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White ML, Triplett OM, Morales N, Van Dyk TR. Associations Among Sleep, Emotional Eating, and Body Dissatisfaction in Adolescents. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01692-4. [PMID: 38578582 DOI: 10.1007/s10578-024-01692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/06/2024]
Abstract
The literature on adolescent sleep has shown a bidirectional relationship between sleep difficulties and altered eating habits, including emotional eating. However, it is unclear if this relationship is related to preexisting body concerns, or if poor sleep is the prime contributor to emotional eating patterns. This study therefore seeks to examine body dissatisfaction as a moderator of the sleep-emotional eating relationship in an at-risk sample. Adolescents (N = 106) presenting for overnight polysomnography self-reported on time-in-bed, insomnia, body dissatisfaction, and emotional eating. Less time-in-bed was correlated with a greater desire for thinness and greater insomnia severity was related to overall emotional eating and eating in response to anxiety, anger, and frustration and in response to depression. Moderation analyses revealed that the relationships between time-in-bed and eating in response to feeling unsettled (b = -.002, 95% CI[- .003, - .001], p < .005) and eating in response to anxiety, anger, and frustration (b = -.01, 95% CI[- .01, - .001], p < .05) were exacerbated by worse body dissatisfaction. Optimizing sleep may attenuate the risk for disordered eating, particularly for adolescents with high body dissatisfaction.
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Affiliation(s)
- Megan L White
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Suite 106, Loma Linda, CA, 92350, USA
| | - Olivia M Triplett
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Suite 106, Loma Linda, CA, 92350, USA
| | - Nuria Morales
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Suite 106, Loma Linda, CA, 92350, USA
| | - Tori R Van Dyk
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Suite 106, Loma Linda, CA, 92350, USA.
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2
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Subotic-Kerry M, Werner-Seidler A, Corkish B, Batterham PJ, Sicouri G, Hudson J, Christensen H, O'Dea B, Li SH. Protocol for a randomised controlled trial evaluating the effect of a CBT-I smartphone application (Sleep Ninja®) on insomnia symptoms in children. BMC Psychiatry 2023; 23:684. [PMID: 37730577 PMCID: PMC10510253 DOI: 10.1186/s12888-023-05185-x] [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: 08/17/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Sleep is necessary for healthy development and mental wellbeing. Despite this, many children do not get the recommended duration of sleep each night, and many experience sleep problems. Although treatable, existing interventions for sleep disturbance are time-consuming, burdensome for families, and focus on providing behavioural strategies to parents rather than upskilling children directly. To address this gap, we modified Sleep Ninja®, an evidence-based cognitive behavioural therapy for insomnia (CBT-I) smartphone app for adolescent sleep disturbance, to be appropriate for 10 to 12 year olds. Here, we describe the protocol for a randomised controlled trial to evaluate the effect of Sleep Ninja on insomnia and other outcomes, including depression, anxiety, sleep quality, and daytime sleepiness, and explore effects on the emergence of Major Depressive Disorder (MDD), compared to an active control group. METHODS We aim to recruit 214 children aged 10 to 12 years old experiencing disturbed sleep. Participants will be screened for inclusion, complete the baseline assessment, and then be randomly allocated to receive Sleep Ninja, or digital psychoeducation flyers (active control) for 6-weeks. The primary outcome, insomnia symptoms, along with depression, anxiety, sleep quality, and daytime sleepiness will be assessed at 6-weeks (primary endpoint), 3-months, and 9-months post-baseline (secondary and tertiary endpoints, respectively). A mixed model repeated measures analytic approach will be used to conduct intention-to-treat analyses to determine whether reductions in insomnia and secondary outcomes are greater for those receiving Sleep Ninja relative to the control condition at the primary and secondary endpoints. The difference in relative risk for MDD onset will be explored at 9-months and compared between conditions. DISCUSSION This is the first clinical trial examining the effects of a CBT-I smartphone app in children experiencing sleep disturbance. Results will provide empirical evidence about the effects of Sleep Ninja on insomnia and other mental health outcomes. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12623000587606). UNIVERSAL TRIAL NUMBER U1111-1294-4167.
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Affiliation(s)
- M Subotic-Kerry
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - A Werner-Seidler
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - B Corkish
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - P J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - G Sicouri
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - J Hudson
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - H Christensen
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - B O'Dea
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - S H Li
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia.
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Cerri LQ, Justo MC, Clemente V, Gomes AA, Pereira AS, Marques DR. Insomnia Severity Index: A reliability generalisation meta-analysis. J Sleep Res 2023:e13835. [PMID: 36737257 DOI: 10.1111/jsr.13835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/22/2022] [Accepted: 01/08/2023] [Indexed: 02/05/2023]
Abstract
The aim of the current study was to conduct a reliability generalisation (RG) meta-analysis of Cronbach's alpha for the Insomnia Severity Index (ISI). A systematic search of three databases (PubMed, Scopus, and Web of Science) from inception to 12 March 2021 was performed. Publications that reported Cronbach's alpha for the total ISI score were included. Only psychometric-focussed studies were considered. Meta-analysis was carried out using a random-effects model to derive a pooled estimate of Cronbach's alphas. The number of participants in the included publications ranged from 25 to 12,056, with 33 studies (42 estimates) comprising internal consistency coefficients, and a combined sample size of N = 29,688. The age range of the included publications was from 13.4 to 74.3 years. Data extraction implied 33 publications out of 706 found through the database search. Cronbach's alphas ranged from 0.65 to 0.92. The majority of the reported coefficients were ≥0.7 and presented a low risk of bias (n = 32). The pooled alpha coefficient was 0.83 (IC [0.81-0.85]; SE = 0.009) with high heterogeneity among the included publications (I2 = 97%). Subgroup analyses including moderators such as continent, setting, risk of bias, and age did not affect significantly the overall result. In general, the cumulative estimate of Cronbach's alpha for the ISI is good. However, this finding should be interpreted with caution since there is a high heterogeneity level and some of the studies might not have checked the assumptions underlying Cronbach's alphas.
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Affiliation(s)
- Luíza Quinália Cerri
- Department of Education and Psychology, Campus Universitário de Santiago, University of Aveiro, Aveiro, Portugal
| | - Mariana Carvalho Justo
- Department of Education and Psychology, Campus Universitário de Santiago, University of Aveiro, Aveiro, Portugal
| | - Vanda Clemente
- Sleep Medicine Centre, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal.,CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Ana Allen Gomes
- CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Anabela Sousa Pereira
- Department of Psychology, Colégio Pedro da Fonseca, Rua da Barba Rala, University of Évora, Évora, Portugal.,Center for Research in Education and Psychology (CIEP), University of Évora, Evora, Portugal.,William James Center for Research - WJCR/UA, Aveiro, Portugal
| | - Daniel Ruivo Marques
- Department of Education and Psychology, Campus Universitário de Santiago, University of Aveiro, Aveiro, Portugal.,CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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Bernhardsson S, Boman C, Lundqvist S, Arvidsson D, Börjesson M, Larsson MEH, Lundh H, Melin K, Nilsen P, Lauruschkus K. Implementation of physical activity on prescription for children with obesity in paediatric health care (IMPA): protocol for a feasibility and evaluation study using quantitative and qualitative methods. Pilot Feasibility Stud 2022; 8:117. [PMID: 35650617 PMCID: PMC9158137 DOI: 10.1186/s40814-022-01075-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical inactivity is a main cause of childhood obesity which tracks into adulthood obesity, making it important to address early in life. Physical activity on prescription (PAP) is an evidence-based intervention that has shown good effect on physical activity levels in adults, but has not been evaluated in children with obesity. This project aims to evaluate the prerequisites, determinants, and feasibility of implementing PAP adapted to children with obesity and to explore children's, parents', and healthcare providers' experiences of PAP. METHODS In the first phase of the project, healthcare providers and managers from 26 paediatric clinics in Region Västra Götaland, Sweden, will be invited to participate in a web-based survey and a subset of this sample for a focus group study. Findings from these two data collections will form the basis for adaptation of PAP to the target group and context. In a second phase, this adapted PAP intervention will be evaluated in a clinical study in a sample of approximately 60 children with obesity (ISO-BMI > 30) between 6 and 12 years of age and one of their parents/legal guardians. Implementation process and clinical outcomes will be assessed pre- and post-intervention and at 8 and 12 months' follow-up. Implementation outcomes are the four core constructs of the Normalization Process Theory; coherence, cognitive participation, collective action, and reflexive monitoring; and appropriateness, acceptability, and feasibility of the PAP intervention. Additional implementation process outcomes are recruitment and attrition rates, intervention fidelity, dose, and adherence. Clinical outcomes are physical activity pattern, BMI, metabolic risk factors, health-related quality of life, sleep, and self-efficacy and motivation for physical activity. Lastly, we will explore the perspectives of children and parents in semi-structured interviews. Design and analysis of the included studies are guided by the Normalization Process Theory. DISCUSSION This project will provide new knowledge regarding the feasibility of PAP for children with obesity and about whether and how an evidence-based intervention can be fitted and adapted to new contexts and populations. The results may inform a larger scale trial and future implementation and may enhance the role of PAP in the management of obesity in paediatric health care in Sweden. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04847271 , registered 14 April 2021.
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Affiliation(s)
- Susanne Bernhardsson
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden. .,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Charlotte Boman
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
| | - Stefan Lundqvist
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden
| | - Daniel Arvidsson
- Department of Food and Nutrition and Sport Science, Faculty of Education, Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden
| | - Mats Börjesson
- Department of Molecular and Clinical Medicine & Center for Health and Performance, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria E H Larsson
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hannah Lundh
- Region Västra Götaland, Centre for Physical Activity, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Melin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per Nilsen
- Division of Health and Society, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Katarina Lauruschkus
- Faculty of Medicine, Institution of Health Sciences, Lund University, Lund, Sweden
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Sundell AL, Angelhoff C. Sleep and its relation to health-related quality of life in 3-10-year-old children. BMC Public Health 2021; 21:1043. [PMID: 34078330 PMCID: PMC8173783 DOI: 10.1186/s12889-021-11038-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 05/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Considering the reports of increasing sleep problems in children, affecting health and well-being in young children and their families, we found it important to gain more knowledge about sleep and its correlation to health-related quality of life (HRQoL) in young, healthy children. The aims with this study were to describe sleep quality, sleep duration, and HRQoL in healthy 3–10-year-old children and to test associations between children’s sleep and HRQoL. Methods Parents of 160 children (average age: 6.9 years, SD ±2.2) participated in the study. Sleep onset problems (SOP), sleep maintenance problems (SMP), and sleep duration were measured by the Pediatric Insomnia Severity Index (PISI). KIDSCREEN-27 was used to measure HRQoL in five dimensions: physical well-being, psychological well-being, autonomy and parent relation, social support and peers, and school environment. Results The average score was 2.2 for SOP (SD +/− 2.2) and 1.3 for SMP (SD +/− 1.6). Few children (2%) were reported to sleep less than 8 h per night. Younger children had statistically significant higher SOP and SMP than older children. Correlations were found between SOP and poor psychological well-being (p < 0.05, ρ = − 0.16), and between SMP and poor physical wellbeing (p < 0.05, ρ = − 0.16), psychological well-being (p < 0.05, ρ = − 0.21), poor school environment (p < 0.01, ρ = − 0.29), autonomy and parent relation (p < 0.05, ρ = − 0.16), and poor social support and peers (p < 0.05, ρ = − 0.19). Conclusion Children’s sleep associates with health-related quality of life and needs to be acknowledged in child health care settings and schools.
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Affiliation(s)
- Anna Lena Sundell
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre of Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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Boggero IA, Krietsch KN, Pickerill HM, Byars KC, Homan KJ, Williams SE, King CD. Improvements in Sleep Correlate With Improvements in Clinical Outcomes Among Adolescents Undergoing Intensive Interdisciplinary Pain Treatment. Clin J Pain 2021; 37:443-453. [PMID: 33782245 PMCID: PMC8102426 DOI: 10.1097/ajp.0000000000000936] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 03/09/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Intensive interdisciplinary pain treatment (IIPT) programs have been shown to restore function, improve coping, and reduce pain in adolescents with chronic pain. Yet, little is known about patients' sleep during IIPT and whether or not improvements in pain treatment outcomes are associated with changes in sleep pre-to-post IIPT treatment. The objectives of the current study were to describe sleep among adolescents entering IIPT and examine associations between sleep parameters and IIPT treatment effects. MATERIALS AND METHODS Self-reported sleep measures and clinical outcomes (eg, functional disability, coping, average pain), were collected from 44 adolescents (mean age=14.57, 68.2% female) at admission and discharge from an inpatient IIPT program. Wrist-worn actigraphy data and sleep diaries from participants' first week and last week in the program were analyzed to characterize sleep parameters. RESULTS Participants self-reported poor sleep/wake patterns, high levels of insomnia symptoms, and subclinical problems with daytime sleepiness upon admission into IIPT, although actigraphic indices of sleep from the first week of IIPT admission were only just under clinical guidelines for healthy adolescent sleep. Better self-reported sleep quality assessed via aggregated sleep diaries from the first week was associated with improvement in average pain and disability over the course of the program. Furthermore, improvements in insomnia symptoms and daytime sleepiness throughout the program were positively correlated with concurrent improvements in functional disability and coping. DISCUSSION Taken together, results suggest that sleep may be associated with IIPT treatment effects and pave the way for future research to continue examining these relationships.
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Affiliation(s)
- Ian A. Boggero
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center (CCHMC)
- Department of Oral Health Science, University of Kentucky College of Dentistry
| | - Kendra N. Krietsch
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center (CCHMC)
- Department of Psychology, St. Louis Children’s Hospital
- School of Medicine, Washington University
| | - Hannah M. Pickerill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center (CCHMC)
| | - Kelly C. Byars
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center (CCHMC)
- Department of Pediatrics, University of Cincinnati College of Medicine
- Division of Pulmonary Medicine, CCHMC
| | - Kendra J. Homan
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center (CCHMC)
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Sara E. Williams
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center (CCHMC)
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Christopher D. King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center (CCHMC)
- Department of Pediatrics, University of Cincinnati College of Medicine
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Angelhoff C, Johansson P, Svensson E, Sundell AL. Swedish translation and validation of the Pediatric Insomnia Severity Index. BMC Pediatr 2020; 20:253. [PMID: 32456677 PMCID: PMC7249377 DOI: 10.1186/s12887-020-02150-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/18/2020] [Indexed: 11/11/2022] Open
Abstract
Background To increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aims of the study were to (1) present a Swedish translation of the PISI, (2) examine the factor structure of the Swedish version of PISI, and test the reliability and validity of the PISI factor structure in a sample of healthy children in Sweden. Methods The English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed. Results In total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors were related to all KIDSCREEN-27 dimensions. Conclusions The Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep.
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Affiliation(s)
- Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital, and Department of Biomedical and Clinical Sciences, Linköping University, SE-58185, Linköping, Sweden. .,Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
| | - Peter Johansson
- Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Erland Svensson
- (Retired) Swedish Defense Research Agency, Linköping, Sweden
| | - Anna Lena Sundell
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre of Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden
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Abstract
Since a thorough review in 2011 by Spruyt, into the integral pitfalls of pediatric questionnaires in sleep, sleep researchers worldwide have further evaluated many existing tools. This systematic review aims to comprehensively evaluate and summarize the tools currently in circulation and provide recommendations for potential evolving avenues of pediatric sleep interest. 144 "tool"-studies (70 tools) have been published aiming at investigating sleep in primarily 6-18 years old per parental report. Although 27 new tools were discovered, most of the studies translated or evaluated the psychometric properties of existing tools. Some form of normative values has been established in 18 studies. More than half of the tools queried general sleep problems. Extra efforts in tool development are still needed for tools that assess children outside the 6-to-12-year-old age range, as well as for tools examining sleep-related aspects beyond sleep problems/disorders. Especially assessing the validity of tools has been pursued vis-à-vis fulfillment of psychometric criteria. While the Spruyt et al. review provided a rigorous step-by-step guide into the development and validation of such tools, a pattern of steps continue to be overlooked. As these instruments are potentially valuable in assisting in the development of a clinical diagnosis into pediatric sleep pathologies, it is required that while they are primary subjective measures, they behave as objective measures. More tools for specific populations (e.g., in terms of ages, developmental disabilities, and sleep pathologies) are still needed.
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Affiliation(s)
- Tabitha Sen
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Karen Spruyt
- Lyon Neuroscience Research Center, INSERM U1028-CNRS UMR 5292, University Claude Bernard, School of Medicine, Lyon, France
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Van Dyk TR, Becker SP, Byars KC. Rates of Mental Health Symptoms and Associations With Self-Reported Sleep Quality and Sleep Hygiene in Adolescents Presenting for Insomnia Treatment. J Clin Sleep Med 2019; 15:1433-1442. [PMID: 31596208 PMCID: PMC6778362 DOI: 10.5664/jcsm.7970] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Despite high prevalence rates of both psychopathology and sleep problems during adolescence, as well as frequent co-occurrence, little is known about the mental health of adolescents presenting for insomnia evaluation and treatment. This study describes (1) rates of mental health symptoms and (2) associations of mental health symptoms with sleep behaviors and schedules in adolescents presenting to a behavioral sleep medicine clinic within an accredited sleep disorders center. METHODS As a part of routine clinical care, 376 adolescents (ages 11 to 18 years) presenting for insomnia evaluation completed measures of insomnia and sleep behavior. Their caregiver reported on mental health diagnoses and symptoms. RESULTS Adolescents had high rates of mental health diagnoses (75%) and clinically elevated symptoms (64%). Affective, anxiety, and attention deficit-hyperactivity disorder (ADHD) symptoms were most commonly reported. Mental health symptoms were related to sleep behaviors and insomnia severity, with ADHD symptoms and affective problems most consistently associated with disrupted sleep. CONCLUSIONS Health providers should assess for mental health problems in youth presenting with sleep-related concerns. Intervening with both sleep and mental health problems should be considered to most effectively improve functioning.
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Affiliation(s)
- Tori R. Van Dyk
- Department of Psychology, Loma Linda University, Loma Linda, California
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kelly C. Byars
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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10
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Van Dyk TR, Becker SP, Byars KC. Mental Health Diagnoses and Symptoms in Preschool and School Age Youth Presenting to Insomnia Evaluation: Prevalence and Associations with Sleep Disruption. Behav Sleep Med 2019; 17:790-803. [PMID: 30260686 PMCID: PMC6526081 DOI: 10.1080/15402002.2018.1518224] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective/Background: Sleep problems and emotional and behavioral difficulties are highly correlated in community samples of youth and in youth presenting to mental health treatment. However, fewer studies have characterized the associations between sleep and psychopathology symptoms in youth presenting to pediatric sleep clinics. This retrospective, cross-sectional study examined the prevalence of psychopathology symptoms and their associations with sleep disruption in youth presenting to a behavioral sleep medicine clinic. Participants: Participants were 373 preschoolers (1.5 to 5 years old) and 300 school age youth (6 to 10 years old) presenting to a pediatric behavioral sleep medicine clinic with a primary insomnia diagnosis. Methods: As a part of routine clinical care, parents completed a battery of pre-evaluation measures assessing insomnia severity, sleep disturbance, history of mental health diagnosis, and psychopathology symptoms. Results: Both preschool and school age youth had high rates of parent-reported mental health diagnoses (35% and 74%, respectively) and clinically elevated psychopathology symptoms (69% of preschoolers and 77% of school age youth) at initial insomnia evaluation. These symptoms were significantly associated with sleep disruption, with ADHD and affective problems most consistently associated with sleep problems in preschoolers and symptoms of anxiety, affective, and behavioral problems most consistently associated with sleep problems in school age youth. Conclusions: Psychopathology symptoms should be regularly assessed in youth presenting to behavioral sleep medicine clinics. Further, the role of psychopathology should be considered in insomnia conceptualization and treatment and, when appropriate, psychopathology symptoms should be targeted in treatment or appropriate referrals should be made.
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Affiliation(s)
- Tori R. Van Dyk
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Kelly C. Byars
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center,Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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