The influence of infant sleep problems and sleep training on maternal subjective well-being

Background

Disturbed sleep during infancy and early childhood can have a detrimental effect on parental sleep and consequently parental well-being. However, there is a paucity of research on how perceived child sleep problems and behavioural sleep interventions as treatment influence maternal subjective well-being.

Aim

This study aimed to explore the incidence of subjective well-being in mothers of children with sleep problems and whether implementing two behavioural sleep interventions changed their well-being.

Setting

The research was conducted in a community setting, with parents voluntarily approaching a sleep consultancy based in South Africa.

Method

Using data from 119 mothers voluntarily approaching a sleep consultancy in South Africa, a pre-test-post-test design was employed to investigate changes in life satisfaction, affect, couple satisfaction, perceived stress and depression approximately 3 weeks after implementation of a sleep intervention.

Results

Results indicate that mothers of children with sleep problems experienced moderate to high life satisfaction and positive affect although the presence of moderate negative affect, couple satisfaction and stress and mild depression suggest possible decreased subjective well-being.

Conclusion

Findings suggest implementation of graduated extinction and extinction with parental presence sleep interventions may improve life satisfaction, affect, stress and depression but not couple satisfaction in the short-term.

Contribution

This study contributes towards understanding the effect of sleep loss on the subjective well-being of mothers and provides preliminary evidence regarding the benefits of two sleep interventions for improving maternal subjective well-being.

Parental experiences of subjective well-being in the context of infant sleep problems

OBJECTIVE

This study explored parental experiences of subjective well-being in the context of infant sleep problems.

BACKGROUND

Although quantitative research has highlighted the deleterious impact of infant sleep problems for parental well-being broadly, little is known about subjective experiences of well-being specifically.

METHOD

This retrospective qualitative study formed part of a larger multiphase project. Ten parents who approached a sleep consultancy for assistance with infant sleep problems participated in the study. Data was collected through in-depth interviews and results were analysed thematically.

RESULTS

Two key themes were identified: (1) the negative influences of insufficient sleep on parental subjective well-being, and (2) the indirect influence of infant sleep problems on parental subjective well-being. Participants highlighted the direct influence of insufficient sleep on their life satisfaction, affect and mood. Further, through its impact on infant well-being and behaviour, and the loss of free time, infant sleep problems indirectly negatively influenced parental subjective well-being. As a result, life satisfaction and affect was deleteriously influenced.

CONCLUSION

Parental subjective well-being may be deleteriously influenced by infant sleep problems, both directly through insufficient sleep and indirectly through the impact of infant sleep problems.

Neurocognitive Effects of Sleep Disruption in Children and Adolescents

A main childhood task is learning. In this task, the role of sleep is increasingly demonstrated. Although most literature examining this role focuses on preadolescence and middle adolescence, some studies apply napping designs in preschoolers. Studies overall conclude that without proper sleep a child's cognitive abilities suffer, but questions on how and to what extent linger. Observational studies show the hazards of potential confounders such as an individual's resilience to poor sleep as well as developmental risk factors (eg, disorders, stressors). A better understanding of cognitive sleep neuroscience may have a big impact on pediatric sleep research and clinical applications.

The effectiveness of weighted blankets on sleep and everyday activities - A retrospective follow-up study of children and adults with attention deficit hyperactivity disorder and/or autism spectrum disorder

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) and Autism Spectrum Disorder (ASD) are often accompanied by sleep problems influencing social, emotional and cognitive functioning in everyday activities.

AIM

The aim of this study was to investigate whether the use of a weighted blanket has a positive impact on sleep and everyday activities in individuals with ADHD and/or ASD.

MATERIAL AND METHODS

The study included 85 individuals diagnosed with ADHD and/or ASD, 48 children aged ≤17 (57%) and 37 adults ≥18 years (44%), who were prescribed with a weighted blanket. The participants responded via a telephone interview.

RESULTS

Findings demonstrated that a weighted blanket improved abilities related to falling asleep, sleeping the whole night, and relaxing during the day. Using a weighted blanket improved morning/evening daily routine, including preparing/going to sleep and waking up in the morning.

CONCLUSIONS

Weighted blankets showed positive impact on falling asleep, sleeping the whole night, and relaxing during the day, and they were used frequently by children and adults with ADHD and/or ASD. Findings indicate that a weighted blanket improved morning/evening routine, however this research area needs further investigation using both subjective and objective parameters.

Sleep Architecture and EEG Power Spectrum Following Cumulative Sleep Restriction: A Comparison between Typically Developing Children and Children with ADHD

No studies have looked at the effects of cumulative sleep restriction (CSR) on sleep architecture or the power spectrum of sleep EEG (electroencephalogram) in school-age children, as recorded by PSG (polysomnography). This is true for both typically developing (TD) children and children with ADHD (attention deficit/hyperactivity disorder), who are known to have more sleep difficulties. Participants were children (ages 6-12 years), including 18 TD and 18 ADHD, who were age- and sex-matched. The CSR protocol included a two-week baseline and two randomized conditions: Typical (six nights of sleep based on baseline sleep schedules) and Restricted (one-hour reduction of baseline time in bed). This resulted in an average of 28 min per night difference in sleep. Based on ANOVAs (analysis of variance), children with ADHD took longer to reach N3 (non-rapid eye movement), had more WASO (wake after sleep onset) (within the first 5.1 h of the night), and had more REM (rapid eye movement) sleep than TD children regardless of condition. During CSR, ADHD participants had less REM and a trend toward longer durations of N1 and N2 compared to the TD group. No significant differences in the power spectrum were found between groups or conditions. In conclusion, this CSR protocol impacted some physiological aspects of sleep but may not be sufficient to cause changes in the power spectrum of sleep EEG. Although preliminary, group-by-condition interactions suggest that the homeostatic processes in children with ADHD may be impaired during CSR.

Annual Research Review: Perspectives on progress in ADHD science - from characterization to cause

The science of attention-deficit/hyperactivity disorder (ADHD) is motivated by a translational goal - the discovery and exploitation of knowledge about the nature of ADHD to the benefit of those individuals whose lives it affects. Over the past fifty years, scientific research has made enormous strides in characterizing the ADHD condition and in understanding its correlates and causes. However, the translation of these scientific insights into clinical benefits has been limited. In this review, we provide a selective and focused survey of the scientific field of ADHD, providing our personal perspectives on what constitutes the scientific consensus, important new leads to be highlighted, and the key outstanding questions to be addressed going forward. We cover two broad domains - clinical characterization and, risk factors, causal processes and neuro-biological pathways. Part one focuses on the developmental course of ADHD, co-occurring characteristics and conditions, and the functional impact of living with ADHD - including impairment, quality of life, and stigma. In part two, we explore genetic and environmental influences and putative mediating brain processes. In the final section, we reflect on the future of the ADHD construct in the light of cross-cutting scientific themes and recent conceptual reformulations that cast ADHD traits as part of a broader spectrum of neurodivergence.

"Sleep is healthy for your body and brain." Use of student-centered photovoice to explore the translation of sleep promotion at school to sleep behavior at home

STUDY OBJECTIVES

Schools are an important setting to teach and reinforce positive health behaviors such as sleep, however, research that incorporates the student perspective of school-based sleep promotion initiatives is limited. This study explored student's perceptions of sleep behavior (how they understood and valued positive and negative sleep behaviors) and determined if and how students translate school-based sleep promotion to the home.

METHODS

Forty-five grade 4 and 5 children (aged 9-11 years) were purposefully sampled from 3 schools participating in the Alberta Project Promoting healthy Living for Everyone in schools (APPLE) in Edmonton, Canada. Using focused ethnography as the method and photovoice as a data generating strategy, qualitative in-depth information was generated through photo-taking and one-on-one interviews. Data were analyzed in an iterative, cyclical process using latent content analysis techniques.

RESULTS

Four themes related to students' perception of sleep behavior within the context of a school-based sleep promotion initiative were identified: sleep is "healthy for your body and brain," sleep habits are rooted in the home environment, school experiences shape positive sleep habits at home, and students translate sleep promotion home if they think it is useful or would be acceptable to the family.

CONCLUSION AND IMPLICATIONS

School-based sleep promotion interventions that are grounded in the comprehensive school health (CSH) approach hold promise for successfully shaping student sleep behavior. To promote health and academic success in children, future interventions should include home-school partnerships that address child sleep across multiple critical learning environments.

Neurocognitive Effects of Sleep Disruption in Children and Adolescents

A main childhood task is learning. In this task, the role of sleep is increasingly demonstrated. Although most literature examining this role focuses on preadolescence and middle adolescence, some studies apply napping designs in preschoolers. Studies overall conclude that without proper sleep a child's cognitive abilities suffer, but questions on how and to what extent linger. Observational studies show the hazards of potential confounders such as an individual's resilience to poor sleep as well as developmental risk factors (eg, disorders, stressors). A better understanding of cognitive sleep neuroscience may have a big impact on pediatric sleep research and clinical applications.

The Effects of Extended-Release Stimulant Medication on Sleep in Children with ADHD

OBJECTIVE

Although stimulant medications, such as methylphenidate hydrochloride (MPH), are effective at reducing the core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), they may also disrupt children's sleep. This study aimed to investigate the acute impact of extended-release MPH on sleep using both actigraphy and polysomnography (PSG).

METHOD

Participants were 26 medication-naïve newly and rigorously diagnosed children with ADHD (23 males; 3 females) with a mean age of 8 years, 8 months (SD = 24.5mos) who were enrolled in a clinically-administered crossover medication trial with 2 conditions: 2 weeks of placebo and 2 weeks of MPH treatment. The effect of condition on sleep variables as measured by actigraphy (primary outcome) and PSG (secondary outcome) was analyzed using repeated measures MANOVAs.

RESULTS

Based on actigraphy data, total sleep time was significantly reduced by 30 minutes and sleep onset latency was significantly increased by 30 minutes in the MPH condition compared to the placebo condition (p<0.001). No differences were found in sleep efficiency. No statistically significant differences were found for the same variables assessed by PSG; however, the means were in the same direction as the actigraphy data. There was a significant increase in the relative percentage of stage N3 sleep by 3.2% during MPH treatment (p<0.05).

CONCLUSIONS

Increased sleep onset latency resulting in reduced total sleep time, which has been linked to poorer daytime functioning, is a potential adverse effect of stimulant medication which may require management to optimize outcome.

Sleep Problems in School Aged Children: A Common Process across Internalising and Externalising Behaviours?

Sleep problems are common in childhood and impact cognitive, psychological and physical wellbeing. The current study investigated the association between sleep problems and internalising and externalising behaviour in 114 school-aged children (5–12 years) from four primary schools in Melbourne, Australia. Data were collected using the Sleep Disorder Inventory for Students to measure sleep and the Conners Behavior Rating Scale to assess behaviour, both by parent report. Hierarchical regression analysis, controlling for socioeconomic status and age, identified moderate associations between sleep problems and emotional distress, aggressive behaviour and hyperactivity/impulsivity. Findings suggest screening for sleep problems in children presenting clinically with behavioural issues is a potentially important clinical practice. Additionally, results support the elaboration of transdiagnostic theory, whereby sleep problems are a common process in both internalising and externalising behaviour in children.