1
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Foster M, Federico A, Klaiman C, Bradshaw J. Early Sleep Differences in Young Infants with Autism Spectrum Disorder. J Dev Behav Pediatr 2023; 44:e519-e526. [PMID: 37556592 PMCID: PMC10592571 DOI: 10.1097/dbp.0000000000001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/09/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Children with autism spectrum disorder (ASD) experience greater sleep challenges than their neurotypical peers, but sleep patterns for infants later diagnosed with ASD are unknown. This study examined differences in total sleep duration and proportion of sleep experienced at night within the first 6 months of life among infants later diagnosed with ASD, infants who demonstrated subclinical characteristics of ASD and were classified as exhibiting the broad autism phenotype (BAP), and their typically developing (TD) peers. In addition, associations between infant sleep variables and developmental outcomes at 24 months were explored. METHODS Participants included 79 infants enrolled in a prospective, longitudinal study of the early development of ASD. Between ages 1 week and 6 months, participants completed a monthly retrospective 24-hour sleep log. At 24 months, participants received a comprehensive diagnostic evaluation, including the Autism Diagnostic Observation Schedule-2 and Mullen Scales of Early Learning and Vineland-II and were clinically characterized as ASD, BAP, or TD. RESULTS When accounting for the influence of age, infants later diagnosed with ASD slept less within the 24-hour period than infants in TD or BAP groups from 0 to 6 months ( p = 0.04). Percentage of sleep experienced during nighttime hours did not significantly differ between groups from 0 to 6 months ( p = 0.25). Greater nighttime sleep percentage at 6 months predicted higher receptive language ( p < 0.001) and fine motor scores ( p < 0.0001) at 24 months. Total sleep duration at 6 months did not predict any developmental outcomes at 24 months. CONCLUSION Findings suggest that differences in sleep may occur among autistic individuals earlier in life than previously documented and have cascading effects on development.
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Affiliation(s)
- Miranda Foster
- College of Arts and Sciences, Department of Psychology, University of South Carolina, Columbia, SC
| | - Alexis Federico
- College of Arts and Sciences, Department of Psychology, University of South Carolina, Columbia, SC
| | - Cheryl Klaiman
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- School of Medicine, Emory University, Atlanta, GA
| | - Jessica Bradshaw
- College of Arts and Sciences, Department of Psychology, University of South Carolina, Columbia, SC
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2
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Lollies F, Schnatschmidt M, Bihlmeier I, Genuneit J, In-Albnon T, Holtmann M, Legenbauer T, Schlarb AA. Associations of sleep and emotion regulation processes in childhood and adolescence - a systematic review, report of methodological challenges and future directions. Sleep Sci 2022; 15:490-514. [PMID: 36419813 PMCID: PMC9670771 DOI: 10.5935/1984-0063.20220082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/03/2021] [Indexed: 07/25/2023] Open
Abstract
Sleep and emotions are closely associated; however, the methodological challenges in the examination of sleep and the processes of emotion regulation in children and adolescents have not been investigated so far. Additionally, there is the demand to identify the levels of emotion regulating processes in which problematic or restricted sleep causes effect. Experimental sleep deprivation as well as prevalent sleep problems have been found to have negative influence on mental health and regulating functions. This review focuses first on the methodological protocols of the included studies. Subsequently, the results are summarized in the context of a multilevel model of emotion regulation. Thereafter, suggestions for future directions are given. Sleep problems and sleep deprivation are associated with a decrease of functional emotion regulating behavior and impaired emotion generation, and prolonged sleep enhances better mood and affect states, positive emotion expression, and faster sensory processing in response to emotional stimuli. This literature review highlights the limitations in current research, focusing on types of measurements, task characteristics, and data analysis. At the conclusion, suggestions are given for the future research direction in the field of sleep and emotion regulation in children and adolescents.
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Affiliation(s)
- Friederike Lollies
- Bielefeld University, Faculty for Psychology and Sports - Bielefeld
- North Rhine Westphalia - Germany
| | - Marisa Schnatschmidt
- Bielefeld University, Faculty for Psychology and Sports - Bielefeld
- North Rhine Westphalia - Germany
| | - Isabell Bihlmeier
- University of Tuebingen, Faculty of Science, Clinical Psychology -
Tuebingen - Baden -Wuerttemberg - Germany
| | - Jon Genuneit
- Leipzig University, Pediatric Epidemiology, Department of
Pediatrics, Medical Faculty - Leipzig - Saxony - Germany
| | - Tina In-Albnon
- University of Koblenz-Landau, Clinical Child and Adolescent
Psychology and Psychotherapy - Koblenz-Landau - Rhineland Palatinate - Germany
| | - Martin Holtmann
- Ruhr University Bochum, LWL - University Hospital Hamm for Child
and Adolescent Psychiatry - Hamm - North Rhine Westphalia - Germany
| | - Tanja Legenbauer
- Ruhr University Bochum, LWL - University Hospital Hamm for Child
and Adolescent Psychiatry - Hamm - North Rhine Westphalia - Germany
| | - Angelika Anita Schlarb
- Bielefeld University, Faculty for Psychology and Sports - Bielefeld
- North Rhine Westphalia - Germany
- University of Tuebingen, Faculty of Science, Clinical Psychology -
Tuebingen - Baden -Wuerttemberg - Germany
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3
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Sam G, Naif M, Zinaf S, Hamoud M, Inad N. Socioemotional behaviour of toddlers influenced by the sleep patterns: Prevalence study. J Family Med Prim Care 2022; 11:941-947. [PMID: 35495796 PMCID: PMC9051712 DOI: 10.4103/jfmpc.jfmpc_340_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 01/18/2022] [Accepted: 01/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background: This study investigates the influence of sleep duration and sleep patterns on the social-emotional behaviour of 3–70-month-old children. Methods: A Brief Infant Sleep Questionnaire (BISQ) and Ages, Stages Questionnaire: Social-Emotional (ASQ:SE) were filled by the participants through a web link. The internal consistency of the items used in the questionnaire was analysed using Cronbach’s alpha and the effects of sleeping disorders on the likelihood of children having social-emotional problems were performed by binary logistic regressions. Results: The highest level of bedtime resistance and nocturnal awakening was observed in children of 27–32 months of age, while sleep anxiety was maximum in 42–53-month-old children. The logistic regression models were found to be statistically significant with Χ2 (3) =19.556 for 3–8-month-old children, Χ2 (3) =11.874 for 9–14-month-old children, Χ2 (3) =8.928 for 15–20-month-old children, Χ2 (3) =10.061 for 21–26-month-old children and Χ2 (3) =38.358 for 54–70-month-old children, P < 0.0005. Conclusion: Our findings imply that no statistically significant association was observed between sleep duration and social-emotional problems, however, sleep disorders significantly impacted social-emotional behaviour and also night-waking caused social-emotional behavioural issues in preschoolers.
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Affiliation(s)
- Gigi Sam
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Kingdom of Saudi Arabia
| | - Maha Naif
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Kingdom of Saudi Arabia
| | - Sarah Zinaf
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Kingdom of Saudi Arabia
| | - Maha Hamoud
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Kingdom of Saudi Arabia
| | - Noora Inad
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Kingdom of Saudi Arabia
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4
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Lin Y, Zhang X, Huang Y, Jia Z, Chen J, Hou W, Zhao L, Wang G, Zhu J. Relationships between screen viewing and sleep quality for infants and toddlers in China: A cross-sectional study. Front Pediatr 2022; 10:987523. [PMID: 36299700 PMCID: PMC9589267 DOI: 10.3389/fped.2022.987523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Abstract
AIM Currently young children have more opportunity to access all kinds of media, while their sleep duration has been steadily decreasing. However, little is known about the relationships between screen viewing and sleep quality, and the reasons of screen viewing for children under three years old in China. This study aimed to describe the relationships between screen viewing and sleep quality of infants and toddlers in mainland China. METHODS A cross-sectional study was conducted. Eight hundred twenty-seven children were recruited at a health care unit from a university affiliated hospital in China, and the questionnaires were completed by their parents. An extended Brief Infant Sleep Questionnaire and a Screen Viewing Questionnaire were used to collect information on children's sleep quality and screen viewing. Multivariate linear regression models were used to assess the relationships between screen viewing and sleep quality among infants and toddlers, adjusted for sociodemographic variables. RESULTS Of the 827 children, 26.9% of the infants and 61.4% of the toddlers did not comply with the World Health Organization (WHO) guideline on screen time. Even after adjusting for the sociodemographic covariates for both infants and toddlers, negative relationships between screen time and total sleep time (P < 0.001), and screen time and nighttime sleep (P < 0.001) existed. TV viewing time was negatively related to infants' total sleep time (β = -0.15, P < 0.001) and toddlers' nighttime sleep (β = -0.1, P < 0.05). Smartphone viewing time was negatively related to toddlers' total sleep time (β = -0.12, P < 0.05) and daytime sleep (β = -0.22, P < 0.05). Parents who offered screen media for children when they needed to do house chores were more likely to report that their children had less total sleep time (β = -0.1, P < 0.05) and shorter longest sleep episode (β = -0.1, P < 0.05). CONCLUSION The majority of toddlers did not meet the WHO guidelines on screen time in China. Screen time was negatively related to total sleep time and nighttime sleep among infants and toddlers. Practical strategies, such as education programs on children's screen viewing, more outdoor exercises and indoor parent-child activities, providing other educational materials instead of screening, early sleep, restricted use of TVs and smartphones, and screen co-viewing, are needed to improve young children's sleep quality and promote their development.
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Affiliation(s)
- Yumin Lin
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Xueqin Zhang
- Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Yinying Huang
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Zhiwei Jia
- Department of Child Health, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Jing Chen
- Department of Child Health, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Wanling Hou
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Lili Zhao
- Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Guiyan Wang
- Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Jiemin Zhu
- Department of Nursing, School of Medicine, Xiamen University, Xiamen, China
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5
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Burstein O, Geva R. The Brainstem-Informed Autism Framework: Early Life Neurobehavioral Markers. Front Integr Neurosci 2021; 15:759614. [PMID: 34858145 PMCID: PMC8631363 DOI: 10.3389/fnint.2021.759614] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/18/2021] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorders (ASD) have long-term implications on functioning at multiple levels. In this perspective, we offer a brainstem-informed autism framework (BIAF) that traces the protracted neurobehavioral manifestations of ASD to early life brainstem dysfunctions. Early life brainstem-mediated markers involving functions of autonomic/arousal regulation, sleep-wake homeostasis, and sensorimotor integration are delineated. Their possible contributions to the early identification of susceptible infants are discussed. We suggest that the BIAF expands our multidimensional understanding of ASD by focusing on the early involvement of brainstem systems. Importantly, we propose an integrated BIAF screener that brings about the prospect of a sensitive and reliable early life diagnostic scheme for weighing the risk for ASD. The BIAF screener could provide clinicians substantial gains in the future and may carve customized interventions long before the current DSM ASD phenotype is manifested using dyadic co-regulation of brainstem-informed autism markers.
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Affiliation(s)
- Or Burstein
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Ronny Geva
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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6
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Lin J, Sun W, Song Y, Dong S, Lin Q, Deng Y, Meng M, Zhu Q, Jiang Y, Wang G, Tong S, Liu S, Mei H, Jiang F. Cohort Profile: The Shanghai Sleep Birth Cohort Study. Paediatr Perinat Epidemiol 2021; 35:257-268. [PMID: 33337549 DOI: 10.1111/ppe.12738] [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: 06/03/2020] [Revised: 10/07/2020] [Accepted: 10/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep disturbances in women occur frequently throughout pregnancy. Previous studies have demonstrated that the increasing incidence of physiological and psychological illness is concurrent with increasing sleep deprivation and poor sleep quality in adults and children. OBJECTIVES The Shanghai Sleep Birth Cohort Study (SSBCS) was established to examine the effect of sleep disturbances during the third trimester on emotional regulation of mothers; to assess the effect of maternal sleep during pregnancy on the growth and development of children; and to explore the influence of children's sleep characteristics on physical and social-emotional development. POPULATION The study was conducted in the Renji Hospital in Pudong New District, Shanghai from May 2012 to July 2013. Women and their newborns who met the inclusion criteria and agreed to participate in this study were recruited to the SSBCS. METHODS The follow-up visits for children were conducted at the age of 42 days, 3, 6, 9, 12, 18, and 24 months, and 3, 4, and 6 years. Data on demographic factors, physical examination, sleep assessment, developmental and psychiatric assessment, diet records, and biological samples were collected throughout the study. PRELIMINARY RESULTS A total of 277 pregnant women were recruited to the study; the response rate was 64.3%. 37.9% of the pregnant women had poor sleep quality and 12.0% suffered from depression. Infant sleep patterns changed during the first year of life, but most sleep characteristics showed little variation from 6 to 12 months. CONCLUSIONS The SSBCS is an on-going prospective cohort study with follow-up to 6 years. The detailed data on demographic factors, sleep assessment, physical examinations, neurodevelopmental and psychiatric assessment, diet records, and biological samples make this research platform an important resource for examining the potential effects of sleep characteristics on both maternal and child health.
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Affiliation(s)
- Jianfei Lin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanjin Song
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shumei Dong
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingmin Lin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujiao Deng
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Meng
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Public Health and Institute of Environment and Population Health, Anhui Medical University, Hefei, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Shijian Liu
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Mei
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Data Science, School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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7
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Schoch SF, Kurth S, Werner H. Actigraphy in sleep research with infants and young children: Current practices and future benefits of standardized reporting. J Sleep Res 2020; 30:e13134. [PMID: 32638500 PMCID: PMC8244022 DOI: 10.1111/jsr.13134] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022]
Abstract
Actigraphy is a cost‐efficient method to estimate sleep–wake patterns over long periods in natural settings. However, the lack of methodological standards in actigraphy research complicates the generalization of outcomes. A rapidly growing methodological diversity is visible in the field, which increasingly necessitates the detailed reporting of methodology. We address this problem and evaluate the current state of the art and recent methodological developments in actigraphy reporting with a special focus on infants and young children. Through a systematic literature search on PubMed (keywords: sleep, actigraphy, child *, preschool, children, infant), we identified 126 recent articles (published since 2012), which were classified and evaluated for reporting of actigraphy. Results show that all studies report on the number of days/nights the actigraph was worn. Reporting was good with respect to device model, placement and sleep diary, whereas reporting was worse for epoch length, algorithm, artefact identification, data loss and definition of variables. In the studies with infants only (n = 58), the majority of articles (62.1%) reported a recording of actigraphy that was continuous across 24 hr. Of these, 23 articles (63.9%) analysed the continuous 24‐hr data and merely a fifth used actigraphy to quantify daytime sleep. In comparison with an evaluation in 2012, we observed small improvements in reporting of actigraphy methodology. We propose stricter adherence to standards in reporting methodology in order to streamline actigraphy research with infants and young children, to improve comparability and to facilitate big data ventures in the sleep community.
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Affiliation(s)
- Sarah F Schoch
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Salome Kurth
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Helene Werner
- Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland.,Division of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zürich, Switzerland
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8
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Association of maternal sleep before and during pregnancy with preterm birth and early infant sleep and temperament. Sci Rep 2020; 10:11084. [PMID: 32632276 PMCID: PMC7338358 DOI: 10.1038/s41598-020-67852-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/15/2020] [Indexed: 02/07/2023] Open
Abstract
This study aimed to investigate the association of maternal sleep before and during pregnancy with preterm birth, infant sleep and temperament at 1 month of age. We used the data of the Japan Environment and Children’s Study, a cohort study in Japan, which registered 103,099 pregnancies between 2011 and 2014. Participants were asked about their sleep before and during pregnancy, and the sleep and temperament of their newborns at 1 month of age. Preterm birth data were collected from medical records. Maternal sleep was not associated with preterm birth, but subjective sleep quality during pregnancy was associated with late preterm birth (birth at 34–36 weeks of gestation). For example, participants with extremely light subjective depth of sleep were more likely to experience preterm birth (RR = 1.19; 95% confidence interval [CI] = 1.04–1.35). Maternal sleep both before and during pregnancy seemed to be associated with infant sleep and temperament at 1 month of age. Infants, whose mothers slept for less than 6 hours before pregnancy, tended to cry intensely (RR = 1.15; 95% CI = 1.09–1.20). Maternal sleep problems before and during pregnancy were associated with preterm birth and child sleep problems and temperament.
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9
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Chaput JP, Gray CE, Poitras VJ, Carson V, Gruber R, Birken CS, MacLean JE, Aubert S, Sampson M, Tremblay MS. Systematic review of the relationships between sleep duration and health indicators in the early years (0-4 years). BMC Public Health 2017; 17:855. [PMID: 29219078 PMCID: PMC5773910 DOI: 10.1186/s12889-017-4850-2] [Citation(s) in RCA: 211] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The objective of this systematic review was to examine for the first time the associations between sleep duration and a broad range of health indicators in children aged 0 to 4 years. Methods Electronic databases were searched with no limits on date or study design. Included studies (published in English or French) were peer-reviewed and met the a priori determined population (apparently healthy children aged 1 month to 4.99 years), intervention/exposure/comparator (various sleep durations), and outcome criteria (adiposity, emotional regulation, cognitive development, motor development, growth, cardiometabolic health, sedentary behaviour, physical activity, quality of life/well-being, and risks/injuries). The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Due to high levels of heterogeneity across studies, narrative syntheses were employed. Results A total of 69 articles/studies (62 unique samples) met inclusion criteria. Data across studies included 148,524 unique participants from 23 countries. The study designs were randomized trials (n = 3), non-randomized interventions (n = 1), longitudinal studies (n = 16), cross-sectional studies (n = 42), or longitudinal studies that also reported cross-sectional analyses (n = 7). Sleep duration was assessed by parental report in 70% of studies (n = 48) and was measured objectively (or both objectively and subjectively) in 30% of studies (n = 21). Overall, shorter sleep duration was associated with higher adiposity (20/31 studies), poorer emotional regulation (13/25 studies), impaired growth (2/2 studies), more screen time (5/5 studies), and higher risk of injuries (2/3 studies). The evidence related to cognitive development, motor development, physical activity, and quality of life/well-being was less clear, with no indicator showing consistent associations. No studies examined the association between sleep duration and cardiometabolic biomarkers in children aged 0 to 4 years. The quality of evidence ranged from “very low” to “high” across study designs and health indicators. Conclusions Despite important limitations in the available evidence, longer sleep duration was generally associated with better body composition, emotional regulation, and growth in children aged 0 to 4 years. Shorter sleep duration was also associated with longer screen time use and more injuries. Better-quality studies with stronger research designs that can provide information on dose-response relationships are needed to inform contemporary sleep duration recommendations. Electronic supplementary material The online version of this article (10.1186/s12889-017-4850-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
| | - Casey E Gray
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Veronica J Poitras
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Reut Gruber
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, H3A 1A1, Canada
| | - Catherine S Birken
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - Joanna E MacLean
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Salomé Aubert
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
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10
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Ordway MR, Sadler LS, Canapari CA, Jeon S, Redeker NS. Sleep, biological stress, and health among toddlers living in socioeconomically disadvantaged homes: A research protocol. Res Nurs Health 2017; 40:489-500. [PMID: 29058789 DOI: 10.1002/nur.21832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/30/2017] [Indexed: 12/13/2022]
Abstract
Healthy sleep is important to behavioral, neurobiological, and physiologic health. In older children and adults, stress biomarkers, such as cortisol and C-reactive protein, increase when they do not practice healthy sleep habits. However, little is known about the relationships among sleep health, stress, and health outcomes among very young children living with socioeconomic adversity, a group that is particularly at risk for poor future health. The NIH-funded study described in this protocol addresses this scientific gap to improve understanding of these relationships during a critical developmental period in children's lives-toddlerhood. We will use a longitudinal design with repeated measures to prospectively examine the relationships among sleep health, stress, and toddlers' health from age 12 to 24 months, to address the following aims: i) examine changes in subjective and objective sleep health measures; ii) examine changes in stress biomarkers; iii) examine the cross-sectional and longitudinal relationships between sleep health measures and stress response; and iv) examine the cross-sectional and longitudinal relationships between sleep health measures, stress biomarkers, and toddlers' behavioral health. The sample will include 113 toddlers and their caregivers. We are collecting subjective and objective data on sleep health, multi-systemic biomarkers of stress, and toddlers' behavioral health. Generalized linear models will be used in the data analyses. Results from this study will be used to support development and testing of interventions, such as those that may improve sleep, among young children at risk for toxic stress.
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Affiliation(s)
| | - Lois S Sadler
- Yale University School of Nursing, West Haven, Connecticut.,Yale Child Study Center, New Haven, Connecticut
| | | | - Sangchoon Jeon
- Yale University School of Nursing, West Haven, Connecticut
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11
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Tsai SY, Lee CC, Chen LC, Tung YC. Infant sleep problems: The sleep characteristics of the "Don't Know" response. J Adv Nurs 2017; 74:181-189. [PMID: 28771793 DOI: 10.1111/jan.13404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2017] [Indexed: 01/05/2023]
Abstract
AIMS To examine the sleep characteristics of infants with parentally reported sleep problems, with parentally reported no sleep problems and with parentally reported uncertain sleep conditions. BACKGROUND Infant sleep problems are recognized as a major health issue worldwide. However, in our daily clinical practices, it is not uncommon for parents not to know whether their infant sleep is problematic. DESIGN AND METHODS A prospective study conducted between 2012 - 2015 where 219 parents completed questionnaires and infants wore an actigraph monitor for 7 days. Multinomial logistic regression models were used to evaluate the actigraphic and parentally reported infant sleep behaviours between the groups. RESULTS Thirty-two (14.61%) parents did not know whether their infant sleep was problematic and 118 (53.88%) parents considered their infant sleep a problem. Compared with infants without sleep problems, infants with uncertain sleep conditions had significantly increased odds of having shortened longest sleep duration according to parental report. A significant association was found for infants without sleep problems compared with those with sleep problems who had significantly more wake after sleep onset as measured by actigraphy, as well as reduced longest sleep duration according to parental report. CONCLUSION Infants with uncertain sleep conditions have the same problematic sleep behaviours resembling those of children with reported sleep problems. Healthcare professionals should actively disseminate sleep knowledge to help parents interpret infant sleep behaviours and consider possible intervention strategies for improving parental sleep-related knowledge and infant sleep.
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Affiliation(s)
- Shao-Yu Tsai
- School of Nursing, National Taiwan University, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Chiou Chen
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.,Department of Physical Therapy, National Taiwan University, Taipei, Taiwan
| | - Yi-Ching Tung
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
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Geoffray MM, Nicolas A, Speranza M, Georgieff N. Are circadian rhythms new pathways to understand Autism Spectrum Disorder? ACTA ACUST UNITED AC 2017. [PMID: 28625682 DOI: 10.1016/j.jphysparis.2017.06.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Autism Spectrum Disorder (ASD) is a frequent neurodevelopmental disorder. ASD is probably the result of intricate interactions between genes and environment altering progressively the development of brain structures and functions. Circadian rhythms are a complex intrinsic timing system composed of almost as many clocks as there are body cells. They regulate a variety of physiological and behavioral processes such as the sleep-wake rhythm. ASD is often associated with sleep disorders and low levels of melatonin. This first point raises the hypothesis that circadian rhythms could have an implication in ASD etiology. Moreover, circadian rhythms are generated by auto-regulatory genetic feedback loops, driven by transcription factors CLOCK and BMAL1, who drive transcription daily patterns of a wide number of clock-controlled genes (CCGs) in different cellular contexts across tissues. Among these, are some CCGs coding for synapses molecules associated to ASD susceptibility. Furthermore, evidence emerges about circadian rhythms control of time brain development processes.
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Affiliation(s)
- M-M Geoffray
- Department of Child and Adolescent Psychiatry, Centre Hospitalier le Vinatier, Lyon, France.
| | - A Nicolas
- Unité d'exploration Hypnologique, Service Hospitalo-Universitaire de Psychiatrie, Centre Hospitalier spécialisé Le Vinatier, Lyon, France
| | - M Speranza
- Department of Child and Adolescent Psychiatry, Hospital of Versailles, France
| | - N Georgieff
- Department of Child and Adolescent Psychiatry, Centre Hospitalier le Vinatier, Lyon, France
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