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Li X, Lau FLF, Chiu WV, Wong CKD, Li AM, Wing YK, Lai YCK, Shea KSC, Li SX. An Open-Label Pilot Trial of a Brief, Parent-Based Sleep Intervention in Children With ADHD. J Atten Disord 2024; 28:1173-1185. [PMID: 38439703 DOI: 10.1177/10870547241233731] [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] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To assess the effects of a brief parent-based behavioral sleep intervention in children with ADHD. METHODS Families with a child with ADHD and parent-reported sleep problems received a brief parent-based sleep intervention, which involved two one-to-one consultation sessions and one telephone follow-up with the parent/caregiver. Child's sleep and clinical symptoms, and parental sleep and daytime functioning were assessed at baseline, 2-week post-intervention, and 3-month follow-up. RESULTS Sixty eligible families (mean age of the child: 9.4 ± 1.5 years; boys: 75%) were recruited, and 43 (72%) completed the whole intervention. The intervention resulted in significant improvements in the child's sleep, clinical symptoms, and parental sleep and parenting stress, and these improvements were generally maintained at 3-month follow-up. CONCLUSION The findings supported the promising effects of a brief parent-based sleep intervention on improving sleep and clinical symptoms in children with ADHD and parental sleep and parenting stress. Further randomized clinical trials with long-term follow-up are needed to test the robustness of the effectiveness of the intervention.
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Affiliation(s)
- Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR
| | - Fanny Lok Fan Lau
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR
| | - Waiyan Vivian Chiu
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR
| | - Ching Kwong Dino Wong
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yee Ching Kelly Lai
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR
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Ljubičić M, Šare S, Kolčić I. Sleep Quality and Evening Salivary Cortisol Levels in Association with the Psychological Resources of Parents of Children with Developmental Disorders and Type 1 Diabetes. J Autism Dev Disord 2024:10.1007/s10803-024-06269-7. [PMID: 38300504 DOI: 10.1007/s10803-024-06269-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Sleep deprivation can decrease parental well-being and degrade mental and physical health in parents of children with chronic illness. The aim of this study was to explore the associations of sleep quality, psychological stress perception, and evening salivary cortisol concentration with self-esteem, optimism and happiness in parents of children with type 1 diabetes and developmental disorders compared to parents of healthy, typically developing children. METHODS We studied 196 parents of children with chronic conditions, including autistic spectrum disorder (N = 33), cerebral palsy (N = 18), Down syndrome (N = 33), and diabetes mellitus type 1 (N = 40) and parents of healthy children (N = 72). We evaluated parental sleep quality, evening salivary cortisol levels, self-esteem, optimism and happiness. Multiple linear regression models were used to assess associations between variables. RESULTS Compared with those of the control group, the parents of children with autistic spectrum disorders had higher evening cortisol concentrations (β = 0.17; p = 0.038) and lower perceptions of happiness (β=-0.17; p = 0.017), while parents of children with type 1 diabetes had disrupted sleep quality (β = 0.25; p = 0.003). Optimism was negatively associated with the evening cortisol concentration (β=-0.18; p = 0.023) and sleep quality index (β=-0.20; p = 0.012). CONCLUSIONS Public health programs aimed at lifestyle habit improvement, respite care, and relaxation for parents of children with chronic conditions would be useful for improving parental sleep quality, self-esteem, optimism and happiness.
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Affiliation(s)
- Marija Ljubičić
- Department of Health Studies, University of Zadar, Splitska 1, Zadar, 23000, Croatia.
| | - Sonja Šare
- Department of Health Studies, University of Zadar, Splitska 1, Zadar, 23000, Croatia
- Medical School Ante Kuzmanića Zadar, Franje Tuđmana 24G, Zadar, 23000, Croatia
| | - Ivana Kolčić
- Department of Public Health, School of Medicine, University of Split, Šoltanska 2, Split, 21000, Croatia
- Algebra LAB, Algebra University College, Gradišćanska ul. 24, Zagreb, 10000, Croatia
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3
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Lee J, Schwichtenberg A, Bliwise D, Ali SZ, Hayat MJ, Clark PC, Spratling R. Simultaneous Recording of Objective Sleep in Mothers and School-aged Children with Developmental Disabilities: A Pilot Study of Actigraphy and Videosomnography. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2023:1-23. [PMID: 37361457 PMCID: PMC10088614 DOI: 10.1007/s10882-023-09896-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 06/26/2023]
Abstract
Mothers of school-aged children ages 3 to 17 years with developmental disabilities (DDs) commonly report sleep problems in their children associated with impaired maternal sleep. However, existing research relies heavily on mothers' self-reported sleep. This study aimed to determine the feasibility of objectively measuring child and mother sleep-wake patterns using actigraphy and videosomnography. This was an observational pilot study. Mothers wore actigraphy watches and video-recorded their child's sleep for 7 nights. Mothers also completed a 7-day sleep diary and questionnaires on sleep quality, depressive symptoms, stress, and child sleep problems. Ten mothers (32-49 years) and ten children with DDs (8-12 years) completed this study. Half of the children were boys with autism spectrum disorders. We successfully recruited 77% of eligible mothers for the study during the pandemic. Eight mothers successfully wore the actigraphy, and nine successfully video-recorded their child's sleep. Mothers rated their participation positively and considered the data collection protocol acceptable. While mothers' sleep patterns from actigraphy were mostly within recommendations, self-reported sleep quality was poor. Child's sleep estimates from videosomnography showed children slept substantially less than recommended sleep hours. Mothers also reported a high frequency of child sleep problems. Consistent with this pattern, mothers also endorsed elevated stress and depression. The use of actigraphy and videosomnography is feasible. Objective sleep measurement for mothers' and children's sleep is needed with self-report to measure multidimensional aspects of sleep and discrepancies between objective and self-report sleep measures. Future studies can use multi-methods sleep measures and work toward interventions that can improve family sleep and reduce mothers' stress and depression.
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Affiliation(s)
- Jiwon Lee
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Stress Urban Life Building Room 911, Atlanta, GA 30303 USA
| | - A.J. Schwichtenberg
- Department of Human Development & Family Studies, College of Health and Human Sciences, Purdue University, West Lafayette, IN USA
| | - Donald Bliwise
- Sleep Center, School of Medicine, Emory University, Atlanta, GA USA
| | - Syeda Zahra Ali
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Matthew J. Hayat
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA USA
| | - Patricia C. Clark
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Stress Urban Life Building Room 911, Atlanta, GA 30303 USA
| | - Regena Spratling
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur Stress Urban Life Building Room 911, Atlanta, GA 30303 USA
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Ergenekon AP, Gümüş Z, Yegit CY, Cenk M, Gulieva A, Kalyoncu M, Selcuk M, Karabulut S, Ozturk G, Eralp EE, Unver O, Karadag B, Gokdemir Y. Depression, anxiety, and sleep quality of caregivers of children with spinal muscular atrophy. Pediatr Pulmonol 2023; 58:1697-1702. [PMID: 36856268 DOI: 10.1002/ppul.26379] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the prevalence of anxiety, depression, sleep, and associated factors in caregivers of children with spinal muscular atrophy (SMA). MATERIALS AND METHODS Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory-State (STAI-S), the State-Trait Anxiety Inventory-Trait (STAI-T), and Pittsburgh Sleep Quality Index (PSQI) were used to assess the anxiety, depression, and sleep quality of the caregivers of children with SMA. Higher scores indicated worse outcome for all three questionnaires. RESULTS Fifty-six caregivers of children with SMA were included in the study. Median age of children was 6 (3.2-10) years and mean age of the caregivers was 37.0 ± 6.5 years. Median scores of the BDI, STAI-S, STAI-T, and PSQI were 12 (7.2-17), 35.5 (31-44), 40.5 (35-48), and 7.0 (5.0-10.0), respectively. There was a positive correlation between BDI and PSQI scores (p < 0.05). There was a negative correlation between the age of the caregivers and PSQI, BDI, STAI-T scores (p = 0.01, r = -0.341; p = 0.006, r = -0.364; p = 0.003, r = -0.395, respectively). There was a negative correlation between the age of the patients and the PSQI scores of the caregivers (p = 0.01, r = -0.33). There was a negative correlation between BDI scores and household income (p = 0.01, r = -0.34). CONCLUSION Caregivers of children with SMA had elevated depression and anxiety levels and they also had decreased sleep quality. Economic and social support resources are needed to help caregivers of those children.
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Affiliation(s)
- Almala Pinar Ergenekon
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Zeynep Gümüş
- Marmara University School of Medicine, Istanbul, Turkey
| | - Cansu Yilmaz Yegit
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Muruvvet Cenk
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Aynur Gulieva
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Mine Kalyoncu
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Merve Selcuk
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Seyda Karabulut
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Gulten Ozturk
- Division of Pediatric Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Olcay Unver
- Division of Pediatric Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
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Yamaoka Y, Doi S, Isumi A, Fujiwara T. Health and social relationships of mothers of children in special education schools. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104374. [PMID: 36395685 DOI: 10.1016/j.ridd.2022.104374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 10/28/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS The number of children in special education schools has increased in Japan. This study aimed to examine the association between special education school enrollment and the health and social relationships of mothers with children in these schools using population-based samples in Japan. METHODS AND PROCEDURES This study used data from the Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016. First, fifth, eighth, and eleventh-grade children in all schools in Kochi prefecture were included (n = 12,623). Associations between school type (regular or special education school) and maternal physical and mental health and social relationships were investigated by multivariate regression models. OUTCOMES AND RESULTS There were 134 children in special education schools (1.1 %) and 12,489 children in regular schools. Mothers of children in special education schools were more likely to have higher body mass index (BMI), poorer mental health and lower neighborhood relations score. Mothers of children in regular schools had higher BMI when their children had higher behavioral problems. CONCLUSION AND IMPLICATIONS Mothers of children in special education schools are at risk of obesity, poor mental health, and having fewer social networks. Services and support should be expanded for caregivers based on their child's behavioral problems and school system.
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Affiliation(s)
- Yui Yamaoka
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
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Micsinszki SK, Ballantyne M, Cleverley K, Green P, Brennenstuhl S, Stremler R. Examining factors associated with sleep quality in parents of children 4-10 years with autism spectrum disorder. Disabil Rehabil 2022:1-13. [PMID: 35979804 DOI: 10.1080/09638288.2022.2103594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Parents of children with autism spectrum disorder often report poorer sleep compared to parents of typically developing children. When parents do not obtain enough quality sleep, functioning may be compromised placing the onus of care on already stressed parents. However, improving sleep duration may not improve sleep quality and is not always feasible. This study aimed to measure sleep quality in parents of children with autism spectrum disorder, determine if stress and children's sleep are associated with sleep quality and whether resources, appraisals, and coping moderate these relationships. MATERIALS AND METHODS Multivariable regression was used to determine the effects of stress and children's sleep problems on sleep quality and test modifying effects. RESULTS Mean (SD) Pittsburgh Sleep Quality Index scores was 8.81 (3.76), with 77.6% of parents scoring above the clinical cut-off. Mean (SD) Children's Sleep Habits Questionnaire scores was 54.03 (8.32), with 96.3% of parents rating their child's sleep above the clinical cut-off. Children's sleep was the only significant predictor and none of the expected effect modifiers were significant. CONCLUSION Children's sleep may be an important target to improve parent sleep quality but requires systematic assessment with interventional research. Implications for rehabilitationBoth parents and their 4-10-year-old children with ASD experience high levels of sleep disturbances.Clinicians can start the conversation early with parents about their children's sleep by providing them with information to increase awareness and recognize healthy sleep habits in their children.Clinicians are important in the assessment, management, and evaluation of pediatric sleep problems, which may have significant spillover effects on parents of children with ASD.There is a need for more resources and training to be available to clinicians to assess children and their parents for sleep problems, which could extend beyond the assessment of sleep and consider parent's daytime functioning and mental health.
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Affiliation(s)
| | - Marilyn Ballantyne
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Kristin Cleverley
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
| | - Pamela Green
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,The Hospital for Sick Children (SickKids), Toronto, Canada
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Ortiz-Rubio A, Torres-Sánchez I, Cabrera-Martos I, Rodríguez-Torres J, López-López L, Prados-Román E, Valenza MC. The Caregiver Burden Inventory as a Sleep Disturbance Screening Tool for Parents of Children with Autism Spectrum Disorder. J Pediatr Nurs 2021; 61:166-172. [PMID: 34090081 DOI: 10.1016/j.pedn.2021.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/10/2021] [Accepted: 05/26/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE The study was conducted to explore the degree to which caregiver burden is associated with sleep quality in parents of children with autism spectrum disorder, and to determine a statistically valid cutoff score for the Caregiver Burden Inventory (CBI) in order to identify parents of risk of poor sleep quality. DESIGN AND METHODS We conducted a cross-sectional analysis. We assessed caregiver burden with the CBI, sleep quality with the Pittsburgh Sleep Quality Index, emotional status with the Hospital Anxiety and Depression Scale, and impact on family with the Impact on Family Scale. Caregiver burden was evaluated with a logistic regression analysis. The best fit model was used in a receiver operating characteristic analysis. Likelihood ratios and post-test probabilities were calculated. RESULTS A total of 116 parents were included in this study. Higher caregiver burden was associated with a reduction in sleep quality in the logistic regression analysis (p < 0.001). The area under the curve for the univariate burden test model (best fit) was 76.70 (p < 0.001). The cutoff score for poor sleep quality was caregiver burden ≥26.50. The post-test probability of poor sleep quality increased to 82.02% from a pre-test probability of 76.72%. CONCLUSIONS Our findings suggest that caregiver burden is associated with sleep quality among parents of children with autism spectrum disorder. The findings suggest that a CBI cutoff score of 26.50 may help to detect risk of poor sleep quality in parents of children with autism spectrum disorder.
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Affiliation(s)
- Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Irene Torres-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | | | - Laura López-López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Esther Prados-Román
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
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8
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Hulst RY, Gorter JW, Voorman JM, Kolk E, Van Der Vossen S, Visser‐Meily JMA, Ketelaar M, Pillen S, Verschuren O. Sleep problems in children with cerebral palsy and their parents. Dev Med Child Neurol 2021; 63:1344-1350. [PMID: 33990937 PMCID: PMC8597175 DOI: 10.1111/dmcn.14920] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
AIM To describe: (1) the frequency and types of sleep problems, (2) parent-rated satisfaction with their child's and their own sleep, and (3) child factors related to the occurrence of sleep problems in children with cerebral palsy (CP) and their parents. The secondary objective was to compare the sleep outcomes of children with CP with those from typically developing children and their parents. METHOD The Sleep section of the 24-hour activity checklist was used to assess the sleep of children with CP and their parents and the sleep of typically developing children and their parents. RESULTS The sleep outcomes of 90 children with CP (median age 5y, range 0-11y, 53 males, 37 females, 84.4% ambulatory) and 157 typically developing peers (median age 5y, range 0-12y; 79 males, 78 females) and their parents were collected. Children with CP were more likely to have a sleep problem than typically developing children. Non-ambulatory children with CP were more severely affected by sleep problems than ambulatory children. The parents of non-ambulatory children were less satisfied about their child's and their own sleep. Waking up during the night, pain/discomfort in bed, and daytime fatigue were more common in children with CP and more prevalent in children who were non-ambulatory. INTERPRETATION These findings highlight the need to integrate sleep assessment into routine paediatric health care practice. What this paper adds Children with cerebral palsy (CP) are more likely to have a sleep problem than typically developing peers. Non-ambulatory children with CP are more severely affected by sleep problems. One-third of parents of children with CP report feeling sleep-deprived often or always compared to a quarter of parents of typically developing children.
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Affiliation(s)
- Raquel Y Hulst
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrecht University and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Jan Willem Gorter
- Department of PediatricsCanChild Centre for Childhood Disability ResearchMcMaster UniversityHamiltonONCanada
| | - Jeanine M Voorman
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrecht University and De Hoogstraat RehabilitationUtrechtthe Netherlands,Department of Rehabilitation, Physical Therapy Science & SportsUMC Utrecht Brain CenterUniversity Medical CenterUtrechtthe Netherlands
| | - Eveline Kolk
- Department of Child and YouthDe Hoogstraat RehabilitationUtrechtthe Netherlands
| | | | - Johanna M A Visser‐Meily
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrecht University and De Hoogstraat RehabilitationUtrechtthe Netherlands,Department of Rehabilitation, Physical Therapy Science & SportsUMC Utrecht Brain CenterUniversity Medical CenterUtrechtthe Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrecht University and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Sigrid Pillen
- Sleep Medicine CenterKempenhaegheHeezethe Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation MedicineUMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrecht University and De Hoogstraat RehabilitationUtrechtthe Netherlands
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9
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Lang CP, Boucaut A, Guppy M, Johnston LM. Children with cerebral palsy: A cross-sectional study of their sleep and their caregiver's sleep quality, psychological health and well-being. Child Care Health Dev 2021; 47:859-868. [PMID: 34265112 DOI: 10.1111/cch.12897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/07/2021] [Accepted: 07/02/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Children with cerebral palsy (CP) are more likely to experience sleep problems. Their sleep difficulties have been shown to be related to poorer sleep quality for their parents and caregivers. While poor sleep has been linked with poorer psychological health in other populations, few studies have focused on the potential effects of children's and caregivers' sleep disturbance on caregivers' psychological health and well-being in families of children with CP. This study investigated the association between caregivers' psychological health and well-being and their sleep quality and the sleep of their children with CP. METHOD Ninety-four caregivers (86% mothers; age range = 29-76 years) of children with CP aged 4 to 14 years of varying physical abilities (Gross Motor Function Classification Scale expanded and revised-level I (24), II (20), III (16), IV (10), V (24)) were recruited from a state-wide rehabilitation service. Caregivers completed the Depression, Anxiety and Stress Scale-21, Warwick-Edinburgh Mental Wellbeing Scale, Resilience Scale, Pediatric Sleep Questionnaire, Pittsburgh Sleep Quality Index, and a demographic questionnaire. RESULTS Sleep problems were reported for 55% of children. Poor sleep quality was reported by 71% of caregivers. While 25% of caregivers reported positive well-being and 86% reported high to very high levels of resilience, 44% reported poor psychological health. Child sleep problems were related to poorer caregiver sleep quality (r = 0.47, p < 0.001). Poorer caregiver sleep quality was related to poorer caregiver psychological health (r = 0.43-0.51, all p < 0.001) and well-being (r = -0.48, p < 0.001), but not resilience (r = 0.18, p = 0.11). CONCLUSIONS High numbers of children with CP and their caregivers experience poor sleep that extends far past infancy. Poor sleep quality is associated with poorer psychological health and well-being for caregivers. Further development of responsive support services that address caregivers' sleep is essential.
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Affiliation(s)
- Cathryne P Lang
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia.,School of Psychology, Australian Catholic University, Brisbane, Queensland, Australia
| | - Amanda Boucaut
- School of Psychology, Australian Catholic University, Brisbane, Queensland, Australia.,A T Psychology, Caboolture, Queensland, Australia
| | - Max Guppy
- Cerebral Palsy League, Geebung, Queensland, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
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10
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Yamashita M. Potential Role of Neuroactive Tryptophan Metabolites in Central Fatigue: Establishment of the Fatigue Circuit. Int J Tryptophan Res 2020; 13:1178646920936279. [PMID: 32647476 PMCID: PMC7325545 DOI: 10.1177/1178646920936279] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/27/2020] [Indexed: 12/23/2022] Open
Abstract
Central fatigue leads to reduced ability to perform mental tasks, disrupted social life, and impaired brain functions from childhood to old age. Regarding the neurochemical mechanism, neuroactive tryptophan metabolites are thought to play key roles in central fatigue. Previous studies have supported the “tryptophan-serotonin enhancement hypothesis” in which tryptophan uptake into extensive brain regions enhances serotonin production in the rat model of exercise-induced fatigue. However, serotonin was transiently released after 30 minutes of treadmill running to exhaustion, but this did not reflect the duration of fatigue. In addition, as the vast majority of tryptophan is metabolized along the kynurenine pathway, possible involvement of the tryptophan-kynurenine pathway in the mechanism of central fatigue induction has been pointed out. More recently, our study demonstrated that uptake of tryptophan and kynurenine derived from the peripheral circulation into the brain enhances kynurenic acid production in rat brain in sleep deprivation–induced central fatigue, but without change in serotonin activity. In particular, dynamic change in glial-neuronal interactive processes within the hypothalamus-hippocampal circuit causes central fatigue. Furthermore, increased tryptophan-kynurenine pathway activity in this circuit causes reduced memory function. This indicates a major potential role for the endogenous tryptophan-kynurenine pathway in central fatigue, which supports the “tryptophan-kynurenine enhancement hypothesis.” Here, we review research on the basic neuronal mechanism underlying central fatigue induced by neuroactive tryptophan metabolites. Notably, these basic findings could contribute to our understanding of latent mental problems associated with central fatigue.
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Affiliation(s)
- Masatoshi Yamashita
- Graduate School of Advanced Integrated Studies in Human Survivability, Kyoto University, Kyoto, Japan
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11
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Feeley CA, Clougherty M, Siminerio L, Charron-Prochownik D, Allende AL, Chasens ER. Sleep in Caregivers of Children With Type 1 Diabetes. DIABETES EDUCATOR 2018; 45:80-86. [PMID: 30465480 DOI: 10.1177/0145721718812484] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose The purpose of this study was to explore caregivers’ descriptions of their experience of nighttime sleep. Design and Methods Caregivers (N = 22) of children 10 to 18 years of age with type 1 diabetes (T1D) were recruited for this descriptive study. Anonymous questionnaires contained demographic information and both open- and closed-ended questions that focused on caregiving as it related to sleep. Open-ended questions were reviewed to help understand the effect of nocturnal caregiving activities on parental sleep. Results The sample of caregivers were all female and had a mean age of 43 years; 96% graduated high school, 68% were married or partnered, and 100% were white. Children had been diagnosed with T1D for a mean of 5 years, with a mean age of 12.2 years. Caregivers reported short sleep duration (mean, 5.8 hours). Over half of the participants reported they required ≥7 hours of sleep to feel their best, 64% indicated trouble sleeping at night, and 86% reported that caregiving interfered with their nighttime sleep, while 54% responded that sleep was “very important.” Content analysis of the open-ended questions revealed 2 themes: (1) anxiety about the child’s blood glucose levels and (2) nighttime disruptions. Conclusions Caregivers are frequently sleep deprived and worry about their child’s nighttime glucose. Caregiving duties, anxiety, and sleep fragmentation may contribute to their poor sleep.
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Affiliation(s)
| | | | - Linda Siminerio
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Anna L Allende
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
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