fort Worth, TX
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6
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Whittingham K, Palmer C, Douglas P, Creedy DK, Sheffield J. Evaluating the “possums” health professional training in parent–infant sleep. Infant Ment Health J 2020; 41:603-613. [DOI: 10.1002/imhj.21885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre UQ Child Health Research Centre The University of Queensland Brisbane Australia
| | - Chloe Palmer
- School of Psychology The University of Queensland Brisbane Australia
| | - Pamela Douglas
- Possums Education Brisbane Australia
- Primary Care Clinical Unit The University of Queensland Brisbane Australia
- Transforming Maternity Care Collaborative Griffith University Brisbane Australia
| | - Debra K. Creedy
- School of Nursing & Midwifery Griffith University Brisbane Australia
| | - Jeanie Sheffield
- School of Psychology The University of Queensland Brisbane Australia
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7
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Macchitella L, Marinelli CV, Signore F, Ciavolino E, Angelelli P. Sleepiness, Neuropsychological Skills, and Scholastic Learning in Children. Brain Sci 2020; 10:brainsci10080529. [PMID: 32784660 PMCID: PMC7464965 DOI: 10.3390/brainsci10080529] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/03/2020] [Accepted: 08/03/2020] [Indexed: 12/25/2022] Open
Abstract
Excessive daytime sleepiness is a frequent condition among children and adolescents that may lead to several and significant daytime consequences, including impaired neurocognitive skills and scholastic performance. Here, we evaluated in one hundred and ninety-one unselected primary school children, the relationship between sleepiness and a wide range of cognitive and academic skills through a standardized neuropsychological test battery. In order to assess the statistical relationship, we performed a partial least squares path modelling, a non-parametrical approach which combined a model of paths between latent variables and the coefficients between indicators and dimensions. Results were validated through the bootstrap approach and suggest that sleepiness is not associated with all cognitive and scholastic abilities, but only with those relying on verbal abilities and complex cognitive functions (i.e., reading comprehension, oral/syntactic comprehension, spelling, and mathematic skills). Our data suggest the idea that sleepiness in children is associated mostly with “higher” (mainly verbal) cognitive function(s), while the visuospatial domain was not affected.
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8
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Carnett A, Hansen S, McLay L, Neely L, Lang R. Quantitative-Analysis of Behavioral Interventions to Treat Sleep Problems in Children with Autism. Dev Neurorehabil 2020; 23:271-284. [PMID: 31355702 DOI: 10.1080/17518423.2019.1646340] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Sleep is an essential activity for human development. Often, children with autism spectrum disorder (ASD) are affected by a lack of sleep due to various types of sleep problems. We identified and analyzed studies that were aimed at utilizing sleep interventions for children with ASD. A systematic search of databases, reference lists, and ancestral searches identified 18 studies for inclusion. Studies were summarized in terms of (a) participants, (b) targeted sleep problem and measures, (d) intervention components, (e) research design and rigor, and (f) results. The aim of this review was to analyze the literature by evaluating the most commonly treated sleep problems, the various treatment components, and strength of the results using a between case parametric effect size estimate. The most commonly treated sleep problems were night wakings and bedtime disturbance. For interventions, all the studies incorporated multiple treatment components, most often including the use of a consistent bedtime routine. Effect size calculations indicated a moderate effect size, however, limited due to the small number of studies. Results suggest the overall effectiveness of behavioral interventions for the treatment of sleep problems for children with ASD. Based on our analysis, suggestions for practitioners regarding current practices and future directions for research are discussed.
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Affiliation(s)
- Amarie Carnett
- San Antonio Applied Behavior Analysis Research Consortium, University of Texas at San Antonio , San Antonio, TX, USA
| | | | - Laurie McLay
- University of Canterbury , Christchurch, New Zealand
| | - Leslie Neely
- San Antonio Applied Behavior Analysis Research Consortium, University of Texas San Antonio , San Antonio, TX, USA
| | - Russell Lang
- Clinic for Autism Research Evaluation and Support, Texas State University , San Marcos, TX, USA
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9
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Kempler L, Sharpe LA, Marshall NS, Bartlett DJ. A brief sleep focused psychoeducation program for sleep-related outcomes in new mothers: a randomized controlled trial. Sleep 2020; 43:5846109. [DOI: 10.1093/sleep/zsaa101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/09/2020] [Indexed: 01/29/2023] Open
Abstract
Abstract
Study Objectives
Poor sleep is commonly problematic during pregnancy and postpartum and is associated with depression. This trial investigated the efficacy of prenatal brief, group sleep psychoeducation in improving postpartum maternal sleep, and depression.
Methods
A total of 215 healthy expectant first-time mothers were cluster randomized (1:1) to receive either a 2 × 1.5 h psychoeducation intervention and a set of booklets, or a set of booklets only. Participants completed questionnaires during pregnancy (pre-intervention), and 6 weeks and 4 months postpartum. A post hoc subset of questionnaires was collected at 10 months postpartum. The primary hypothesis was the intervention group would have improved postpartum sleep quality, and reduced levels of insomnia symptoms, fatigue, and daytime sleepiness compared to the control group. Secondary outcomes included depression, anxiety, and stress.
Results
Linear mixed model analyses failed to confirm a group by time interaction on primary or secondary outcomes across all time points. There was no effect of the intervention on outcomes at 6 weeks, or 10 months postpartum. A significant time by group interaction was found at 4 months, favoring the intervention for sleep quality (p = 0.03) and insomnia symptoms (p = 0.03), but not fatigue or daytime sleepiness.
Conclusions
Prenatal sleep psychoeducation did not produce a sustained effect on maternal sleep throughout the postpartum period. There was little evidence of benefits on depressive symptoms.
Clinical Trial Registration
ACTRN12611000859987
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Affiliation(s)
- Liora Kempler
- School of Psychology, University of Sydney, Sydney, Australia
- Sleep and Circadian Research Group (CIRUS) and NeuroSleep Centre of Research Excellence, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
| | - Louise A Sharpe
- School of Psychology, University of Sydney, Sydney, Australia
| | - Nathaniel S Marshall
- Sleep and Circadian Research Group (CIRUS) and NeuroSleep Centre of Research Excellence, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
- Sydney Nursing School, University of Sydney, Sydney, Australia
| | - Delwyn J Bartlett
- Sleep and Circadian Research Group (CIRUS) and NeuroSleep Centre of Research Excellence, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
- Central Clinical School, University of Sydney, Sydney, Australia
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10
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Ntafouli M, Galbiati A, Gazea M, Bassetti CLA, Bargiotas P. Update on nonpharmacological interventions in parasomnias. Postgrad Med 2019; 132:72-79. [PMID: 31760836 DOI: 10.1080/00325481.2019.1697119] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Parasomnias are abnormal behaviors that occur during sleep and can be associated, in particular during adulthood, with impaired sleep quality, daytime dysfunction, and occasionally with violent and harmful nocturnal behaviors. In these cases, therapies are often considered. Longterm pharmacological treatments are not always well tolerated and often have limited efficacy. Therefore, behavioral approaches remain an important treatment option for several types of parasomnias. However, the evidence-based approaches are limited. In the current review, we highlight results from various nonpharmacological techniques on different types of parasomnias and provide a glimpse into the future of nonpharmacological treatments in this field.
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Affiliation(s)
- Maria Ntafouli
- Sleep Wake Epilepsy Center and Department of Neurology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Andrea Galbiati
- Faculty of Psychology, "Vita-Salute" San Raffaele University, Milan, Italy.,Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mary Gazea
- Centre for experimental Neurology, Dept. of Neurology, Inselspital University Hospital, University of Bern, Bern, Switzerland.,Department of Biomedical Research (DBMR), Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Claudio L A Bassetti
- Sleep Wake Epilepsy Center and Department of Neurology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Panagiotis Bargiotas
- Sleep Wake Epilepsy Center and Department of Neurology, Inselspital University Hospital, University of Bern, Bern, Switzerland.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
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11
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Pinato L, Ribeiro EM, Leite RFP, Lopes TF, Pessoa ALS, Guissoni Campos LM, Piffer GE, Souza ALDM, Giacheti CM. Sleep findings in Brazilian children with congenital Zika syndrome. Sleep 2019; 41:4791871. [PMID: 29325155 DOI: 10.1093/sleep/zsy009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Study Objectives Zika virus infection during pregnancy may result in congenital Zika syndrome (CZS), whose characteristics are being described. Methods The present study aimed to investigate the sleep characteristics of 136 infants/toddlers (88 with CZS and 48 with typical development (TD), age and gender matched, 60% girls and 40% boys in both groups) using the Brief Infant Sleep Questionnaire. The ages of children in both groups ranged from 5 to 24 months (CZS 15.9 ± 0.4 vs. TD 15.8 ± 1.0 months, P= 0.90). Results The results show that 34.1% of CZS and 2% of TD children were defined as poor sleepers, 15% of CZS and 2% of TD children remained awake at night for a period longer than 1 hour, and 24% of CZS and 2% of TD children slept less than 9 hours. The CZS group showed shorter total sleep time (CZS 11.24 ± 2.6 vs. TD 12.02 ± 1.9 hours, P= 0.03) and shorter nocturnal sleep duration than the TD group (CZS 8.2 ± 0.2 vs. TD 9.4 ± 0.2 hours, P= 0.0002). In contrast to the control group (P= 0.02, r= -0.34), in the CZS group, no correlation was found between age and nocturnal wakefulness. Future studies should explore these data in relation to the development and maturation of the central nervous system of these children. Conclusions Considering the well-known consequences of poor sleep quality on health in several populations, the presence of sleep disorders should be considered in CZS using multidisciplinary treatments.
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Affiliation(s)
- Luciana Pinato
- São Paulo State University - UNESP, Marilia, São Paulo, Brazil
| | - Erlane M Ribeiro
- Albert Sabin Children's Hospital, Fortaleza, Ceará, Brazil.,Christus University Center, Fortaleza, Ceará, Brazil
| | | | - Thayse F Lopes
- Albert Sabin Children's Hospital, Fortaleza, Ceará, Brazil
| | - André L S Pessoa
- Albert Sabin Children's Hospital, Fortaleza, Ceará, Brazil.,State University of Ceará (UECE), Fortaleza, Ceará, Brazil
| | | | | | - Ana L D M Souza
- São Paulo State University - UNESP, Marilia, São Paulo, Brazil
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12
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Voltaire ST, Teti DM. Early nighttime parental interventions and infant sleep regulation across the first year. Sleep Med 2018; 52:107-115. [DOI: 10.1016/j.sleep.2018.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/29/2018] [Accepted: 07/30/2018] [Indexed: 01/08/2023]
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13
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Investigation on the Neural Mechanism of Hypnosis-Based Respiratory Control Using Functional MRI. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:8182542. [PMID: 30065621 PMCID: PMC6051291 DOI: 10.1155/2018/8182542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/26/2018] [Accepted: 05/16/2018] [Indexed: 11/22/2022]
Abstract
Respiratory control is essential for treatment effect of radiotherapy due to the high dose, especially for thoracic-abdomen tumor, such as lung and liver tumors. As a noninvasive and comfortable way of respiratory control, hypnosis has been proven effective as a psychological technology in clinical therapy. In this study, the neural control mechanism of hypnosis for respiration was investigated by using functional magnetic resonance imaging (fMRI). Altered spontaneous brain activity as well as neural correlation of respiratory motion was detected for eight healthy subjects in normal state (NS) and hypnosis state (HS) guided by a hypnotist. Reduced respiratory amplitude was observed in HS (mean ± SD: 14.23 ± 3.40 mm in NS, 12.79 ± 2.49 mm in HS, p=0.0350), with mean amplitude deduction of 9.2%. Interstate difference of neural activity showed activations in the visual cortex and cerebellum, while deactivations in the prefrontal cortex and precuneus/posterior cingulate cortex (PCu/PCC) in HS. Within these regions, negative correlations of neural activity and respiratory motion were observed in visual cortex in HS. Moreover, in HS, voxel-wise neural correlations of respiratory amplitude demonstrated positive correlations in cerebellum anterior lobe and insula, while negative correlations were shown in the prefrontal cortex and sensorimotor area. These findings reveal the involvement of cognitive, executive control, and sensorimotor processing in the control mechanisms of hypnosis for respiration, and shed new light on hypnosis performance in interaction of psychology, physiology, and cognitive neuroscience.
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14
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Breen DP, Högl B, Fasano A, Trenkwalder C, Lang AE. Sleep-related motor and behavioral disorders: Recent advances and new entities. Mov Disord 2018; 33:1042-1055. [PMID: 29756278 DOI: 10.1002/mds.27375] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 12/30/2022] Open
Abstract
Patients with sleep-related motor and behavioral disorders present to a variety of subspecialty clinics (neurology, sleep medicine, respiratory medicine, psychiatry). Diagnosing these disorders can be difficult, and sometimes they have a significant impact on quality of life. Alongside a number of common and well-recognized conditions, several new disease entities have been described in recent years that present with abnormal nocturnal motor phenomena (such as ADCY5-associated disease and anti-IgLON5 disease). Our understanding of the neural basis and prognostic significance of other sleep-related disorders has also grown, particularly rapid eye movement sleep behavior disorder. This review (along with a collection of previously unpublished videos) is intended to aid in the recognition and treatment of these patients. The recent change in terminology from nocturnal frontal lobe epilepsy to sleep-related hypermotor epilepsy is also discussed. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- David P Breen
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Canada
| | - Claudia Trenkwalder
- Centre of Parkinsonism and Movement Disorders, Paracelsus-Elena Hospital, Kassel, Germany.,Department of Neurosurgery, University Medical Center, Göttingen, Germany
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Canada
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15
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Reynolds KC, Patriquin M, Alfano CA, Loveland KA, Pearson DA. Parent-Reported Problematic Sleep Behaviors in Children with Comorbid Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2017; 39:20-32. [PMID: 29081833 PMCID: PMC5656274 DOI: 10.1016/j.rasd.2017.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Sleep problems are frequent and well documented in children with Autism Spectrum Disorders (ASD), children with Attention Deficit/Hyperactivity Disorder (ADHD) and children with internalizing problems, however limited work has examined sleep problems in children presenting with comorbid ASD/ADHD. In healthy children, sleep problems negatively impact social, emotional, and academic functioning. The current study sought to examine diagnostic severity as predictors of sleep problems in children with comorbid ASD/ADHD. Additionally, the association between sleep and "real-life" functional domains (i.e., intellectual functioning, academic achievement, and executive functioning) were assessed. METHOD Sleep, internalizing difficulties, intellectual functioning, academic achievement and executive functioning were assessed in 85 children with who carried the dual diagnoses of ASD and ADHD. RESULTS Internalizing difficulties, rather than ASD or ADHD symptom severity, was the most consistent predictor of problematic sleep behaviors (i.e., nightmares overtiredness, sleeping less than other children, trouble sleeping, and Total Problematic Sleep Behaviors) in this sample. Further, parent report of problematic sleep behaviors was significantly associated with functional domains after controlling for ASD, ADHD, and internalizing symptoms. CONCLUSIONS Results suggest that internalizing symptoms are associated with problematic sleep behaviors in children with comorbid ASD/ADHD and may have implications for the "real-life" functioning among children with comorbid ASD/ADHD.
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Affiliation(s)
- Katharine C. Reynolds
- University of Houston, Department of Psychology; 3695 Cullen Boulevard Room 126 Houston, TX 77204-5022
| | - Michelle Patriquin
- The Menninger Clinic; 12301 S. Main St. Houston TX 77035
- Department of Psychiatry and Behavioral Science, Baylor College of Medicine
| | - Candice A. Alfano
- University of Houston, Department of Psychology; 3695 Cullen Boulevard Room 126 Houston, TX 77204-5022
| | - Katherine A. Loveland
- University of Texas Medical School at Houston; 1941 East Road, Rm. 3.126 BBSB; Houston, TX, 77054
| | - Deborah A. Pearson
- University of Texas Medical School at Houston; 1941 East Road, Rm. 3.126 BBSB; Houston, TX, 77054
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Rea CJ, Smith RL, Taveras EM. Associations of Parent Health Behaviors and Parenting Practices with Sleep Duration in Overweight and Obese Children. J Clin Sleep Med 2016; 12:1493-1498. [PMID: 27655464 DOI: 10.5664/jcsm.6274] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 07/18/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine the extent to which parent health behaviors and parenting practices are associated with school-age children's sleep duration. METHODS We surveyed 790 parents of children, aged 6 to 12 y, who had a body mass index (BMI) ≥ 90th percentile and were participating in a randomized controlled obesity trial. The main exposures were parent sleep duration, screen time and physical activity, parental limits placed on child TV viewing time and TV content, and parents' confidence regarding their ability to help their child get enough sleep. The primary outcome was child sleep duration. We used linear regression models to examine associations of parent behaviors and parenting practices with child sleep duration. RESULTS On average, children slept 9.2 h per night, whereas parents slept 6.9 h. Parents reported having an average of 1.9 h of screen time per day and 0.6 h of physical activity. There were 57.3% of parents who reported feeling very/extremely confident that they could help their child get enough sleep. In adjusted multivariate analyses, child sleep duration was 0.09 h/day (95% confidence interval: 0.03, 0.15) longer for each 1-h increment in parent sleep duration. Additionally, children whose parents reported being very/extremely confident they could help their child get age-appropriate sleep duration slept 0.67 h/day longer (95% confidence interval: 0.54, 0.81) than those whose parents were not/somewhat confident. CONCLUSIONS Educating parents about their own sleep health and enhancing parent confidence to help their children get enough sleep are potential areas of intervention to increase child sleep duration.
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Affiliation(s)
- Corinna J Rea
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Renata L Smith
- Harvard Medical School, Boston, MA.,Harvard Pilgrim Health Care Institute, Boston, MA
| | - Elsie M Taveras
- Harvard Medical School, Boston, MA.,Division of General Academic Pediatrics, Mass General Hospital for Children, Boston, MA
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Etherton H, Blunden S, Hauck Y. Discussion of Extinction-Based Behavioral Sleep Interventions for Young Children and Reasons Why Parents May Find Them Difficult. J Clin Sleep Med 2016; 12:1535-1543. [PMID: 27655457 DOI: 10.5664/jcsm.6284] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 08/17/2016] [Indexed: 11/13/2022]
Abstract
ABSTRACT The majority of behavioral sleep interventions for young children involve extinction procedures where parents must ignore their child's cries for a period. Many parents have difficulties with this, contributing to attrition, non-compliance, and treatment avoidance. Yet why these methods are difficult to implement has rarely been addressed in the literature. This paper discusses seven potential reasons why parents may find extinction sleep interventions difficult: enduring crying, practical considerations, fear of repercussions, misinformation, incongruence with personal beliefs, different cultural practices, and parent wellness. These reasons are discussed in relation to the current literature. Practicing health professionals and sleep researchers could benefit from an awareness of these issues when suggesting extinction interventions and offering alternatives which may be more appropriate for family circumstances and facilitate parental informed choice.
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Affiliation(s)
- Hayley Etherton
- Appleton Institute, Central Queensland University, Wayville, Australia
| | - Sarah Blunden
- Appleton Institute, Central Queensland University, Wayville, Australia
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18
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Behavioral Treatments for Non-Rapid Eye Movement Parasomnias in Children. CURRENT SLEEP MEDICINE REPORTS 2016. [DOI: 10.1007/s40675-016-0049-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Resistance to Cry Intensive Sleep Intervention in Young Children: Are We Ignoring Children's Cries or Parental Concerns? CHILDREN-BASEL 2016; 3:children3020008. [PMID: 27417246 PMCID: PMC4934563 DOI: 10.3390/children3020008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 04/19/2016] [Indexed: 11/16/2022]
Abstract
The majority of behavioural sleep interventions for young children (defined as 5 years of age or less) involve extinction procedures where parents must ignore their child’s cries for a period. Many parents have difficulties implementing and maintaining these procedures, leading to attrition, non-compliance and treatment avoidance. Yet the reasons for these methods being difficult to implement for parents have not been well understood or addressed in the literature. In fact, they are being ignored. We discuss that understanding and addressing parental concerns may enable better targeted sleep interventions.
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20
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Spooner R, Lushington K, Keage HA, Blunden S, Kennedy JD, Schembri M, Wabnitz D, Martin AJ, Kohler MJ. Cognition, temperament, and cerebral blood flow velocity in toddlers and preschool children with sleep-disordered breathing or behavioral insomnia of childhood. Sleep Med 2016; 21:77-85. [DOI: 10.1016/j.sleep.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 02/09/2016] [Accepted: 02/09/2016] [Indexed: 12/01/2022]
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Williams CJ, Kessler D, Fernyhough C, Lewis G, Pearson RM. The association between maternal-reported responses to infant crying at 4 weeks and 6 months and offspring depression at 18: a longitudinal study. Arch Womens Ment Health 2016; 19:401-8. [PMID: 26837614 PMCID: PMC4799796 DOI: 10.1007/s00737-015-0592-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 12/07/2015] [Indexed: 11/29/2022]
Abstract
The purpose of the present study is to examine the association between maternal response to infant crying and the psychological health of the child in later life. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, consisting of 15,247 pregnancies, 10,278 with exposure variables and 3201 complete cases were identified as having exposure, covariate and outcome data. Using a postal questionnaire, mothers were asked regarding their infant at 4 weeks and 6 months, 'If they cry what do you do?': (a) pick them up immediately; (b) if they cry, leave them for a while, and if they do not stop, pick them up; or (c) never pick them up until you are ready. Outcome was an International Statistical Classification-10th revision criteria (ICD-10) diagnosis of depression at 18 years for the infant. Offspring of mothers who at 4 weeks reported that they never picked their infants up until they were ready were more likely to have depression at 18 years (OR = 2.06, CI 0.95-4.47, adjusted for sociodemographic confounding variables). There was no evidence for an association at 6 months. Including adjustment variables reduced the strength of our association; an observed objective measure of maternal response rather than a self-report may have more accurately determined the mother's actual responses. There is some evidence for an association between maternal reporting of responses to infant crying at 4 weeks and risk of developing depression at 18 years. If this association is found to be causal, interventions encouraging mothers to represent and respond to their infants' emotional states may help prevent offspring depression.
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Affiliation(s)
- Catherine J Williams
- Centre for Academic Primary Care, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - David Kessler
- Centre for Mental Health, Addiction and Suicide Research, Oakfield House, Oakfield Road, Bristol, BS8 2BN, UK
| | - Charles Fernyhough
- Department of Psychology, Durham University, Science Site, South Road, Durham, 1 DH1 3LE, UK
| | - Glyn Lewis
- Division of Psychiatry, Charles Bell House, 67-73 Riding House St, London, W1W 7EJ, UK
| | - Rebecca M Pearson
- Centre for Mental Health, Addiction and Suicide Research, Oakfield House, Oakfield Road, Bristol, BS8 2BN, UK
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Abstract
OBJECTIVE Crying and unsettled behavior in infancy is common. Prolonged disturbed infant sleep can have significant negative effects on the development of the child, and on the psychological well-being of the mother. Compared to studies examining the effects of behavioral sleep programs such as extinction-based techniques in infants over 6 months of age, fewer studies have looked at such strategies in infants under 6 months of age. The aim of this article is to summarize the literature examining the effects of behavioral techniques on infant sleep outcomes in the first 6 months of life and provide evidence based recommendations for the management of infant sleep disturbance. METHOD An electronic search of the literature was performed to identify studies which examined the effects of a behavioral intervention aimed at improving sleep in infants under 6 months of age. RESULTS Eleven studies were identified, of which 8 demonstrated improvements in infant sleep outcomes subsequent to the implementation of an educational behavioral program. CONCLUSION Education directed to parents about the use of simple, prescriptive, behavioral techniques is effective in improving infant sleep. Long term follow-up studies have failed to find any negative effects on the child, either from a psychological or physical perspective.
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Do psychosocial sleep interventions improve infant sleep or maternal mood in the postnatal period? A systematic review and meta-analysis of randomised controlled trials. Sleep Med Rev 2015; 29:15-22. [PMID: 26555938 DOI: 10.1016/j.smrv.2015.08.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 06/24/2015] [Accepted: 08/07/2015] [Indexed: 12/14/2022]
Abstract
Sleep complaints are common amongst mothers of infants and insufficient, inefficient or fragmented sleep is associated with postnatal depression. The aim of this review is to determine whether psychosocial sleep-focused interventions offered in the perinatal period improve infant sleep or maternal mood. We searched PubMed, PsycInfo, EMBASE and CINAHL with no date restriction. We reviewed 1097 articles, resulting in nine papers (n = 1,656) that fit the eligibility criteria for inclusion in the analyses. The primary outcome was infant sleep, defined as maternal reports of infant nocturnal total sleep time and number of night-time wakes. The secondary outcome was maternal mood. The meta-analysis indicated improvements in reported infant nocturnal total sleep time (Hedge's g = 0.204, p < 0.01). However, there was no evidence for reducing infant night wakes (Hedge's g = 0.103, p = 0.134). There was evidence of maternal mood improvements (Hedge's g = 0.152, p = 0.014), however, this could have been influenced by publication bias. Psychosocial sleep interventions appear to impact the amount of sleep that a mother reports her baby to have, although the infants continue to wake as frequently. More research is needed to confirm whether sleep-related improvements can translate into improvements in maternal mood.
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Behavioural and Cognitive-Behavioural Treatments of Parasomnias. Behav Neurol 2015; 2015:786928. [PMID: 26101458 PMCID: PMC4458546 DOI: 10.1155/2015/786928] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 05/12/2015] [Indexed: 11/17/2022] Open
Abstract
Parasomnias are unpleasant or undesirable behaviours or experiences that occur predominantly during or within close proximity to sleep. Pharmacological treatments of parasomnias are available, but their efficacy is established only for few disorders. Furthermore, most of these disorders tend spontaneously to remit with development. Nonpharmacological treatments therefore represent valid therapeutic choices. This paper reviews behavioural and cognitive-behavioural managements employed for parasomnias. Referring to the ICSD-3 nosology we consider, respectively, NREM parasomnias, REM parasomnias, and other parasomnias. Although the efficacy of some of these treatments is proved, in other cases their clinical evidence cannot be provided because of the small size of the samples. Due to the rarity of some parasomnias, further multicentric researches are needed in order to offer a more complete account of behavioural and cognitive-behavioural treatments efficacy.
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Loutzenhiser L, Hoffman J, Beatch J. Parental perceptions of the effectiveness of graduated extinction in reducing infant night-wakings. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.910864] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Lynn Loutzenhiser
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - John Hoffman
- Centre for Families Work and Well-Being, University of Guelph, Guelph, Ontario, Canada
| | - Jacqueline Beatch
- Department of Psychology, University of Calgary, Calgary, Saskatchewan, Canada
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Shanahan L, Copeland WE, Angold A, Bondy CL, Costello EJ. Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry 2014; 53:550-8. [PMID: 24745954 PMCID: PMC4144678 DOI: 10.1016/j.jaac.2013.12.029] [Citation(s) in RCA: 187] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 10/28/2013] [Accepted: 02/18/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We tested whether sleep problems co-occur with, precede, and/or follow common psychiatric disorders during childhood and adolescence. We also clarified the role of comorbidity and tested for specificity of associations among sleep problems and psychiatric disorders. METHOD Data came from the Great Smoky Mountains Study, a representative population sample of 1,420 children, assessed 4 to 7 times per person between ages 9 and 16 years for major Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) disorders and sleep problems. Sleep-related symptoms were removed from diagnostic criteria when applicable. RESULTS Sleep problems during childhood and adolescence were common, with restless sleep and difficulty falling asleep being the most common symptoms. Cross-sectional analyses showed that sleep problems co-occurred with many psychiatric disorders. Longitudinal analyses revealed that sleep problems predicted increases in the prevalence of later generalized anxiety disorder (GAD) and high GAD/depression symptoms, and oppositional defiant disorder (ODD). In turn, GAD and/or depression and ODD predicted increases in sleep problems over time. CONCLUSIONS Sleep problems both predict and are predicted by a diagnostic cluster that includes ODD, GAD, and depression. Screening children for sleep problems could offer promising opportunities for reducing the burden of mental illness during the early life course.
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Affiliation(s)
| | | | - Adrian Angold
- Department of Psychiatry and Behavioral Sciences, Duke University
| | - Carmen L. Bondy
- Department of Psychology, University of North Carolina, Chapel Hill
| | - E. Jane Costello
- Department of Psychiatry and Behavioral Sciences, Duke University
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29
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Holstein BE, Pedersen TP, Bendtsen P, Madsen KR, Meilstrup CR, Nielsen L, Rasmussen M. Perceived problems with computer gaming and internet use among adolescents: measurement tool for non-clinical survey studies. BMC Public Health 2014; 14:361. [PMID: 24731270 PMCID: PMC3990242 DOI: 10.1186/1471-2458-14-361] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 04/07/2014] [Indexed: 11/17/2022] Open
Abstract
Background Existing instruments for measuring problematic computer and console gaming and internet use are often lengthy and often based on a pathological perspective. The objective was to develop and present a new and short non-clinical measurement tool for perceived problems related to computer use and gaming among adolescents and to study the association between screen time and perceived problems. Methods Cross-sectional school-survey of 11-, 13-, and 15-year old students in thirteen schools in the City of Aarhus, Denmark, participation rate 89%, n = 2100. The main exposure was time spend on weekdays on computer- and console-gaming and internet use for communication and surfing. The outcome measures were three indexes on perceived problems related to computer and console gaming and internet use. Results The three new indexes showed high face validity and acceptable internal consistency. Most schoolchildren with high screen time did not experience problems related to computer use. Still, there was a strong and graded association between time use and perceived problems related to computer gaming, console gaming (only boys) and internet use, odds ratios ranging from 6.90 to 10.23. Conclusion The three new measures of perceived problems related to computer and console gaming and internet use among adolescents are appropriate, reliable and valid for use in non-clinical surveys about young people’s everyday life and behaviour. These new measures do not assess Internet Gaming Disorder as it is listed in the DSM and therefore has no parity with DSM criteria. We found an increasing risk of perceived problems with increasing time spent with gaming and internet use. Nevertheless, most schoolchildren who spent much time with gaming and internet use did not experience problems.
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Affiliation(s)
- Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK 1353 Copenhagen K, Denmark.
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Turnbull K, Reid GJ, Morton JB. Behavioral Sleep Problems and their Potential Impact on Developing Executive Function in Children. Sleep 2013; 36:1077-1084. [PMID: 23814345 PMCID: PMC3669074 DOI: 10.5665/sleep.2814] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Bedtime resistance and night waking are common sleep problems throughout childhood, especially in the early years. These sleep problems may lead to difficulties in neurobehavioral functioning, but most research into childhood sleep problems has not emphasized the importance of the developmental context in which disruptions in neurobehavioral and daytime functioning occur. We review the development of sleep as well as executive functioning (EF) in childhood and suggest that EF may be particularly vulnerable to the effects of these common childhood sleep problems because of its prolonged course of maturation. Behavioral problems associated with common sleep problems suggest poor self-regulation in the context of sleep loss, and developing EF skills play important roles in self-regulation. A research agenda that considers a developmental approach to sleep and sleep problems in the context of childhood EF performance is outlined to promote future research in this area. CITATION Turnbull K; Reid GJ; Morton JB. Behavioral sleep problems and their potential impact on developing executive function in children. SLEEP 2013;36(7):1077-1084.
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Affiliation(s)
- Kathryn Turnbull
- Department of Psychology, The University of Western Ontario, London, Ontario, Canada
| | - Graham J. Reid
- Department of Psychology, The University of Western Ontario, London, Ontario, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Paediatrics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - J. Bruce Morton
- Department of Psychology, The University of Western Ontario, London, Ontario, Canada
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Sleep problems in children: a guide for primary care physicians. Indian J Pediatr 2013; 80:492-8. [PMID: 23378039 DOI: 10.1007/s12098-012-0960-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 12/28/2012] [Indexed: 10/27/2022]
Abstract
Sleep problems are commonly encountered in children with a prevalence of 20-42 %. Sleep problem usually entails a sleep pattern that is unsatisfactory or cause of concern to the parent, child or physician. Children present to primary care physicians or pediatricians with mainly three types of sleep related problems-first group has disorders of initiating and maintaining sleep (dyssomnias); second category (hypersomnias) is characterized by excessive sleepiness and third section represents abnormal activity or behavior during sleep, also classified as parasomnias. Evaluation of a child with sleep problem involves a comprehensive sleep history followed by detailed medical, developmental and behavioral history. One simple sleep screening tool used for evaluation of sleep in children-BEARS (B is bed time problems, E is excessive day time sleepiness, A is awakenings during the night, R is regularity as well as duration of sleep, and S is snoring) has been discussed. This article discusses common sleep problems observed in different age groups starting right from neonatal to the adolescent period followed by management strategies to optimize outcome of sleep in children.
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Zadra A, Desautels A, Petit D, Montplaisir J. Somnambulism: clinical aspects and pathophysiological hypotheses. Lancet Neurol 2013; 12:285-94. [PMID: 23415568 DOI: 10.1016/s1474-4422(12)70322-8] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Somnambulism, or sleepwalking, can give rise to a wide range of adverse consequences and is one of the leading causes of sleep-related injury. Accurate diagnosis is crucial for proper management and imperative in an ever-increasing number of medicolegal cases implicating sleep-related violence. Unfortunately, several widely held views of sleepwalking are characterised by key misconceptions, and some established diagnostic criteria are inconsistent with research findings. The traditional idea of somnambulism as a disorder of arousal might be too restrictive and a comprehensive view should include the idea of simultaneous interplay between states of sleep and wakefulness. Abnormal sleep physiology, state dissociation, and genetic factors might explain the pathophysiology of the disorder.
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Affiliation(s)
- Antonio Zadra
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada
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Wong CJ, Moxey-Mims M, Jerry-Fluker J, Warady BA, Furth SL. CKiD (CKD in children) prospective cohort study: a review of current findings. Am J Kidney Dis 2012; 60:1002-11. [PMID: 23022429 DOI: 10.1053/j.ajkd.2012.07.018] [Citation(s) in RCA: 153] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 07/02/2012] [Indexed: 11/11/2022]
Abstract
Chronic kidney disease (CKD) is a life-long condition associated with substantial morbidity and premature death due to complications from a progressive decrease in kidney function. The incidence and prevalence of all stages of CKD in children continues to increase worldwide. Between 2000 and 2008, the kidney replacement therapy incidence rate in those aged 0-19 years increased 5.9% to 15 per million population, highlighting the importance of CKD research in children. Many comorbid conditions seen in adults with CKD, including cardiovascular disease and cognitive impairment, also are highly prevalent in children, implicitly demonstrating the crucial need for initiating therapy early to improve health outcomes in children with CKD. The CKiD (Chronic Kidney Disease in Children) Study is a prospective cohort study of 586 children aged 1-16 years with an estimated glomerular filtration rate of 30-90 mL/min/1.73 m(2). Since its inception, CKiD has identified risk factors for CKD progression and cardiovascular disease in children with CKD and highlighted the effects of CKD on outcomes unique to children, including neurocognitive development and growth. This review summarizes the findings to date, illustrating the spectrum of CKD-associated complications in children and emphasizing areas requiring further investigation. Taken in sum, these elements stress that initiating treatment at an early age is essential for reducing long-term morbidity and mortality in children with CKD.
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Affiliation(s)
- Cynthia J Wong
- Department of Pediatrics, Division of Nephrology, Lucile Packard Children's Hospital, Palo Alto, CA, USA.
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Schlarb AA, Brandhorst I. Mini-KiSS Online: an Internet-based intervention program for parents of young children with sleep problems - influence on parental behavior and children's sleep. Nat Sci Sleep 2012; 4:41-52. [PMID: 23620677 PMCID: PMC3630970 DOI: 10.2147/nss.s28337] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Behavioral sleep problems are highly common in early childhood. These sleep problems have a high tendency to persist, and they may have deleterious effects on early brain development, attention, and mood regulation. Furthermore, secondary effects on parents and their relationship are documented. Negative parental cognition and behavior have been found to be important influencing factors of a child's behavioral sleep problems. Therefore, in the current study we examined the acceptance and efficacy of a newly developed Internet-based intervention program called Mini-KiSS Online for sleep disturbances for children aged 6 months to 4 years and their parents. PATIENTS AND METHODS Fifty-five children (54.54% female; aged 8-57 months) suffering from psychophysiological insomnia or behavioral insomnia participated in the 6-week online treatment. Sleep problems and treatment acceptance were examined with a sleep diary, anamnestic questionnaires, a child behavior checklist (the Child Behavior Checklist 1.5-5), and treatment evaluation questionnaires. RESULTS The evaluation questionnaires showed a high acceptance of Mini-KiSS Online. Parents would recommend the treatment to other families, were glad to participate, and reported that they were able to deal with sleep-related problems of their child after Mini-KiSS Online. Parental behavior strategies changed with a reduction of dysfunctional strategies, such as staying or soothing the child until they fell asleep, allowing the child to get up again and play or watch TV, or reading them another bedtime story. Frequency and duration of night waking decreased as well as the need for external help to start or maintain sleep. All parameters changed significantly, not only in the questionnaires but also in the sleep diary. CONCLUSION Mini-KiSS Online is shown to be a highly accepted and effective treatment to change parental behavior and reduce behavioral sleep problems in early childhood.
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Affiliation(s)
- Angelika A Schlarb
- University of Tuebingen, Faculty of Science, Department of Psychology, Tuebingen ; University of KoblenzLandau, Department of Psychology, Landau, Germany
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Taylor BJ, Heath ALM, Galland BC, Gray AR, Lawrence JA, Sayers RM, Dale K, Coppell KJ, Taylor RW. Prevention of Overweight in Infancy (POI.nz) study: a randomised controlled trial of sleep, food and activity interventions for preventing overweight from birth. BMC Public Health 2011; 11:942. [PMID: 22182309 PMCID: PMC3293097 DOI: 10.1186/1471-2458-11-942] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 12/19/2011] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Rapid weight gain during the first three years of life predicts child and adult obesity, and also later cardiovascular and other morbidities. Cross-sectional studies suggest that infant diet, activity and sleep are linked to excessive weight gain. As intervention for overweight children is difficult, the aim of the Prevention of Overweight in Infancy (POI.nz) study is to evaluate two primary prevention strategies during late pregnancy and early childhood that could be delivered separately or together as part of normal health care. METHODS/DESIGN This four-arm randomised controlled trial is being conducted with 800 families recruited at booking in the only maternity unit in the city of Dunedin, New Zealand. Mothers are randomised during pregnancy to either a usual care group (7 core contacts with a provider of government funded "Well Child" care over 2 years) or to one of three intervention groups given education and support in addition to "Well Child" care: the Food, Activity and Breastfeeding group which receives 8 extra parent contacts over the first 2 years of life; the Sleep group which receives at least 3 extra parent contacts over the first 6 months of life with a focus on prevention of sleep problems and then active intervention if there is a sleep problem from 6 months to 2 years; or the Combination group which receives all extra contacts. The main outcome measures are conditional weight velocity (0-6, 6-12, 12-24 months) and body mass index z-score at 24 months, with secondary outcomes including sleep and physical activity (parent report, accelerometry), duration of breastfeeding, timing of introduction of solids, diet quality, and measures of family function and wellbeing (parental depression, child mindedness, discipline practices, family quality of life and health care use). This study will contribute to a prospective meta-analysis of early life obesity prevention studies in Australasia. DISCUSSION Infancy is likely to be the most effective time to establish patterns of behaviour around food, activity and sleep that promote healthy child and adult weight. The POI.nz study will determine the extent to which sleep, food and activity interventions in infancy prevent the development of overweight. TRIAL REGISTRATION Clinical Trials NCT00892983. Prospective meta-analysis registered on PROSPERO CRD420111188. Available from http://www.crd.york.ac.uk/PROSPERO.
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Affiliation(s)
- Barry J Taylor
- Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Anne-Louise M Heath
- Department of Human Nutrition, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Andrew R Gray
- Department of Preventive and Social Medicine, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Julie A Lawrence
- Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Rachel M Sayers
- Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Kelly Dale
- Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Kirsten J Coppell
- Edgar National Centre for Diabetes and Obesity Research, University of Otago, PO Box 913, Dunedin 9016, New Zealand
| | - Rachael W Taylor
- Edgar National Centre for Diabetes and Obesity Research, University of Otago, PO Box 913, Dunedin 9016, New Zealand
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Quach J, Hiscock H, Ukoumunne OC, Wake M. A brief sleep intervention improves outcomes in the school entry year: a randomized controlled trial. Pediatrics 2011; 128:692-701. [PMID: 21890825 DOI: 10.1542/peds.2011-0409] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the feasibility of screening for child sleep problems and the efficacy of a behavioral sleep intervention in improving child and parent outcomes in the first year of schooling. METHODS A randomized controlled trial was nested in a population survey performed at 22 elementary schools in Melbourne, Australia. Intervention involved 2 to 3 consultations that covered behavioral sleep strategies for children whose screening results were positive for a moderate/severe sleep problem. Outcomes were parent-reported child sleep problem (primary outcome), sleep habits, psychosocial health-related quality of life, behavior, and parent mental health (all at 3, 6, and 12 months) and blinded, face-to-face learning assessment (at 6 months). RESULTS The screening survey was completed by 1512 parents; 161 (10.8%) reported a moderate/severe child sleep problem, and 108 of 136 (79.2% of those eligible) entered the trial. Sleep problems tended to resolve more rapidly in intervention children. Sleep problems affected 33% of 54 intervention children versus 43% of 54 control children at 3 months (P = .3), 25.5% vs 46.8% at 6 months (P = .03), and 32% vs 33% at 12 months (P = .8). Sustained sleep-habit improvements were evident at 3, 6, and 12 months (effect sizes: 0.33 [P = .03]; 0.51 [P = .003]; and 0.40 [P = .02]; respectively), and there were initial marked improvements in psychosocial scores that diminished over time (effect sizes: 0.47 [P = .02]; 0.41 [P = .09]; and 0.26 [P = .3]; respectively). Better prosocial behavior was evident at 12 months (effect size: 0.35; P = .03), and learning and parent outcomes were similar between groups. CONCLUSIONS School-based screening for sleep problems followed by a targeted, brief behavioral sleep intervention is feasible and has benefits relevant to school transition.
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Affiliation(s)
- Jon Quach
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
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Blunden SL, Thompson KR, Dawson D. Behavioural sleep treatments and night time crying in infants: Challenging the status quo. Sleep Med Rev 2011; 15:327-34. [DOI: 10.1016/j.smrv.2010.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 11/19/2010] [Accepted: 11/19/2010] [Indexed: 11/28/2022]
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Gallagher KS, Odenheimer G, Kunik ME. Treating sleep problems in dementia caregivers based on parent-child interventions. Am J Alzheimers Dis Other Demen 2011; 26:366-72. [PMID: 21697142 PMCID: PMC10845321 DOI: 10.1177/1533317511412048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Interventions developed for improving sleep in parents of young children or in developmentally delayed children might also prove effective for persons with dementia and their caregivers. METHODS We selectively reviewed the literature for interventions effective in improving sleep in parents of young children or in developmentally delayed children. RESULTS Graduated extinction and adult fading have been minimally explored in dementia populations. They are fairly brief and could be administered during primary care or dementia clinic visits. Combination strategies such as extinction and sleep-enhancing medication are very effective and may be applicable for persons with dementia and their caregivers. Physical capabilities and degree of cognitive decline of patients with dementia must be considered, and medical staff and caregivers should adjust behavioral strategies to maximize the use of patients' intact cognitive abilities. CONCLUSIONS Interventions for divergent populations prone to similar problems as those of patients with dementia might be effective and advance existing research.
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Affiliation(s)
| | - Germaine Odenheimer
- Oklahoma City Veterans Affairs Medical Center, Oklahoma City, OK, USA
- University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - Mark E. Kunik
- Baylor College of Medicine, Houston, TX, USA
- VA HSR & D Houston Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, USA
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Blunden S. Behavioural treatments to encourage solo sleeping in pre-school children: an alternative to controlled crying. J Child Health Care 2011; 15:107-17. [PMID: 21685226 DOI: 10.1177/1367493510397623] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Behavioural sleep treatments teach children to self soothe and sleep alone but often require a parent to ignore their child's cries for extended periods, a technique parents may find difficult. This paper presents a modified version of sleep training which aims to improve sleep but reduce crying in children and increase compliance in parents. Thirty-three children (Mean [SD] age = 27.01 [13.4] mths) from a clinical non-controlled population presenting with Behavioural Insomnia of Childhood, utilised a five-week sleep training method that teaches parents to gradually withdraw their assistance, allowing them to attend and calm their child whenever they choose and not to ignore their cries, components that differ from commonly utilised methods. Post treatment, all negative sleep associations, co-sleeping and family stress were reduced and all measures of sleep significantly improved: total night time sleep; time taken until sleep onset (SOL) and minutes awake during the night (WASO) (all p = < 0.002) with large treatment effects sizes (d = 0.94-1.85). Whilst the results are preliminary, this may offer an alternative method to explore in larger studies, given that many parents may have difficulty with ignoring the extended bouts of crying which often accompany commonly utilised sleep training methods.
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Affiliation(s)
- Sarah Blunden
- Centre for Sleep Research, University of South Australia, Australia.
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Paine S, Gradisar M. A randomised controlled trial of cognitive-behaviour therapy for behavioural insomnia of childhood in school-aged children. Behav Res Ther 2011; 49:379-88. [DOI: 10.1016/j.brat.2011.03.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 03/11/2011] [Accepted: 03/28/2011] [Indexed: 11/29/2022]
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Abstract
Bedtime struggles, delayed sleep onset, and problematic night wakings are extremely common in the pediatric population, and have a significant impact on quality of life of both children and caregivers. This article reviews the research and clinical nosology of childhood insomnia, prevalence, and etiologic factors in infants, children, and adolescents. Clinical presentation, evaluation, and treatment, both behavioral and pharmacologic, of the most common types of pediatric insomnia are presented. Insomnia in special populations, particularly children with chronic medical, psychiatric, and neurodevelopmental disorders, is discussed. Future directions in childhood insomnia are presented.
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Affiliation(s)
- Judith A Owens
- Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC 20010, USA.
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Tikotzky L, Sadeh A. The role of cognitive-behavioral therapy in behavioral childhood insomnia. Sleep Med 2010; 11:686-91. [PMID: 20620108 DOI: 10.1016/j.sleep.2009.11.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 11/13/2009] [Accepted: 11/17/2009] [Indexed: 10/19/2022]
Abstract
Behavioral insomnia is a very common problem throughout childhood. It has negative impact on children and their families and can persist for many years if not treated. Interventions based on cognitive-behavioral therapy (CBT) principles have mainly focused on withdrawing excessive parental bedtime involvement and helping children develop self-soothing strategies for falling asleep and resuming sleep during the night. With young children, these interventions are mostly based on training and modifying parental behaviors. Changing parental sleep-related expectations, beliefs and perceptions is an important component in these interventions. With older children and adolescents, more versatile interventions exist and they include additional components of CBT including relaxation and stress reduction techniques, modifying cognitive processes related to worrying and anxiety, positive imagery training and others. Extensive research has established the efficacy of behavioral interventions in early childhood. However, research on interventions for older children has been very limited and has failed to provide sufficient information on the efficacy of specific CBT techniques for childhood insomnia.
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Affiliation(s)
- Liat Tikotzky
- Department of Psychology, Ben Gurion University of the Negev, Israel
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Simola P, Niskakangas M, Liukkonen K, Virkkula P, Pitkäranta A, Kirjavainen T, Aronen ET. Sleep problems and daytime tiredness in Finnish preschool-aged children-a community survey. Child Care Health Dev 2010; 36:805-11. [PMID: 20645995 DOI: 10.1111/j.1365-2214.2010.01112.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep is important to the well-being and development of children. Specially, small children are vulnerable to the effects of inadequate sleep. However, not much is known about the frequency of all types of sleep problems and daytime tiredness in preschool-aged children. OBJECTIVE To evaluate the prevalence of a wide spectrum of sleep problems, daytime tiredness and associations between these in 3- to 6-year-old Finnish children. METHODS A population-based study where parents of 3- to 6-year-old children (n= 904) living in Helsinki filled in the Sleep Disturbance Scale for Children (SDSC). RESULTS Of the children, 45% had at least one sleep-related problem occurring at least three times a week: 14.1% were unwilling to go to bed, 10.2% had difficulties in falling asleep, 10.2% had bruxism, 6.4% sleep talking, 2.1% sleep terrors, 8.2% had sleep-related breathing problem, 11.2% had excessive sweating while falling asleep and 12.9% excessive sweating during sleep. Age and gender were related to phenotype of the sleeping problems. In multiple regression analysis, the difficulties in initiating and maintaining sleep were most strongly associated with tiredness in the morning and during the day. CONCLUSIONS Different types of sleep problems are frequent in preschool-aged children. Poor sleep quality is associated with morning and daytime tiredness. In screening for sleep problems in children, attention should be paid not only to sleep amount but also to sleep quality.
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Affiliation(s)
- P Simola
- Clinic for Children and Adolescents, Institute of Clinical Medicine, Department of Psychology, University of Helsinki, Helsinki, Finland.
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Črnčec R, Matthey S, Nemeth D. Infant sleep problems and emotional health: a review of two behavioural approaches. J Reprod Infant Psychol 2010. [DOI: 10.1080/02646830903294995] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Healey D, France KG, Blampied NM. Treating sleep disturbance in infants: What generalizes? BEHAVIORAL INTERVENTIONS 2009. [DOI: 10.1002/bin.274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Matthey S, Speyer J. Changes in unsettled infant sleep and maternal mood following admission to a parentcraft residential unit. Early Hum Dev 2008; 84:623-9. [PMID: 18511223 DOI: 10.1016/j.earlhumdev.2008.04.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2008] [Revised: 04/03/2008] [Accepted: 04/07/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Maternal mood disorders are common in the first postnatal year, particularly if the infant has sleep problems. AIMS This study explored the effectiveness of a residential parentcraft unit's treatment for infant sleep problems, and also its impact on the mother's depression, anxiety, and bonding. STUDY DESIGN A one-group pretest-posttest design with follow-up was used. Assessments were conducted while participants were at the service, and at 5 weeks and 4 months after discharge. PARTICIPANTS Mothers (n=116) with infants 3 weeks to 3 years old presenting to a five-day program at an Australian residential parentcraft service because of unsettled infant sleep were recruited. OUTCOME MEASURES The Edinburgh Postnatal Depression Scale, the Hospital Anxiety and Depression Scale-Anxiety subscale (maternal mood), the Being a Mother & Bonding Scale (maternal experience and mother-infant bonding), and a Change Questionnaire (for infant sleep and maternal emotional health). RESULTS By 5 weeks post-discharge significant improvements were reported for infant sleep behavior, maternal mood (depressive and anxious symptoms), and maternal-infant bonding. 80% of the women reported an improvement on both their infants' sleep and their own emotional health, with strategies and support provided in the unit being cited by most women as the reason for improvement. Emotional health improvements were most often attributed to the improvement in the infant's sleep. All improvements by 5 weeks were maintained by the 4 four months assessment. CONCLUSION Where postnatal mood difficulties are reported along with unsettled infant sleep difficulties, the evidence from this uncontrolled study, together with previously research, suggests that treatment which principally focuses on the baby-care issue can have a significant impact on many women's emotional health.
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Affiliation(s)
- Stephen Matthey
- Infant, Child & Adolescent Mental Health Service, Sydney South West Area Health Service, Sydney Australia.
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Abstract
BACKGROUND A study, entitled Evaluation of an Intervention Aimed at Resolving Behavioural Sleep Problems in 6- to 12-month-old Infants: A Pilot Study, was undertaken to evaluate the efficacy of a behavioural sleep intervention. This descriptive qualitative study aimed to describe parents' perceptions of the sleep intervention and any burden associated with participating in the study. METHODS Fourteen of the 35 families who had participated in the quantitative study were interviewed. Respondents comprised well-educated, middle-class and mixed-ethnicity families. Data were collected through semi-structured interviews, with open-ended trigger questions, and were analysed using inductive content analysis. RESULT Nine themes, which subsumed a number of categories, were constructed. Parents changed their perspectives about sleep and parenting styles; they experienced many challenges and inadvertent benefits; and they welcomed a structured framework for assisting with sleep problems. The parents fitted intervention strategies into their realities; many factors interfered with their success; and their support systems and their expectations of the study varied. CONCLUSION These parents' previous education about normal infant sleep cycles and behavioural sleep problems was inadequate. The parents who were able to use the structured framework, flexible strategies and access to healthcare professionals for problem solving not only excelled in resolving their infants' sleep problems, but also gained confidence about their parenting skills and success.
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Affiliation(s)
- L Tse
- Vancouver Coastal Health Authority, Vancouver, BC, Canada.
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Jiang F, Shen X, Yan C, Wu S, Jin X, Dyken M, Lin-Dyken D. Epidemiological study of sleep characteristics in Chinese children 1-23 months of age. Pediatr Int 2007; 49:811-6. [PMID: 18045277 DOI: 10.1111/j.1442-200x.2007.02449.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sleep plays a critical role in normal development and the effects of culture upon sleep are especially important in young children. The purpose of the present paper was to determine the sleep times and the prevalence of sleep problems and co-sleeping in children from Shanghai. METHODS A cross-sectional design incorporating parental self-report was used to investigate the sleep-related habits of 1129 children, 1-23 months of age, randomly selected from the five districts of Shanghai, China. RESULTS The total sleep time (TST) of Chinese young children was less than that reported in Western populations, and the prevalence of sleep problems (65.97%) was higher than that for Western children. The sleep problems of children were significantly related to perinatal factors and certain behavior problems. The rate of bed sharing did not differ between boys and girls but significantly increased with age from 44.07% in 1-month-olds to 71.51% in 23-month-olds. CONCLUSIONS Sleep problems that cross cultures result from a variety of behavioral and health problems. Nevertheless, it is speculated that reduced TST in Chinese children may be related to factors unique to China, such as co-sleeping and child-rearing practices.
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Affiliation(s)
- Fan Jiang
- Department of Pediatric Development and Behavior, School of Medicine Shanghai Jiao Tong University Affiliated Shanghai Children's Medical Center, Shanghai, China
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OTA K, OTA A, KITAE S. Analysis of the sleeping habits of young children in relation to environmental factors and their psychological state. Sleep Biol Rhythms 2007. [DOI: 10.1111/j.1479-8425.2007.00322.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Selim CA, France KG, Blampied NM, Liberty KA. Treating treatment-resistant infant sleep disturbance with combination pharmacotherapy and behavioural family interventions. AUSTRALIAN PSYCHOLOGIST 2007. [DOI: 10.1080/00050060500545044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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