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O'Sullivan R, Bissell S, Hamilton A, Bagshaw A, Richards C. Concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions: A systematic review and meta-analysis. Sleep Med Rev 2023; 71:101814. [PMID: 37422998 DOI: 10.1016/j.smrv.2023.101814] [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: 03/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
The purpose of this systematic review and meta-analysis is to delineate the concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions (NDCs). A systematic literature search identified 31 studies that compare objective and subjective estimates of sleep parameters in autism, ADHD or rare genetic syndromes associated with intellectual disability. The meta-analyses revealed smaller mean differences and larger correlations indicative of greater concordance for parameters associated with sleep scheduling compared to parameters associated with sleep duration and night awakenings. Relative to objective measures, subjective measures produced: 1) greater estimates of total sleep time, sleep efficiency and time in bed; and 2) lower estimates of wake after sleep onset and number of night awakenings. Subgroup analyses also revealed differences in concordance between measurement comparison types (e.g., stronger correlations between actigraphy and sleep diaries, compared to actigraphy and questionnaires) and NDC diagnostic groups. The results predominantly replicate concordance trends observed in typically-developing samples, although some NDC-specific patterns of concordance were identified. This indicates that objective and subjective sleep measures retain broadly similar properties across populations, although researchers and clinicians should be cautious of the impact of NDC-related characteristics on sleep parameter estimates. These findings should inform sleep assessment design and the interpretation of sleep parameter estimates in NDCs, increasing the rigour of sleep parameter description across research and clinical settings.
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Affiliation(s)
- Rory O'Sullivan
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK.
| | - Stacey Bissell
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Anna Hamilton
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Andrew Bagshaw
- School of Psychology, University of Birmingham, UK; Centre for Human Brain Health, University of Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
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Fetta A, Soliani L, Trevisan A, Pugliano R, Ricci E, Di Pisa V, Pignataro V, Angotti M, Rocca A, Salce B, Mancardi MM, Giordano L, Pruna D, Parmeggiani A, Cordelli DM. Cognitive, Behavioral, and Sensory Profile of Pallister–Killian Syndrome: A Prospective Study of 22 Individuals. Genes (Basel) 2022; 13:genes13020356. [PMID: 35205401 PMCID: PMC8872298 DOI: 10.3390/genes13020356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Developmental delay and intellectual disability are two pivotal elements of the phenotype of Pallister–Killian Syndrome (PKS). Our study aims to define the cognitive, adaptive, behavioral, and sensory profile of these patients and to evaluate possible correlations between the different aspects investigated and with the main clinical and demographic variables. Methods: Individuals of any age with genetically confirmed PKS were recruited. Those ≤ 42 months were administered the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III), and those > 42 months the Vineland Adaptive Behavior Scales—Second Edition (Vineland-II). Stereotyped behaviors (Stereotypy Severity Scale, SSS) and aggressive behaviors (Behavior Problems Inventory—Short Version, BPIs) were assessed in all subjects > 1 year; sensory profile (Child Sensory Profile 2, C-SP2) in all aged 2–18 years. Results: Twenty-two subjects were enrolled (11 F/11 M; age 9 months to 28 years). All subjects ≤ 42 months had psychomotor developmental delay. Of the subjects > 42 months, 15 had low IQ deviation, and 1 in the normal range. Stereotypies were frequent (median SSS-total score 25/68). Lower Vineland-II values corresponded to greater intensity and frequency of stereotypies (p = 0.004 and p = 0.003), and self-injurious behaviors (p = 0.002 and p = 0.002). Patients with severe low vision had greater interference of stereotypies (p = 0.027), and frequency and severity of aggressive behaviors (p = 0.026; p = 0.032). The C-SP2, while not homogeneous across subjects, showed prevalence of low registration and sensory seeking profiles and hypersensitivity to tactile and auditory stimuli. Lower Vineland-II scores correlated with higher Registration scores (p = 0.041), while stereotypies were more frequent and severe in case of high auditory sensitivity (p = 0.019; p = 0.007). Finally, greater sleep impairment correlated with stereotypies and self-injurious behaviors, and lower Vineland-II scores. Conclusions: The present study provides a further step in the investigation of the etiopathogenesis of the syndrome. Furthermore, these aspects could guide rehabilitation therapy through the identification of targeted protocols.
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Affiliation(s)
- Anna Fetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Luca Soliani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Alessia Trevisan
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Rosa Pugliano
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Emilia Ricci
- Child Neuropsychiatry Unit, Epilepsy Center, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università di Milano, 98051 Milan, Italy;
| | - Veronica Di Pisa
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
| | - Veronica Pignataro
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
| | - Marida Angotti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
| | - Alessandro Rocca
- UO di Pediatria d’Urgenza, IRCCS Policlinico Sant’Orsola, 40138 Bologna, Italy;
| | - Bianca Salce
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Maria Margherita Mancardi
- Child Neuropsychiatry Unit, Department of Medical and Surgical Neurosciences and Rehabilitation, IRCCS Istituto Giannina Gaslini, 16128 Genova, Italy;
| | - Lucio Giordano
- Child Neuropsychiatric Division, Spedali Civili, 25123 Brescia, Italy;
| | - Dario Pruna
- Department of Pediatric Neurology and Epileptology, Pediatric Depatment, ARNAS Brotzu, 09134 Cagliari, Italy;
| | - Antonia Parmeggiani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
| | - Duccio Maria Cordelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuropsichiatria dell’Età Pediatrica, 40139 Bologna, Italy; (A.F.); (L.S.); (R.P.); (V.D.P.); (V.P.); (M.A.); (B.S.); (A.P.)
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy;
- Correspondence:
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