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López-Zamora M, Cano-Villagrasa A, Cortés-Ramos A, Porcar-Gozalbo N. The Influence of Sleep Disorders on Neurobiological Structures and Cognitive Processes in Pediatric Population with ASD and Epilepsy: A Systematic Review. Eur J Investig Health Psychol Educ 2023; 13:2358-2372. [PMID: 37998056 PMCID: PMC10670909 DOI: 10.3390/ejihpe13110166] [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: 09/06/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023] Open
Abstract
Autism Spectrum Disorder (ASD) and epilepsy are increasingly prevalent comorbidities in our society. These two disorders are often accompanied by other comorbidities, such as sleep disorders, significantly impacting the quality of life of individuals with ASD and epilepsy. To date, clinical approaches have primarily been descriptive in nature. Therefore, this study aimed to analyze the relationship between ASD, epilepsy, and sleep disorders, exploring neurobiological dysfunctions and cognitive alterations. A total of 22 scientific articles were selected using a systematic literature review following the criteria established using the PRISMA model. The selected articles were gathered from major databases: Medline, PubMed, PsycINFO, Google Scholar, and Web of Science. Inclusion criteria specified that study participants had an official diagnosis of ASD, the article precisely described the evaluation parameters used in the study participants, and individual characteristics of the sleep disorders of the study participants were specified. The results indicate, firstly, that the primary cause of sleep disorders in this population is directly linked to abnormal serotonin behaviors. Secondly, significant alterations in memory, attention, and hyperactivity were observed. In conclusion, sleep disorders negatively impact the quality of life and neurocognitive development of the pediatric population with ASD and epilepsy.
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Affiliation(s)
- Miguel López-Zamora
- Department of Developmental and Educational Psychology, University of Malaga, 29010 Malaga, Spain;
| | - Alejandro Cano-Villagrasa
- Faculty of Health Sciences, Universidad Internacional de Valencia, 46002 Valencia, Spain;
- Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos n°135, Guadalupe, 30107 Murcia, Spain
| | - Antonio Cortés-Ramos
- Department of Developmental and Educational Psychology, Faculty of Educational and Sports Sciences of Melilla, University of Granada, 18071 Granada, Spain;
| | - Nadia Porcar-Gozalbo
- Faculty of Health Sciences, Universidad Internacional de Valencia, 46002 Valencia, Spain;
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Hayton J, Azhari A, Esposito G, Iles R, Chadiarakos M, Gabrieli G, Dimitriou D, Mangar S. Short Report: Lack of Diurnal Variation in Salivary Cortisol Is Linked to Sleep Disturbances and Heightened Anxiety in Adolescents with Williams Syndrome. Behav Sci (Basel) 2023; 13:220. [PMID: 36975245 PMCID: PMC10045386 DOI: 10.3390/bs13030220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
OBJECTIVE The aim of the current study was to examine the potential relationship between sleep patterns, cortisol levels, and anxiety profiles in adolescents with Williams Syndrome (WS) compared to typically developing adolescents. METHOD Thirteen adolescents with WS and thirteen TD adolescents (age range 12-18 years) were recruited. Participants were provided with a "testing kit", containing instructions for collecting data through a sleep diary, MotionWare actigraphy, the Childhood Sleep Habits Questionnaire (CSHQ), and the Spence Children's Anxiety Scale, and a salivary cortisol collection kit. RESULTS Adolescents in the WS group did not show diurnal variation in salivary cortisol. Significantly higher scores were reported for two CSHQ subsections, night wakings and parasomnias, in the WS group. Regarding the actigraphy, only significantly longer sleep latency was observed in the WS group. In comparison to the TD group, the WS group had significantly higher anxiety. As expected, the TD group showed typical diurnal variation in cortisol, whereas the WS group showed a flattened cortisol profile throughout the day. CONCLUSIONS From the developmental perspective, this study provides new data supporting the conclusion that sleep problems are not transient but continue to persist into adolescence in WS. Future studies ought to consider examining the role of cortisol and its interplay with anxiety levels and sleep problems across the lifespan in individuals with WS.
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Affiliation(s)
- Jessica Hayton
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK
- Psychology and Human Development, UCL Institute of Education, London WC1H 0AA, UK
| | - Atiqah Azhari
- Psychology Programme, School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore 599494, Singapore
| | - Gianluca Esposito
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Ray Iles
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB2 1TN, UK
| | - Michaella Chadiarakos
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK
| | - Giulio Gabrieli
- Neuroscience and Behaviour Laboratory, Italian Institute of Technology, 00161 Roma, Italy
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK
- Psychology and Human Development, UCL Institute of Education, London WC1H 0AA, UK
| | - Stephen Mangar
- Department of Clinical Oncology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK
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Bin Eid W, Lim M, Gabrieli G, Kölbel M, Halstead E, Esposito G, Dimitriou D. Habilitation of sleep problems among mothers and their children with autism spectrum disorder: Insights from multi-level exploratory dyadic analyses. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:915060. [PMID: 36211831 PMCID: PMC9533106 DOI: 10.3389/fresc.2022.915060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022]
Abstract
Few habilitation strategies for children with autism spectrum disorder (ASD) consider their sleep-related problems. Together with the fact that caregivers of children with ASD also face issues with sleep, there may be yet-to-be uncovered relationships between caregiver-child sleep patterns and sleep quality, offering a key opportunity for clinicians to consider the needs of both child and caregiver in terms of sleep. 29 dyads of mothers and their children with ASD were recruited for this cohort study and both subjective (self-report questionnaires and sleep diaries) and objective (cortisol samples and actigraphy) measures of sleep were collected to investigate significant predictors of sleep quality. Comparative, correlational, and hierarchical analyses were conducted. Findings indicated that both mother and child experience sleep deprivation in terms of shorter sleep duration and poor sleep quality in terms of longer sleep onset latencies and a higher frequency of wake bouts. Exploratory hierarchical analyses also found that child-related sleep difficulties such as sleep disordered breathing and night waking significantly predict mothers' sleep quality, which may point to the bi-directional influence of mother-child sleep. Based on these findings, it is recommended that clinicians adopt a family systems perspective and consider the sleep environment of the household, particularly that of the caregiver and child, when designing interventions for sleep-related problems in ASD. Finally, there is a need for additional support to promote good quality sleep among caregivers of children with ASD to bolster out-of-clinic care.
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Affiliation(s)
- Wasmiah Bin Eid
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
| | - Melanie Kölbel
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
- Department of Developmental Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elizabeth Halstead
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Gianluca Esposito
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
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Chua B, Neoh M, Jeon M, Joyce A, Iandolo G, Hayton J, Esposito G, Dimitriou D. Impact of sleep on attention in primary school-aged autistic children: Exploratory cross-cultural comparison between Singapore and UK children. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 128:104271. [PMID: 35759855 DOI: 10.1016/j.ridd.2022.104271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/17/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is a growing body of research studying the impact sleep has on attention among typically developing (TD) children, but research is lacking among autistic children. AIMS The present study aimed to explore, for the first time, differences in (1) attention, (2) sleep parameters among primary school-aged Singaporean autistic children (N = 26) and Singaporean TD children (N = 20), and with UK autistic (N = 11) and UK TD children (N = 16), and (3) the impact of sleep on attention. METHODS AND PROCEDURES Actigraphy was used to objectively assess sleep, and a Continuous Performance Task was used to measure attentional domains. OUTCOMES AND RESULTS There were inconclusive findings indicating that autistic children had poorer sustained attention than TD children. Although autistic children did not display more sleep difficulties than TD children, they showed shorter actual sleep duration (Singapore ASD = 7:00 h, UK ASD = 7:35 h, p < .01) and longer sleep latency (Singapore ASD = 30:15 min, UK ASD = 60:00 min, p < .01) than clinical recommendations. Sleep difficulties were also present among Singaporean and UK TD children. Both TD groups had less actual sleep duration than recommended (Singapore TD = 6:32 h, UK TD = 8:07 h). Singaporean TD children had sleep efficiency below recommended criterion (78.15%). Sleep impacted attention across all groups, but effects were different for autistic and TD groups. CONCLUSIONS AND IMPLICATIONS The study highlighted the importance for practitioners and carers to adopt a child-centred approach to assessing sleep and attentional difficulties, especially among autistic children due to the high variability in performance within the group. The impact of cultural and school-setting differences on sleep was also raised.
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Affiliation(s)
- Beatrice Chua
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Michelle Neoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Mina Jeon
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Anna Joyce
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK; Faculty of Health and Life Sciences, Coventry University, UK
| | - Giuseppe Iandolo
- Department of Psychology, School of Biomedical Sciences, European University of Madrid, Madrid, Spain; Observation and Functional Diagnosis Division, PSISE Clinical and Developmental Psychological Service, Madrid, Spain
| | - Jessica Hayton
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK.
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McCabe SM, Abbiss CR, Libert JP, Bach V. Functional links between thermoregulation and sleep in children with neurodevelopmental and chronic health conditions. Front Psychiatry 2022; 13:866951. [PMID: 36451768 PMCID: PMC9703054 DOI: 10.3389/fpsyt.2022.866951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
The bi-directional relationship between sleep and wake is recognized as important for all children. It is particularly consequential for children who have neurodevelopmental disorders (NDDs) or health conditions which challenge their sleep and biological rhythms, and their ability to maintain rhythms of participation in everyday activities. There are many studies which report the diverse reasons for disruption to sleep in these populations. Predominantly, there is focus on respiratory, pharmaceutical, and behavioral approaches to management. There is, however, little exploration and explanation of the important effects of body thermoregulation on children's sleep-wake patterns, and associated behaviors. Circadian patterns of sleep-wake are dependent on patterns of body temperature change, large enough to induce sleep preparedness but remaining within a range to avoid sleep disturbances when active thermoregulatory responses against heat or cold are elicited (to maintain thermoneutrality). Additionally, the subjective notion of thermal comfort (which coincides with the objective concept of thermoneutrality) is of interest as part of general comfort and associated behavioral responses for sleep onset and maintenance. Children's thermoregulation and thermal comfort are affected by diverse biological functions, as well as their participation in everyday activities, within their everyday environments. Hence, the aforementioned populations are additionally vulnerable to disruption of their thermoregulatory system and their capacity for balance of sleep and wakefulness. The purpose of this paper is to present hitherto overlooked information, for consideration by researchers and clinicians toward determining assessment and intervention approaches to support children's thermoregulation functions and promote their subjective thermal comfort, for improved regulation of their sleep and wake functions.
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Affiliation(s)
- Susan M McCabe
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Chris R Abbiss
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | | | - Véronique Bach
- PeriTox UMR_I 01, University of Picardie Jules Verne, Amiens, France
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