1
|
Orjatsalo M, Toppila J, Heimola M, Tuisku K, Simola P, Ämmälä AJ, Räisänen P, Parkkola K, Paunio T, Alakuijala A. Snoring was related to self-reported daytime sleepiness and tiredness in young adults performing compulsory conscript service. J Clin Sleep Med 2023; 19:243-251. [PMID: 36111359 PMCID: PMC9892747 DOI: 10.5664/jcsm.10294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES In young adults performing compulsory military service, fatigue and somnolence are common and presumably associated with objective or self-reported sleep deprivation. We aimed to find out whether objective sleep parameters from ambulatory polysomnography could explain their self-reported tiredness and sleepiness and whether habits were associated with sleep parameters or tiredness. METHODS Seventy (67 male, age 18-24 years) participants had their sleep assessed with polysomnography. Their self-reported symptoms and demographic data were obtained from online survey including Epworth Sleepiness Scale, Beck's Depression Inventory, items from Basic Nordic Sleep Questionnaire, Internet Addiction Scale, and lifestyle questions. RESULTS Snoring (audio recording, percentage of total sleep time) was associated with self-reported sleepiness (P = .010) and tiredness (P = .030) and snoring seemed to, partially, explain sleepiness (P = .029). Twenty-six percent of the conscripts had self-reported sleep deprivation (mismatch between reported need for sleep and reported sleep). Self-reported sleep deprivation was significantly associated with somnolence (P = .016) and fatigue (P = .026). Smartphone usage, both average time (P = .022) and frequency of usage (P = .0093) before bedtime, was associated with shorter total sleep time. On average, objective sleep time was rather short (7 hours, 6 minutes), sleep efficiency high (94.9%), proportion of N3 sleep high (27.7%), and sleep latency brief (9 minutes)-suggesting that many of the conscripts might have chronic partial sleep deprivation. CONCLUSIONS Snoring might predispose to tiredness in presumably healthy young adults. Conscripts may have partial sleep deprivation. CITATION Orjatsalo M, Toppila J, Heimola M, et al. Snoring was related to self-reported daytime sleepiness and tiredness in young adults performing compulsory conscript service. J Clin Sleep Med. 2023;19(2):243-251.
Collapse
Affiliation(s)
- Maija Orjatsalo
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jussi Toppila
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mikko Heimola
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Katinka Tuisku
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helskinki, Finland
| | - Petteri Simola
- Finnish Defence Research Agency, Human Performance Division, Tuusula, Finland
| | - Antti-Jussi Ämmälä
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
- Centre for Military Medicine, The Finnish Defence Forces, Riihimäki, Finland
| | - Pekka Räisänen
- Centre for Military Medicine, The Finnish Defence Forces, Riihimäki, Finland
| | - Kai Parkkola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland, and National Defence University, Helsinki, Finland
| | - Tiina Paunio
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helskinki, Finland
| | - Anniina Alakuijala
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
2
|
Myllylä M, Kyröläinen H, Ojanen T, Ruohola JP, Heinonen OJ, Simola P, Vahlberg T, Parkkola KI. The Effects of Individual Characteristics of the Naval Personnel on Sleepiness and Stress during Two Different Watchkeeping Schedules. Int J Environ Res Public Health 2022; 19:13451. [PMID: 36294028 PMCID: PMC9603121 DOI: 10.3390/ijerph192013451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Naval service can have a significant impact on the wellbeing of seafarers, and the operation of warships is highly dependent on the personnel on board. Nevertheless, there is a lack of knowledge concerning the impact of seafarers' individual characteristics on their wellbeing in a naval environment. Therefore, the aim of this study was to investigate individual characteristics of the naval personnel that may be associated with the amount of sleepiness, fatigue and stress responses experienced during shift work and irregular working hours in a naval environment. METHODS The study took place on a Finnish Defence Forces' Navy missile patrol boat on which 18 crewmembers served as study participants. The measurement periods lasted two separate weeks (seven days and six nights) during shift work with two different watchkeeping systems (4:4, 4:4/6:6). The onboard measurements consisted of the Karolinska Sleepiness Scale, salivary stress hormones, cognitive tests (Sustained Attention to Response Task and N-back Task) and heart rate variability. RESULTS Participants of older ages or with a longer history in naval service were associated with a greater amount of sleepiness, fatigue and stress responses on board. On the contrary, increased physical activity and a higher level of physical fitness, especially standing long jump, were associated with a lower amount of sleepiness, fatigue and fewer stress responses. In addition, an athletic body composition together with a healthy lifestyle may be beneficial, considering the stress responses on board. CONCLUSION The present results are well in line with the previous literature regarding shift work and irregular working hours. The results highlight the importance of regular physical activity and good physical fitness during service in the naval environment.
Collapse
Affiliation(s)
- Mikko Myllylä
- Centre for Military Medicine, The Finnish Defence Forces, 20241 Turku, Finland
- Doctoral Programme in Clinical Research, University of Turku, 20014 Turku, Finland
| | - Heikki Kyröläinen
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
- Department of Leadership and Military Pedagogy, National Defence University, 00861 Helsinki, Finland
| | - Tommi Ojanen
- Human Performance Division, Finnish Defence Research Agency, The Finnish Defence Forces, 04310 Tuusula, Finland
| | - Juha-Petri Ruohola
- The Navy Command Finland, The Finnish Defence Forces, 20811 Turku, Finland
| | - Olli J. Heinonen
- Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, 20520 Turku, Finland
| | - Petteri Simola
- Human Performance Division, Finnish Defence Research Agency, The Finnish Defence Forces, 04310 Tuusula, Finland
| | - Tero Vahlberg
- Department of Biostatistics, University of Turku, 20014 Turku, Finland
| | - Kai I. Parkkola
- Department of Leadership and Military Pedagogy, National Defence University, 00861 Helsinki, Finland
- Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| |
Collapse
|
3
|
Heimola M, Paulanto K, Alakuijala A, Tuisku K, Simola P, Ämmälä AJ, Räisänen P, Parkkola K, Paunio T. Chronotype as self-regulation: morning preference is associated with better working memory strategy independent of sleep. Sleep Adv 2021; 2:zpab016. [PMID: 37193569 PMCID: PMC10104420 DOI: 10.1093/sleepadvances/zpab016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/10/2021] [Indexed: 05/18/2023]
Abstract
Study Objectives We set out to examine how chronotype (diurnal preference) is connected to ability to function in natural conditions where individuals cannot choose their sleep schedule. We conducted a cross-sectional study in military conscript service to test the hypothesis that sleep deprivation mediates the adverse effects of chronotype on cognitive functioning. We also examined the effects of time of day. Methods One hundred forty participants (ages 18-24 years) completed an online survey, including the Morningness-Eveningness Questionnaire and a Cambridge Neuropsychological Test Automated Battery. Most (n = 106) underwent an actigraphy recording. After bivariate analyses, we created a mediation model (self-reported sleepiness and sleep deprivation mediating effect of chronotype on cognition) and a moderation model (synchrony between most alert time and testing time). Results Reaction times in inhibition task correlated negatively with sleep efficiency and positively with sleep latency in actigraphy. There was no relation to ability to inhibit responses. More significantly, spatial working memory performance (especially strategicness of performance) correlated positively with morning preference and negatively with sleep deprivation before service. Synchrony with most alert time of the day did not moderate these connections. No other cognitive task correlated with morningness or sleep variables. Conclusions In line with previous research, inhibitory control is maintained after insufficient sleep but with a tradeoff of slower performance. The connection between morning preference and working memory strategy is a novel finding. We suggest that diurnal preference could be seen as an adaptive strategy, as morningness has consistently been associated with better academic and health outcomes.
Collapse
Affiliation(s)
- Mikko Heimola
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Kaisu Paulanto
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Anniina Alakuijala
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katinka Tuisku
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Petteri Simola
- Finnish Defence Research Agency, Human Performance Division, Tuusula, Finland
| | - Antti-Jussi Ämmälä
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
- Centre for Military Medicine, The Finnish Defence Forces, Helsinki, Finland
| | - Pekka Räisänen
- Centre for Military Medicine, The Finnish Defence Forces, Helsinki, Finland
| | - Kai Parkkola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- National Defence University, Helsinki, Finland
| | - Tiina Paunio
- Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| |
Collapse
|
4
|
Mansikka H, Simola P, Virtanen K, Harris D, Oksama L. Fighter pilots' heart rate, heart rate variation and performance during instrument approaches. Ergonomics 2016; 59:1344-1352. [PMID: 26942339 DOI: 10.1080/00140139.2015.1136699] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 12/21/2015] [Indexed: 06/05/2023]
Abstract
Fighter pilots' heart rate (HR), heart rate variation (HRV) and performance during instrument approaches were examined. The subjects were required to fly instrument approaches in a high-fidelity simulator under various levels of task demand. The task demand was manipulated by increasing the load on the subjects by reducing the range at which they commenced the approach. HR and the time domain components of HRV were used as measures of pilot mental workload (PMWL). The findings of this study indicate that HR and HRV are sensitive to varying task demands. HR and HRV were able to distinguish the level of PMWL after which the subjects were no longer able to cope with the increasing task demands and their instrument landing system performance fell to a sub-standard level. The major finding was the HR/HRV's ability to differentiate the sub-standard performance approaches from the high-performance approaches. Practitioner Summary: This paper examined if HR and HRV were sensitive to varying task demands in a fighter aviation environment and if these measures were related to variations in pilot's performance.
Collapse
Affiliation(s)
- Heikki Mansikka
- a Faculty of Engineering and Computing, Human Systems Integration Group , Coventry University , Coventry , UK
- b Doctrine and Concept Division , Finnish Defence Research Agency , Riihimäki , Finland
| | - Petteri Simola
- c Finnish Defence Research Agency , Tuusula , Finland
- d Cognitive Brain Research Unit, Cognitive Science, Institute of Behavioral Sciences , University of Helsinki Helsinki , Finland
| | - Kai Virtanen
- e Systems Analysis Laboratory, Department of Mathematics and Systems Analysis , School of Science, Aalto University , Helsinki , Finland
| | - Don Harris
- a Faculty of Engineering and Computing, Human Systems Integration Group , Coventry University , Coventry , UK
| | - Lauri Oksama
- f National Defence University , Helsinki , Finland
| |
Collapse
|
5
|
Mansikka H, Virtanen K, Harris D, Simola P. Fighter pilots' heart rate, heart rate variation and performance during an instrument flight rules proficiency test. Appl Ergon 2016; 56:213-219. [PMID: 27109324 DOI: 10.1016/j.apergo.2016.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/09/2016] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
Increased task demand will increase the pilot mental workload (PMWL). When PMWL is increased, mental overload may occur resulting in degraded performance. During pilots' instrument flight rules (IFR) proficiency test, PMWL is typically not measured. Therefore, little is known about workload during the proficiency test and pilots' potential to cope with higher task demands than those experienced during the test. In this study, fighter pilots' performance and PMWL was measured during a real IFR proficiency test in an F/A-18 simulator. PMWL was measured using heart rate (HR) and heart rate variation (HRV). Performance was rated using Finnish Air Force's official rating scales. Results indicated that HR and HRV differentiate varying task demands in situations where variations in performance are insignificant. It was concluded that during a proficiency test, PMWL should be measured together with the task performance measurement.
Collapse
Affiliation(s)
- Heikki Mansikka
- Human Systems Integration Group, Faculty of Engineering and Computing, Coventry University, Priory Street, Coventry CV1 5FB, United Kingdom.
| | - Kai Virtanen
- Systems Analysis Laboratory, Department of Mathematics and Systems Analysis, School of Science, Aalto University, P.O.Box 11100, FIN 00076 Aalto, Helsinki, Finland.
| | - Don Harris
- Human Systems Integration Group, Faculty of Engineering and Computing, Coventry University, Priory Street, Coventry CV1 5FB, United Kingdom.
| | - Petteri Simola
- Finnish Defence Research Agency, Human Performance Division, Rantatie 66, 04401 Järvenpää, Tuusula, Finland; Cognitive Brain Research Unit, Cognitive Science, Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
| |
Collapse
|
6
|
Abstract
This study compared sleep in patients with Conduct Disorder/Oppositional Defiant Disorder (CD/ODD) and normative children and evaluated the associations between sleep and behavioral symptoms in patients. Participants were 30 patients, aged 7 to 12 years, with diagnoses of CD/ODD and their age and gender matched controls. Patients with CD/ODD and their parents reported significantly more sleep problems than did the control children and their parents (p values < 0.01). By actigraphy, CD/ODD children with comorbid ADHD slept significantly less than did the patients with CD/ODD alone and the controls. In patients, low sleep amount and efficiency associated with increased amount of parent-reported externalizing symptoms (r = -0.72, 0.66, p values < 0.001). Results highlight the need of evaluating sleep in children with CD/ODD. Improving their sleep may ease their symptoms.
Collapse
Affiliation(s)
- Eeva T Aronen
- a Department of Child Psychiatry Children's Hospital, Helsinki University and Helsinki University Central Hospital
| | | | | | | |
Collapse
|
7
|
Simola P, Liukkonen K, Pitkäranta A, Pirinen T, Aronen ET. Psychosocial and somatic outcomes of sleep problems in children: a 4-year follow-up study. Child Care Health Dev 2014; 40:60-7. [PMID: 22774762 DOI: 10.1111/j.1365-2214.2012.01412.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Inadequate sleep in children relates to medical and psychosocial problems. However, not much is known about the effects of sleep problems persisting from pre-school to school age on somatic and psychosocial symptoms. OBJECTIVES To examine the associations between sleep disturbances and psychosocial symptoms, somatic complaints, medical problems at school age. METHODS This was a population-based 4-year follow-up study of sleep problems in Finnish children (n = 470). Parents filled in Sleep Disturbance Scale for Children during pre-school and school years. Children were categorized into four groups: no sleep problems, sleep problems only at pre-school or only at school age, and persistent sleep problems. At follow-up the parents filled in Child Behavior Checklist and a background questionnaire. RESULTS The children with persistent sleep problems (9%) had a 16-fold risk of having psychosocial symptoms on subclinical/clinical range compared with the children without sleep problems. The psychosocial symptoms that were related strongest to prolonged sleep problems were aggression, social and attention problems, and anxious/depressed mood. Also, somatic complaints (ninefold risk) and medical problems (P < 0.001) were typical for children with persistent sleep problems. CONCLUSIONS Persistent sleep problems in children associate with high levels of psychosocial, somatic and medical problems. In paediatric health care more attention should be paid to recognizing, monitoring of the persistence and treatment of sleep problems before school transition period.
Collapse
Affiliation(s)
- P Simola
- Department of Child Psychiatry, Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Psychology, Helsinki University, Helsinki, Finland
| | | | | | | | | |
Collapse
|
8
|
Vuontela V, Carlson S, Troberg AM, Fontell T, Simola P, Saarinen S, Aronen ET. Working memory, attention, inhibition, and their relation to adaptive functioning and behavioral/emotional symptoms in school-aged children. Child Psychiatry Hum Dev 2013; 44:105-22. [PMID: 22661151 DOI: 10.1007/s10578-012-0313-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The present study investigated the development of executive functions (EFs) and their associations with performance and behavior at school in 8-12-year-old children. The EFs were measured by computer-based n-back, Continuous Performance and Go/Nogo tasks. School performance was evaluated by Teacher Report Form (TRF) and behavior by TRF and Child Behavior Checklist. The studied dimensions of EF were cognitive efficiency/speed, working memory/attention and inhibitory control. Strong age effects were found for these cognitive abilities (p values <0.01). Inhibitory control was associated with better adaptive functioning (learning, working hard and behaving well), academic performance and less psychiatric symptoms (p values <0.05), specially in 8-9-year-old children. In this youngest age group low inhibitory control was also associated with teacher-reported inattention (p = 0.042). Low inhibitory control was associated with teacher- and parent-reported internalizing symptoms (p < 0.01). These results suggest that maturational factors may underlie low adaptive functioning and psychiatric symptoms during early school years. Further studies are needed to evaluate the association between inhibition and emotional symptoms.
Collapse
Affiliation(s)
- Virve Vuontela
- Neuroscience Unit, Institute of Biomedicine/Physiology, University of Helsinki, Helsinki, Finland.
| | | | | | | | | | | | | |
Collapse
|
9
|
Simola P, Laitalainen E, Liukkonen K, Virkkula P, Kirjavainen T, Pitkäranta A, Aronen ET. Sleep disturbances in a community sample from preschool to school age. Child Care Health Dev 2012; 38:572-80. [PMID: 21790716 DOI: 10.1111/j.1365-2214.2011.01288.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the prevalence of various sleep problems at school age in a Finnish community sample and to evaluate the persistence of the sleep problems from the preschool age to school age in a 4-year follow-up. METHODS Parents completed the Sleep Disturbance Scale for Children questionnaire on their child's sleep during the preschool years (3-6 years) and again during the school years (7-11 years). At follow-up the parents also completed a questionnaire on family structure and socio-economic status. RESULTS The parents of 481 children completed the questionnaires during both the first study and the follow-up (girls 49%, boys 51%; mean age 9, range 7-11). At the population level, sleep problems slightly declined from preschool to school age (P < 0.05). However, sleep problems at preschool age showed a strong persistence to school age. At the follow-up, 35% of the children who were considered to have a sleep disorder at preschool age still suffered from it at school age. At the community level, this equates to 9% of the children. The children with no sleep problems at preschool age rarely developed sleep problems at school age. CONCLUSIONS This study showed that various types of sleep problems are common at school age. Sleep problems persisted from preschool to school age at the individual level. It is important to recognize all types of sleep problems, especially persistent ones. Persistent sleep problems in children may cause and exacerbate other somatic, cognitive and psychiatric problems. Therefore, more attention should be focused on sleep problems in paediatric health care with interventions aimed particularly at children with prolonged sleep problems.
Collapse
Affiliation(s)
- P Simola
- Clinic for Children and Adolescents, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland.
| | | | | | | | | | | | | |
Collapse
|
10
|
Pirinen T, Kolho KL, Simola P, Ashorn M, Aronen ET. Parent-adolescent agreement on psychosocial symptoms and somatic complaints among adolescents with inflammatory bowel disease. Acta Paediatr 2012; 101:433-7. [PMID: 22122226 DOI: 10.1111/j.1651-2227.2011.02541.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM To investigate parent-adolescent agreement on psychosocial and somatic symptoms in adolescents with inflammatory bowel disease (IBD). METHODS A questionnaire-based postal survey comprising Finnish adolescents aged 10-18 years with IBD (n = 156) and their parents. Emotional, behavioural and somatic symptoms were measured using the Child Behaviour Checklist (parent report) and the Youth Self-Report. RESULTS In paediatric IBD, adolescents and parents agreed on the presence of a psychosocial problem (in subclinical/clinical range) in 5% of the cases but disagreed in 21%. In 74% of the dyads, respondents agreed that no problems existed. Agreement in reporting psychosocial or somatic symptoms was poor to low (κ = 0.00-0.38). The lowest agreement was on anxious/depressed mood (κ = 0.02) and thought problems (κ = 0.00) and the highest on social problems. The parents reported more somatic symptoms in their adolescents than the adolescents themselves (p < 0.001). CONCLUSION Young IBD patients and their parents disagree in reporting psychosocial and somatic symptoms of the patients. The adolescents as well as their parents need to be involved; otherwise, many symptoms of clinical significance would go unnoticed.
Collapse
Affiliation(s)
- T Pirinen
- Hospital for Children and Adolescents, Helsinki University Central Hospital, and Helsinki University, Helsinki, Finland.
| | | | | | | | | |
Collapse
|
11
|
Abstract
BACKGROUND Motor retardation is a cardinal feature in adult depression. Limited information exists about motor activity in depressed children. The present study evaluated motor activity in depressed children compared to controls and investigated whether motor activity can be linked with the severity of symptoms in depressed children. METHOD Motor activity during both day- and night time was recorded by actigraphy in twenty-two depressed children and their controls. A K-SADS-PL interview of the child and his/her mother was used to diagnose depression. The depressed children filled in the Child Depression Inventory (CDI) as a self-report of the severity of depression. Parents and teachers of both depressed children and controls filled in the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). RESULTS Motor activity was reduced during the daytime in depressed children compared to controls (p<0.001). Depressed children spent more time in total immobility during the night time than their peers (p<0.05). In depressed children motor activity was linked with the severity of self- (r=-0.45, p<0.05) and teacher-reported (r=-0.52, p<0.05) symptoms. Depressed children with suicidal ideation (n=10) differed significantly in motor activity compared to depressed children without suicidal ideation (n=12) and controls (n=22). LIMITATIONS Sample size was only moderate. CONCLUSIONS Reduced motor activity is an important feature of childhood depression. Objectively measured motor activity can distinguish depressed children from their peers. Motor retardation can be linked with the severity of depression, especially suicidal ideation and possibly subtype depressed children into groups with different etiology, treatment needs and course of illness.
Collapse
Affiliation(s)
- Eeva T Aronen
- Children's Hospital, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland
| | | | | |
Collapse
|
12
|
Pirinen T, Kolho KL, Simola P, Ashorn M, Aronen ET. Parent and self-report of sleep-problems and daytime tiredness among adolescents with inflammatory bowel disease and their population-based controls. Sleep 2011; 33:1487-93. [PMID: 21102990 DOI: 10.1093/sleep/33.11.1487] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES to evaluate the frequency of sleep problems and daytime tiredness among adolescents with inflammatory bowel disease (IBD) in comparison with their healthy peers. DESIGN Parent and self-reports of sleep problems and daytime tiredness. SETTING questionnaire-based postal survey. INTERVENTION N/A. PARTICIPANTS one hundred sixty Finnish adolescents with IBD; 236 adolescents matched for age, sex, and place of residence; and the parents of both groups. MEASUREMENTS AND RESULTS Sleep Self-Report and sleep questions of the Child Behavior Check-List, and Youth Self-Report. The parents of adolescents with IBD reported in their index child more trouble sleeping (P < 0.01), more nightmares (P < 0.01), sleeping more than most children during the day/night (P < 0.001), and overtiredness (P < 0.001) than did the parents of control subjects. In contrast, adolescents with IBD themselves did not report more problems than their peers. However, in the group of patients with self-reported severe IBD symptoms, both the parents and the adolescents reported trouble sleeping and overtiredness more often (P values < 0.01) than in the group with mild symptoms or control subjects. Adolescents with severe IBD reported more often that their symptoms affected the quality of their sleep (P < 0.001) than did adolescents with mild disease. CONCLUSIONS adolescents with severe IBD symptoms have disturbed sleep and are overtired more often than are adolescents with mild IBD symptoms or control subjects. Thus, in adolescents with severe IBD symptoms, evaluating sleep is important in characterizing the disease burden. Both parent and adolescent reports are needed for comprehensive assessment of sleep in the young.
Collapse
Affiliation(s)
- Teija Pirinen
- Institute of Clinical Medicine, Clinic for Children and Adolescents, University of Helsinki, Finland
| | | | | | | | | |
Collapse
|
13
|
Simola P, Niskakangas M, Liukkonen K, Virkkula P, Pitkäranta A, Kirjavainen T, Aronen ET. Sleep problems and daytime tiredness in Finnish preschool-aged children-a community survey. Child Care Health Dev 2010; 36:805-11. [PMID: 20645995 DOI: 10.1111/j.1365-2214.2010.01112.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep is important to the well-being and development of children. Specially, small children are vulnerable to the effects of inadequate sleep. However, not much is known about the frequency of all types of sleep problems and daytime tiredness in preschool-aged children. OBJECTIVE To evaluate the prevalence of a wide spectrum of sleep problems, daytime tiredness and associations between these in 3- to 6-year-old Finnish children. METHODS A population-based study where parents of 3- to 6-year-old children (n= 904) living in Helsinki filled in the Sleep Disturbance Scale for Children (SDSC). RESULTS Of the children, 45% had at least one sleep-related problem occurring at least three times a week: 14.1% were unwilling to go to bed, 10.2% had difficulties in falling asleep, 10.2% had bruxism, 6.4% sleep talking, 2.1% sleep terrors, 8.2% had sleep-related breathing problem, 11.2% had excessive sweating while falling asleep and 12.9% excessive sweating during sleep. Age and gender were related to phenotype of the sleeping problems. In multiple regression analysis, the difficulties in initiating and maintaining sleep were most strongly associated with tiredness in the morning and during the day. CONCLUSIONS Different types of sleep problems are frequent in preschool-aged children. Poor sleep quality is associated with morning and daytime tiredness. In screening for sleep problems in children, attention should be paid not only to sleep amount but also to sleep quality.
Collapse
Affiliation(s)
- P Simola
- Clinic for Children and Adolescents, Institute of Clinical Medicine, Department of Psychology, University of Helsinki, Helsinki, Finland.
| | | | | | | | | | | | | |
Collapse
|
14
|
Väistö T, Aronen ET, Simola P, Ashorn M, Kolho KL. Psychosocial symptoms and competence among adolescents with inflammatory bowel disease and their peers. Inflamm Bowel Dis 2010; 16:27-35. [PMID: 19575356 DOI: 10.1002/ibd.21002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The aim was to evaluate psychosocial symptoms and competence as reported by the parents and the adolescents themselves among patients with inflammatory bowel disease (IBD) in relation to population-based controls. METHODS Standardized Achenbach questionnaires-Child Behavior Checklist (CBCL) for the parents and Youth Self-Report (YSR) for the adolescents-were sent to Finnish families of adolescents with IBD (age 10-18 years), and their controls matched for age, gender, and place of residence. The final study group comprised 160 adolescents with IBD and 236 controls with their parents, respectively. RESULTS According to parent reports, adolescents with IBD had more symptoms of anxious/depressed mood (P < 0.001), withdrawn/depressed mood (P < 0.05), social problems (P < 0.05), thought problems (P < 0.001), somatic complaints (P < 0.001), and lower competence (P < 0.05) than population-based controls. Unexpectedly, there was no group difference in the amount of self-reported psychosocial symptoms, somatic complaints, or competence between adolescents with IBD and their peers. However, adolescents with severe IBD reported significantly more emotional problems (P < 0.001) than those with mild symptoms or controls. CONCLUSIONS According to parents, adolescents with IBD have more emotional problems, social problems, thought problems, and lower competence than their population-based peers. Self-perceived severity of the IBD symptoms is associated with a larger amount of parent and self-reported emotional symptoms. Complementary methods should be used while assessing the psychosocial well-being of adolescents with IBD as questionnaires alone may be insufficient.
Collapse
Affiliation(s)
- Teija Väistö
- Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | | | | | | | | |
Collapse
|
15
|
Aronen ET, Liukkonen K, Simola P, Virkkula P, Uschakoff A, Korkman M, Kirjavainen T, Pitkäranta A. Mood is associated with snoring in preschool-aged children. J Dev Behav Pediatr 2009; 30:107-14. [PMID: 19258911 DOI: 10.1097/dbp.0b013e31819d70a2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study emotional and behavioral problems and sleep and cognitive performance in snoring and nonsnoring 3- to 6-year-old children. METHODS As part of an epidemiological study of sleep disordered breathing (SDB) in preschool-aged children, 43 snorers and 46 nonsnorers participated in a clinical study. Their parents completed the Child Behavior Checklist (CBCL). The children were assessed with Wechsler Preschool and Primary Scale of Intelligence, Revised and subtests of the Developmental Neuropsychological Assessment (NEPSY-A) representing aspects of attention, language skills, sensorimotor functions, memory, and learning. RESULTS On the CBCL snoring children had significantly more parent reported internalizing symptoms (p < .05) than the nonsnoring children, especially symptoms of anxious/depressed mood (p < .01) and emotional reactivity (p < .05). More children from the snoring group than from the nonsnoring group (22 vs 11%) scored in the subclinical or clinical range on the internalizing scale. Interestingly, no significant difference between the groups was found in the amount of externalizing symptoms. The amount of sleep problems other than snoring was higher in the snoring than in the nonsnoring group (p < .01). On tests measuring auditory attention (p < .01) and language skills (verbal IQ, p < .05), the snoring group performed worse than the nonsnoring group. CONCLUSIONS Our results support the view that SDB should be considered a possible risk factor for mood disorder symptoms and impaired cognitive performance in children.
Collapse
Affiliation(s)
- Eeva T Aronen
- Department of Child Psychiatry, Hospital for Children and Adolescents, Helsinki University Central Hospital, Neuroscience Unit of the Helsinki Brain Research Center, Helsinki, Finland.
| | | | | | | | | | | | | | | |
Collapse
|
16
|
de la Chapelle A, Simola K, Simola P, Knuutila S, Gahmberg N, Pajunen L, Lundqvist C, Sarna S, Murros J. Heteromorphic X chromosomes in 46,XX males? Hum Genet 1979; 52:157-67. [PMID: 511171 DOI: 10.1007/bf00271568] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper reports an attempt to determine whether the short arm of one of the X chromosomes in XX males is longer than normal. In a blind study comparing coded photomicrographs of 15 G-banded mitoses from each of five XX males and five control females, the results were ambiguous and somewhat contradictory, but gave the impression of, or were compatible with, an XXp+ phenomenon in at least two of the five XX males. Measurements of the X chromosomes from the above cells and, in addition, from 15 mitoses from each of six XXY males, failed to disclose any XXp+ phenomenon. Statistical analysis indicated that in the five XX males there was no difference in the lengths of the two Xp arms. The reasons for the apparent discrepancy between the results of ocular inspection and measurement are discussed. The putative heteromorphism might be an alteration in shape, staining intensity, or position of bands, neither of which necessarily leads to an increase in length. We conclude that our results do not indicate any XXp+ phenomenon in the five XX males tested. However, the presence or absence of XXp+ is not in itself evidence for or against interchange betweenthe X and Y in the paternal meiosis. Our results emphasize that the etiology of XX males is likely to be heterogeneous.
Collapse
|