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Zhai S, Hash J, Ward TM, Yuwen W, Sonney J. Analysis, evaluation, and reformulation of social cognitive theory: Toward parent-child shared management in sleep health. J Pediatr Nurs 2023; 73:e65-e74. [PMID: 37481389 DOI: 10.1016/j.pedn.2023.07.011] [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] [Received: 12/20/2022] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/24/2023]
Abstract
THEORETICAL PRINCIPLES Social Cognitive Theory (SCT) is a middle-range theory with triadic determinism between behavioral, environmental, and personal. SCT has been a guiding framework in health promotion research as it helps understand people's behaviors. PHENOMENA ADDRESSED Behavioral Insomnia of Childhood (BIC) is highly prevalent, affecting up to 45% of typically developing children and 80% of children with special healthcare needs. BIC leads to sleep deficiency, disrupted physical and psychological health, poor school performance, behavioral dysfunction, and negatively affects parental and family functioning. Using Fawcett's framework, we analyzed and evaluated SCT in a pediatric sleep context and propose a reformulation of SCT to better inform sleep research. RESEARCH LINKAGES SCT is individually focused and does not account for interdependence within relationships. Pediatric sleep interventions have limited long-term effects and sustainability without considering the parent-child dyadic interdependency. We advance the argument that the parent-child shared management (PCSM) perspective is beneficial for understanding pediatric sleep health. PCSM is a concept that reflects the shared responsibility and interdependence that parent and child have for managing child health. It assumes that with parents' ongoing support, children's responsibility for their health management increases over time, along with developmental progression and health-related experiences. We propose reformulating SCT by integrating PCSM in the pediatric sleep context: SCT with Shared Management (SCT-SM). The proposed SCT-SM accounts for parent-child interdependence and role transition. Shared management interventions that engage parents and children in active roles in managing sleep have potential sustainable effects in improving sleep and quality of life. (250).
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Affiliation(s)
- Shumenghui Zhai
- School of Nursing, Pacific Lutheran University, 12180 Park Ave. S, Tacoma, WA 98447, United States of America.
| | - Jonika Hash
- School of Nursing, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, United States of America
| | - Teresa M Ward
- School of Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, United States of America
| | - Weichao Yuwen
- School of Nursing & Healthcare Leadership, University of Washington Tacoma, 1922 Pacific Ave, Tacoma, WA 98402, United States of America
| | - Jennifer Sonney
- School of Nursing, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, United States of America
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Guo X, Meng Y, Lian H, Li Y, Xu Y, Zhang R, Xu J, Wang H, Xu S, Cai W, Xiao L, Su T, Tang Y. Marital status and living apart affect sleep quality in male military personnel: a study of the China's Navy during COVID-19. Front Psychiatry 2023; 14:1178235. [PMID: 37575585 PMCID: PMC10412872 DOI: 10.3389/fpsyt.2023.1178235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Abstract
Background Marital status is a robust sociodemographic predictor of sleep. Having to live apart from spouse may have different implications than those of cohabitants or singles, especially in military personnel. Further research on this group will help provide knowledge in advance and facilitate early targeted interventions. Methods An online questionnaire study was conducted from July to November 2021. A total of 1,832 male military personnel completed the questionnaire. The marital status was measured by a self-reported single choice question. Pittsburgh sleep quality index (PSQI), Epworth Sleepiness Scale (ESS) and The Dysfunctional Beliefs and Attitudes about sleep scale (DBAS-16) were used to measure sleep-related outcomes. Inverse probability weighting (IPW) was applied to reduce the effects of confounding. Logistic regression was used to analyze the relationship between marital status and sleep and explore the impact of living together or not. Results After inverse probability weighting, the prevalence of poor sleep quality, sleepiness and dysfunctional beliefs were 16.1, 20.1 and 7.1%, respectively. One-way ANOVA results for the means of both groups were statistically significantly different, except for the sleep latency and sleep disturbance dimensions of PSQI. Participants who were married were more likely to have poor sleep quality (OR: 1.408, 95% CI: [1.10, 1.80]), to have daytime sleepiness (OR: 1.560, 95% CI: [1.27, 1.92]) and to develop dysfunctional beliefs and attitudes (OR: 2.497, 95% CI: [1.65, 3.80]) than those who were unmarried. Further analysis showed that the odds of developing poor sleep quality and DBAS in participants who married but living apart were significantly bigger than those unmarried (OR: 1.548 and 3.991, respectively.), while there were no significant differences in the odds of daytime sleepiness (OR: 0.738, p = 0.050). Age was a protective factor for the development of bad sleep outcomes, while family economic was an independent risk factor. Conclusion Marital status appear important for sleep quality, daytime sleepiness and sleep beliefs. The effect of living apart or not should be considered separately as an important predictor of sleep.
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Affiliation(s)
- Xin Guo
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yao Meng
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
- Department of Diving and Hyperbaric Medical Research, Naval Medical Center, Naval Medical University, Shanghai, China
| | - Hao Lian
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yinan Li
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Ying Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Ruike Zhang
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Jingzhou Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Hao Wang
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Shuyu Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Wenpeng Cai
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Lei Xiao
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Tong Su
- Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yunxiang Tang
- Faculty of Psychology, Naval Medical University, Shanghai, China
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Maratia F, Bacaro V, Crocetti E. Sleep Is a Family Affair: A Systematic Review and Meta-Analysis of Longitudinal Studies on the Interplay between Adolescents' Sleep and Family Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054572. [PMID: 36901581 PMCID: PMC10001512 DOI: 10.3390/ijerph20054572] [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: 12/20/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 05/06/2023]
Abstract
Family is one of the primary socialization contexts influencing adolescents' psychological health. In this regard, a crucial indicator of adolescents' health is their sleep quality. Nevertheless, it is still unclear how multiple family factors (i.e., demographic and relational) are intertwined with adolescents' sleep quality. For this reason, this systematic review with meta-analysis aims to comprehensively summarize and integrate previous longitudinal research investigating the reciprocal relation between demographics (e.g., family structure) and positive (e.g., family support) and negative (e.g., family chaos) relational family factors and adolescents' sleep quality. Several search strategies were applied, and a final set of 23 longitudinal studies that matched the eligibility criteria were included in this review. The total number of participants was 38,010, with an average age at baseline of 14.7 years (SD = 1.6, range: 11-18 years). On the one hand, the meta-analytic results showed that demographic factors (e.g., low socio-economic status) were not related to adolescents' sleep quality at a later time point. On the other hand, positive and negative family relational factors were positively and negatively related to adolescents' sleep, respectively. Furthermore, the results suggested that this association could be bidirectional. Practical implications and suggestions for future research are discussed.
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Robbins R, Beebe DW, Byars KC, Grandner M, Hale L, Tapia IE, Wolfson AR, Owens JA. Adolescent sleep myths: Identifying false beliefs that impact adolescent sleep and well-being. Sleep Health 2022; 8:632-639. [PMID: 36180345 PMCID: PMC9772111 DOI: 10.1016/j.sleh.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Commonly held beliefs about sleep unsupported by scientific evidence (ie, myths) among adolescents and their parents/caregivers may adversely influence sleep-related attitudes and behaviors among adolescents. Thus, identifying such myths with the goal of developing effective evidence-based counter-messages has the potential to improve sleep health in adolescents. METHOD We identified myths with a panel of adolescent sleep health experts (n = 12) using the Delphi method in three sequential steps: (1) focus groups; (2) online discussion; and (3) closed-ended questionnaires with which the experts rated myths on: (1) falseness and (2) public health significance using 5-point Likert scales ranging from 1 (not at all false/important for public health) to 5 (extremely false/important for public health). Next, we explored the prevalence of the myths among a demographically diverse sample of parents/caregivers of adolescents in the United States. Finally, we report the counterevidence to refute each myth. RESULTS Ten myths about adolescent sleep were identified by the experts using the Delphi method. The most prevalent myths were the beliefs that (1) "Going to bed and waking up late on the weekends is no big deal for adolescents, as long as they get enough sleep during that time," reported by 74% of parents/caregivers; (2) "If school starts later, adolescents will stay up that much later," reported by 69% of parents/caregivers; and (3) "Melatonin supplements are safe for adolescents because they are natural," reported by 66% of parents/caregivers. CONCLUSION Parents/caregivers have the potential to serve as sleep health advocates for their adolescent and support their adolescent's sleep health behaviors. Our study found that many parents/caregivers endorse myths about adolescent sleep that may hinder their ability to support their adolescent's sleep health. Future research may explore methods for promoting evidence-based beliefs about adolescent sleep among parents/caregivers.
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Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
| | - Dean W Beebe
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Kelly C Byars
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Michael Grandner
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook Medicine, Program in Public Health, Stony Brook, NY, USA
| | - Ignacio E Tapia
- Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia. Philadelphia, PA, USA
| | - Amy R Wolfson
- Department of Psychology, Loyola University Maryland, Baltimore, MD, USA
| | - Judith A Owens
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA
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Chan NY, Lam SP, Zhang J, Chan JWY, Yu MMW, Suh S, Yang CM, Okajima I, Li AM, Wing YK, Li SX. Efficacy of Email-delivered Versus Face-to-face Group Cognitive Behavioral Therapy for Insomnia in Youths: A Randomized Controlled Trial. J Adolesc Health 2022; 70:763-773. [PMID: 35125265 DOI: 10.1016/j.jadohealth.2021.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/06/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of the study was to compare the efficacy of group-based therapy (GT) and email-delivered self-help (ESH) cognitive behavioral therapy for insomnia (CBT-I) with the wait-list (WL) control group in youths. METHODS The study involved an assessor-blind, parallel group randomized controlled trial in youths meeting the diagnostic criteria for insomnia disorder. Participants were randomized to one of the three groups (8-week GT, 8-week ESH, or WL). Participants in all three groups were assessed at baseline and after treatment (week 9 for the WL group). The two treatment groups were additionally assessed at one month and six months after the intervention. Treatment effects were examined using linear mixed models. RESULTS A total of 135 youths (mean age: 20.0 ± 2.5 years, female: 67.4%) were recruited. After treatment, both active treatment groups showed significant improvements in insomnia symptoms (GT vs. WL: Cohen's d = -1.03, ESH vs. WL: d = -.63), less presleep arousal (d = -.52 to -1.47), less sleep-related dysfunctional belief (d = -.88 to -1.78), better sleep hygiene practice (d = -.79 to -.84), and improved daytime functioning (d = -.56 to -.96) compared with the WL group. In addition, GT outperformed ESH in improving maladaptive sleep-related beliefs and mood symptoms at post-treatment and 6-month follow-up. A reduction of suicidality with moderate effect size favoring GT emerged at 6-month follow-up. DISCUSSION Our findings suggested that both group-based and email-delivered CBT-I were effective in treating youth insomnia, but group-based CBT-I showed superior effects on reducing maladaptive beliefs and mood symptoms.
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Affiliation(s)
- Ngan Yan Chan
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Siu Ping Lam
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mandy Man Wai Yu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Korea
| | - Chien-Ming Yang
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
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Khor SPH, McClure A, Aldridge G, Bei B, Yap MBH. Modifiable parental factors in adolescent sleep: A systematic review and meta-analysis. Sleep Med Rev 2020; 56:101408. [PMID: 33326915 DOI: 10.1016/j.smrv.2020.101408] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 01/01/2023]
Abstract
Sleep problems are prevalent during adolescence, but parents may be able to support adolescents to sleep better. A systematic search of records from six databases from inception up to November 2019, identified 103 peer-reviewed publications that examined behaviourally and cognitively modifiable parental factors associated with sleep in adolescents aged 12-18 years. Although included studies were largely cross-sectional and heterogeneous, with heavy reliance on self-reported measures, associations with sound, convergent levels of evidence were found for: 1) parental rule-setting for bedtimes and parent sleep behaviours with longer sleep duration in adolescents; 2) healthy parent sleep and family functioning with better adolescent sleep quality; and 3) parental warmth with better adolescent daytime functioning. Effect sizes were in the small to moderate range. The identified parental factors are recommended targets for inclusion in parenting programs to support adolescent sleep, however, would require validation in intervention studies. Opportunities for research are outlined for the identified parental factors, sleep domains with limited evidence, and better understanding the mechanisms or possible moderators in the associations between parental factors and sleep outcomes.
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Affiliation(s)
- Sarah P H Khor
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia
| | - Anne McClure
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia
| | - Grace Aldridge
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia
| | - Marie B H Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Australia; School of Population and Global Health, University of Melbourne, Australia.
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Lee J, Yeo S, Kim K, Chung S. Sleep Environment and Non-Rapid Eye Movement-Related Parasomnia Among Children: 42 Case Series. SLEEP MEDICINE RESEARCH 2020. [DOI: 10.17241/smr.2020.00535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sabot DL, Hicks RE. Does psychological capital mediate the impact of dysfunctional sleep beliefs on well-being? Heliyon 2020; 6:e04314. [PMID: 32617422 PMCID: PMC7322688 DOI: 10.1016/j.heliyon.2020.e04314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/05/2020] [Accepted: 06/22/2020] [Indexed: 11/28/2022] Open
Abstract
Dysfunctional sleep beliefs are strongly involved in sleep difficulties, which in turn negatively predict psychological health and well-being. In contrast, psychological capital (PsyCap) is a positive cognitive resource, comprising four dimensions (hope, self-efficacy, resilience, and optimism), that positively predicts psychological well-being. Significant associations between sleep beliefs and well-being, and PsyCap and well-being are detailed; however, research on their interrelations (among sleep beliefs, well-being, and PsyCap) remains scarce. This cross-sectional study aimed to elucidate the relationships among the variables. The convenience sample consisted of 123 Australian working adults. Participants completed an online survey comprising four empirically established measures (Dysfunctional Beliefs and Attitudes about Sleep Scale, Psychological Well-being Scale, Psychological Capital Questionnaire, and a social desirability scale). Hypotheses were derived from Conservation of Resources (COR) theory, which underlines the importance of cognitive mechanisms that guide adaptive psychological responses. Results were consistent with hypotheses: dysfunctional sleep beliefs significantly and negatively predicted PsyCap, and PsyCap mediated the relationship between sleep beliefs and well-being. Findings suggested that PsyCap, which can be developed, may help buffer the adverse effects of sleep beliefs to benefit well-being. Replication of model coefficients in larger samples and future testing of PsyCap training within sleep-hygiene practices are recommended.
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Affiliation(s)
- Debbie L. Sabot
- School of Psychology, Faculty of Society and Design, Bond University; Australia
| | - Richard E. Hicks
- School of Psychology, Faculty of Society and Design, Bond University; Australia
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Peltz JS, Rogge RD, Connolly H. Parents still matter: the influence of parental enforcement of bedtime on adolescents’ depressive symptoms. Sleep 2019; 43:5647326. [DOI: 10.1093/sleep/zsz287] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/28/2019] [Indexed: 12/14/2022] Open
Abstract
Abstract
Study Objectives
The aim of the current study was to test a multilevel mediation model that examined how adolescent sleep duration might be linked to depressive symptoms via their daytime energy levels. Furthermore, the study examined how parents’ enforcement of various types of bedtime rules predicted the duration of adolescent sleep.
Methods
A total of 193 adolescent (ages 14–17; Mage = 15.7 years old, SD = .94; 54.4% female; 71% Caucasian) and parent dyads completed baseline, online surveys, and adolescents also completed online 7-day, twice-daily (i.e. morning and evening) reports of their sleep duration (morning diary) and their energy levels and depressive symptoms throughout the day (evening diary). Parents (Mage = 47.6 years old, SD = 5.4; 80% female) completed assessments of enforcement of bedtime-related rules (i.e. bedtime, cessation of electronic media usage, prohibiting afternoon/evening caffeine consumption). Multilevel modeling enabled the testing of the mediation model both at the between-person level and within individuals.
Results
Results suggested that adolescents’ energy levels mediated the association between adolescents’ sleep duration and depressive symptoms. Furthermore, both greater enforcement of bedtimes and later school start times predicted longer sleep durations for adolescents, and were indirectly associated with adolescents’ depressive symptoms.
Conclusions
These findings underscore the importance of adolescents obtaining sufficient sleep to support their mental health and suggest a critical point of intervention for preventing or decreasing insufficient sleep. Given the diverse threats to adolescents’ sleep as well as adolescents’ desire for greater independence, collaborative, autonomy-promoting bedtime limit-setting is recommended to support adolescents’ well-being.
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Affiliation(s)
| | - Ronald D Rogge
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY
| | - Heidi Connolly
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
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