Sleep disorders in children and adolescents†

Evaluation of the Garmin Vivofit 4 for assessing sleep in youth experiencing sleep disturbances

Objective

Wearable monitors are increasingly used to assess sleep. However, validity is unknown for certain monitors and populations. We tested the Garmin Vivofit 4 in a pediatric clinical sample.

Methods

Participants (n = 25) wore the monitor on their nondominant wrist during an overnight polysomnogram. Garmin and polysomnography were compared using 95% equivalence testing, mean absolute error, and Bland-Altman analysis.

Results

On average (mean ± SD), the Garmin predicted later sleep onset (by 0.84 ± 1.60 hours) and earlier sleep offset (by 0.34 ± 0.70 hours) than polysomnography. The resulting difference for total sleep time was -0.55 ± 1.21 hours. Sleep onset latency was higher for Garmin than polysomnography (77.4 ± 100.9 and 22.8 ± 20.0 minutes, respectively), while wake after sleep onset was lower (5.2 ± 9.3 and 43.2 ± 37.9 minutes, respectively). Garmin sleep efficiency averaged 3.3% ± 13.8% lower than polysomnography. Minutes in light sleep and deep sleep (the latter including rapid eye movement) were within ±3.3% of polysomnography (both SDs = 14.9%). No Garmin means were significantly equivalent with polysomnography (adjusted p > 0.99). Mean absolute errors were 0.47 to 0.95 hours for time-based variables (sleep onset, offset, and latency, plus total sleep time and wake after sleep onset), and 8.9% to 21.2% for percentage-based variables (sleep efficiency and sleep staging). Bland-Altman analysis showed systematic bias for wake after sleep onset, but not other variables.

Conclusions

The Vivofit 4 showed consistently poor individual-level validity, while group-level validity was better for some variables (total sleep time and sleep efficiency) than others.

Sleep disorders in attention-deficit hyperactivity disorder and autism spectrum disorder: a pragmatic approach to assessment and management

Sleep is essential for survival and humans spend approximately one-third of their life asleep. Adequate sleep is needed to maintain both physical and psychological health. Routinely getting less than the recommended amount of sleep for your age can have profound negative effects on health, such as increasing the likeliness of psychiatric illness, diabetes, cardiovascular disease and stroke. In children and adults with neurodevelopmental disorders, the prevalence of sleep disorders is significantly higher than in the general population. Given the relationship between sleep and psychiatric disorders, it is essential that psychiatrists have knowledge of the principles of sleep medicine. In this article, we focus on the common sleep disorders found in those with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and give an overview of screening, diagnosis and management.

Evaluation of child development: beyond the neuromotor aspect

OBJECTIVE

To review the epidemiology and update the scientific knowledge on the problems of development and behavior in childhood, and the recommendations for the role of the pediatrician in identifying and managing delays and disturbances in child development and mental health.

SOURCES

A search for relevant literature was performed in the PubMed and Scopus databases and publications of the National Scientific Council on the Developing Child.

SUMMARY OF THE FINDINGS

With the decline in the incidence of communicable diseases in children, problems with development, behavior, and emotional regulation are increasingly becoming a part of the work of pediatricians, yet many are not trained and feel uncomfortable about this extension of their role. The available screening tools for child development and behavior are reviewed, and a 'school readiness' checklist is presented, together with recommendations on how the pediatrician can incorporate developmental surveillance into routine practice, aware of the need for children to acquire social, emotional, and cognitive skills so that they can develop their full potential.

CONCLUSIONS

The pediatrician's role in the future will include both physical and mental health, recognizing that social development, resilience, and emotional maturity are as important as physical growth and neuromotor skills in a child's life course.