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Vasileva ES, Anisimov GV, Kalashnikova TP. [Current approaches to the diagnosis and treatment of behavioral insomnia in children]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:62-67. [PMID: 33076647 DOI: 10.17116/jnevro202012009262] [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] [Indexed: 01/08/2023]
Abstract
Behavioral insomnia is the most common sleep disorder in young children. It significantly reduces the quality of parent's life and is one of the common complaints to a pediatrician or neurologist. The basis treatment of childhood insomnia is behavioral therapy, which includes sleep hygiene, age-appropriate daily routine and sleep associations, stable bedtime routines, positive reinforcement, bedtime fading, scheduled awakenings. Although a systematic ignoring («crying it out») is effective and widely used in behavioral therapy, it has low compliance and its safety is insufficiently studied. Therefore, a systematic ignoring is not a priority method of behavioral therapy and should not be used in children under 6 months of age. Behavioral therapy of childhood insomnia is complemented by psychological and informational support from parents, and in some cases, drug therapy. Prevention includes education of expectant parents on baby sleep hygiene.
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Affiliation(s)
- E S Vasileva
- The first medical and pedagogical center «Lingua Bona», Perm, Russia
| | - G V Anisimov
- The first medical and pedagogical center «Lingua Bona», Perm, Russia
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2
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Shurney D, Gustafson PA. Lifestyle Medicine in Children. Am J Lifestyle Med 2020; 14:54-56. [PMID: 31903083 DOI: 10.1177/1559827619879090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Dexter Shurney
- Zipongo, Inc, Zipongo-Eating Well Made Simple, San Francisco, California; Dr. Paula Gustafson From - Major Health Partners, Shelbyville, IN
| | - Paula A Gustafson
- Zipongo, Inc, Zipongo-Eating Well Made Simple, San Francisco, California; Dr. Paula Gustafson From - Major Health Partners, Shelbyville, IN
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Beresford B, McDaid C, Parker A, Scantlebury A, Spiers G, Fairhurst C, Hewitt C, Wright K, Dawson V, Elphick H, Thomas M. Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbance in children with neurodisabilities: a systematic review. Health Technol Assess 2019; 22:1-296. [PMID: 30382936 DOI: 10.3310/hta22600] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is uncertainty about the most appropriate ways to manage non-respiratory sleep disturbances in children with neurodisabilities (NDs). OBJECTIVE To assess the clinical effectiveness and safety of NHS-relevant pharmacological and non-pharmacological interventions to manage sleep disturbance in children and young people with NDs, who have non-respiratory sleep disturbance. DATA SOURCES Sixteen databases, including The Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE, were searched up to February 2017, and grey literature searches and hand-searches were conducted. REVIEW METHODS For pharmacological interventions, only randomised controlled trials (RCTs) were included. For non-pharmacological interventions, RCTs, non-randomised controlled studies and before-and-after studies were included. Data were extracted and quality assessed by two researchers. Meta-analysis and narrative synthesis were undertaken. Data on parents' and children's experiences of receiving a sleep disturbance intervention were collated into themes and reported narratively. RESULTS Thirty-nine studies were included. Sample sizes ranged from 5 to 244 participants. Thirteen RCTs evaluated oral melatonin. Twenty-six studies (12 RCTs and 14 before-and-after studies) evaluated non-pharmacological interventions, including comprehensive parent-directed tailored (n = 9) and non-tailored (n = 8) interventions, non-comprehensive parent-directed interventions (n = 2) and other non-pharmacological interventions (n = 7). All but one study were reported as having a high or unclear risk of bias, and studies were generally poorly reported. There was a statistically significant increase in diary-reported total sleep time (TST), which was the most commonly reported outcome for melatonin compared with placebo [pooled mean difference 29.6 minutes, 95% confidence interval (CI) 6.9 to 52.4 minutes; p = 0.01]; however, statistical heterogeneity was extremely high (97%). For the single melatonin study that was rated as having a low risk of bias, the mean increase in TST was 13.2 minutes and the lower CI included the possibility of reduced sleep time (95% CI -13.3 to 39.7 minutes). There was mixed evidence about the clinical effectiveness of the non-pharmacological interventions. Sixteen studies included interventions that investigated the feasibility, acceptability and/or parent or clinician views of sleep disturbance interventions. The majority of these studies reported the 'family experience' of non-pharmacological interventions. LIMITATIONS Planned subgroup analysis was possible in only a small number of melatonin trials. CONCLUSIONS There is some evidence of benefit for melatonin compared with placebo, but the degree of benefit is uncertain. There are various types of non-pharmacological interventions for managing sleep disturbance; however, clinical and methodological heterogeneity, few RCTs, a lack of standardised outcome measures and risk of bias means that it is not possible to draw conclusions with regard to their effectiveness. Future work should include the development of a core outcome, further evaluation of the clinical effectiveness and cost-effectiveness of pharmacological and non-pharmacological interventions and research exploring the prevention of, and methods for identifying, sleep disturbance. Research mapping current practices and exploring families' understanding of sleep disturbance and their experiences of obtaining help may facilitate service provision development. STUDY REGISTRATION This study is registered as PROSPERO CRD42016034067. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Adwoa Parker
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Gemma Spiers
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Heather Elphick
- Department of Respiratory Medicine, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Megan Thomas
- Blenheim House Child Development Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
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Short Sleep and Adolescents' Performance on a Concussion Assessment Battery: An Experimental Sleep Manipulation Study. Clin J Sport Med 2018; 28:395-397. [PMID: 28742612 PMCID: PMC5776054 DOI: 10.1097/jsm.0000000000000454] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Correlational studies have linked short sleep to adolescents' report of postconcussion symptoms and cognitive performance during concussion assessments. This study tested whether those are cause-effect relationships. DESIGN Three-week randomly counterbalanced, within-subjects, crossover experiment. SETTING Adolescents slept at home with weekly visits to an outpatient clinic for sleep monitor uploads and outcome assessments. PARTICIPANTS Twenty-four healthy 14- to 17.9-year-olds. CONDITIONS After an initial sleep-stabilization period, adolescents experienced 5-night spans of short sleep (SS; 6.5 hours/night in bed) versus Healthy Sleep Opportunity (HS; 9.5 hours/night in bed). MAIN OUTCOME MEASURES Cognitive indexes and the postconcussion symptom scale (PCSS) from the Immediate PostConcussion Assessment and Cognitive Testing. RESULTS Adolescents reported significantly worse symptoms on the PCSS after SS than HS, even after excluding items manifestly related to sleep. Verbal memory was also worse after SS than HS, though the effect was small. The manipulation did not significantly affect other cognitive indexes. CONCLUSIONS A realistic "dose" of short sleep, similar to what many adolescents experience regularly on school nights, can cause or contribute to symptom reports during concussion assessments. Consistent with previous sleep research, one-on-one cognitive tests seem to be less sensitive than measures of emotional and behavioral functioning to the effects of short sleep.
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Esbensen AJ, Hoffman EK. Impact of sleep on executive functioning in school-age children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:569-580. [PMID: 29696706 PMCID: PMC6005178 DOI: 10.1111/jir.12496] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/15/2017] [Accepted: 04/01/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND Sleep problems have an impact on executive functioning in the general population. While children with Down syndrome (DS) are at high risk for sleep problems, the impact of these sleep problems on executive functioning in school-age children with DS is less well documented. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports and neuropsychology assessments of executive functioning among school-age children with DS. METHOD Thirty school-age children with DS wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Children completed a neuropsychology assessment of their inhibitory control, ability to shift and working memory. Their parents and teachers completed rating scales to assess these same constructs of executive functioning. RESULTS Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire (CSHQ), but not actigraph-measured sleep period or efficiency, were predictive of parent reports of concerns with inhibitory control, shifting and working memory, and of teacher reports of inhibitory control. No measure of sleep was predictive of executive functioning as measured by the neuropsychology assessment. CONCLUSION The study findings corroborate the preliminary literature that parent-reported sleep problems are related to executive functioning in school-age children with DS, particularly in the area of inhibitory control across home and school. These findings have implications for understanding contributing factors to academic performance and school behaviour in school-age children with DS.
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Affiliation(s)
- A J Esbensen
- Division of Developmental and Behavioral Pediatric, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati, School of Medicine, Cincinnati, OH, USA
| | - E K Hoffman
- Division of Developmental and Behavioral Pediatric, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Esbensen AJ, Hoffman EK, Stansberry E, Shaffer R. Convergent validity of actigraphy with polysomnography and parent reports when measuring sleep in children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:281-291. [PMID: 29314419 PMCID: PMC5847446 DOI: 10.1111/jir.12464] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/07/2017] [Accepted: 11/29/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND There is a need for rigorous measures of sleep in children with Down syndrome as sleep is a substantial problem in this population and there are barriers to obtaining the gold standard polysomnography (PSG). PSG is cost-prohibitive when measuring treatment effects in some clinical trials, and children with Down syndrome may not cooperate with undergoing a PSG. Minimal information is available on the validity of alternative methods of assessing sleep in children with Down syndrome, such as actigraphy and parent ratings. Our study examined the concurrent and convergent validity of different measures of sleep, including PSG, actigraphy and parent reports of sleep among children with Down syndrome. METHOD A clinic (n = 27) and a community (n = 47) sample of children with Down syndrome were examined. In clinic, children with Down syndrome wore an actigraph watch during a routine PSG. In the community, children with Down syndrome wore an actigraph watch for a week at home at night as part of a larger study on sleep and behaviour. Their parent completed ratings of the child's sleep during that same week. RESULTS Actigraph watches demonstrated convergent validity with PSG when measuring a child with Down syndrome's total amount of sleep time, total wake time after sleep onset and sleep period efficiency. In contrast, actigraph watches demonstrated poor correlations with parent reports of sleep, and with PSG when measuring the total time in bed and total wake episodes. Actigraphy, PSG and parent ratings of sleep demonstrated poor concurrent validity with clinical diagnosis of obstructive sleep apnoea. CONCLUSION Our current data suggest that actigraph watches demonstrate convergent validity and are sensitive to measuring certain sleep constructs (duration, efficiency) in children with Down syndrome. However, parent reports, such as the Children's Sleep Habits Questionnaire, may be measuring other sleep constructs. These findings highlight the importance of selecting measures of sleep related to target concerns.
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Affiliation(s)
- A J Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - E K Hoffman
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - E Stansberry
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Shaffer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Svingos A, Greif S, Bailey B, Heaton S. The Relationship Between Sleep and Cognition in Children Referred for Neuropsychological Evaluation: A Latent Modeling Approach. CHILDREN-BASEL 2018; 5:children5030033. [PMID: 29495597 PMCID: PMC5867492 DOI: 10.3390/children5030033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/22/2018] [Accepted: 02/23/2018] [Indexed: 11/23/2022]
Abstract
Children with conditions affecting cognitive processes experience high levels of sleep disturbance, which may further compound the cognitive ramifications of their disorders. Despite this, existing studies in this area have been primarily confined to only particular diagnostic groups and/or a limited scope of sleep and cognitive parameters. The current study characterized the nature of sleep problems and examined the relationship between a wide range of sleep-related problems and cognitive functioning in a large (N = 103) diagnostically heterogeneous sample of youth (aged 6–16) referred for neuropsychological assessment. Structural equation modeling was used to examine the relationship between sleep-related problems (i.e., daytime sleepiness, sleep onset latency, sleep fragmentation, sleep time variability, sleep debt) and cognitive performance (i.e., executive functioning, sustained attention, memory, processing speed). Sleep fragmentation emerged as the most prominent sleep-related problem in the present sample. Structural equation modeling demonstrated a negative association between sleep-related problems and cognition that did not reach statistical significance (β = −0.084, p = 0.629). The current statistical approach may be used as a conceptual framework for future work examining these multi-dimensional constructs in a parsimonious fashion.
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Affiliation(s)
- Adrian Svingos
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL 32610, USA.
| | - Sarah Greif
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL 32610, USA.
| | - Brittany Bailey
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL 32610, USA.
| | - Shelley Heaton
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL 32610, USA.
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Esbensen AJ, Hoffman EK, Beebe DW, Byars KC, Epstein J. Links between sleep and daytime behaviour problems in children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:115-125. [PMID: 29282827 PMCID: PMC5775033 DOI: 10.1111/jir.12463] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/11/2017] [Accepted: 11/29/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND In the general population, sleep problems have an impact on daytime performance. Despite sleep problems being common among children with Down syndrome, the impact of sleep problems on daytime behaviours in school-age children with Down syndrome is an understudied topic. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports of daytime behaviour problems among school-age children with Down syndrome. METHOD Thirty school-age children with Down syndrome wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Their parent and teacher completed a battery of measures to assess daytime behaviour. RESULTS Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire, but not actigraph-measured sleep efficiency, was predictive of parent and teacher behavioural concerns on the Nisonger Child Behaviour Rating Form and the Vanderbilt ADHD Rating Scales. Actigraph-measured sleep period and parent-reported sleep duration on the Children's Sleep Habits Questionnaire was predictive of daytime parent-reported inattention. Actigraph-measured sleep period was predictive of parent-reported hyperactivity/impulsivity. CONCLUSION The study findings suggest that sleep problems have complex relationships to both parent-reported and teacher-reported daytime behaviour concerns in children with Down syndrome. These findings have implications for understanding the factors impacting behavioural concerns and their treatment in school-age children with Down syndrome.
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Affiliation(s)
- A J Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - E K Hoffman
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - D W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - K C Byars
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Abstract
OBJECTIVE To characterize practice patterns regarding sleep evaluation and intervention among children with Down syndrome (DS). METHOD Data were obtained from electronic health records from 2009 to 2013 for a retrospective cohort of 954 children with DS, aged 5 to 21 years during the time sampled. International Classification of Diseases, Ninth Revision, diagnoses were used to identify children with obstructive sleep apnea and/or behavioral sleep disturbances. Primary outcomes were confirmed by participation in an overnight diagnostic polysomnography (PSG) and/or documented provision of specified sleep interventions including positive airway pressure, otolaryngology (ENT) surgery, sleep medication, and behavioral sleep therapy. RESULTS Overall, 47.7% of children with DS had undergone PSG, 39.1% had diagnosed sleep problems, and of those diagnosed with sleep problems, 81.2% had received sleep intervention. Consistent with best practice clinical care, sleep treatments matched the diagnosed sleep problems. Age, gender, and race, but not body mass index (BMI), were associated with PSG completion rate and occurrence rates for ENT surgery and sleep medication usage. BMI was associated with obstructive sleep apnea. CONCLUSION Despite high rates of reported sleep problems in children with DS, less than half underwent PSG. Children diagnosed with sleep problems received treatment consistent with their sleep diagnosis. However, age and gender were associated with differential rates of treatment delivery that was incongruous with prevalence rates for diagnosed sleep problems. These findings underscore the importance of screening for sleep problems in children with DS, and referring for and providing appropriate targeted sleep interventions.
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Taylor HG, Bowen SR, Beebe DW, Hodges E, Amin R, Arens R, Chervin RD, Garetz SL, Katz ES, Moore RH, Morales KH, Muzumdar H, Paruthi S, Rosen CL, Sadhwani A, Thomas NH, Ware J, Marcus CL, Ellenberg SS, Redline S, Giordani B. Cognitive Effects of Adenotonsillectomy for Obstructive Sleep Apnea. Pediatrics 2016; 138:peds.2015-4458. [PMID: 27464674 PMCID: PMC4960728 DOI: 10.1542/peds.2015-4458] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2016] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Research reveals mixed evidence for the effects of adenotonsillectomy (AT) on cognitive tests in children with obstructive sleep apnea syndrome (OSAS). The primary aim of the study was to investigate effects of AT on cognitive test scores in the randomized Childhood Adenotonsillectomy Trial. METHODS Children ages 5 to 9 years with OSAS without prolonged oxyhemoglobin desaturation were randomly assigned to watchful waiting with supportive care (n = 227) or early AT (eAT, n = 226). Neuropsychological tests were administered before the intervention and 7 months after the intervention. Mixed model analysis compared the groups on changes in test scores across follow-up, and regression analysis examined associations of these changes in the eAT group with changes in sleep measures. RESULTS Mean test scores were within the average range for both groups. Scores improved significantly (P < .05) more across follow-up for the eAT group than for the watchful waiting group. These differences were found only on measures of nonverbal reasoning, fine motor skills, and selective attention and had small effects sizes (Cohen's d, 0.20-0.24). As additional evidence for AT-related effects on scores, gains in test scores for the eAT group were associated with improvements in sleep measures. CONCLUSIONS Small and selective effects of AT were observed on cognitive tests in children with OSAS without prolonged desaturation. Relative to evidence from Childhood Adenotonsillectomy Trial for larger effects of surgery on sleep, behavior, and quality of life, AT may have limited benefits in reversing any cognitive effects of OSAS, or these benefits may require more extended follow-up to become manifest.
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Affiliation(s)
- H. Gerry Taylor
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Susan R. Bowen
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Dean W. Beebe
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | - Raouf Amin
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Raanan Arens
- Department of Pediatrics, Children’s Hospital at Montefiore and Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Ronald D. Chervin
- Neurology and Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan
| | - Susan L. Garetz
- Department of Otolaryngology–Head and Neck Surgery and Sleep Disorders Center, University of Michigan Health Center, Ann Arbor, Michigan
| | - Eliot S. Katz
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Reneé H. Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Knashawn H. Morales
- Department of Biostatistics and Epidemiology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hiren Muzumdar
- Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Shalini Paruthi
- Department of Pediatrics, Cardinal Glennon Children’s Medical Center, Saint Louis University, St Louis, Missouri
| | - Carol L. Rosen
- Department of Pediatrics, Rainbow Babies & Children’s Hospital, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Anjali Sadhwani
- Boston Children’s Hospital/Harvard Medical School, Boston, Massachusetts
| | - Nina Hattiangadi Thomas
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Neuropsychology and Assessment Group, and
| | - Janice Ware
- Boston Children’s Hospital/Harvard Medical School, Boston, Massachusetts
| | - Carole L. Marcus
- Department of Pediatrics, Sleep Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Susan S. Ellenberg
- Department of Biostatistics and Epidemiology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Susan Redline
- Department of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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van Kooten JAMC, Terwee CB, Kaspers GJL, van Litsenburg RRL. Content validity of the Patient-Reported Outcomes Measurement Information System Sleep Disturbance and Sleep Related Impairment item banks in adolescents. Health Qual Life Outcomes 2016; 14:92. [PMID: 27315795 PMCID: PMC4912794 DOI: 10.1186/s12955-016-0496-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 06/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep problems are common in adolescents and can have a negative impact on daily functioning and quality of life; therefore recognition of sleep problems is important. The PROMIS (Patient-Reported Outcomes Information System) Sleep Disturbance (SD) and Sleep Related Impairment (SRI) items banks are internationally used, well-validated instruments developed for and tested in adults. This study evaluates the content validity of the self- and proxy versions of the PROMIS-SD and the PROMIS-SRI in adolescents. METHODS Experts (n = 6), adolescents (n = 24, 12-18 years) and their parents (n = 7) commented on the relevance and comprehensibility of the item banks. RESULTS Experts considered all items relevant, only a few items were found irrelevant by adolescents and parents. The majority of items were comprehensible. The ability of parents to report on their adolescent's sleep was limited. CONCLUSION The PROMIS-SD and PROMIS-SRI have adequate content validity in adolescents. Considering their psychometric robustness and the possibility of Computerized Adaptive Testing, which is efficient as well as patient-friendly, these item banks could prove very useful in the evaluation of adolescent sleep. The validity of the proxy scales, however, is limited considering the difficulties reported by the parents. Further psychometric evaluation of these scales in adolescents is required.
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Affiliation(s)
- Jojanneke A M C van Kooten
- Department of Pediatric oncology - hematology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, VU University Amsterdam, Amsterdam, The Netherlands
| | - Gertjan J L Kaspers
- Department of Pediatric oncology - hematology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Raphaёle R L van Litsenburg
- Department of Pediatric oncology - hematology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands.
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Beebe DW. Sleep Problems as Consequence, Contributor, and Comorbidity: Introduction to the Special Issue on Sleep, Published in Coordination With Special Issues in Clinical Practice in Pediatric Psychology and Journal of Developmental and Behavioral Pediatrics. J Pediatr Psychol 2016; 41:583-7. [PMID: 27189693 DOI: 10.1093/jpepsy/jsw037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 04/10/2016] [Indexed: 02/01/2023] Open
Abstract
Despite long-standing public and scientific interest in the phenomenon of sleep, the current decade has shown tremendous growth in our understanding of the sleep of children who have medical or developmental conditions. To accommodate, promote, and guide that growth, Journal of Pediatric Psychology, Clinical Practice in Pediatric Psychology, and Journal of Developmental and Behavioral Pediatrics have published coordinated special issues, encompassing >30 relevant articles. This article introduces the special issue in Journal of Pediatric Psychology, highlighting papers that illustrate how sleep problems are not only commonly comorbid with childhood medical and developmental conditions; they are also likely caused by and contribute to these conditions. In doing so, these coordinated special issues guide clinical care and reveal opportunities for future research.
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Affiliation(s)
- Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine
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Saenz J, Yaugher A, Alexander GM. Sleep in infancy predicts gender specific social-emotional problems in toddlers. Front Pediatr 2015; 3:42. [PMID: 26029685 PMCID: PMC4426713 DOI: 10.3389/fped.2015.00042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/25/2015] [Indexed: 11/14/2022] Open
Abstract
Despite strong evidence linking sleep to developmental outcomes, the longitudinal relationship between sleep and emotional well-being remains largely unknown. To address this gap in our knowledge, the current study examined sleep in infancy, measured via actigraphy, as a predictor of social-emotional problems in toddlers. A total of 47 children (29 males) were included in this longitudinal study. At time one, actigraphy measures of sleep were obtained from 3- to 4-month-old infants. At time two, parents rated their 18- to 24-month-old toddler's social-emotional well-being using the Brief Infant Toddler Social Emotional Assessment. Results indicated that boys tended to have higher levels of externalizing behaviors than did girls. Additionally, boys with longer sleep durations also showed lower sleep efficiency. In girls, sleep duration in infancy was a significant predictor of autism spectrum disorder behaviors and approached significance as a predictor of externalizing problems in toddlerhood. Our findings are the first to show a relationship between sleep measured in infancy and autism spectrum disorder symptomatology measured in early childhood. They suggest that the etiology of social-emotional problems may differ between genders and raise the possibility that sleep/wake cycles may be differentially related to autism spectrum disorder symptoms in girls and boys.
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Affiliation(s)
- Janet Saenz
- Department of Psychology, Texas A&M University , College Station, TX , USA ; Division of Adolescent Medicine, Children's Hospital Los Angeles , Los Angeles, CA , USA
| | - Ashley Yaugher
- Department of Psychology, Texas A&M University , College Station, TX , USA
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Shay N, Yeates KO, Walz NC, Stancin T, Taylor HG, Beebe DW, Caldwell CT, Krivitzky L, Cassedy A, Wade SL. Sleep problems and their relationship to cognitive and behavioral outcomes in young children with traumatic brain injury. J Neurotrauma 2014; 31:1305-12. [PMID: 24665961 PMCID: PMC4108979 DOI: 10.1089/neu.2013.3275] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study examined the effect of traumatic brain injury (TBI) in young children on sleep problems and the relationship of sleep problems to neuropsychological and psychosocial functioning. Participants were drawn from an ongoing longitudinal study of injury in young children recruited from 3 to 6 years of age. They constituted three groups: orthopedic injury (OI; n=92), complicated mild/moderate TBI (mTBI; n=55); and severe TBI (sTBI; n=20). Caregivers completed the Children's Sleep Habits Questionnaire (CSHQ), as well as ratings of behavioral adjustment, adaptive functioning, and everyday executive function at 1, 6, 12, and 18 months postinjury. Retrospective ratings of preinjury sleep and psychosocial functioning were obtained at the initial assessment. Children completed neuropsychological testing at all occasions. Children with complicated mTBI demonstrated more total sleep problems than children with OI at 6 months postinjury, but not at 12 or 18 months. Children with sTBI displayed more bedtime resistance and shorter sleep duration than those with complicated mTBI or OI at several occasions. Across groups, total sleep problems predicted more emotional and behavioral problems and worse everyday executive function as rated by parents across follow-up occasions. In contrast, sleep problems were generally not related to neuropsychological test performance. The results suggest that young children with TBI demonstrate more sleep problems than children with injuries not involving the head. Sleep problems, in turn, significantly increase the risk of poor psychosocial outcomes across time, but are not associated with worse neuropsychological test performance.
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Affiliation(s)
- Nicole Shay
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Keith O. Yeates
- Department of Pediatrics, The Ohio State University, Columbus, Ohio
- Center for Behavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Nicolay C. Walz
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Terry Stancin
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - H. Gerry Taylor
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Dean W. Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Carolyn T. Caldwell
- U.S. Army Northern Regional Medical Command, Aberdeen Proving Ground, Maryland
| | - Lauren Krivitzky
- Department of Child and Adolescent Psychiatry, Children's Hospital Of Philadelphia, Philadelphia, Pennsylvania
| | - Amy Cassedy
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Sociology, McMicken College of Arts and Sciences, University of Cincinnati, Cincinnati, Ohio
| | - Shari L. Wade
- Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, Cincinnati, Ohio
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