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de Sena S, Häggman M, Ranta J, Roienko O, Ilén E, Acosta N, Salama J, Kirjavainen T, Stevenson N, Airaksinen M, Vanhatalo S. NAPping PAnts (NAPPA): An open wearable solution for monitoring Infant's sleeping rhythms, respiration and posture. Heliyon 2024; 10:e33295. [PMID: 39027497 PMCID: PMC11255670 DOI: 10.1016/j.heliyon.2024.e33295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 05/13/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Study objectives To develop a non-invasive and practical wearable method for long-term tracking of infants' sleep. Methods An infant wearable, NAPping PAnts (NAPPA), was constructed by combining a diaper cover and a movement sensor (triaxial accelerometer and gyroscope), allowing either real-time data streaming to mobile devices or offline feature computation stored in the sensor memory. A sleep state classifier (wake, N1/REM, N2/N3) was trained and tested for NAPPA recordings (N = 16649 epochs of 30 s), using hypnograms from co-registered polysomnography (PSG) as a training target in 33 infants (age 2 weeks to 18 months; Mean = 4). User experience was assessed from an additional group of 16 parents. Results Overnight NAPPA recordings were successfully performed in all infants. The sleep state classifier showed good overall accuracy (78 %; Range 74-83 %) when using a combination of five features related to movement and respiration. Sleep depth trends were generated from the classifier outputs to visualise sleep state fluctuations, which closely aligned with PSG-derived hypnograms in all infants. Consistently positive parental feedback affirmed the effectiveness of the NAPPA-design. Conclusions NAPPA offers a practical and feasible method for out-of-hospital assessment of infants' sleep behaviour. It can directly support large-scale quantitative studies and development of new paradigms in scientific research and infant healthcare. Moreover, NAPPA provides accurate and informative computational measures for body positions, respiration rates, and activity levels, each with their respective clinical and behavioural value.
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Affiliation(s)
- Sofie de Sena
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
| | - Matias Häggman
- School of Science, Department of Mathematics and Systems Analysis, Aalto University, Espoo, Finland
| | - Jukka Ranta
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Oleksii Roienko
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elina Ilén
- Department of Materials Science and Engineering, Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Natalia Acosta
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jonna Salama
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Turkka Kirjavainen
- Department of Paediatrics, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Nathan Stevenson
- Brain Modelling Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Manu Airaksinen
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
| | - Sampsa Vanhatalo
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
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Lo Moro G, Scaioli G, Conrado F, Lusiani L, Pinto S, Rolfini E, Bert F, Siliquini R. Parental Perception of Children's Mental Health During the Pandemic: Insights From an Italian Cross-Sectional Study. THE JOURNAL OF SCHOOL HEALTH 2024; 94:539-550. [PMID: 38532496 DOI: 10.1111/josh.13449] [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: 06/09/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND This study explores the impact of the pandemic on children's mental health. It examined the understanding of parents regarding their children's mental condition and their ability to identify issues, 2 years post the outbreak of the COVID-19 pandemic. METHODS Using a cross-sectional design, 507 Italian parents reported on their youngest child aged between 2 and 17, totaling 507 children. The outcomes focused on were parental perception of children's mental health deterioration, scores on the Strengths and Difficulties Questionnaire (SDQ) above the clinical cut-off, and parental under-recognition of mental health issues. Descriptive analyses and multivariable logistic regression models were executed (significance at p < .05). RESULTS Parents were 88.1% women (median age 41 years, interquartile range [IQR] = 36-47). Their children were 50.3% female [median age 6 years (IQR = 4-11)]. The data revealed 21.1% of parents perceived a deterioration in their children's mental health, while 44.2% had SDQ scores above the cut-off. Parental under-recognition of mental issues was found in 20.1% of cases. Significant correlations were found between parental perception of deterioration, SDQ scores, and factors like parental mental distress and children's sleep issues. IMPLICATIONS The findings suggest that schools and verified websites can serve as critical conduits for providing parents with reliable information. By promoting early identification and intervention, such mechanisms can help ensure mental health equity for children. CONCLUSIONS The research highlights the effect of the pandemic on children's mental health and the issue of parental under-recognition. The results underscore the importance of public health initiatives that enhance mental health information accessibility and reliability for parents.
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Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Giacomo Scaioli
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy; Health Local Unit "ASL TO3", Turin, Italy
| | - Francesco Conrado
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Luca Lusiani
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Sonia Pinto
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Edoardo Rolfini
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy
| | - Fabrizio Bert
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy; Health Local Unit "ASL TO3", Turin, Italy
| | - Roberta Siliquini
- Department of Public Health Sciences, University of Turin, Via Santena 5 Bis, 10126, Turin, Italy; A.O.U. City of Health and Science of Turin, Turin, Italy
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Booker LA, Wilson D, Spong J, Fitzgibbon C, Deacon-Crouch M, Lenz KE, Skinner TC. Maternal Circadian Disruption from Shift Work and the Impact on the Concentration of Melatonin in Breast Milk. Breastfeed Med 2024; 19:33-39. [PMID: 38150529 DOI: 10.1089/bfm.2023.0252] [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: 12/29/2023]
Abstract
Background and Objective: Melatonin in breast milk exhibits a 24-hour circadian rhythm, present in nighttime breast milk but nearly undetectable in daytime breast milk. Shift work can disrupt the circadian timing of individuals, evident in changes in melatonin in saliva and urine samples. However, it is unknown whether these changes are also reflected in breast milk from a shift working mother. The aim of this study was to investigate whether maternal circadian rhythm disturbance from shift work impacts the melatonin concentration in breast milk. Materials and Methods: Breast milk and saliva samples were collected from 11 shift working mothers at four timepoints across five consecutive days. This included during their day shift or nonworkdays to act as a control, night shift, subsequent night shifts and postnight shift. Where possible, pre- and postfeed collections were also undertaken. Samples were grouped into four-time intervals: 12-6:30 am, 7-11:30 am, 12-6:30 pm, 7-11:30 pm, and melatonin levels (picogram per milliliter) in the breast milk and saliva samples were analyzed. Results: There was a significant decrease in breast milk melatonin (p = 0.026) at the 12-6:30 am time interval on subsequent night shifts, compared with control days. However, there was no overall time and shift type interaction effect (p = 0.70). In addition, no observed difference in melatonin levels was found in saliva samples, or when comparing pre- and postfeed breast milk. Breast milk melatonin however was found to be significantly higher compared with saliva (p > 0.001), at all but one time interval. Conclusion: The findings suggest that there is a potential effect of maternal circadian rhythm disruption from shift work on breast milk melatonin levels. This is an important step in exploring the role of maternal circadian timing and the effect on breast milk composition. Expansion of this research and exploration of other circadian rhythm misalignment sleep disorders on breast milk is highly recommended.
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Affiliation(s)
- Lauren A Booker
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Danielle Wilson
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Cheree Fitzgibbon
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Katrin E Lenz
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Timothy C Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
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Booker LA, Spong J, Deacon-Crouch M, Skinner TC. Preliminary Exploration into the Impact of Mistimed Expressed Breast Milk Feeding on Infant Sleep Outcomes, Compared to Other Feeding Patterns. Breastfeed Med 2022; 17:853-858. [PMID: 36137055 DOI: 10.1089/bfm.2022.0125] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background and Objective: The presence and fluctuation of melatonin in breast milk during the night and day may be providing sleep timing information to infants, thereby supporting/enabling the development of their own circadian cycle. If this is the case, then it is important that infants consume breast milk according to the time of day it is produced. However, breast milk is not always consumed at the "right" time. The aim of this study was to investigate whether consuming mistimed expressed breast milk impacts infant sleep compared with other feeding types. Methods: A total of 329 mothers completed an online anonymous survey. Mothers were grouped into one of five groups; direct breastfed only, formula only, express mistimed, express-timed, and combined breastfed/formula fed. Results: Cross-sectional analysis showed mistimed expressed breast milk was significantly associated with delayed sleep onset of the infant (p < 0.001), but direct breastfed infants had significantly more awakenings at night (p < 0.001). Conclusions: The findings from this study suggest a potential effect of mistimed expressed breast milk consumption on an infant's circadian rhythm, affecting some aspects of their sleep. This is an important first step in exploring mistimed feeding on infant sleep outcomes and provides preliminary evidence that warrants future research.
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Affiliation(s)
- Lauren A Booker
- University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.,Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia.,Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Deacon-Crouch
- Rural Department Nursing & Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Timothy C Skinner
- University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.,Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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Hernandez-Reif M, Gungordu N. Infant sleep behaviors relate to their later cognitive and language abilities and morning cortisol stress hormone levels. Infant Behav Dev 2022; 67:101700. [DOI: 10.1016/j.infbeh.2022.101700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 01/06/2022] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
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