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Rajan A, Chakrabarty B, Gulati S, Jauhari P, Pandey RM, Tripathi M, Kabra SK, Jain V, Sikka K, Zulfiqar L, Upadhyay AD, Gupta S, Chandeliya K. Childhood and Adolescent Sleep Awareness in Caregivers and Health Care Providers: A Community- and Hospital-Based Survey. Pediatr Neurol 2023; 147:14-23. [PMID: 37531700 DOI: 10.1016/j.pediatrneurol.2023.06.018] [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: 08/05/2022] [Revised: 05/19/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Sleep disorders are common in childhood and adolescence with mental and physical consequences needing appropriate intervention by caregivers and health care providers (HCPs). The objective of the study, conducted at a tertiary teaching hospital and public school in north India, was to develop validated questionnaires to evaluate childhood and adolescent sleep awareness in caregivers and HCPs. METHODS The study participants (caregivers represented by parents of 2-18 year olds attending a public school and of those attending outpatient services at the study hospital and HCPs represented by medical interns and nursing graduates within 1 year of graduation) were enrolled after appropriate screening. RESULTS Two separate questionnaires in English for caregivers (also translated in Hindi) and HCPs were applied on 313 caregivers and 175 HCPs (110 medical interns and 65 nursing graduates) and developed and validated with a Cronbach α of 0.73 and 0.74, respectively. The questionnaires covered three domains: sleep hygiene, sleep related health problems, and miscellaneous. Both group of respondents had >50% correct responses in sleep hygiene. The ĸ agreement between knowledge and practice of sleep hygiene in caregivers was 0.2. Poor response (<50% correct responses) was seen in sleep-related health problems in both groups of respondents implying knowledge deficit in various sleep disorders. The HCPs performed poorly on basic theoretical questions in miscellaneous domain. For consultation of sleep problems, most caregivers (48%) chose pediatricians. CONCLUSION There is a need to strengthen undergraduate medical and nursing curriculum in sleep. Caregivers should be made aware of implications of unhealthy sleep.
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Affiliation(s)
- Aswani Rajan
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Sheffali Gulati
- Coordinator DM Pediatric Neurology Programme, Faculty-in-Charge, Centre of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Jauhari
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sushil Kumar Kabra
- Division of Pediatric Pumonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Jain
- Pediatric Endocrinology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - Luhar Zulfiqar
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Datt Upadhyay
- Scientist II, Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sandhya Gupta
- Nursing College, All India Institute of Medical Sciences, New Delhi, India
| | - Kamlesh Chandeliya
- Chief Nursing Officer, All India Institute of Medical Sciences, New Delhi, India
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Zulfiqar L, Chakrabarty B, Gulati S, Jauhari P, Pandey RM, Tripathi M, Kabra SK, Jain V, Sikka K, Rajan A, Kaur P. The Childhood and Adolescent Sleep Evaluation Questionnaire (CASEQ): Development and validation of an ICSD-3-based screening instrument, a community and hospital-based study. J Sleep Res 2021; 31:e13479. [PMID: 34494338 DOI: 10.1111/jsr.13479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/29/2021] [Accepted: 08/21/2021] [Indexed: 12/01/2022]
Abstract
Sleep disorders are common in children and adolescents. Polysomnography is the gold-standard diagnostic method; however, it is a tedious procedure. The objective of the study was to develop a screening questionnaire for sleep problems based on International Classification of Sleep Disorders-3 in children and adolescents, and validate it with clinical evaluation and polysomnography. A questionnaire was developed in English and Hindi with content validation by eight multidisciplinary experts. Respondents were parents of children and adolescents, aged 2-18 years, recruited from a public school and a tertiary care teaching hospital in north India. A subset of these children and adolescents underwent overnight polysomnography and detailed clinical evaluation within 4 weeks of applying the questionnaire. The questionnaire, named Childhood and Adolescent Sleep Evaluation Questionnaire, contains primary questions covering all subgroups of disorders under International Classification of Sleep Disorders-3, and secondary questions on sleep hygiene and comorbidities. The questionnaire was filled by 750 respondents, out of which 100 cases underwent polysomnography and clinical evaluation. The internal consistency in the form of Cronbach's α was 0.8 for the questionnaire. The sensitivity, specificity, positive and negative predictive values for the questionnaire in identifying those with sleep problems compared with detailed clinical and polysomnographic evaluations were 85%, 100%, 100% and 62.5%, respectively. For individual subgroups of disorders, the sensitivity, specificity, positive and negative predictive values varied between 72.7% and 100%, 88.9% and 100%, 62.5% and 100% and 81.6% and 100%, respectively. The Childhood and Adolescent Sleep Evaluation Questionnaire has good psychometric properties, moreover, its simplicity and translatability make it ideal for use at the community and hospital settings.
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Affiliation(s)
- Luhar Zulfiqar
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Centre of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
| | - Prashant Jauhari
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sushil Kumar Kabra
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Jain
- Pediatric Endocrinology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - Aswani Rajan
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhjot Kaur
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Lushington K, Biggs S, Martin AJ, Kennedy JD. Sleep disordered breathing in children: which symptoms do parents consider a problem? Sleep Med 2021; 81:33-41. [PMID: 33636542 DOI: 10.1016/j.sleep.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE Parents tend to under-report symptoms suggestive of sleep disordered breathing (SDB) at medical consultation. It is thought that a contributing factor may be whether parents view SDB symptoms as a problem. The aim of the study was to examine to what extent parents view SDB symptoms as a problem in children recruited from the general community and especially in children who currently have symptoms suggestive of SDB. METHODS Parents of 1639 children aged 5-10 y attending middle school in South Australia completed a questionnaire which included demographics and assessed the frequency over the previous school week of 32 sleep habits including six SDB sleep habit items. The sample was restricted to typically developing children and excluded children with medical problems likely to impact SDB. The final sample included 1610 children without a prior diagnosis of SDB and 29 with a prior diagnosis and/or treatment of SDB. Parents were asked to rate children's sleep habits using a 4-pt scale (never, rarely, sometimes and usually) and if the sleep habit was perceived to be a problem (yes/no). Children who sometimes or usually reported a sleep habit item were labelled as symptomatic. RESULTS Parents of children with, compared to those without, a prior diagnosis of SDB, were more likely to report the presence of SDB symptoms which were more frequently viewed as a problem. In children without a prior diagnosis of SDB, parents of symptomatic children viewed most SDB symptoms as a problem ranging from 91% for apnoea, 63% snorted/gasped, 63% watched child breathing at night, 58% snored loudly, 49% snored to 32% breathing heavily at night. Additional analyses in the combined sample revealed that a prior diagnosis of SDB, gender, socioeconomic status and ethnicity were weak predictors of whether parents viewed SDB sleep symptoms as a problem. CONCLUSION In children with symptoms suggestive of SDB, most parents viewed most SDB symptoms as a problem especially apnoea. The high frequency is contrary to that expected given the under-reporting of SDB symptoms at medical consultation. This suggests that additional factors other than whether parents consider SDB symptoms as a problem might better explain the under-reporting of SDB symptoms at medical consultation. Given the important impact on child health and medical service provision, future studies examining the factors that prompt parents to discuss SDB symptoms at medical consultation are warranted.
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Affiliation(s)
| | - Sarah Biggs
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Alfred James Martin
- University of Adelaide, Adelaide, Australia; Women's and Children's Hospital Adelaide, Australia
| | - John Declan Kennedy
- University of Adelaide, Adelaide, Australia; Women's and Children's Hospital Adelaide, Australia
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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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Cooney MR, Short MA, Gradisar M. An open trial of bedtime fading for sleep disturbances in preschool children: a parent group education approach. Sleep Med 2018; 46:98-106. [DOI: 10.1016/j.sleep.2018.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/15/2018] [Accepted: 03/04/2018] [Indexed: 10/17/2022]
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Goldberger-Raskin BS, Gothelf D, Bachner-Melman R, Lang C, Kushnir J. The association between sleep disturbances of children with anxiety disorders and those of their mothers. Sleep Med 2018; 43:77-82. [DOI: 10.1016/j.sleep.2017.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 10/01/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
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Ystrom E, Hysing M, Torgersen L, Ystrom H, Reichborn-Kjennerud T, Sivertsen B. Maternal Symptoms of Anxiety and Depression and Child Nocturnal Awakenings at 6 and 18 Months. J Pediatr Psychol 2017; 42:1156-1164. [PMID: 28369506 PMCID: PMC5896619 DOI: 10.1093/jpepsy/jsx066] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 12/16/2022] Open
Abstract
Objective We aim to estimate the pathways between maternal symptoms of anxiety and depression and child nocturnal awakenings via structural equation modeling using a sibling design. Methods Structural equation modeling on data from 14,926 sibling dyads or triads from the Norwegian Mother and Child Cohort Study. Results At 6 months, we estimated the association between maternal symptoms of anxiety and child nocturnal awakenings to be owing to several nonsignificant pathways. Child nocturnal awakenings at 18 months, however, were influenced by concurrent maternal symptoms of anxiety (β = .10) and depression (β = .12). Neither maternal symptoms of anxiety (β = .04) nor depression (β = -.00) was influenced by concurrent child nocturnal awakenings. Conclusions Our findings suggest that maternal mental health influences child sleep behavior at 18 months after birth, and not vice versa. This is in support of hypotheses on maternal mental health influencing child sleep during toddlerhood.
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Affiliation(s)
- Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health
- Department of Psychology, University of Oslo
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, UNI Research Health
| | - Leila Torgersen
- Department of Child Development, Norwegian Institute of Public Health
| | - Hilde Ystrom
- Child and Adolescence Outpatient Clinic Oslo South, Division of Mental Health and Addiction, Oslo University Hospital
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health
- Institute of Clinical Medicine, University of Oslo
| | - Børge Sivertsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UNI Research Health
- Public Mental Health, Norwegian Institute of Public Health
- Department of Psychiatry, Helse Fonna HF
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Um YH, Hong SC, Jeong JH. Sleep Problems as Predictors in Attention-Deficit Hyperactivity Disorder: Causal Mechanisms, Consequences and Treatment. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:9-18. [PMID: 28138105 PMCID: PMC5290714 DOI: 10.9758/cpn.2017.15.1.9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/06/2016] [Accepted: 09/11/2016] [Indexed: 01/11/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is notorious for its debilitating consequences and early age of onset. The need for early diagnosis and intervention has frequently been underscored. Previous studies have attempted to clarify the bidirectional relationship between ADHD and sleep problems, proposing a potential role for sleep problems as early predictors of ADHD. Sleep deprivation, sleep-disordered breathing, and circadian rhythm disturbances have been extensively studied, yielding evidence with regard to their induction of ADHD-like symptoms. Genetic-phenotypic differences across individuals regarding the aforementioned sleep problems have been elucidated along with the possible use of these characteristics for early prediction of ADHD. The long-term consequences of sleep problems in individuals with ADHD include obesity, poor academic performance, and disrupted parent-child interactions. Early intervention has been proposed as an approach to preventing these debilitating outcomes of ADHD, with novel treatment approaches ranging from melatonin and light therapy to myofunctional therapy and adjustments of the time point at which school starts.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Muller D, Signal L, Elder D, Gander P. Environmental and behavioural factors associated with school children's sleep in Aotearoa/New Zealand. J Paediatr Child Health 2017; 53:68-74. [PMID: 27586066 DOI: 10.1111/jpc.13268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/27/2016] [Accepted: 05/17/2016] [Indexed: 11/29/2022]
Abstract
AIM To collect objective and subjective sleep data on 6- to 8-year-old children across the week and to identify factors within the family environment associated with sleep differences. METHODS Data were collected (n = 52) using actigraphy and diaries for 7 consecutive days and nights and a questionnaire incorporating the Children's Sleep Habits Questionnaire was completed by parents. RESULTS Children's actigraphic sleep periods averaged 10 h on school nights and 9.5 h on non-school nights and parents over-estimated children's sleep compared with actigraphy. One third (37%) of children had potential sleep problems. Children who shared a bedroom (31%) had shorter sleep onset latencies and those who consumed caffeinated drinks (33%) went to sleep and awoke later. Increased screen time was associated with later bedtimes on school nights and children with screens in bedrooms (12%) went to bed later and slept less on school nights, and had higher Children's Sleep Habits Questionnaire scores. Children living with a shift-working adult (27%) slept longer on non-school nights and had shorter sleep onset latencies on school nights. CONCLUSIONS It is important to consider children's sleep within the wider family context and to be aware that parents may over-estimate their children's sleep. Simple strategies to promote sleep health in clinical settings or education programmes include regular weekend bedtimes that align with those on school nights, removing technology from bedrooms and minimising caffeine consumption. An awareness of potential sleep differences associated with shift-working adults may ensure children are supported to have consistent sleep routines that promote adequate sleep.
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Affiliation(s)
- Diane Muller
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
| | - Leigh Signal
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
| | - Dawn Elder
- Department of Paediatrics, University of Otago, Wellington, New Zealand
| | - Philippa Gander
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
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Ozgoli G, Sheikhan Z, Soleimani F, Nasiri M, Amiri S. Prevalence of Sleep Disorders Among Children 4 - 6 Years Old in Tehran Province, Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e22052. [PMID: 27651942 PMCID: PMC5020400 DOI: 10.5812/ircmj.22052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 04/21/2015] [Accepted: 05/11/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sleep patterns may change over a person's lifetime; however, the quantity and quality of sleep always depend on individual factors such as age, sex, and psychological and environmental factors. In children, sleep is as important as development. Quantitative sleep problems related to sleep onset and qualitative sleep disorders such as frequent awakenings may lead to insufficient sleep. OBJECTIVES This study aimed to assess the prevalence of sleep disorders among children 4 - 6 years old attending the health centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2013. PATIENTS AND METHODS This was a cross-sectional study on 400 children selected using a multistage sampling method. Data were collected by interviews. The questionnaire included two sections: a demographic section with questions about the demographic characteristics of the children and parents and a children's sleep habit questionnaire (CSHQ). Data were analyzed by SPSS 16 and different statistical tests were used (P < 0.05). RESULTS The mean age of the children was 64.27 ± 9.3 months. The prevalence of sleep disorders was 36.25%. Sleep disorders were significantly associated with age, height, body mass index, residence of children, father's occupation, mother's diseases, father's drug abuse, and parents' marital status (P < 0.05). CONCLUSIONS Sleep disorders in children threaten growth and development, and are dangerous for their health. Sleep disorders should be considered in the differential diagnosis of children's learning and behavioral problems.
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Affiliation(s)
- Giti Ozgoli
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Zohre Sheikhan
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Zohre Sheikhan, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-02188202512, Fax: +98-02188202512, E-mail:
| | - Farin Soleimani
- Pediatric Nero-rehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Malihe Nasiri
- Department of Biostatistics, Faculty of Paramedic, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Saba Amiri
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Schlarb A, Brömer L, Brandhorst I, Wagner J, Milicevic V, Hautzinger M. Sleep problems among family members of a universal parent-training. SOMNOLOGIE 2013. [DOI: 10.1007/s11818-013-0615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Nicholl HM, Begley CM. Explicating caregiving by mothers of children with complex needs in ireland: a phenomenological study. J Pediatr Nurs 2012; 27:642-51. [PMID: 23101728 DOI: 10.1016/j.pedn.2011.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 07/05/2011] [Accepted: 07/06/2011] [Indexed: 10/17/2022]
Abstract
This qualitative phenomenological study explored mothers' experiences of caring for a child with complex needs. After ethical approval was obtained, data were collected through 11 diaries and 48 interviews with 17 mothers in Ireland. Caring for a child with complex needs involves the delivery of care in an inside world of the home, the world outside the home, and a "going-between" world. Caregiving, 1 of 8 closely linked dimensions, is presented, including its 4 categories. These are normal mothering, technical caregiving, preemptive caregiving, and individualized caregiving. Professionals require a greater understanding of the experiences of mothers caring for children with complex needs at home.
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Affiliation(s)
- Honor M Nicholl
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
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Abstract
OBJECTIVE To review evidence of trauma and exile-related mental health in young refugees from the Middle East. METHOD A review of four empirical studies: i) a qualitative study of 11 children from torture surviving families, ii) a cohort study of 311 3-15-year-old asylum-seeking children, iii) a qualitative study of 14 members of torture surviving families and iv) a follow-up study of 131 11-23-year-old refugees. RESULTS The reactions of the children were not necessarily post-traumatic stress disorder specific. Seventy-seven per cent suffered from anxiety, sleep disturbance and/or depressed mood at arrival. Sleep disturbance (prevalence 34%) was primarily predicted by a family history of violence. At follow-up, 25.9% suffered from clinically relevant psychological symptoms. Traumatic experiences before arrival and stressful events in exile predicted internalizing behaviour, witnessing violence and frequent school changes in exile predicted externalizing behaviour. School participation, Danish friends, language proficiency and mother's education predicted less long-term psychological problems. CONCLUSION Psychological problems are frequent in refugee children, but the extents are reduced over time in exile. Traumatic experience before arrival is most important for the short-term reaction of the children while aspects of life in exile are important for the children's ability to recover from early traumatization.
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Affiliation(s)
- E Montgomery
- Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark.
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Byars KC, Yeomans-Maldonado G, Noll JG. Parental functioning and pediatric sleep disturbance: An examination of factors associated with parenting stress in children clinically referred for evaluation of insomnia. Sleep Med 2011; 12:898-905. [DOI: 10.1016/j.sleep.2011.05.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Revised: 05/19/2011] [Accepted: 05/23/2011] [Indexed: 01/28/2023]
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Weiss MD, Salpekar J. Sleep problems in the child with attention-deficit hyperactivity disorder: defining aetiology and appropriate treatments. CNS Drugs 2010; 24:811-28. [PMID: 20839894 DOI: 10.2165/11538990-000000000-00000] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
An estimated 25-50% of children and adolescents with attention-deficit hyperactivity disorder (ADHD) experience problems with sleep. The most common sleep problems reported in children with ADHD include delayed sleep onset, sleep or bedtime resistance, prolonged tiredness upon waking and daytime sleepiness. Higher incidences of sleep disorders such as restless legs syndrome, periodic limb movement disorder and sleep-disordered breathing have been reported in paediatric ADHD populations compared with control populations. In some cases, medications for ADHD and/or co-morbid disorders may also contribute to sleep disturbances. Assessment tools, such as parent-child questionnaires and sleep diaries, can help clinicians evaluate sleep disturbances. Sleep problems may potentially exacerbate ADHD symptoms, and interventions targeted at ensuring adequate sleep (including behavioural, dietary, specific pharmacological agents for treatment-induced insomnia, and melatonin) could in turn potentially attenuate symptoms associated with ADHD, such as irritability. Whether metabolic or neurological pathways common to both sleep and ADHD may be disrupted, and whether targeting treatments to these pathways may simultaneously improve both ADHD and sleep symptoms, needs further elucidation.
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Affiliation(s)
- Margaret D Weiss
- Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada.
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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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Chu J, Richdale AL. Sleep quality and psychological wellbeing in mothers of children with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2009; 30:1512-22. [PMID: 19664896 DOI: 10.1016/j.ridd.2009.07.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Accepted: 07/10/2009] [Indexed: 05/16/2023]
Abstract
Sleep and behavioural difficulties are common in children with developmental disabilities. Mothers often wake and tend to their child when their child is having sleep difficulties. Therefore, mothers of children with developmental disabilities can have poor sleep quality due to these disruptions. The present study investigated the impact of sleep and behaviour problems in children with developmental disabilities on mothers' sleep quality and psychological wellbeing. The sample consisted of 46 mothers and 50 children with developmental disabilities. The results indicated that greater sleep and behaviour problems in children were significantly associated with disturbed sleep and increased depression, anxiety and stress levels in mothers. Mothers' sleep disturbance was also found to significantly predict poor maternal psychological wellbeing. The research limitations, implications of findings, and directions for future research are also discussed.
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Affiliation(s)
- Judy Chu
- RMIT University, Division of Psychology, School of Health Sciences, Bundoora, VIC 3083, Australia.
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Mohammadi M, Amintehran E, Ghaleh-bandi MF, Ashrafi MR, Shoaee S, Ghalehbaghi B. Reliability and Validity of Persian Version of “BEARS” Pediatric Sleep Questionnaire. ACTA ACUST UNITED AC 2008. [DOI: 10.5005/ijsm-3-1-14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
AIM This paper is a report of a study to identify research priorities of clinical staff working with families at a Western Australian centre for parenting. BACKGROUND Australian centres for parenting focus on children's needs while working in partnership with parents, families and their communities. These agencies incorporate primary healthcare strategies in their unique approach with families. Clinicians' research priorities at these centres have not been explored in an Australian context. METHOD In 2005, a Delphi study was conducted in which clinicians were asked to provide a list of five important issues relating to care provided to children, parents and their families. Research topics identified were then ranked for their importance to the family and clinicians. Finally, the top 10 research topics were ranked for priority. FINDINGS In round 1, 148 research topics were identified. Thirty-six topics were removed, due to the availability of existing evidence. Content analysis was used to collapse statements into 26 research questions, which were further classified into seven categories: parenting issues; sleep and settling issues; postnatal depression; evaluation and impact of programmes; staffing issues; centre marketing services and others. Issues relating to sleep and settling and postnatal depression were rated as top research priorities. CONCLUSION The priorities of clinicians working with families provide research direction for this Western Australian centre and potentially other centres in Australia and similar settings elsewhere in the world. The Delphi approach in determining clinicians' perceptions of relevant research areas may be useful to direct research in other contexts.
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Affiliation(s)
- Yvonne Hauck
- School of Nursing and Midwifery, Curtin University of Technology, Perth, WA, Australia.
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Freeman KA. Treating bed time resistance with the bed time pass: a systematic replication and component analysis with 3-year-olds. J Appl Behav Anal 2007; 39:423-8. [PMID: 17236339 PMCID: PMC1702334 DOI: 10.1901/jaba.2006.34-05] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Bedtime resistance, a common pediatric problem, that was displayed by 4 unrelated 3-year-old children was treated with the bedtime pass (i.e., provision of a small notecard exchangeable for one trip out of the bedroom after bedtime) plus extinction. Bedtime resistance was eliminated for all participants. Further, treatment did not produce extinction bursts, as is common when using extinction procedures alone. Component analysis with 1 participant suggested that use of both components of the intervention produced the best outcomes. Findings extend the literature on the treatment of pediatric bedtime resistance as well as the application of behavior analysis to clinical psychology and pediatric care.
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Affiliation(s)
- Kurt A Freeman
- Child Development and Rehabilitation Center, Oregon Health & Science University, P.O. Box 574, Portland 97207, USA.
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Warren SL, Howe G, Simmens SJ, Dahl RE. Maternal depressive symptoms and child sleep: models of mutual influence over time. Dev Psychopathol 2006; 18:1-16. [PMID: 16478549 DOI: 10.1017/s0954579406060019] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of the research was to test hypotheses concerning the associations between maternal depressive symptoms and child sleep using longitudinal data to examine possible predictive pathways. Data from the National Institute of Child Health and Human Development Study of Early Child Care with 1222 children studied from 1 to 36 months of age were analyzed to examine: effects on trajectories over time, and phase-specific effects over three defined age periods (6 to 15, 15 to 24, and 24 to 36 months). Child sleep was found to influence maternal depressive symptoms only for the 15- to 24-month age period, where, contrary to expectation, longer duration of child awakenings predicted decreased maternal depressive symptoms. Maternal depressive symptoms were found to predict an increased frequency of child awakenings across the 15- to 24-month age period only. In contrast, maternal depressive symptoms were found to significantly predict increased duration of child awakenings both for the 3-year trajectory and across the 15- to 24- and 24- to 36-month age periods. Additional research is needed to clarify the mechanisms by which maternal depressive symptoms predict increased duration of child awakenings.
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Affiliation(s)
- Susan L Warren
- George Washington University, Ross 550, 2300 Eye Street NW, Washington, DC 20037, USA.
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Rose M, Holzer C, Tuden C, Rosenberg M, Herndon DN, Blakeney P. Reported Stress of Parents of Burned Children Differs on the Spanish and English Versions of the Parenting Stress Inventory. ACTA ACUST UNITED AC 2005; 26:446-52. [PMID: 16151294 DOI: 10.1097/01.bcr.0000176772.76245.95] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Parenting Stress Inventory (PSI) is a 101-item self-report questionnaire measuring stress in children and their parents. For several years, we have been administering the English and Spanish versions of the PSI to parents of children with >40% total body surface area burn at discharge, 6 months, 1 year, and every year at followup at clinic. The aim of the present study was to evaluate differences between Spanish- and English-speaking families with respect to stress and to further examine potential psychometric differences between the instruments that may contribute to these differences. In the present study, we found the instruments to be equivalent but have significant differences between the two versions, suggesting cultural differences in how coping and stress are manifested in these groups. Spanish-speaking parents noted significantly more distress than the English-speaking parents. Both groups indicated most severe problems on the Child domains of the PSI, suggesting that parents perceived their interactions and relationship as it pertain to their child to be most troubled.
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Affiliation(s)
- Mary Rose
- Shriners Burns Hospital for Children, Galveston, Texas 77550, USA
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Abstract
Sleep problems are very prevalent during childhood and may have adverse developmental impact. The efficacy of a number of cognitive-behavioral interventions for the most prevalent problems such as difficulty falling asleep and night-wakings has been repeatedly demonstrated with relatively rapid outcomes and high success rates. Preventive interventions in infancy have shown some promise in lowering the rates of sleep problems in infants of trained parents. Cognitive-behavioral interventions have also been proposed for childhood parasomnias (sleepwalking, night terrors, nightmares, and rhythmic behaviors), however, very limited research has been conducted to assess the efficacy of these interventions. Specific methodological issues, limitations and needs have been identified in the clinical literatures. These issues include: (a) integrating objective sleep assessment methods in clinical research; (b) identifying the specific curative factors of various effective interventions; (c) the absence of long-term follow-up studies for assessing relapse problems; (d) assessing the role of mode of delivery (i.e., professional consultation versus written information) in treatment efficacy; and (e) the need to expand the research on clinical interventions for the parasomnias.
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Affiliation(s)
- Avi Sadeh
- Department of Psychology, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
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Owens JA, Dalzell V. Use of the 'BEARS' sleep screening tool in a pediatric residents' continuity clinic: a pilot study. Sleep Med 2005; 6:63-9. [PMID: 15680298 DOI: 10.1016/j.sleep.2004.07.015] [Citation(s) in RCA: 189] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2004] [Revised: 07/09/2004] [Accepted: 07/14/2004] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the effectiveness of a simple, 5-item pediatric sleep screening instrument, the BEARS (B=Bedtime Issues, E=Excessive Daytime Sleepiness, A=Night Awakenings, R=Regularity and Duration of Sleep, S=Snoring) in obtaining sleep-related information and identifying sleep problems in the primary care setting. SETTING Pediatric residents' continuity clinic in a tertiary care children's hospital. METHODS BEARS forms were placed in the medical records of a convenience sample of 2 to 12 year old children presenting for well child visits over the 5 month study period. Sleep-related information recorded in the BEARS visit and in the pre-BEARS visit, which was the subject's most recent previous well child check (WCC), was coded with respect to whether or not a sleep problem was indicated, and whether sleep issues were addressed. RESULTS A total of 195 children had both a documented pre-BEARS and BEARS WCC visit. BEARS visits were significantly more likely than the pre-BEARS visits to have any sleep information recorded (98.5% vs. 87.7%, p<0.001), and to have information recorded about bedtime issues (93.3% vs. 7.7%, p<0.001), excessive daytime sleepiness (93.9% vs. 5.6%, p<0.001), snoring (92.8% vs. 7.2%, p<0.001), nighttime awakenings (91.3% vs. 29.2%, p<0.001), and regularity and duration of sleep (65.3% vs. 31.5%, p<0.001). Significantly more sleep problems were identified during the BEARS visits in the domains of bedtime issues (16.3% vs. 4.1%, p<0.001), nighttime awakenings (18.4% vs. 6.8%, p<0.001) and snoring (10.7% vs. 4.6%, p=0.012). Finally, almost twice as many BEARS charts had sleep mentioned in the Impression and Plan (13.1% vs. 7.3%), which approached significance (p=0.07). CONCLUSIONS The BEARS appears to be a user-friendly pediatric sleep screening tool which significantly increases the amount of sleep information recorded as well as the likelihood of identifying sleep problems in the primary care setting.
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Affiliation(s)
- Judith A Owens
- Division of Pediatric Ambulatory Medicine, Brown University School of Medicine, Rhode Island Hospital, 593 Eddy St., Potter Building, Suite 200, Providence, RI 02903, USA.
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Sadeh A. A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample. Pediatrics 2004; 113:e570-7. [PMID: 15173539 DOI: 10.1542/peds.113.6.e570] [Citation(s) in RCA: 538] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To develop and validate (using subjective and objective methods) a brief infant sleep questionnaire (BISQ) that would be appropriate for screening in pediatric settings. DESIGN Two studies were performed to assess the properties of the BISQ. Study I compared BISQ measures with sleep diary measures and objective actigraphic sleep measures for clinical (N = 43) and control (N = 57) groups of infants (5-29 months of age). The second study was based on an Internet survey of 1028 respondents who completed the BISQ posted on an infant sleep web site. RESULTS In study I, BISQ measures were found to be correlated significantly with sleep measures derived from actigraphy and sleep diaries. BISQ measures (number of night wakings and nocturnal sleep duration) were the best predictors for distinguishing between clinical and control samples. High test-retest correlations (r >.82) were demonstrated for BISQ measures for a subsample of 26 infants. Study II provided a developmental perspective on BISQ measures. The study demonstrated that BISQ measures derived from a large Internet survey provided developmental and sleep ecology-related findings that corresponded to the existing literature findings on sleep patterns in early childhood. CONCLUSIONS The findings provide psychometric, clinical, and ecologic support for the use of the BISQ as a brief infant sleep screening tool for clinical and research purposes. Potential clinical cutoff scores are provided.
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Affiliation(s)
- Avi Sadeh
- Department of Psychology, Tel Aviv University, Tel Aviv, Israel.
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des Rivières-Pigeon C, Saurel-Cubizolles MJ, Romito P. Division of domestic work and psychological distress 1 year after childbirth: a comparison between France, Quebec and Italy. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2002. [DOI: 10.1002/casp.697] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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