The Role of Infant Sleep in Intergenerational Transmission of Trauma

PubMed Central

Hairston, Ilana S.; Waxler, Ellen; Seng, Julia S.; Fezzey, Amanda G.; Rosenblum, Katherine L.; Muzik, Maria

2011-01-01

Introduction: Children of parents who experienced trauma often present emotional and behavioral problems, a phenomenon named inter-generational transmission of trauma (IGTT). Combined with antenatal factors, parenting and the home environment contribute to the development and maintenance of sleep problems in children. In turn, infant sleep difficulty predicts behavioral and emotional problems later in life. The aim of this study was to investigate whether infant sleep problems predict early behavioral problems indicative of IGTT. Methods: 184 first-time mothers (ages 18–47) participated. N = 83 had a history of childhood abuse and posttraumatic stress disorder (PTSD+); 38 women reported childhood abuse but did not meet diagnostic criteria for PTSD (PTSD−); and the control group (N = 63) had neither a history of abuse nor psychopathology (CON). Depression, anxiety, and sleep difficulty were assessed in the mothers at 4 months postpartum. Infant sleep was assessed using the Child Behavior Sleep Questionnaire (CSHQ). Outcome measures included the Parent Bonding Questionnaire (PBQ) at 4 months and the Child Behavior Check List (CBCL) at 18 months. Results: Infants of PTSD+ mothers scored higher on the CSHQ and had more separation anxiety around bedtime than PTSD− and CON, and the severity of their symptoms was correlated with the degree of sleep disturbance. Maternal postpartum depression symptoms mediated impaired mother-infant bonding, while infant sleep disturbance contributed independently to impaired bonding. Mother-infant bonding at 4 months predicted more behavioral problems at 18 months. Conclusions: Infant sleep difficulties and maternal mood play independent roles in infant-mother bonding disturbance, which in turn predicts behavioral problems at 18 months. Citation: Hairston IS; Waxler E; Seng JS; Fezzey AG; Rosenblum KL; Muzik M. The role of infant sleep in intergenerational transmission of trauma. SLEEP 2011;34(10):1373-1383. PMID:21966069

The role of sleep problems in the relationship between peer victimization and antisocial behavior: A five-year longitudinal study.

PubMed

Chang, Ling-Yin; Wu, Wen-Chi; Wu, Chi-Chen; Lin, Linen Nymphas; Yen, Lee-Lan; Chang, Hsing-Yi

2017-01-01

Peer victimization in children and adolescents is a serious public health concern. Growing evidence exists for negative consequences of peer victimization, but research has mostly been short term and little is known about the mechanisms that moderate and mediate the impacts of peer victimization on subsequent antisocial behavior. The current study intended to examine the longitudinal relationship between peer victimization in adolescence and antisocial behavior in young adulthood and to determine whether sleep problems influence this relationship. In total, 2006 adolescents participated in a prospective study from 2009 to 2013. The moderating role of sleep problems was examined by testing the significance of the interaction between peer victimization and sleep problems. The mediating role of sleep problems was tested by using bootstrapping mediational analyses. All analyses were conducted using SAS 9.3 software. We found that peer victimization during adolescence was positively and significantly associated with antisocial behavior in young adulthood (β = 0.10, p < 0.0001). This association was mediated, but not moderated by sleep problems. Specifically, peer victimization first increased levels of sleep problems, which in turn elevated the risk of antisocial behavior (indirect effect: 0.01, 95% bootstrap confidence interval: 0.004, 0.021). These findings imply that sleep problems may operate as a potential mechanism through which peer victimization during adolescence leads to increases in antisocial behavior in young adulthood. Prevention and intervention programs that target sleep problems may yield benefits for decreasing antisocial behavior in adolescents who have been victimized by peers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sleep Deprivation, Allergy Symptoms, and Negatively Reinforced Problem Behavior.

ERIC Educational Resources Information Center

Kennedy, Craig H.; Meyer, Kim A.

1996-01-01

A study of the relationship between presence or absence of sleep deprivation, allergy symptoms, and the rate and function of problem behavior in three adolescents with moderate to profound mental retardation found that problem behavior was negatively reinforced by escape from instruction, and both allergy symptoms and sleep deprivation influenced…

Effects of Adenotonsillectomy on Parent-Reported Behavior in Children With Obstructive Sleep Apnea.

PubMed

Thomas, Nina Hattiangadi; Xanthopoulos, Melissa S; Kim, Ji Young; Shults, Justine; Escobar, Emma; Giordani, Bruno; Hodges, Elise; Chervin, Ronald D; Paruthi, Shalini; Rosen, Carol L; Taylor, Gerry H; Arens, Raanan; Katz, Eliot S; Beebe, Dean W; Redline, Susan; Radcliffe, Jerilynn; Marcus, Carole L

2017-04-01

The childhood obstructive sleep apnea syndrome (OSAS) is associated with behavioral abnormalities. Studies on the effects of OSAS treatment on behavior are conflicting, with few studies using a randomized design. Further, studies may be confounded by the inclusion of behavioral outcome measures directly related to sleep. The objective of this study was to determine the effect of adenotonsillectomy on behavior in children with OSAS. We hypothesized that surgery would improve behavioral ratings, even when sleep symptom items were excluded from the analysis. This was a secondary analysis of Child Behavior Checklist (CBCL) data, with and without exclusion of sleep-specific items, from the Childhood Adenotonsillectomy Trial (CHAT). CBCL was completed by caregivers of 380 children (7.0+1.4 [range 5-9] years) with OSAS randomized to early adenotonsillectomy (eAT) versus 7 months of watchful waiting with supportive care (WWSC). There was a high prevalence of behavioral problems at baseline; 16.6% of children had a Total Problems score in the clinically abnormal range. At follow-up, there were significant improvements in Total Problems (p < .001), Internalizing Behaviors (p = .04), Somatic Complaints (p = .01), and Thought Problems (p = .01) in eAT vs. WWSC participants. When specific sleep-related question items were removed from the analysis, eAT showed an overall improvement in Total (p = .02) and Other (p = .01) problems. Black children had less improvement in behavior following eAT than white children, but this difference attenuated when sleep-related items were excluded. This large, randomized trial showed that adenotonsillectomy for OSAS improved parent-rated behavioral problems, even when sleep-specific behavioral issues were excluded from the analysis. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Evaluation of a Behavioral Treatment Package to Reduce Sleep Problems in Children with Angelman Syndrome

ERIC Educational Resources Information Center

Allen, Keith D.; Kuhn, Brett R.; DeHaai, Kristi A.; Wallace, Dustin P.

2013-01-01

The purpose of this investigation was to evaluate the effectiveness of a behavioral treatment package to reduce chronic sleep problems in children with Angelman Syndrome. Participants were five children, 2-11 years-of-age. Parents maintained sleep diaries to record sleep and disruptive nighttime behaviors. Actigraphy was added to provide…

Sleep Is Associated with Problem Behaviors in Children and Adolescents with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Goldman, Suzanne E.; McGrew, Susan; Johnson, Kyle P.; Richdale, Amanda L.; Clemons, Traci; Malow, Beth A.

2011-01-01

Multiple sleep problems have been reported in children with Autism Spectrum Disorder (ASD). The association of poor sleep with problematic daytime behaviors has been shown in small studies of younger children. We assessed the relationship between sleep and behavior in 1784 children, ages 2-18, with confirmed diagnosis of ASD participating in the…

Effects of Adenotonsillectomy on Parent-Reported Behavior in Children With Obstructive Sleep Apnea

PubMed Central

Thomas, Nina Hattiangadi; Xanthopoulos, Melissa S.; Kim, Ji Young; Shults, Justine; Escobar, Emma; Giordani, Bruno; Hodges, Elise; Chervin, Ronald D.; Paruthi, Shalini; Rosen, Carol L.; Taylor, Gerry H.; Arens, Raanan; Katz, Eliot S.; Beebe, Dean W.; Redline, Susan; Radcliffe, Jerilynn

2017-01-01

Abstract Objectives: The childhood obstructive sleep apnea syndrome (OSAS) is associated with behavioral abnormalities. Studies on the effects of OSAS treatment on behavior are conflicting, with few studies using a randomized design. Further, studies may be confounded by the inclusion of behavioral outcome measures directly related to sleep. The objective of this study was to determine the effect of adenotonsillectomy on behavior in children with OSAS. We hypothesized that surgery would improve behavioral ratings, even when sleep symptom items were excluded from the analysis. Methods: This was a secondary analysis of Child Behavior Checklist (CBCL) data, with and without exclusion of sleep-specific items, from the Childhood Adenotonsillectomy Trial (CHAT). CBCL was completed by caregivers of 380 children (7.0+1.4 [range 5–9] years) with OSAS randomized to early adenotonsillectomy (eAT) versus 7 months of watchful waiting with supportive care (WWSC). Results: There was a high prevalence of behavioral problems at baseline; 16.6% of children had a Total Problems score in the clinically abnormal range. At follow-up, there were significant improvements in Total Problems (p < .001), Internalizing Behaviors (p = .04), Somatic Complaints (p = .01), and Thought Problems (p = .01) in eAT vs. WWSC participants. When specific sleep-related question items were removed from the analysis, eAT showed an overall improvement in Total (p = .02) and Other (p = .01) problems. Black children had less improvement in behavior following eAT than white children, but this difference attenuated when sleep-related items were excluded. Conclusions: This large, randomized trial showed that adenotonsillectomy for OSAS improved parent-rated behavioral problems, even when sleep-specific behavioral issues were excluded from the analysis. PMID:28199697

Behavioral Interventions to Address Sleep Disturbances in Children with Autism Spectrum Disorders: A Review

ERIC Educational Resources Information Center

Turner, Kylan S.; Johnson, Cynthia R.

2013-01-01

Sleep problems are a common occurrence among children with autism spectrum disorders (ASD). In addition to the adverse effects that sleep problems present for children's neurodevelopment, learning, and daytime behaviors, these sleep problems also present significant challenges for the entire family. This article outlines the results of a…

Impact of a Behavioral Sleep Intervention on New School Entrants' Social Emotional Functioning and Sleep: A Translational Randomized Trial.

PubMed

Hiscock, Harriet; Quach, Jon; Paton, Kate; Peat, Rebecca; Gold, Lisa; Arnup, Sarah; Sia, Kah-Ling; Nicolaou, Elizabeth; Wake, Melissa

2018-05-14

Determine the effects and costs of a brief behavioral sleep intervention, previously shown to improve child social-emotional functioning, sleep, and parent mental health, in a translational trial. Three hundred thirty-four school entrant children from 47 primary schools in Melbourne, Australia, with parent-reported moderate to severe behavioral sleep problems. intervention group received sleep hygiene practices and standardized behavioral strategies delivered by trained school nurses in 2013 and 2014. Control group children could receive usual community care. Outcome measures: child social-emotional functioning (Pediatric Quality of Life Inventory 4.0 psychosocial health summary score-primary outcome), sleep problems (parent-reported severity, Children's Sleep Habits Questionnaire), behavior, academic function, working memory, child and parent quality of life, and parent mental health. At six months post randomization, 145 (of 168) intervention and 155 (of 166) control families completed the primary outcome for which there was no difference. Intervention compared with control children had fewer sleep problems (35.2% vs. 52.7% respectively, OR 0.5; 95% CI 0.3 to 0.8, p = 0.002) and better sleep patterns (e.g., longer sleep duration). Their parents reported fewer symptoms of depression. All differences attenuated by 12 months. There was no difference in other outcomes at either time point. Intervention costs: $AUS 182/child. A brief behavioral sleep intervention, delivered by school nurses to children with behavioral sleep problems, does not improve social emotional functioning. Benefits to child sleep and parent mental health are evident at 6 but not 12 months. Approaches that increase intervention dosage may improve outcomes.

Sleep, Cognition, and Behavioral Problems in School-Age Children: A Century of Research Meta-Analyzed

ERIC Educational Resources Information Center

Astill, Rebecca G.; Van der Heijden, Kristiaan B.; Van IJzendoorn, Marinus H.; Van Someren, Eus J. W.

2012-01-01

Clear associations of sleep, cognitive performance, and behavioral problems have been demonstrated in meta-analyses of studies in adults. This meta-analysis is the first to systematically summarize all relevant studies reporting on sleep, cognition, and behavioral problems in healthy school-age children (5-12 years old) and incorporates 86 studies…

Sleep Differences by Race in Preschool Children: The Roles of Parenting Behaviors and Socioeconomic Status.

PubMed

Patrick, Kristina E; Millet, Genevieve; Mindell, Jodi A

2016-01-01

This study aimed to examine whether socioeconomic variables (SES) and parenting behaviors mediate differences in sleep problems between Black and White preschool-aged children. Parents of 191 preschool-aged children (53% male; 77% White) completed questionnaires regarding SES and sleep behaviors. Parenting behaviors and SES were analyzed as mediators of differences in sleep problems between Black and White children. Parent behaviors related to bedtime routine and independence mediated the relationship between race and parent-reported bedtime difficulty, parent confidence managing sleep, and sleep onset latency. SES mediated the relationship between race and sleep onset latency. Sleep differences between Black and White preschool children were primarily mediated by parent behaviors rather than socioeconomic variables. Results may reflect differences in cultural practices and provide important information for treatment and parent-directed intervention regarding improving sleep in young children.

Family Chaos and Child Functioning in Relation to Sleep Problems Among Children at Risk for Obesity.

PubMed

Boles, Richard E; Halbower, Ann C; Daniels, Stephen; Gunnarsdottir, Thrudur; Whitesell, Nancy; Johnson, Susan L

2017-01-01

This study evaluated the influence of child and family functioning on child sleep behaviors in low-income minority families who are at risk for obesity. A cross-sectional study was utilized to measure child and family functioning from 2013 to 2014. Participants were recruited from Head Start classrooms while data were collected during home visits. A convenience sample of 72 low-income Hispanic (65%) and African American (32%) families of preschool-aged children were recruited for this study. We assessed the association of child and family functioning with child sleep behaviors using a multivariate multiple linear regression model. Bootstrap mediation analyses examined the effects of family chaos between child functioning and child sleep problems. Poorer child emotional and behavioral functioning related to total sleep behavior problems. Chaos associated with bedtime resistance significantly mediated the relationship between Behavioral and Emotional Screening System (BESS) and Bedtime Resistance. Families at high risk for obesity showed children with poorer emotional and behavioral functioning were at higher risk for problematic sleep behaviors, although we found no link between obesity and child sleep. Family chaos appears to play a significant role in understanding part of these relationships. Future longitudinal studies are necessary to establish causal relationships between child and family functioning and sleep problems to further guide obesity interventions aimed at improving child sleep routines and increasing sleep duration.

Influence of sleep disorders on the behavior of individuals with autism spectrum disorder

PubMed Central

Fadini, Cintia C.; Lamônica, Dionísia A.; Fett-Conte, Agnes C.; Osório, Elaine; Zuculo, Gabriela M.; Giacheti, Célia M.; Pinato, Luciana

2015-01-01

The aim of this study was to investigate the correlation between sleep disorders and the behavior of subjects with autism spectrum disorder (ASD) and control subjects using specific questionnaires. A small percentage (1.8%) of the control subjects had symptoms indicative of sleep-breathing disorders (SBD) and nocturnal sweating. Fifty-nine percent of the subjects with ASD had symptoms indicative of at least one sleep disorder, with SBD the most commonly reported (38%). In the control group, the symptoms of SBD were correlated with social, thought, attentional, aggression, externalizing and behavioral problems. In the ASD group, disorders of arousal (DA) were correlated with thinking problems, and disorders of excessive somnolence were correlated with thinking and behavioral problems. These results suggest that children and adolescents with ASD have a high frequency of sleep disorders, which in turn correlate with some of the behavioral traits that they already exhibit. Furthermore, sleep disturbances, when present in the typically developing children, also correlated with behavioral problems. PMID:26150777

Contributions of circadian tendencies and behavioral problems to sleep onset problems of children with ADHD.

PubMed

Gruber, Reut; Fontil, Laura; Bergmame, Lana; Wiebe, Sabrina T; Amsel, Rhonda; Frenette, Sonia; Carrier, Julie

2012-11-28

Children with attention-deficit/hyperactivity disorder (ADHD) are two to three times more likely to experience sleep problems. The purpose of this study is to determine the relative contributions of circadian preferences and behavioral problems to sleep onset problems experienced by children with ADHD and to test for a moderation effect of ADHD diagnosis on the impact of circadian preferences and externalizing problems on sleep onset problems. After initial screening, parents of children meeting inclusion criteria documented child bedtime over 4 nights, using a sleep log, and completed questionnaires regarding sleep, ADHD and demographics to assess bedtime routine prior to PSG. On the fifth night of the study, sleep was recorded via ambulatory assessment of sleep architecture in the child's natural sleep environment employing portable polysomnography equipment. Seventy-five children (26 with ADHD and 49 controls) aged 7-11 years (mean age 8.61 years, SD 1.27 years) participated in the present study. In both groups of children, externalizing problems yielded significant independent contributions to the explained variance in parental reports of bedtime resistance, whereas an evening circadian tendency contributed both to parental reports of sleep onset delay and to PSG-measured sleep-onset latency. No significant interaction effect of behavioral/circadian tendency with ADHD status was evident. Sleep onset problems in ADHD are related to different etiologies that might require different interventional strategies and can be distinguished using the parental reports on the CSHQ.

Sleep Duration, Snoring Prevalence, Obesity, and Behavioral Problems in a Large Cohort of Primary School Students in Japan.

PubMed

Sakamoto, Naoko; Gozal, David; Smith, Dale L; Yang, Limin; Morimoto, Noriko; Wada, Hiroo; Maruyama, Kotatsu; Ikeda, Ai; Suzuki, Yohei; Nakayama, Meiho; Horiguchi, Itsuko; Tanigawa, Takeshi

2017-03-01

Poor or short sleep and the presence of snoring indicative of sleep-disordered breathing (SDB) have been associated with behavioral problems in school-aged children. We examined the relationship between SDB, sleep duration, obesity risk, and behavioral characteristics in Japanese elementary school students using a large-scale survey. We conducted a cross-sectional study of children enrolled in all 46 public primary schools in Matsuyama city, Japan. The children's parents or guardians completed a questionnaire that covered sleep habits, presence of SDB risk, and behavioral characteristics. In total, 24 296 responses were received (90% response rate). After excluding incomplete responses, we analyzed complete datasets for 17 769 children. Mean sleep duration decreased with age, as did the prevalence of pediatric SDB. We found an increased risk for the presence of SDB and short sleep among overweight/obese children. With SDB or short sleep, we observed significantly increased odds of restless behaviors, fidgety behaviors, and poor concentration in school. Shorter sleep duration was associated with increased risk of obesity, and in turn, obesity increased SDB risk. Both short sleep duration and SDB risk were significantly associated with behavioral problems in school. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Parental functioning and pediatric sleep disturbance: an examination of factors associated with parenting stress in children clinically referred for evaluation of insomnia.

PubMed

Byars, Kelly C; Yeomans-Maldonado, Gloria; Noll, Jennie G

2011-10-01

Parenting stress is an aspect of parent functioning relevant in clinical settings. Within the context of behavioral sleep medicine, the role of parenting stress is not well understood. Prospective evaluation of patients 1.5-10 years old with insomnia. Subjects were 156 primary caregiver-child pairs who completed the Parenting Stress Index-Short Form (PSI-SF), Child Sleep Habits Questionnaire (CSHQ) and Child Behavior Checklist (CBCL). (1) determine prevalence of clinically significant parenting stress in primary caregivers of children clinically referred for insomnia; (2) identify childhood sleep problems that play a role in parenting stress; (3) identify relevant correlates of parenting stress within the context of a behavioral sleep medicine clinic; and (4) identify the most salient child sleep and behavioral variables associated with parenting stress. Forty-seven percent of primary caregivers had clinically significant parenting stress. When examining the relationship between child sleep problems and parenting stress, bedtime resistance (p=0.030) and daytime sleepiness (p=0.0003) stood alone as having the most salient associations with parenting stress. When considering a broader range of covariates (child age and child gender) and clinically relevant variables (parent history of sleep problems, parent history of psychiatric conditions, child behavior problems and child sleep problems) in a single regression equation, both child externalizing behavior problems (β=0.570, p<0.0001) and child daytime sleepiness (β=0.152, p=0.028) independently explained significant variability in parenting stress. Many primary caregivers of children clinically-referred for insomnia evaluation and treatment have significant parenting stress. Parenting stress is associated with daytime behavioral problems and sleepiness in children with insomnia. Clinicians working with pediatric insomnia patients should carefully evaluate parenting stress and child daytime behavior as these aspects of functioning may have an impact on service delivery and treatment outcomes. Copyright © 2011 Elsevier B.V. All rights reserved.

Sleep Disorders as a Risk to Language Learning and Use.

PubMed

McGregor, Karla K; Alper, Rebecca M

2015-05-01

Are people with sleep disorders at higher risk for language learning deficits than healthy sleepers? Scoping Review. PubMed, Google Scholar, Trip Database, ClinicalTrials.gov. sleep disorders AND language AND learning; sleep disorders language learning -deprivation -epilepsy; sleep disorders AND verbal learning. 36. Children and adults with sleep disorders were at a higher risk for language problems than healthy sleepers. The language problems typically co-occurred with problems of attention and executive function (in children and adults), behavior (in children), and visual-spatial processing (in adults). Effects were typically small. Language problems seldom rose to a level of clinical concern but there were exceptions involving phonological deficits in children with sleep-disordered breathing and verbal memory deficits among adults with sleep-disordered breathing or idiopathic REM sleep behavior disorder. Case history interviews should include questions about limited sleep, poor-quality sleep, snoring, and excessive daytime sleepiness. Medical referrals for clients with suspected sleep disorders are prudent.

Organizational justice and sleeping problems: The Whitehall II study.

PubMed

Elovainio, Marko; Ferrie, Jane E; Gimeno, David; De Vogli, Roberto; Shipley, Martin; Brunner, Eric J; Kumari, Meena; Vahtera, Jussi; Marmot, Michael G; Kivimäki, Mika

2009-04-01

To test the hypothesis that organizational injustice contributes to sleeping problems. Poor sleep quality can be a marker of prolonged emotional stress and has been shown to have serious effects on the immune system and metabolism. Data were from the prospective Whitehall II study of white-collar British civil servants (3143 women and 6895 men, aged 35-55 years at baseline). Age, employment grade, health behaviors, and depressive symptoms were measured at Phase 1 (1985-1988) and baseline sleeping problems were assessed at Phase 2 (1989-1990). Organizational justice was assessed twice, at Phases 1 and 2. The outcome was mean of sleeping problems during Phases 5 (1997-1999) and 7 (2003-2004). In men, low organizational justice at Phase 1 and Phase 2 were associated with overall sleeping problems, sleep maintenance problems, sleep onset problems, and nonrefreshing sleep at Phases 5 and 7. In women, a significant association was observed between low organizational justice and overall sleeping problems and sleep onset problems. These associations were robust to adjustments for age, employment grade, health behaviors, job strain, depressive symptoms, and sleeping problems at baseline. This study shows that perceived unfair treatment at workplace is associated with increased risk of poor sleep quality in men and women, one potential mechanism through which justice at work may affect health.

Treatment preferences and help-seeking behaviors for sleep problems among psychiatric outpatients.

PubMed

Chang, Sherilyn; Seow, Esmond; Koh, Sok Hian Doris; Verma, Swapna K; Mok, Yee Ming; Abdin, Edimansyah; Chong, Siow Ann; Subramaniam, Mythily

To understand treatment preferences and help-seeking behaviors among psychiatric patients for their sleep problems, and to examine determinants of problem recognition and help-seeking among patients with sleep difficulties. A cross-sectional survey was conducted among psychiatric outpatients in Singapore (n=400). Participants completed questionnaires that assessed their sleep quality, daytime fatigue, help-seeking behavior, treatment preferences for sleep problems, and sociodemographic information. Multiple logistic regressions were used to identify correlates of patients who recognized their sleep difficulties and of those who had sought help. Mental health professionals were the most preferred choice (60.8%) for consultation on sleep problems. Among patients with poor sleep quality (n=275), 28.4% denied having any problems and 38.9% had not sought help. Patients with chronic physical comorbidity were less likely to recognize their sleep problems (OR=0.432, p-value=0.009), while those with psychiatric comorbidity were twice as likely to perceive the problems (OR=2.094, p-value=0.021) and to seek help (OR=1.957, p-value=0.022). Daytime fatigue was associated with higher odds of problem recognition (OR=1.106, p-value=0.001) and help-seeking (OR=1.064, p-value=0.016). A considerable number of patients did not perceive their poor sleep as an issue and had not sought help for it. General sleep hygiene education is needed for psychiatric patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Cognitive-behavioral therapy and hypnotic relaxation to treat sleep problems in an adolescent with diabetes.

PubMed

Perfect, Michelle M; Elkins, Gary R

2010-11-01

Inadequate sleep among adolescents frequently contributes to obesity and reduced academic performance, along with symptoms of anxiety, depression, fatigue, and attention deficits. The etiological bases of sleep quality has been associated with both stress and sleep habits. These problems tend to be especially important for adolescents with diabetes as the effects of poor sleep complicate health outcomes. This case example concerns a 14-year-old adolescent girl with a history of type I diabetes and stress-related sleep difficulties. Treatment included cognitive-behavioral methods and hypnotic relaxation therapy. Results of this case example and other controlled research suggest that hypnotic relaxation therapy is well accepted, results in good compliance, and serves as a useful adjunctive to cognitive-behavioral intervention for sleep problems. © 2010 Wiley Periodicals, Inc.

Association between sleep behavior and sleep-related factors among university students in Hong Kong.

PubMed

Suen, Lorna K P; Hon, K L Ellis; Tam, Wilson W S

2008-09-01

Sleep problems among university students are common; however, the association between many sleep-related factors and sleep behaviors is still unclear. The purpose of this study is to examine different sleep behaviors and sleep-related factors influencing such behaviors in university students. A descriptive survey was conducted on 400 university students in Hong Kong. The instruments for data collection consisted of the Pittsburgh Sleep Quality Index (PSQI), a sleep hygiene practice questionnaire, demographic data, and other sleep-related factors. The results reveal that 57.5% of the 400 university students are poor sleepers. Sex, year of study, sleep hygiene practice, and perceived adequate sleep in the past month all demonstrate significant associations with poor sleepers. A high prevalence of sleep-related problems among college students is confirmed and associated factors are identified. Students should be encouraged to follow sleep hygiene practice, adequate time management for academic and social activities, and suitable stress-relieving measures.

Sleep Problem Trajectories and Well-Being in Children with Attention-Deficit Hyperactivity Disorder: A Prospective Cohort Study.

PubMed

Lycett, Kate; Sciberras, Emma; Hiscock, Harriet; Mensah, Fiona K

2016-06-01

Sleep problems affect up to 70% of children with attention-deficit/hyperactivity disorder (ADHD) and are associated with poorer child and family well-being in cross-sectional studies. However, whether these associations hold longitudinally is unclear. The authors aimed to examine the longitudinal relationship between sleep problem trajectories and well-being in children with ADHD. Children with ADHD (n = 186), aged 5 to 13 years, were recruited from 21 pediatric practices across the state of Victoria, Australia. Sleep problem severity data were collected at 3 time points (baseline, 6, and 12 mo) and were used to classify sleep problem trajectories. Child and family well-being (e.g., child emotional and behavioral problems, quality of life [QoL]) were measured at baseline and 12 months by teacher and/or caregiver-report. The well-being of children with "transient" and "persistent" sleep problems was compared with those "never" experiencing sleep problems using a series of hierarchical linear regression models. After accounting for socio-demographic factors, children with transient and persistent sleep trajectories experienced more caregiver-reported behavioral and emotional problems (effect size [ES] both 0.7) and poorer child QoL (ES: -0.7 and -1.2, respectively). These associations remained after also accounting for ADHD medication and symptom severity and comorbidities, but after accounting for baseline measures many associations weakened to the point of nonsignificance. In the fully adjusted model-transient sleep problems were associated with behavioral and emotional problems (ES: 0.2). These associations were not evident by teacher-report. Children with ADHD experiencing transient or persistent sleep problems have poorer caregiver-reported well-being. Managing sleep problems in children with ADHD may improve child well-being.

Community based study of sleep bruxism during early childhood

PubMed Central

Insana, Salvatore P.; Gozal, David; McNeil, Daniel W.; Montgomery-Downs, Hawley E.

2012-01-01

Objectives The aims for this study were to determine the prevalence of sleep-bruxism among young children, explore child behavior problems that may be associated with sleep-bruxism, and identify relations among sleep-bruxism, health problems, and neurocognitive performance. Methods The current study was a retrospective analysis of parent report surveys, and behavioral and neurocognitive assessments. Parents of 1953 preschool and 2888 first grade children indicated their child’s frequency of bruxism during sleep. A subsample of preschool children (n = 249) had additional behavioral, as well as neurocognitive assessments. Among the subsample, parents also reported on their child’s health, and completed the Child Behavioral Checklist; children were administered the Differential Ability Scales, and Pre-Reading Abilities subtests of the Developmental Neuropsychological Assessment. Results 36.8% of preschoolers and 49.6% of first graders were reported to brux ≥ 1 time per week. Among the preschool subsample, bruxing was independently associated with increased internalizing behaviors (β = .17). Bruxism was also associated with increased health problems (β = .19), and increased health problems were associated with decreased neurocognitive performance (β = .22). Conclusions The prevalence of sleep-bruxism was high. A dynamic and potentially clinically relevant relation exists among sleep-bruxism, internalizing behaviors, health, and neurocognition. Pediatric sleep-bruxism may serve as a sentinel marker for possible adverse health conditions, and signal a need for early intervention. These results support the need for an interdisciplinary approach to pediatric sleep medicine, dentistry, and psychology. PMID:23219144

Differential Outcomes of Sleep Problems in Children with and Without Special Health Care Needs: Australian Population Study.

PubMed

Quach, Jon; Mensah, Fiona K; Hiscock, Harriet

2016-06-01

In a nationally representative sample of Australian children at ages 4 to 5, 6 to 7, 8 to 9, 10 to 11, and 12 to 13 years, we aim to examine the (1) prevalence of sleep problems in children with and without special health care needs (SHCN); (2) association of sleep problems with child behavior, health-related quality of life, learning and parent mental health outcomes; and (3) whether associations between sleep problems and outcomes among children with SHCN are larger in magnitude than among children without SHCN. Biennial data from 5 waves of the Growing Up in Australia Study. Child SHCN as defined by the Children Special Health Care Needs Screener and parent report of child sleep problem. Child: parent-reported health-related quality of life; parent-reported and teacher-reported behavior; nonverbal and verbal cognition and teacher-reported learning. Parent: self-report mental health. Logistic and linear regression, adjusted for family socioeconomic position. Children with SHCN were more likely to have sleep problems, odds ranging from 2.0 (95% confidence interval [CI], 1.6-2.5) at 4 to 5 years to 3.9 (95% CI, 3.0-5.2) at 8 to 9 years. Compared with children who had neither condition, those with either sleep problems or SHCN had similarly poor child and maternal outcomes. Children with both SHCN and sleep problems had the poorest outcomes at every age (all p < .001). Tests of interaction found sleep problems are more strongly associated with poorer behavior and health-related quality of life among children with SHCN than those without during the preschool and early school years. Sleep problems in children with SHCN are common and are associated with poorer child and maternal outcomes. These associations are stronger for poorer behavior and health-related quality of life among children with SHCN than those without during the preschool and early school years.

Bruxism in children: effect on sleep architecture and daytime cognitive performance and behavior.

PubMed

Herrera, Marcela; Valencia, Ignacio; Grant, Mitzie; Metroka, David; Chialastri, Augustine; Kothare, Sanjeev V

2006-09-01

Sleep bruxism is an involuntary mandibular movement with tooth grinding during sleep. The prevalence of sleep bruxism in children is high and may lead to frequent arousals with altered daytime functioning. We investigated the sleep architecture, the incidence of gastroesophageal reflux, and the daytime cognitive behavioral functioning in a group of children with sleep bruxism. DESIGN-PATIENTS: This prospective pilot study included 10 children. Polysomnographic data with pH-probe analysis was compared with 10 age- and sex-matched controls. Each patient completed a dental evaluation, a nighttime polysomnogram, and cognitive behavioral tests (Kaufman Brief Intelligence Test and Achenbach Child Behavior Checklist). Eight of 10 children had clinically significant bruxism and the 2 remaining patients had recent teeth exfoliation. There was no difference on sleep architecture between patients and controls, except for a higher arousal index for the bruxism group (36.7 vs 20.7, p < .007). Sleep bruxism occurred more frequently in stage 2 and rapid eye movement sleep, with arousals in 66% of the cases. There was no relationship of bruxism to gastroesophageal reflux or intelligence. However, 40% of the patients had elevated scores on the Achenbach Child Behavior Checklist, indicating significant attention and behavior problems, and there were moderate correlations between the arousal index and several of the behavior-problem scales from the Achenbach Child Behavior Checklist (0.5 to 0.6). The data suggest that children with bruxism have a higher arousal index, which may be associated with an increased incidence of attention-behavior problems. Future studies investigating pediatric sleep bruxism will need to focus on behavior issues that may be prevalent in this population.

Youth Screen Time and Behavioral Health Problems: The Role of Sleep Duration and Disturbances.

PubMed

Parent, Justin; Sanders, Wesley; Forehand, Rex

2016-05-01

The purpose of this study was to examine the indirect effect of youth screen time (e.g., television, computers, smartphones, video games, and tablets) on behavioral health problems (i.e., internalizing, externalizing, and peer problems) through sleep duration and disturbances. The authors assessed a community sample of parents with a child in one of the following three developmental stages: young childhood (3-7 yrs; N = 209), middle childhood (8-12 yrs; N = 202), and adolescence (13-17 yrs; N = 210). Path analysis was used to test the hypothesized indirect effect model. Findings indicated that, regardless of the developmental stage of the youth, higher levels of youth screen time were associated with more sleep disturbances, which, in turn, were linked to higher levels of youth behavioral health problems. Children who have increased screen time are more likely to have poor sleep quality and problem behaviors.

The prospective relationship between sleep problems and suicidal behavior in the National Longitudinal Study of Adolescent Health.

PubMed

Wong, Maria M; Brower, Kirk J

2012-07-01

Previous research has found a longitudinal relationship between sleep problems and suicidal behavior while controlling for depression and other important covariates in a high risk sample of adolescents and controls. In this paper, we replicated this longitudinal relationship in a national sample and examined whether the relationship was partially mediated by depression, alcohol-related problems and other drug use. Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH). In bivariate analyses, sleep problems (i.e., having trouble falling asleep or staying asleep) at Wave 1 were associated with suicidal thoughts and suicide attempts at Waves 1, 2, and 3 (W1, 2 and 3). In multivariate analyses, controlling for depression, alcohol problems, illicit drug use, and important covariates such as gender, age, and chronic health problems, sleep problems at a previous wave predicted suicidal thoughts and suicide attempts at a subsequent wave. In mediation analyses, W2 depression significantly mediated the effect of W1 sleep problems on W3 suicide thoughts. Moreover, W2 suicidal thoughts also significantly mediated the effect of W1 sleep problems on W3 suicidal attempts. Sleep problems appear to be a robust predictor of subsequent suicidal thoughts and attempts in adolescence and young adulthood. Having trouble falling sleeping or staying asleep had both direct and indirect effects (via depression and suicidal thoughts) on suicidal behavior. Future research could determine if early intervention with sleep disturbances reduces the risk for suicidality in adolescents and young adults. Copyright © 2012 Elsevier Ltd. All rights reserved.

Relationships between parental sleep quality, fatigue, cognitions about infant sleep, and parental depression pre and post-intervention for infant behavioral sleep problems.

PubMed

Hall, Wendy A; Moynihan, Melissa; Bhagat, Radhika; Wooldridge, Joanne

2017-04-04

Maternal and paternal depression has been associated with infants' behavioral sleep problems. Behavioral sleep interventions, which alter parental cognitions about infant sleep, have improved infant sleep problems. This study reports relationships between parental depression, fatigue, sleep quality, and cognitions about infant sleep pre and post-intervention for a behavioral sleep problem. This secondary analysis of data from Canadian parents (n = 455), with healthy infants aged 6-to-8-months exposed to a behavioral sleep intervention, examined baseline data and follow-up data from 18 or 24 weeks post intervention (group teaching or printed material) exposure. Parents reported on sleep quality, fatigue, depression, and cognitions about infant sleep. Data were analyzed using Pearson's r and stepwise regression analysis. Parents' fatigue, sleep quality, sleep cognitions, and depression scores were correlated at baseline and follow-up. At baseline, sleep quality (b = .52, 95% CI .19-.85), fatigue (b = .48, 95% CI .33-.63), doubt about managing infant sleep (b = .44, 95% CI .19-.69), and anger about infant sleep (b = .69, 95% CI .44-.94) were associated with mothers' depression. At baseline, fathers' depression related to sleep quality (b = .42, 95% CI .01-.83), fatigue (b = .47, 95% CI .32-.63), and doubt about managing infant sleep (b = .50, 95% CI .24-.76). At follow-up, mothers' depression was associated with sleep quality (b = .76, 95% CI .41-1.12), fatigue (b = .25, 95% CI .14-.37), doubt about managing infant sleep (b = .44, 95% CI .16-.73), sleep anger (b = .31, 95% CI .02-.59), and setting sleep limits (b = -.22, 95% CI -.41-[-.03]). At follow-up, fathers' depression related to sleep quality (b = .84, 95% CI .46-1.22), fatigue (b = .31, 95% CI .17-.45), sleep doubt (b = .34, 95% CI .05-.62), and setting sleep limits (b = .25, 95% CI .01-.49). Mothers' and fathers' cognitions about infant sleep demonstrate complex relationships with their depression scores. While mothers' setting sleep limit scores are associated with decreased depression scores, fathers' setting limits scores are associated with increased depression scores. Parental doubts about managing infant sleep and difficulties with setting sleep limits require attention in interventions.

Assessment and behavioral treatment of feeding and sleeping disorders in children with autism spectrum disorders.

PubMed

Kodak, Tiffany; Piazza, Cathleen C

2008-10-01

Children diagnosed with autism or autism spectrum disorders (ASD) are more likely than other children to exhibit behaviors characteristic of a feeding or sleeping disorder. Parents of children with these disorders may be extremely concerned about the health and safety of their child. Sleeping and feeding problems can cause a great deal of stress to parents and other family members. Behavioral assessment and treatment procedures have been developed to address behavior problems related to sleeping and feeding disorders. This article reviews the literature about assessment and treatment, and provides recommendations regarding services to family members of individuals diagnosed with ASD and feeding or sleeping disorders.

Cosleeping and Behavioral Sleep Problems in School-aged Children with Neurodevelopmental and Mental Health Disorders.

PubMed

Bastida-Pozuelo, María-Felisa; Meltzer, Lisa J; Sánchez-Ortuño, María-Montserrat

2018-06-01

The aim of this study was to explore the presence of sleep-related complaints and their relationship to cosleeping in a sample of 57 children with mental health disorders. Information about the practice of cosleeping was collected through an interview and behavioral sleep problems were evaluated with a subset of items from the Spanish version of the Pediatric Sleep Questionnaire (PSQ). Controlling for age, cosleepers scored higher on insomnia, daytime sleepiness and poor sleep scheduling, compared to solitary sleepers. Therefore, mental health professionals should explore the child's sleep environment and, when necessary, use appropriate interventions to address such problems. Copyright © 2018 Elsevier Inc. All rights reserved.

The Consequences of Insufficient Sleep for Adolescents: Links Between Sleep and Emotional Regulation.

ERIC Educational Resources Information Center

Dahl, Ronald E.

1999-01-01

Reviews current scientific and clinical information regarding consequences of insufficient sleep in adolescents, including sleepiness; tiredness; changes in mood, attention, and behavior; emotional and behavior problems' effects on sleep patterns; and bidirectional effects. Lifestyle forces are pushing teens' sleep/arousal balance in the wrong…

Sleep Disturbances, Psychosocial Difficulties, and Health Risk Behavior in 16,781 Dutch Adolescents.

PubMed

Verkooijen, Sanne; de Vos, Nelleke; Bakker-Camu, Betty J W; Branje, Susan J T; Kahn, René S; Ophoff, Roel A; Plevier, Carolien M; Boks, Marco P M

2018-03-09

To investigate the prevalence of adolescent sleep disturbances and their relation to psychosocial difficulties and health risk behaviors with the use of data from a province-wide health survey (n = 16,781). Psychosocial difficulties were measured with the Strength and Difficulties Questionnaire. Additional assessments included self-reported sleep disturbances, suicidality, and health risk behaviors including current use of tobacco, alcohol, and drugs, physical inactivity, and compulsive use of multimedia. We used multilevel analyses to investigate the relationhips, including differences, between boys and girls, as well as the mediating role of emotional problems. Just under 20% of adolescents reported sleep disturbances in the previous month. These sleep disturbances were associated with psychosocial problems (odds ratio [OR], 6.42; P < .001), suicidality (OR, 3.90-4.14; P < .001), and all health risk behaviors (OR, 1.62-2.66; P < .001), but not with physical inactivity. We found moderation by gender for the relations between sleep and suicide attempts (OR, 0.38; P < .002) and between sleep and cannabis use (OR, 0.52; P = .002), indicating attenuated relationships in girls compared with boys. Emotional problems partially mediated the relationships between sleep disturbances and multimedia use. This study reiterates the high prevalence of sleep disturbances during adolescence. These sleep disturbances were strongly related to psychosocial problems and a wide range of health risk behaviors. Although the direction of causality cannot be inferred, this study emphasizes the need for awareness of impaired sleep in adolescents. Moreover, the gender differences in associated suicide attempts and cannabis use call for further research into tailored intervention strategies. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Sleep Behaviors and Sleep Quality in Children with Autism Spectrum Disorders

PubMed Central

Souders, Margaret C.; Mason, Thorton B. A.; Valladares, Otto; Bucan, Maja; Levy, Susan E.; Mandell, David S.; Weaver, Terri E.; Pinto-Martin, Jennifer

2009-01-01

Study Objectives: (1) Compare sleep behaviors of children with autism spectrum disorders (ASD) with sleep behaviors of typically developing (TD) children using the Children's Sleep Habits Questionnaire (CSHQ); (2) compare sleep quality—defined as mean activity, sleep latency, number of awakenings, sleep efficiency and total sleep time—of the cohort of children with ASD and TD, as measured by 10 nights of actigraphy; and (3) estimate the prevalence of sleep disturbances in the ASD and TD cohorts. Design: Descriptive cross-sectional study. Setting: The Children's Hospital of Philadelphia. Participants: Randomly selected children from the Regional Autism Center. The ASD cohort of 59 children, aged 4 to 10 years, (26 with autism, 21 with pervasive developmental disorder-not otherwise specified [PDD-NOS], and 12 with Asperger disorder) were compared with 40 TD control subjects. Measurements and Results: The CSHQ, sleep diaries, and 10 nights of actigraphy using the Sadeh algorithm of children with ASD and TD control subjects were compared. CSHQ showed 66.1% of parents of children with ASD (62.5% autism, 76.2% PDD-NOS, 58.3% Asperger disorder) and 45% of parents of the control subjects reported that their children had sleep problems. Actigraphic data showed that 66.7% of children with ASD (75% autism, 52.4% PDD-NOS, 75% Asperger disorder) and 45.9% of the control subjects had disturbed sleep. Conclusions: The prevalence estimate of 45% for mild sleep disturbances in the TD cohort highlights pediatric sleep debt as a public health problem of concern. The prevalence estimate of 66% for moderate sleep disturbances in the ASD cohort underscores the significant sleep problems that the families of these children face. The predominant sleep disorders in the ASD cohort were behavioral insomnia sleep-onset type and insomnia due to PDD. Citation: Souders MC; Mason TBA; Valladares O; Bucan M; Levy SE; Mandell DS; Weaver TE; Pinto-Martin D. Sleep behaviors and sleep quality in children with autism spectrum disorders. SLEEP 2009;32(12):1566-1578. PMID:20041592

Parental Sleep Quality and Behavior Problems of Children with Autism

ERIC Educational Resources Information Center

Mihaila, Iulia; Hartley, Sigan L.

2018-01-01

This study explored the impact of parental sleep quality on the experience of behavior problems by children with autism spectrum disorder. A 14-day daily diary was used in a sample of 176 mother-father couples. Dyadic multilevel models were conducted to examine the between-person and within-person effects of previous-night sleep quality on…

Prospective relationship between poor sleep and substance-related problems in a national sample of adolescents

PubMed Central

Wong, Maria M.; Roberson, Gail; Dyson, Rachel

2014-01-01

Background Previous studies showed that poor sleep prospectively predicted alcohol related problems and illicit drug use in adolescents and young adults (Wong et al., 2010, 2012). However, more works needs to be done to elucidate the nature of these problems. The purpose of this study was to examine whether sleep difficulties and hours of sleep prospectively predicted several serious substance related problems, e.g., binge drinking, driving under the influence of alcohol, risky sexual behavior. Methods Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH). Data were collected from interviews and questionnaires. The current study analyzed data from the first three waves of data (T1: 1994–95; T2: 1996; T3: 2001–02). In all analyses, we used sleep difficulties at a previous wave to predict substance-related problems at a subsequent wave, while controlling for substance-related problems at a previous wave. Results Holding T1 alcohol-related problems constant, sleep difficulties at T1 significantly predicted alcohol-related interpersonal problems, binge drinking, gotten drunk or very high on alcohol, driving under the influence of alcohol, getting into a sexual situation one later regretted due to drinking, ever using any illicit drugs and drugs-related problems at T2. T1 hours of sleep negatively predicted T2 alcohol-related interpersonal problems and binge drinking. The relationship between T2 sleep variables and T3 substance-related problems were consistent with previous waves, though the effect was weaker. Conclusions Sleep difficulties and hours of sleep are a significant predictor of a number of substance-related problems. It may be useful to educate adolescents about the importance of sleep, sleep hygiene and the potential consequences of poor sleep on drinking and related behaviors. PMID:25598438

Termination of short term melatonin treatment in children with delayed Dim Light Melatonin Onset: effects on sleep, health, behavior problems, and parenting stress.

PubMed

van Maanen, Annette; Meijer, Anne Marie; Smits, Marcel G; Oort, Frans J

2011-10-01

To investigate the effects of termination of short term melatonin treatment on sleep, health, behavior, and parenting stress in children with delayed Dim Light Melatonin Onset. Forty-one children (24 boys, 17 girls; mean age=9.43 years) entered melatonin treatment for 3 weeks and then discontinued treatment by first taking a half dose for 1 week and then stopping completely for another week. Sleep was measured with sleep diaries filled in by parents and with actometers worn by children. Analyses were conducted with linear mixed models. Sleep latency was longer during the stop week compared to the treatment weeks. Sleep start was later and actual sleep time was shorter during the half dose and stop weeks compared to the treatment weeks. Sleep efficiency deteriorated in the stop week. Dim Light Melatonin Onset was earlier after treatment, but this effect disappeared after the stop week. In addition to the effects on sleep, results from questionnaires completed by parents showed that melatonin treatment also had positive effects on children's health and behavior problems and parenting stress. While health deteriorated after treatment discontinuation, the effects on behavior problems and parenting stress remained. Behavior problems at baseline did not influence the effect of melatonin treatment. This study showed that complete termination of treatment after 4 weeks of melatonin use was too early. However, clinicians may advise a lower dose after a successful treatment trial of several weeks. Copyright © 2011 Elsevier B.V. All rights reserved.

Association of problem behavior with sleep problems and gastroesophageal reflux symptoms.

PubMed

Sakaguchi, Katsuyoshi; Yagi, Takakazu; Maeda, Aya; Nagayama, Kunihiro; Uehara, Sawako; Saito-Sakoguchi, Yoko; Kanematsu, Kyoko; Miyawaki, Shouichi

2014-02-01

There are few large-scale epidemiologic studies examining the associations between sleep problems, gastroesophageal reflux disease (GERD) symptoms, lifestyle and food habits and problem behaviors (PB) in adolescents. The aim of this study was to evaluate the associations among these factors in Japanese adolescents. A cross-sectional survey of 1840 junior high school students was carried out using questionnaires. The subjects were classified into PB or normal behavior (NB) groups using the Pediatric Symptom Checklist (PSC). The scores of the sleep-related factors, sleep bruxism, lifestyle and food habits, and GERD symptoms were compared. Logistic regression analysis was used to determine the factors related to PB. Mean subject age was 13.3 ± 1.8 years. The PB group had significantly longer sleep latency and higher GERD symptom score (P < 0.001). Furthermore, the PB group was significantly more likely to experience absence of the mother at dinner time, skip breakfast, and have <30 min of conversation among family at dinner time. The PB group had significantly higher frequencies of sleep bruxism, difficulty falling asleep within 30 min, nightmares, feeling of low sleep quality, daytime somnolence, and daytime lack of motivation. Feelings of low sleep quality had the strongest association with PB, with an adjusted odds ratio of 12.88 (95% confidence interval: 8.99-18.46). PB in adolescents are associated with sleep problems, including sleep bruxism, as well as lifestyle and food habits and GERD symptoms. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Sleep Problems, Overtiredness and Overanxiety and Frustrating Children: From Birth to Preschool. Unit for Child Studies. Selected Papers Number 24.

ERIC Educational Resources Information Center

Harris, Michael J.

The first of the two discussions presented here, "Sleep Problems, Overtiredness and Overanxiety," describes sleeping behavior of children from birth to 3 years of age and considers situations that affect children's sleep. Topics briefly addressed include the physiology of sleep; developmental aspects of sleep patterns; the effect of lack…

Pathological Gambling, Problem Gambling and Sleep Complaints: An Analysis of the National Comorbidity Survey: Replication (NCS-R)

PubMed Central

Siani, Aaron; Rosenthal, Richard J.; Fong, Timothy W.

2012-01-01

The purpose of this study is to investigate the relationship between sleep disturbances and gambling behavior. Data from the National Comorbidity Survey—Replication (NCS-R) was used to examine the relationship between three specific sleep complaints (difficulty initiating sleep [DIS], difficulty maintaining sleep [DMS], and early morning awakening [EMA]) and gambling behavior. Bivariate logistic regression models were used to control for potentially confounding psychiatric disorders and age. Almost half of respondents with problem gambling behavior (45.9%) and two thirds (67.7%) of respondents with pathological gambling behavior reported at least one sleep compliant. Compared to respondents with no gambling pathology, respondents with pathological gambling were significantly more likely to report at least one sleep complaint (Adjusted Odds Ratio [AOR] = 3.444, 95% CI = 1.538–7.713), to report all sleep complaints (AOR = 3.449, 95% CI = 1.503–7.914), and to report any individual complaint (DIS: OR = 2.300, 95% CI = 1.069–4.946; DMS: AOR = 4.604, 95% CI = 2.093–10.129; EMA: AOR = 3.968, 95% CI = 1.856–8.481). The relationship between problem gambling and sleep complaints were more modest (any sleep complaint: AOR = 1.794, 95% CI = 1.142–2.818; all three sleep complaints: AOR = 2.144, 95% CI = 1.169–3.931; DIS: AOR = 1.961, 95% CI = 1.204–3.194; DMS: AOR = 1.551, 95% CI = 0.951–2.529; EMA: AOR = 1.796, 95% CI = 1.099–2.935). Given the individual and societal ramifications linked with the presence of sleep problems, this study presents another health-related repercussion associated with gambling pathology rarely discussed in the literature. PMID:22396174

Poor sleep as a potential causal factor in aggression and violence.

PubMed

Kamphuis, Jeanine; Meerlo, Peter; Koolhaas, Jaap M; Lancel, Marike

2012-04-01

Clinical observations suggest that sleep problems may be a causal factor in the development of reactive aggression and violence. In this review we give an overview of existing literature on the relation between poor sleep and aggression, irritability, and hostility. Correlational studies are supporting such a relationship. Although limited in number, some studies suggest that treatment of sleep disturbances reduces aggressiveness and problematic behavior. In line with this is the finding that sleep deprivation actually increases aggressive behavior in animals and angriness, short-temperedness, and the outward expression of aggressive impulses in humans. In most people poor sleep will not evoke actual physical aggression, but certain individuals, such as forensic psychiatric patients, may be particularly vulnerable to the emotional dysregulating effects of sleep disturbances. The relation between sleep problems and aggression may be mediated by the negative effect of sleep loss on prefrontal cortical functioning. This most likely contributes to loss of control over emotions, including loss of the regulation of aggressive impulses to context-appropriate behavior. Other potential contributing mechanisms connecting sleep problems to aggression and violence are most likely found within the central serotonergic and the hypothalamic-pituitary-adrenal-axis. Individual variation within these neurobiological systems may be responsible for amplified aggressive responses induced by sleep loss in certain individuals. It is of great importance to identify the individuals at risk, since recognition and adequate treatment of their sleep problems may reduce aggressive and violent incidents. Copyright © 2012 Elsevier B.V. All rights reserved.

The Longitudinal Association Between Poor Sleep Quality and Cyberbullying, Mediated by Anger.

PubMed

Erreygers, Sara; Vandebosch, Heidi; Vranjes, Ivana; Baillien, Elfi; De Witte, Hans

2018-01-09

Adolescents tend to go to bed later and sleep less as they grow older, although their need for sleep stays the same throughout adolescence. Poor sleep has negative consequences on personal and interpersonal functioning, including increased aggressive tendencies. With adolescents' social life increasingly including interactions via digital media, these interactions may also become more aggressive when adolescents' sleep problems increase. One of the ways in which online aggression may be enacted is through cyberbullying. Although previous research has examined the role of sleep disruptions in offline bullying, the role of sleep in cyberbullying has not yet been addressed. Therefore, this study examines the longitudinal effect of poor sleep quality on later cyberbullying behavior. Thirteen- to fourteen-year-old adolescents completed self-report measures on sleep quality, anger, cyberbullying perpetration, and frequency of digital media use. Because one of the pathways through which sleep is proposed to be linked to aggression is an affective pathway, namely via angry affect, a mediation model of poor sleep quality predicting cyberbullying via feelings of anger was tested. Results from structural equation modeling and a bootstrap test indicated that poor sleep quality was indeed indirectly associated with later cyberbullying behavior through heightened feelings of anger, even when taking the effects of the use of digital media and previous cyberbullying behavior into account. This finding provides support for the proposed affective pathway linking sleep problems to aggression. As sleep problems and anger seem to play a predicting role in cyberbullying behavior, suggestions for cyberbullying intervention and prevention strategies are formulated.

Sleep Habits and Sleep Problems in Healthy Preschoolers.

PubMed

Murthy, C L Srinivasa; Bharti, Bhavneet; Malhi, Prahbhjot; Khadwal, Alka

2015-07-01

To describe the sleep patterns and problems in children aged between 12 and 36 mo of age. This cross sectional survey was collected over a span of 1 y in Advanced Pediatric Centre, PGIMER, Chandigarh and crèches of Chandigarh. Children in the age group of 12 to 36 mo were included in study. Children with chronic illness, developmental delay, seizure disorder and lack of consent were excluded. A total of 368 children were enrolled. Main outcome measures were sleep duration over 1 to 3 y of life; sleep behavior at onset, during and waking of sleep and parent reported sleep problems and their predictors. The average duration of sleep was 12.5 h (S.D = 1.9). The mean total sleep duration and mean day time sleep duration decreased, while mean night time sleep increased as the age advanced from 12 to 36 mo. Following were the frequency of sleep habits seen in the index study; bed time routine was seen only in 68(18.5 %), a regular bed time ritual was seen in 281(76.4 %), 329(89.4 %) children frequently required 0-20 min time to fall asleep, 11(3 %) parents used sleep inducing drugs. Night waking (1 to 3 times a night) was seen in 297(80.7 %) and its frequency declined with age. Parent reported sleep problems were seen in 12.8 % (47/368). Lack of co-sleeping and night waking were considered as strongest predictors of parent reported sleep problems. Toddlers' sleep duration, night waking behavior, and day time naps decrease as the age progress while night time sleep duration increases with age. Lack of co-sleeping and night waking are considered as strongest predictors of parent reported sleep problems.

Youth internalizing symptoms, sleep-related problems, and disordered eating attitudes and behaviors: A moderated mediation analysis.

PubMed

Chardon, Marie L; Janicke, David M; Carmody, Julia K; Dumont-Driscoll, Marilyn C

2016-04-01

Internalizing symptoms increase the risk for disordered eating; however, the mechanism through which this relationship occurs remains unclear. Sleep-related problems may be a potential link as they are associated with both emotional functioning and disordered eating. The present study aims to evaluate the mediating roles of two sleep-related problems (sleep disturbance and daytime sleepiness) in the relationship between youth internalizing symptoms and disordered eating, and to explore if age moderates these relations. Participants were 225 youth (8-17years) attending a primary care appointment. Youth and legal guardians completed questionnaires about youth disordered eating attitudes and behaviors, internalizing symptoms, sleep disturbance, and daytime sleepiness. Mediation and moderated mediation analyses were utilized. The mediation model revealed both youth sleep disturbance and daytime sleepiness independently mediated the association between internalizing symptoms and disordered eating attitudes and behaviors, and explained 18% of the variance in disordered eating. The moderated mediation model including youth age accounted for 21% of the variance in disordered eating; youth age significantly interacted with sleep disturbance, but not with daytime sleepiness, to predict disordered eating. Sleep disturbance only mediated the relationship between internalizing symptoms and disordered eating in youth 12years old and younger, while daytime sleepiness was a significant mediator regardless of age. As sleep-related problems are frequently improved with the adoption of health behaviors conducive to good sleep, these results may suggest a relatively modifiable and cost-effective target to reduce youth risk for disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Description of a Sleep-Restriction Program to Reduce Bedtime Disturbances and Night Waking

ERIC Educational Resources Information Center

Durand, V. Mark; Christodulu, Kristin V.

2004-01-01

The authors describe a behavioral intervention designed to reduce sleep problems without increasing disruption at bedtime or throughout the evening. Sleep restriction was used to reduce the bedtime and nighttime sleep problems of two children, a 4-year-old girl with autism and a 4-year-old girl with developmental delay. Sleep restriction involved…

The Nature of and Behavioral Treatment of Sleep Problems in Youth with Bipolar Disorder

ERIC Educational Resources Information Center

Schwartz, Lisa A.; Feeny, Norah C.

2007-01-01

Bipolar spectrum disorders (BP) occur in up to 1% of youth and are associated with significant impairment. Individuals with BP are often characterized by a decreased need for sleep or dysregulated sleep-wake schedules. For children, such sleep problems often relate to impairment in school and social functioning. Thus, sleep is an especially…

Children with Autism: Sleep Problems and Symptom Severity

ERIC Educational Resources Information Center

Tudor, Megan E.; Hoffman, Charles D.; Sweeney, Dwight P.

2012-01-01

Relationships between the specific sleep problems and specific behavioral problems of children with autism were evaluated. Mothers' reports of sleep habits and autism symptoms were collected for 109 children with autism. Unlike previous research in this area, only children diagnosed with autism without any commonly comorbid diagnoses (e.g.,…

An investigation on sleep behaviors of the elderly hospitalized in Zahedan

PubMed Central

Sargazi, Maryam; Salehi, Shayesteh; Naji, Seyed Ali

2012-01-01

Background: Sleep is an essential need in every individual's life. A disorder in the natural sleep can cause physical and mental problems. The elderly are usually faced with more sleep problems. Therefore, the present study aimed to define sleep behavior among the elderly hospitalized in Zahedan. Materials and Methods: This is a descriptive analytical study conducted on 300 elderly people aged 60 years and over who were hospitalized in Zahedan. In this research convenience sampling method was used and the research tool was a questionnaire. The data were collected through interviews. Descriptive (frequency distribution) and inferential (X2) statistical tests were employed to analyze the data. Findings: The results showed that 62% of the hospitalized elderly people (total of 300) had sleep disorder. About 44.7%took sleep medication in order to sleep, and only 16.7% did not take sleeping medications. About 44.7% had no special schedule for the time of their sleeping and waking up, and 4.3% were involved in drug abuse and smoking, and had a big dinner before sleeping. There was a significant association between sleep disorder, gender, education, living in urban or rural areas, the cause of hospitalization, and suffering from a chronic disease Conclusions: Sleep disorder and inappropriate sleep related behaviors had a high prevalence among the elderly. With regard to the important role of sleep in the quality of life of the elderly, detection of the reasons of sleep disorder, motivating them to practice an appropriate sleep behavior, and preventing them from having inappropriate sleep related behaviors are crucial issues. PMID:23493461

Validation of the Behavioral Risk Factor Surveillance System Sleep Questions

PubMed Central

Jungquist, Carla R.; Mund, Jaime; Aquilina, Alan T.; Klingman, Karen; Pender, John; Ochs-Balcom, Heather; van Wijngaarden, Edwin; Dickerson, Suzanne S.

2016-01-01

Study Objective: Sleep problems may constitute a risk for health problems, including cardiovascular disease, depression, diabetes, poor work performance, and motor vehicle accidents. The primary purpose of this study was to assess the validity of the current Behavioral Risk Factor Surveillance System (BRFSS) sleep questions by establishing the sensitivity and specificity for detection of sleep/ wake disturbance. Methods: Repeated cross-sectional assessment of 300 community dwelling adults over the age of 18 who did not wear CPAP or oxygen during sleep. Reliability and validity testing of the BRFSS sleep questions was performed comparing to BFRSS responses to data from home sleep study, actigraphy for 14 days, Insomnia Severity Index, Epworth Sleepiness Scale, and PROMIS-57. Results: Only two of the five BRFSS sleep questions were found valid and reliable in determining total sleep time and excessive daytime sleepiness. Conclusions: Refinement of the BRFSS questions is recommended. Citation: Jungquist CR, Mund J, Aquilina AT, Klingman K, Pender J, Ochs-Balcom H, van Wijngaarden E, Dickerson SS. Validation of the behavioral risk factor surveillance system sleep questions. J Clin Sleep Med 2016;12(3):301–310. PMID:26446246

Development of the Behavioral Evaluation of Disorders of Sleep Scale

ERIC Educational Resources Information Center

Schreck, Kimberly A.; Mulick, James A.; Rojahn, Johannes

2003-01-01

We describe the development, preliminary psychometric properties, and cross-validation of the Behavioral Evaluation of Disorders of Sleep (BEDS: Schreck 1997/1998). Parental reports of problem sleep behavior in elementary school aged children 5 years to 12 years were collected for two samples. With the first sample, an exploratory factor analysis…

Treating the Sleep Disorders of Childhood: Current Practice in the United Kingdom

ERIC Educational Resources Information Center

Bartlet, L. B.

2006-01-01

Sleep disorders are common in childhood. Their prevalence is especially high in the presence of disability or chronic illness. They cause considerable stress to the children themselves and to their parents. Sleep deprivation leads to daytime behavioral problems and educational difficulties. In assessing sleep problems thorough history taking is…

Pharmacological Treatment of Sleep Disturbance in Developmental Disabilities: A Review of the Literature

ERIC Educational Resources Information Center

Hollway, Jill A.; Aman, Michael G.

2011-01-01

Sleep disturbance is a common problem in children with developmental disabilities. Effective pharmacologic interventions are needed to ameliorate sleep problems that persist when behavior therapy alone is insufficient. The aim of the present study was to provide an overview of the quantity and quality of pharmacologic research targeting sleep in…

Defining Problematic Infant Sleep: Shifting the Focus from Deviance to Difference

ERIC Educational Resources Information Center

Middlemiss, Wendy

2004-01-01

This article examines research that calls into question the soundness of current definitions of problematic infant sleep. Current research suggests that infant night wakings and signaling behaviors may be normative. Research is inconclusive on whether early sleep problems are predictive of later sleep problems. The article also describes research…

Relationship between Sleep Quality and Health Risk Behaviors in Undergraduate College Students

ERIC Educational Resources Information Center

Vail-Smith, Karen; Felts, W. Michael; Becker, Craig

2009-01-01

The Sleep Quality Index (SQI) and the Centers for Disease Control's National College Health Risk Survey (NCHRS) were administered to 859 undergraduates at a large southeastern university. Results indicated that 76.6% reported occasional sleep problems and 11.8 % experienced poor sleep quality. Among the problems reported, "general morning…

The Relationship Between Caffeine, Sleep, and Behavior in Children.

PubMed

Watson, Emily J; Banks, Siobhan; Coates, Alison M; Kohler, Mark J

2017-04-15

To examine caffeine consumption from various dietary sources in a cohort of Australian children and the relationship between caffeine consumption, sleep, and daytime behavior. Children aged 8 to 12 years and their parents/guardians completed a battery of questionnaires. Children completed a caffeine questionnaire while parents completed questionnaires regarding demographics, sleep, and behavior. The final sample consisted of 309 children (mean ± standard deviation [SD] age 10.6 ± 1.3 years, male = 48%) and corresponding parent reports. On average a mean ± SD 10.2 ± 17.4 mg/day of caffeine was consumed with a range of zero to 151 mg/day. Of the children who consumed caffeine (87% of the sample), the largest contributor was coffee and tea; making up 41% of total caffeine intake, and sodas (soft drinks) contributed to 40% of caffeine intake. Total caffeine consumption was significantly associated with sleep routine ( r = 0.152); morning tiredness ( r = 0.129); restless sleep ( r = 0.113); and internalizing behavioral problems ( r = 0.128). Using path analysis, caffeine consumption was positively associated with morning tiredness (β = 0.111, P = .050) which was positively associated with internalizing behaviors (β = 0.432, P < .001). The addition of sleep routine and restless sleep to the model led to a complete mediation of caffeine consumption on morning tiredness, as well as a partial mediation of the association between morning tiredness and internal behaviors. In 8- to 12-year-olds the primary sources of caffeine are coffee/tea and sodas. Overall mean caffeine consumption is small by adult standards but has an effect on behavior and sleep in children. The effect on behavior is mediated by disrupted sleep, indicating that caffeine is a contributor to sleep problems and related behavior in children. © 2017 American Academy of Sleep Medicine

Cognitive-behavioral versus non-directive therapy for preschoolers with severe nighttime fears and sleep-related problems.

PubMed

Kahn, Michal; Ronen, Alon; Apter, Alan; Sadeh, Avi

2017-04-01

To compare the efficacy of a developmentally appropriate cognitive-behavioral therapy protocol for preschoolers with severe nighttime fears and sleep-related problems, with an active control treatment. Ninety children aged four to six years (63% boys) with severe nighttime fears and their parents were randomized to either cognitive-behavioral therapy including parent involved play (CBT-PIP) or to a structurally equivalent non-directive treatment (TEPT; triadic expressive play therapy). Treatment conditions were also equivalent in parent- and child-rated credibility and expectancy, and in therapist-rated compliance. Children and parents were assessed at baseline, during the first intervention week and four weeks after treatment. Measures included actigraphy, daily sleep logs, structured diagnostic interviews and parent questionnaires. Significant reductions were observed in nighttime fears and objectively and subjectively measured sleep disruptions in both intervention groups following treatment. Parent reports indicated more advantageous outcomes for CBT-PIP compared to TEPT, with greater reductions in sleep problems and co-sleeping as well as higher customer satisfaction in the former group. While CBT-PIP showed no significant advantage compared to the active control in reducing fears or in improving objectively measured sleep, it was significantly more beneficial in reducing the adverse behavioral features of nighttime fears. Copyright © 2016 Elsevier B.V. All rights reserved.

Sleep in children with autistic spectrum disorder.

PubMed

Cortesi, Flavia; Giannotti, Flavia; Ivanenko, Anna; Johnson, Kyle

2010-08-01

Children and adolescents with autistic spectrum disorders (ASD) suffer from sleep problems, particularly insomnia, at a higher rate than typically developing children, ranging from 40% to 80%. Sleep problems in ASD might occur as a result of complex interactions between biological, psychological, social/environmental, and family factors, including child rearing practices that are not conducive to good sleep. Interestingly, children with a history of developmental regression have a more disturbed sleep pattern than children without regression. Even though regulation of sleep in children with ASD is still poorly understood, circadian abnormalities in autism might be the result of genetic abnormalities related to melatonin synthesis and melatonin's role in modulating synaptic transmission. Recently a bifurcation of the sleep/wake cycle with increased sensitivity to external noise and short sleep duration causing irregular sleep onset and wake up times has been suggested. Identifying and treating sleep disorders may result not only in improved sleep, but also impact favorably on daytime behavior and family functioning. Several studies have also demonstrated effectiveness of behavioral interventions for sleep onset and maintenance problems in these populations. When behavioral interventions are not effective or lead only to a partial response, pharmacological treatment options should be considered. Studies of melatonin use in children with ASD provide evidence for its effectiveness and safety in the long run. The clinician assessing a child with an ASD should screen carefully for sleep disorders and make referrals as indicated. Copyright 2010 Elsevier B.V. All rights reserved.

A Descriptive Analysis of Sleep Behaviour in Children with Fragile X.

ERIC Educational Resources Information Center

Richdale, Amanda L.

2003-01-01

A study involving 13 children (ages 3-19) with Fragile X found four had a sleep problem that had been present for more than 2 years in three. Six additional children exhibited various problematic sleep behaviors. Parental reports of a sleep problem were associated with more severe psychopathology and parental stress. (Contains references.)…

The Relationship Between Caffeine, Sleep, and Behavior in Children

PubMed Central

Watson, Emily J.; Banks, Siobhan; Coates, Alison M.; Kohler, Mark J.

2017-01-01

Study Objectives: To examine caffeine consumption from various dietary sources in a cohort of Australian children and the relationship between caffeine consumption, sleep, and daytime behavior. Methods: Children aged 8 to 12 years and their parents/guardians completed a battery of questionnaires. Children completed a caffeine questionnaire while parents completed questionnaires regarding demographics, sleep, and behavior. Results: The final sample consisted of 309 children (mean ± standard deviation [SD] age 10.6 ± 1.3 years, male = 48%) and corresponding parent reports. On average a mean ± SD 10.2 ± 17.4 mg/day of caffeine was consumed with a range of zero to 151 mg/day. Of the children who consumed caffeine (87% of the sample), the largest contributor was coffee and tea; making up 41% of total caffeine intake, and sodas (soft drinks) contributed to 40% of caffeine intake. Total caffeine consumption was significantly associated with sleep routine (r = 0.152); morning tiredness (r = 0.129); restless sleep (r = 0.113); and internalizing behavioral problems (r = 0.128). Using path analysis, caffeine consumption was positively associated with morning tiredness (β = 0.111, P = .050) which was positively associated with internalizing behaviors (β = 0.432, P < .001). The addition of sleep routine and restless sleep to the model led to a complete mediation of caffeine consumption on morning tiredness, as well as a partial mediation of the association between morning tiredness and internal behaviors. Conclusions: In 8- to 12-year-olds the primary sources of caffeine are coffee/tea and sodas. Overall mean caffeine consumption is small by adult standards but has an effect on behavior and sleep in children. The effect on behavior is mediated by disrupted sleep, indicating that caffeine is a contributor to sleep problems and related behavior in children. Citation: Watson EJ, Banks S, Coates AM, Kohler MJ. The relationship between caffeine, sleep and behavior in children. J Clin Sleep Med. 2017;13(4):533–543. PMID:28162144

Effectiveness of Sleep-Based Interventions for Children with Autism Spectrum Disorder: A Meta-Synthesis.

PubMed

Cuomo, Belinda M; Vaz, Sharmila; Lee, Elinda Ai Lim; Thompson, Craig; Rogerson, Jessica M; Falkmer, Torbjorn

2017-05-01

Sleep problems are common in children with autism spectrum disorder (ASD). This meta-synthesis collated eight previously published systematic reviews examining the efficacy of sleep interventions in children with ASD in an attempt to present a clear analysis of trialed interventions. The collated reviews consider five major groups of sleep interventions for children with ASD: melatonin therapy, pharmacologic treatments other than melatonin, behavioral interventions, parent education/education programs, and alternative therapies (massage therapy, aromatherapy, and multivitamin and iron supplementation). These eight reviews were based on 38 original studies and address the efficacy of interventions across 17 sleep problem domains. The results of this meta-synthesis suggest that no single intervention is effective across all sleep problems in children with ASD. However, melatonin, behavioral interventions, and parent education/education program interventions appear the most effective at ameliorating multiple domains of sleep problems compared with other interventions. Due to the heterogeneous causative factors and presentations of disordered sleep, further research into the effectiveness of sleep interventions may target specific phenotypic subgroups rather than a broad analysis across the general ASD population. Similarly, future research needs to consider the efficacy of different polytherapeutic approaches in order to provide clinicians with evidence to inform best practice. In the meantime, this review supports clinicians' decision making for a majority of the identified sleep problems in the ASD population. © 2017 Pharmacotherapy Publications, Inc.

Sleep disorders in children with cerebral palsy: neurodevelopmental and behavioral correlates.

PubMed

Romeo, Domenico M; Brogna, Claudia; Quintiliani, Michela; Baranello, Giovanni; Pagliano, Emanuela; Casalino, Tiziana; Sacco, Annalisa; Ricci, Daniela; Mallardi, Maria; Musto, Elisa; Sivo, Serena; Cota, Francesco; Battaglia, Domenica; Bruni, Oliviero; Mercuri, Eugenio

2014-02-01

We aimed to estimate the frequency of sleep disorders in children with cerebral palsy (CP) using the Sleep Disturbance Scale for Children (SDSC) and to evaluate the relations between sleep disorders and motor, cognitive, and behavioral problems. One hundred and sixty-five children with CP ages 6-16 years (mean age, 11years) were assessed using the SDSC, the Gross Motor Function Classification System (GMFCS), the Wechsler Intelligence Scale for Children and the Child Behavior Check List (CBCL) to assess sleep, motor, cognitive, and behavioral problems, respectively. An abnormal total sleep score was found in 19% of children with CP; more than 40% of children had an abnormal score on at least one SDSC factor. The SDSC total score was significantly associated (P<.01) with mental retardation, epilepsy, CBCL scores, and level 5 on the GMFCS. Our results confirm that sleep disorders are common in children with cerebral palsy. The relationship between motor and cognitive behavior and epilepsy should be further explored to better understand how these factors influence one another to identify effective treatments and to improve the well-being of the child. Copyright © 2014 Elsevier B.V. All rights reserved.

Sleep and gastrointestinal disturbances in autism spectrum disorder in children.

PubMed

Klukowski, Mark; Wasilewska, Jolanta; Lebensztejn, Dariusz

2015-01-01

Autism spectrum disorder (ASD), a neurodevelopmental disorder with a prevalence of 1 in 68 children, commonly presents with comorbid conditions which include sleep disorders. Sleep disorders reported in ASD include, among others, increased bedtime resistance, insomnia, parasomnia, sleep disordered breathing, morning rise problems, and daytime sleepiness. Polysomnography studies show that children with ASD have altered sleep architecture including shorter total sleep time and longer sleep latency than typically developing peers. Sleep-related problems have been shown to affect overall autism scores, social skills decits, stereotypic behavior, and cognitive performance. Additionally, problematic sleep in children with ASD has been associated with higher levels of parental stress. Underlying causes specically related to sleep disorders are not fully known. Gastrointestinal (GI) disorders are commonly associated with sleep problems in these patients. Children with ASD and GI symptoms have been found to have a higher prevalence of sleep disturbances compared with typically developing peers who do not have GI symptoms. Treatment approaches to children with sleep disorders are varied and range from lifestyle modications and behavioral interventions to drug therapies and surgical interventions. Physicians should take into account GI disorders as possible underlying causes of sleep-related problems in children with ASD. Therapeutic interventions should begin with less invasive methods before progressing to more invasive options such as pharmacotherapy and should be based on medical indications in order to provide effective care while minimizing potential adverse health effects. Evidence-based studies concerning GI and sleep disorders in children with ASD are limited and further studies are warranted.

Effects of a sleep education program with self-help treatment on sleeping patterns and daytime sleepiness in Japanese adolescents: A cluster randomized trial.

PubMed

Tamura, Norihisa; Tanaka, Hideki

2016-01-01

Subjective insufficient sleep and delayed sleep-wake patterns have been reported as the primary causes for daytime sleepiness, a reasonably significant and prevalent problem for adolescents worldwide. Systematic reviews have indicated that the success of sleep education programs has thus far been inconsistent, due to the lack of a tailored approach that allows for evaluation of individual differences in behavior patterns. One way to resolve this problem is to assess the individual sleep behaviors of adolescents by using a checklist containing the recommended behaviors for promoting sleep health. Such self-help education programs have already been implemented for elementary school children, school nurses and the elderly. The present study aimed to verify the effects of a sleep education program with supplementary self-help treatment, based on a checklist of sleep-promoting behaviors, in addition to evaluation of changes in sleeping patterns, sleep-promoting behaviors and daytime sleepiness in adolescents. A cluster randomized controlled trial involving 5 Japanese junior high schools was conducted, and 243 students (sleep education: n = 122; waiting list: n = 121; 50.6% female; 7th grade) were included in the final analysis. The sleep education group was provided with information on proper sleep health and sleep-promoting behaviors. The students in this group were asked to practice one sleep-promoting behavior as a goal for 2 weeks and to monitor their practice using sleep diaries. Both pre- and post-treatment questionnaires were administered to students in order to assess knowledge of sleep-promoting behaviors, sleeping patterns and daytime functioning. Students in the sleep education group showed significant improvement in their knowledge of sleep health (F1,121 = 648.05, p < 0.001) and in their sleep-promoting behaviors (F1,121 = 55.66, p < 0.001). Bedtime on both school nights (F1,121 = 50.86, p < 0.001) and weekends (F1,121 = 15.03, p < 0.001), sleep-onset latency (F1,121 = 10.26, p = 0.002), total sleep time on school nights (F1,121 = 12.45, p = 0.001), subjective experience of insufficient sleep (McNemar χ(2)(1) = 4.03, p = 0.045) and daytime sleepiness (McNemar χ(2)(1) = 4.23, p = 0.040) were also improved in the sleep education group. In contrast, no significant improvement in these variables was observed for students in the waiting-list group. In conclusion, the sleep education program with self-help treatment was effective not only in increasing sleep knowledge but also in improving sleep-promoting behavior and sleeping patterns/reducing daytime sleepiness for students in the sleep education group, in comparison with the waiting-list group.

The Effect of Sleep Problems on Suicidal Risk among Young Adults in the Presence of Depressive Symptoms and Cognitive Processes.

PubMed

Weis, Dafna; Rothenberg, Lee; Moshe, Lital; Brent, David A; Hamdan, Sami

2015-01-01

We aimed to investigate the effect of sleep problems, depression, and cognitive processes on suicidal risk among 460 young adults. They completed self-report questionnaires assessing suicidal behavior, sleep quality, depressive symptoms, emotion regulation, rumination, and impulsivity. Suicidal participants exhibited higher rates of depressive symptoms, sleep problems, expressive suppression, rumination, and impulsivity. A confirmatory factor analysis model revealed pathways to suicidal risk that showed no direct pathways between sleep problems and suicidal risk. Instead, sleep was related to suicidal risk via depression and rumination, which in turn increased suicidal risk. These results suggest that addressing sleep problems will be useful in either the treatment or prevention of depressive and rumination symptoms and reduction in suicidal risk.

The Relations Between Sleep, Personality, Behavioral Problems, and School Performance in Adolescents.

PubMed

Schmidt, Ralph E; Van der Linden, Martial

2015-06-01

According to recent meta-analyses, adolescents across different countries and cultures do not get the recommended amount of sleep. Extracurricular activities, part-time jobs, and use of electronic devices in the evening delay bedtime in adolescents. Early school start times also shorten the time for sleep. Insufficient sleep in adolescents has been associated with weakened emotional-behavioral regulation and poor academic achievement. Multicomponent intervention programs have been developed on the basis of cognitive-behavioral therapy for insomnia to improve sleep in youth. Copyright © 2015 Elsevier Inc. All rights reserved.

Sleep in children with autism spectrum disorder.

PubMed

Kotagal, Suresh; Broomall, Eileen

2012-10-01

Children with autism spectrum disorder demonstrate an increased prevalence of difficulties with sleep initiation and maintenance. The consequences may include alterations in daytime behavior, memory, and learning in patients, and significant stress in caretakers. The dysregulation of melatonin synthesis, sensitization to environmental stimuli, behavioral insomnia syndromes, delayed sleep phase syndrome, rapid eye movement sleep behavior disorder, and comorbid anxiety, depression, and epilepsy comprise common etiologic factors. The clinical assessment of sleep problems in this population and a management algorithm are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

Variation in Common Preschool Sleep Problems as an Early Predictor for Depression and Anxiety Symptom Severity across Time

ERIC Educational Resources Information Center

Whalen, Diana J.; Gilbert, Kirsten E.; Barch, Deanna M.; Luby, Joan L.; Belden, Andy C.

2017-01-01

Background: Child and adolescent psychopathology has been linked to increased sleep problems, but there has been less investigation of this relationship in younger samples with early-onset psychopathology. This study examined three specific but commonly observed aspects of sleep behaviors in young children--(i) Sleep onset latency, (ii) Refusal to…

Long-term mother and child mental health effects of a population-based infant sleep intervention: cluster-randomized, controlled trial.

PubMed

Hiscock, Harriet; Bayer, Jordana K; Hampton, Anne; Ukoumunne, Obioha C; Wake, Melissa

2008-09-01

Maternal depression is an established risk for adverse child development. Two thirds of clinically significant depressive symptoms occur in mothers reporting an infant sleep problem. We aimed to determine the long-term effects of a behavioral intervention for infant sleep problems on maternal depression and parenting style, as well as on child mental health and sleep, when the children reached 2 years of age. We conducted a cluster-randomized trial in well-child centers across 6 government areas of Melbourne, Australia. Participants included 328 mothers reporting an infant sleep problem at 7 months, drawn from a population sample (N = 739) recruited at 4 months. We compared the usual well-child care (n = 154) versus a brief behavior-modification program designed to improve infant sleep (n = 174) delivered by well-child nurses at ages 8 to 10 months and measured maternal depression symptoms (Edinburgh Postnatal Depression Scale); parenting practices (Parent Behavior Checklist); child mental health (Child Behavior Checklist); and maternal report of a sleep problem (yes or no). At 2 years, mothers in the intervention group were less likely than control mothers to report clinical depression symptoms: 15.4% vs 26.4% (Edinburgh Postnatal Depression Scale community cut point) and 4.2% vs 13.2% (Edinburgh Postnatal Depression Scale clinical cut point). Neither parenting style nor child mental health differed markedly between the intervention and control groups. A total of 27.3% of children in the intervention group versus 32.6% of control children had a sleep problem. The sleep intervention in infancy resulted in sustained positive effects on maternal depression symptoms and found no evidence of longer-term adverse effects on either mothers' parenting practices or children's mental health. This intervention demonstrated the capacity of a functioning primary care system to deliver effective, universally offered secondary prevention.

Sleep Disruption as a Correlate to Cognitive and Adaptive Behavior Problems in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Taylor, Matthew A.; Schreck, Kimberly A.; Mulick, James A.

2012-01-01

Sleep problems associated with autism spectrum disorders (ASD) have been well documented, but less is known about the effects of sleep problems on day-time cognitive and adaptive performance in this population. Children diagnosed with autism or pervasive developmental disorder-not otherwise specified (PDD-NOS) (N = 335) from 1 to 10 years of age…

Daily dynamics in sleep and behavior of young African-American children: A convoluted dyad?!

PubMed

Spruyt, Karen; Alaribe, Calista U; Nwabara, Odochi U

2016-01-01

Prior research has provided evidence that in children sleep and behavior are related. We aimed to determine the association between naturalistic daily variations in sleep and behavioral functioning. African American children, 5.4±1.7years old, living on the south side of Chicago participated in a repeated measures study to assess this sleep-behavior link. Data was obtained from three separate two-week periods of 24-hour actigraphy and the parental version of the Behavioral Assessment System for Children. Canonical correlations analyses were applied to investigate the relation between individual changes in sleep and behavior. After 1-month, weekday average sleep duration primarily related to internalizing behaviors, while within-child variability of sleep related to behavioral changes which may involve internalizing and externalizing symptoms. Week-weekend differences in sleep associated with maladaptive social skills. Over a 6-week period, sleep onset latency and sleep offset latency related to behavioral symptoms and maladaptive skills. Over a period of 3-months, sleep associated with symptomatic behaviors while the adverse impact of within-child variability of sleep attenuated. Alternatively, the week-weekend differences in bedtime, wake-up time, wake after sleep onset and sleep onset latency in particular related to internalizing and externalizing behavior problems. Findings showed that poor sleep related to dysfunctional behaviors. While maladaptive at the beginning, they may develop into symptomatic behaviors with potentially internalizing characteristics. As time goes on, individual changes in sleep onset and offset might be important clinical markers of a chronic 'social dysregulation'. Continued sufficient and regular sleep may improve daytime and nighttime behavioral regulation in early childhood. Copyright © 2015 Elsevier B.V. All rights reserved.

Sleep Patterns among South Korean Infants and Toddlers: Global Comparison.

PubMed

Ahn, Youngmin; Williamson, Ariel A; Seo, Hyun-Joo; Sadeh, Avi; Mindell, Jodi A

2016-02-01

The purpose of this study was to examine sleep patterns in a large sample of infants and toddlers (ages birth to 36 months) in Korea, and to compare sleep patterns, sleep problems, sleep ecology, and parental behaviors to global sleep data on young children in both predominantly Asian (P-A) and predominantly Caucasian (P-C) countries/regions. We additionally examined parent and child demographic information, parental behaviors, and aspects of the sleep ecology as predictors of sleep patterns among infants and toddlers in Korea. Parents/caregivers of 1,036 Korean infants and toddlers completed an expanded, internet-based version of the brief infant sleep questionnaire. Consistent with other studies of sleep in early childhood, sleep/wake patterns became increasingly consolidated with older child age for the Korea sample. Compared to both P-A and P-C infants and toddlers, children in Korea had the latest bedtimes, shortest total sleep and daytime sleep durations, and the least frequent rates of napping. Even though half of parents perceive their children's sleep problematic, parental perceptions of severe child sleep problems were the lowest. Within Korea, breastfeeding and bottle-feeding at sleep resumption were associated with increased nocturnal awakenings. Evening television viewing was associated with later bedtimes, which may have implications for sleep hygiene recommendations in clinical practice. The current study provides important information about sleep/wake patterns, parental behaviors, and aspects of the sleep ecology for infants and toddlers for physicians to support healthy sleep in Korea.

Sleep Patterns among South Korean Infants and Toddlers: Global Comparison

PubMed Central

2016-01-01

The purpose of this study was to examine sleep patterns in a large sample of infants and toddlers (ages birth to 36 months) in Korea, and to compare sleep patterns, sleep problems, sleep ecology, and parental behaviors to global sleep data on young children in both predominately Asian (P-A) and predominately Caucasian (P-C) countries/regions. We additionally examined parent and child demographic information, parental behaviors, and aspects of the sleep ecology as predictors of sleep patterns among infants and toddlers in Korea. Parents/caregivers of 1,036 Korean infants and toddlers completed an expanded, internet-based version of the brief infant sleep questionnaire. Consistent with other studies of sleep in early childhood, sleep/wake patterns became increasingly consolidated with older child age for the Korea sample. Compared to both P-A and P-C infants and toddlers, children in Korea had the latest bedtimes, shortest total sleep and daytime sleep durations, and the least frequent rates of napping. Even though half of parents perceive their children’s sleep problematic, parental perceptions of severe child sleep problems were the lowest. Within Korea, breastfeeding and bottle-feeding at sleep resumption were associated with increased nocturnal awakenings. Evening television viewing was associated with later bedtimes, which may have implications for sleep hygiene recommendations in clinical practice. The current study provides important information about sleep/wake patterns, parental behaviors, and aspects of the sleep ecology for infants and toddlers for physicians to support healthy sleep in Korea. PMID:26839481

Prevalence of sleep problems in Japanese preschoolers in a medium-sized city: Community-based survey using the Children's Sleep Habits Questionnaire.

PubMed

Takahashi, Michio; Adachi, Masaki; Yasuda, Sayura; Osato-Kaneda, Ayako; Saito, Manabu; Kuribayashi, Michito; Nakamura, Kazuhiko

2017-06-01

Although the mean score of the Children's Sleep Habits Questionnaire (CSHQ) differs between countries, there are no normative data for the CSHQ of Japanese preschoolers based on a community sample. The aims of this study were therefore to present normative data for the CSHQ and determine the prevalence and characteristics of sleep problems in Japanese preschoolers. Parents or the primary caregiver of 482 preschoolers aged 4-5 years completed the CSHQ and the Strength and Difficulties Questionnaire. Approximately 80% of preschoolers scored above the cut-off for sleep disturbance on the CSHQ. In addition, co-sleeping was prevalent in Japanese preschoolers but the habit of co-sleeping contributed little to behavioral and emotional problems. Sleep problems appear to be prevalent in Japanese preschoolers based on the CSHQ, and could be associated with the Japanese sleep habit of co-sleeping. © 2017 Japan Pediatric Society.

Epidemiology and management of insomnia in children with autistic spectrum disorders.

PubMed

Miano, Silvia; Ferri, Raffaele

2010-04-01

Insomnia is the predominant sleep concern in children with autistic spectrum disorder (ASD), and its nature is most likely multifactorial, with neurochemical (abnormalities in serotonergic transmission or melatonin levels), psychiatric (anxiety), and behavioral (poor sleep habits) etiological factors involved. Children with ASD experience sleep problems similar to those of typically developing children, although the prevalence is markedly higher, occurring in 44-83% of school-aged children with ASD. Caregivers usually report that insomnia is the most frequent sleep disorder, described as disorders of initiating and maintaining sleep, restless sleep, bedtime resistance, co-sleeping, alterations of sleep hygiene, and early awakenings in the morning. Many actigraphic studies have added information on sleep disorders, confirming the questionnaire findings in the majority of cases. There are relatively few polysomnographic data for ASD, compared with questionnaire studies, and most of these studies reported a reduction in total sleep time and more undifferentiated sleep in the youngest patients. These findings were associated with several sleep microstructure alterations during rapid eye movement (REM) sleep, and with non-REM (NREM) sleep microstructure changes that appeared to be related to cognitive impairment rather than to the autistic core. Moreover, few data about other less frequent sleep disorders, such as periodic limb movements disorder and obstructive sleep apnea syndrome, bruxism, and the influence of epilepsy and EEG abnormalities, are available. Both pharmacologic and behavioral interventions have been suggested for the treatment of sleep problems in autistic children. The most common types of behavioral interventions are complete extinction (removing reinforcement to reduce a behavior) and various forms of graduated extinction. Melatonin has shown promising results in the treatment of insomnia in children with ASD. Although controlled studies are limited, there are more data demonstrating the safety and effectiveness of melatonin in ASD than for other sedative/hypnotic drugs. Finally, a dual treatment for insomnia in ASDs with melatonin and behavioral techniques has been suggested. A recent study using a combination of genetic and functional experimental techniques reported evidence that low melatonin concentration caused by a primary deficit in acetylserotonin methyltransferase activity is a risk factor for ASD. Sleep problems usually start at the same age as developmental regression, suggesting a higher vulnerability at this period of life. Further studies, beginning at younger ages, are necessary to better investigate these aspects and the role of melatonin in insomnia in children with ASD.

Earlier school start times are associated with higher rates of behavioral problems in elementary schools.

PubMed

Keller, Peggy S; Gilbert, Lauren R; Haak, Eric A; Bi, Shuang; Smith, Olivia A

2017-04-01

Early school start times may curtail children's sleep and inadvertently promote sleep restriction. The current study examines the potential implications for early school start times for behavioral problems in public elementary schools (student ages 5-12 years) in Kentucky. School start times were obtained from school Web sites or by calling school offices; behavioral and disciplinary problems, along with demographic information about schools, were obtained from the Kentucky Department of Education. Estimated associations controlled for teacher/student ratio, racial composition, school rank, enrollment, and Appalachian location. Associations between early school start time and greater behavioral problems (harassment, in-school removals, suspensions, and expulsions) were observed, although some of these associations were found only for schools serving the non-Appalachian region. Findings support the growing body of research showing that early school start times may contribute to student problems, and extend this research through a large-scale examination of elementary schools, behavioral outcomes, and potential moderators of risk. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Sleep, chronotype, and sleep hygiene in children with attention-deficit/hyperactivity disorder, autism spectrum disorder, and controls.

PubMed

van der Heijden, K B; Stoffelsen, R J; Popma, A; Swaab, H

2018-01-01

Sleep problems are highly prevalent in ADHD and autism spectrum disorder (ASD). Better insight in the etiology is of clinical importance since intervention and prevention strategies of sleep problems are directed at underlying mechanisms. We evaluated the association of sleep problems and sleep patterns with sleep hygiene (behavioral/environmental practices that influence sleep quality, e.g. caffeine use), access to electronic media, chronotype, and anxiety/depression in children aged 6-12 years with ADHD, ASD, or typical development (TD) using parental questionnaires. ANOVA and linear regression analyses were adjusted for age and sex. Children with ADHD and ASD showed more sleep problems (63.6 and 64.7%, vs 25.1% in TD) and shorter sleep duration than controls, while differences between ADHD and ASD were not significant. Sleep hygiene was worse in ADHD and ASD compared to TD, however, the association of worse sleep hygiene with more sleep problems was only significant in ASD and TD. There was a significant association of access to electronic media with sleep problems only in typically developing controls. Chronotype did not differ significantly between groups, but evening types were associated with sleep problems in ADHD and TD. Associations of greater anxiety/depression with more sleep problems were shown in ADHD and TD; however, anxiety/depression did not moderate the effects of chronotype and sleep hygiene. We conclude that sleep problems are highly prevalent in ADHD and ASD, but are differentially related to chronotype and sleep hygiene. In ASD, sleep problems are related to inadequate sleep hygiene and in ADHD to evening chronotype, while in TD both factors are important. Clinical implications are discussed.

Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial.

PubMed

Price, Anna M H; Wake, Melissa; Ukoumunne, Obioha C; Hiscock, Harriet

2012-10-01

Randomized trials have demonstrated the short- to medium-term effectiveness of behavioral infant sleep interventions. However, concerns persist that they may harm children's emotional development and subsequent mental health. This study aimed to determine long-term harms and/or benefits of an infant behavioral sleep program at age 6 years on (1) child, (2) child-parent, and (3) maternal outcomes. Three hundred twenty-six children (173 intervention) with parent-reported sleep problems at age 7 months were selected from a population sample of 692 infants recruited from well-child centers. The study was a 5-year follow-up of a population-based cluster-randomized trial. Allocation was concealed and researchers (but not parents) were blinded to group allocation. Behavioral techniques were delivered over 1 to 3 individual nurse consultations at infant age 8 to 10 months, versus usual care. The main outcomes measured were (1) child mental health, sleep, psychosocial functioning, stress regulation; (2) child-parent relationship; and (3) maternal mental health and parenting styles. Two hundred twenty-five families (69%) participated. There was no evidence of differences between intervention and control families for any outcome, including (1) children's emotional (P = .8) and conduct behavior scores (P = .6), sleep problems (9% vs 7%, P = .2), sleep habits score (P = .4), parent- (P = .7) and child-reported (P = .8) psychosocial functioning, chronic stress (29% vs 22%, P = .4); (2) child-parent closeness (P = .1) and conflict (P = .4), global relationship (P = .9), disinhibited attachment (P = .3); and (3) parent depression, anxiety, and stress scores (P = .9) or authoritative parenting (63% vs 59%, P = .5). Behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.

Sleep disturbances in preschool age children with cerebral palsy: a questionnaire study.

PubMed

Romeo, Domenico M; Brogna, Claudia; Musto, Elisa; Baranello, Giovanni; Pagliano, Emanuela; Casalino, Tiziana; Ricci, Daniela; Mallardi, Maria; Sivo, Serena; Cota, Francesco; Battaglia, Domenica; Bruni, Oliviero; Mercuri, Eugenio

2014-09-01

The study aimed to analyze (i) the prevalence of sleep disorders in pre-school children with cerebral palsy (CP) using the Sleep Disturbance Scale for Children (SDSC), (ii) the possible association with motor, cognitive and behavioral problems, and (iii) the possible differences with typically developing children matched for age and gender. One-hundred children with CP (age range: 3-5 years, mean: 3.8 years) were assessed using the SDSC, the Gross Motor Function Classification System (GMFCS), the Wechsler Preschool and Primary Scale of Intelligence, and the Child Behaviour Check List (CBCL) to assess sleep, motor, cognitive, and behavioral problems, respectively. Further 100 healthy children matched for age and sex were assessed using the SDSC. An abnormal total sleep score was found in 13% of children with CP while 35% had an abnormal score on at least one SDSC factor. SDSC total score was significantly associated with pathological internalizing scores on CBCL and active epilepsy on multivariate analysis. CP group reported higher significant median scores on SDSC total, parasomnias, and difficulty in initiating and maintaining sleep factors. In pre-school children sleep disorders are more common in children with CP than in healthy control group and are often associated with epilepsy and behavioral problems. Copyright © 2014 Elsevier B.V. All rights reserved.

External validity of children's self-reported sleep functioning: associations with academic, social, and behavioral adjustment.

PubMed

Becker, Stephen P

2014-09-01

Several child-report measures of sleep functioning have been developed but very few studies have examined the external validity of child self-reported sleep in relation to daytime functioning. This study examined child-reported sleep in relation to teacher-rated psychopathology symptoms and also tested the hypothesis that child-reported sleep would be associated with poorer child- and teacher-reported functioning after controlling for demographics and psychopathology symptoms that are known to be associated with adjustment. Participants were 175 children (81 boys, 94 girls) in 1st-6th grades (ages 6-13) and their teachers. Children completed the Sleep Self-Report. Teachers completed a measure of attention-deficit/hyperactivity disorder (ADHD), oppositional/conduct, and anxiety/depression symptoms. Children and teachers completed multiple measures of academic, behavioral, and social/peer functioning. Child-reported sleep was significantly associated with teacher-rated inattentive and internalizing symptoms, even after controlling for child demographics, hyperactivity-impulsivity, and conduct problems. Multilevel modeling analyses further indicated that, after controlling for child demographics and psychopathology symptoms, child-reported sleep problems were significantly associated with poorer child- and teacher-reported academic, behavioral, and social functioning (including increased reactive aggression, peer rejection, loneliness, and lower friendship satisfaction and self-worth). Findings provide initial support for the external validity of children's self-reported sleep functioning. Results of this study suggest that it may be clinically useful to screen for sleep problems by assessing for children's own perceptions of their sleep. Future studies should include both child- and parent-reported sleep functioning to further examine the utility of children's ratings of sleep functioning. Copyright © 2014 Elsevier B.V. All rights reserved.

Sleep and adolescent suicidal behavior.

PubMed

Liu, Xianchen

2004-11-01

Suicide risk begins to increase during adolescence. Adolescents do not get enough sleep and are also at risk for many sleep disturbances. This study examined the association between sleep patterns and sleep problems and adolescent suicidal behavior. A questionnaire survey of adolescents attending school was conducted in one prefecture of Shandong Province, People's Republic of China. A total of 1,362 adolescents attending school (mean age 14.6 years, 60% males) participated in the survey. Respondents completed a self-administered questionnaire that asked about sleep patterns, sleep problems, suicidal behavior, depressive symptoms, and demographic characteristics of the family and adolescent. Overall, 19.3% of the sample reported having suicidal ideation, 10.5% having suicide attempts in the past 6 months, 16.9% having insomnia symptoms, 2.3% having taken hypnotic medication, and 48.9% having experience of nightmares in the past month. Mean night sleep duration was 7.6 hours (SD = 0.8). Logistic regression analyses showed that sleeping less than 8 hours at night (OR = 2.89, 95% confidence interval [CI] = 1.07-7.81) and frequent nightmares (OR = 2.43, 95% CI = 1.76-3.35) were significantly associated with increased risk for suicide attempts after adjustment for age, sex, father's occupation, and depressive symptoms and that nightmares (OR = 1.69, 95% CI = 1.20-2.38) were also significantly related to suicidal ideation. These findings demonstrate the association between short sleep duration and nightmares and suicidal behavior and highlight the potential role of sleep intervention in the prevention of adolescent suicide.

Association of sleep habits with behavior problems and resilience of 6- to 7-year-old children: results from the A-CHILD study.

PubMed

Doi, Satomi; Fujiwara, Takeo; Ochi, Manami; Isumi, Aya; Kato, Tsuguhiko

2018-05-01

Childhood sleep habits are associated with mental health development; however, little is known about the impact of irregular bedtimes on the mental health of early school-aged children. The aims of this study were to examine the effect of weekday sleep habits (varying bedtimes depending on the night of the week and later than 22:00 h bedtime) on behavior problems, prosocial behavior, and resilience of children aged 6-7 years. Data were taken from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, which involved the participation of 4291 caregivers of first-grade children (6-7 years old) living in Adachi City, Tokyo. Resilience (using the Children's Resilient Coping Scale), behavior problems (using the Strength and Difficulties Questionnaire), both modified to range 0-100, and sleep habits were measured via a questionnaire filled out by caregivers. Propensity-score matching was used to determine the associations between irregular and late bedtime, behavior problems, prosocial behavior, and resilience. A total of 320 (7.5%) children showed irregular bedtime on school nights and 540 (13.6%) children went to bed later than 22:00 h. Children with irregular bedtimes on weekdays showed lower resilience (β = -3.50, 95% confidence interval (CI) = -5.90 to -1.10) and higher levels of behavior problems (β = 3.29, 95% CI = 1.13-5.46), especially hyperactivity/inattention (β = 5.76, 95% CI = 2.03 to 9.49) and peer relationship problems (β = 3.79, 95% CI = 1.02-6.55). On the other hand, no association between bedtime after 22:00 h and resilience or behavior problems was found. Among early school-aged children, irregular bedtime on weekdays may be a risk factor for lower resilience and behavior problems. Published by Elsevier B.V.

Parental behaviors and sleep outcomes in infants and toddlers: a cross-cultural comparison.

PubMed

Mindell, Jodi A; Sadeh, Avi; Kohyama, Jun; How, Ti Hwei

2010-04-01

To assess the prevalence of parental behaviors and other factors of sleep ecology and to analyze their relationships with sleep outcomes in a large sample of children ages birth to 36months in multiple countries/regions. Parents of 29,287 infants and toddlers (48% boys; Australia, Canada, China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, New Zealand, Philippines, Singapore, Taiwan, Thailand, United Kingdom, United States, and Vietnam) completed an internet-based expanded version of the Brief Infant Sleep Questionnaire. Overall, there is a high level of parental involvement in sleep onset and sleep maintenance for young children, with significant differences in parenting behaviors across cultural groups. For predominantly-Caucasian, the most common behavior occurring at bedtime is falling asleep independently in own crib/bed (57%), compared to just 4% of those children living in predominantly-Asian regions. Parental behaviors and sleep ecology, including parental presence at sleep onset, bedtime, and bedtime routine, significantly explain a portion of the variance in sleep patterns. Overall, parental behaviors are more highly predictive of nighttime sleep outcomes in predominantly-Caucasian regions. Finally, parental involvement in sleep onset mediates the relationship between cosleeping and sleep outcomes. Overall, the best predictors of nighttime sleep are related to parental behaviors at bedtime and during the night. Furthermore, sleep disruption and decreased total sleep associated with bed sharing and room sharing are mediated by parental presence at bedtime. These findings provide additional support for addressing parental behaviors in behavioral interventions for infant and toddler sleep problems. Copyright 2010 Elsevier B.V. All rights reserved.

Anxiety Sensitivity and Sleep-Related Problems in Anxious Youth

PubMed Central

Weiner, Courtney L.; Elkins, Meredith; Pincus, Donna; Comer, Jonathan

2015-01-01

Anxiety disorders constitute the most common mental health disturbance experienced by youth. Sleep-related problems (SRPs) are highly prevalent among anxious youth and encompass a variety of problems including nighttime fears, insomnia, and refusal to sleep alone. Given that chronic sleep disturbance is associated with a range of behavioral and physical problems in youth and predicts future psychopathology, it is important to elucidate the nature of SRPs in anxious youth. The present study investigated the relationship between sleep problems and anxiety sensitivity in a sample of 101 anxious youth, ages 6–17. Heightened anxiety sensitivity significantly predicted prolonged sleep onset latency across the sample, even after accounting for severity of anxiety, depression, and age. Results support previous research indicating that SRPs are common among anxious youth and suggest that anxiety sensitivity may play a particularly important role in sleep onset latency. PMID:25863826

Screening for Sleep Problems in Early Intervention and Early Childhood Special Education: A Systematic Review of Screening and Assessment Instruments

ERIC Educational Resources Information Center

Bonuck, Karen A.; Hyden, Christel; Ury, Guenn; Barnett, Josephine; Ashkinaze, Hannah; Briggs, Rahil D.

2011-01-01

Behavioral insomnias of childhood (BIC) and sleep disordered breathing (SDB) disorders cause disrupted and/or inefficient sleep. Left untreated in early childhood, both conditions increase the risk of compromised development, particularly in the areas of behavior, cognition, and growth. This systematic review determined whether and how current…

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature

ERIC Educational Resources Information Center

Wheaton, Anne G.; Chapman, Daniel P.; Croft, Janet B.

2016-01-01

Background: Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy…

Association of Stress, General Health, and Alcohol Use with Poor Sleep Quality among U.S. College Students

ERIC Educational Resources Information Center

Valerio, Teresa D.; Kim, Myoung Jin; Sexton-Radek, Kathy

2016-01-01

Background: Poor sleep among college students is a major, growing problem associated with lower academic performance, higher rates of health and emotional problems, and development of chronic sleep disorders. Purpose: Though previous studies have focused on individual colleges, our study purpose was to reveal the association of behaviors and…

[Mini-KiSS--a multimodal group therapy intervention for parents of young children with sleep disorders: a pilot study].

PubMed

Schlarb, Angelika Anita; Brandhorst, Isabel; Hautzinger, Martin

2011-05-01

Sleep disorders in early childhood tend to be chronic and almost always a burden for the parents. This study developed and evaluated a multimodal parent training program for children 0.5 to 4 years of age suffering from sleep disorders (Mini-KiSS). We hypothesized that there would be specific improvements following the structured group training (reduction of sleep problems, improvement of parental well-being). The pilot study consisted of a pre-post test design without control group. Participants were n = 17 parents of children 0.5 to 4 years of age with sleep disorders determined according to the ICSD-II. Each of the six sessions was evaluated, and changes were assessed by sleep diary and CBCL. Behavioral and emotional problems of the child were assessed by CBCL, parental well-being, and SCL-90-R. The results showed high acceptance of Mini-KiSS and satisfactory feasibility. Children showed significant improvements of the sleep disturbances such as nightly awakenings as well as sleeping in parents' bed. Furthermore, improvements were found for children's emotional and behavioral problems and for parental well-being, in particular for the depression scale of the mother. This pilot study shows a high acceptance and good feasibility of the multimodal short-time parent-training program Mini-KiSS. Sleep problems were significantly reduced.

Putting Children's Sleep Problems to Bed: Using Behavior Change Theory to Increase the Success of Children's Sleep Education Programs and Contribute to Healthy Development.

PubMed

Blunden, Sarah; Benveniste, Tessa; Thompson, Kirrilly

2016-07-01

Sleep is critical for the healthy development of children, yet most children simply don't get enough. Whilst school based sleep education programs have been developed for parents and their children, they have had mixed success. We consider how use of behavior change theory in existing school-based sleep education programs can be improved by applying and apply a broader model to these programs. We find that the mixed success of school-based sleep education programs may be due to a plausible but misleading assumption that simply increasing information about the importance of sleep and the risks of insufficient and/or inefficient sleep will necessarily result in improved sleep behaviors. We identify the potential benefits of using behavior change theory in the development of sleep education programs but in particular, there is a need for theories incorporate the multiple biological, environmental and social impacts on children's sleep. Bronfenbrenner's Bioecological model is presented to illustrate how one such behavior change theory could significantly improve the success of sleep education programs and ultimately support the healthy development of children.

Treat the source not the symptoms: why thinking about sleep informs the social determinants of health.

PubMed

Hale, Lauren; Hale, Benjamin

2010-06-01

Based on theoretical and empirical work, we argue that autonomy is likely an important underlying source of healthy sleep. The implication is that 'treatment' for sleep problems cannot be understood as an individual-level behavioral problem but must instead be addressed in concert with larger scale social factors that may be inhibiting high-quality sufficient sleep in large segments of the population. When sleep is understood as a proxy for health, the implications extend even further. Policies and interventions that facilitate the autonomy of individuals therefore may not only help reduce individual sleep problems but also have broader consequences for ameliorating social disparities in health.

Perceived insufficient rest or sleep--four states, 2006.

PubMed

2008-02-29

Chronic sleep loss is an under-recognized public health problem that has a cumulative effect on physical and mental health. Sleep loss and sleep disorders can reduce quality of life and productivity, increase use of health-care services, and result in injuries, illness, or deaths. Epidemiologic surveys suggest that mean sleep duration among U.S. adults has decreased during the past two decades (CDC, unpublished data, 2007). An estimated 50-70 million persons in the United States have chronic sleep and wakefulness disorders. Most sleep disorders are marked by difficulty falling or staying asleep, daytime sleepiness, sleep-disordered breathing, or abnormal movements, behaviors, or sensations during sleep. To examine characteristics of men and women who reported days of perceived insufficient rest or sleep during the preceding 30 days, CDC analyzed 2006 Behavioral Risk Factor Surveillance System (BRFSS) data from four states (Delaware, Hawaii, New York, and Rhode Island). This report summarizes the results of that analysis. Among all respondents, 29.6% reported no days of insufficient rest or sleep during the preceding 30 days and 10.1% reported insufficient rest or sleep every day during the preceding 30 days. Rest and sleep insufficiency can be assessed in general medical-care visits and treated through effective behavioral and pharmacologic methods. Expanded and more detailed surveillance of insufficient rest or sleep (e.g., national estimates) might clarify the nature of this problem and its effect on the health of the U.S. population.

Parent-Reported Symptoms of Sleep-Disordered Breathing Are Associated With Increased Behavioral Problems at 2 Years of Age: The Canadian Healthy Infant Longitudinal Development Birth Cohort Study.

PubMed

Tamana, Sukhpreet K; Smithson, Lisa; Lau, Amanda; Mariasine, Jennifer; Young, Rochelle; Chikuma, Joyce; Lefebvre, Diana L; Subbarao, Padmaja; Becker, Allan B; Turvey, Stuart E; Sears, Malcolm R; Pei, Jacqueline; Mandhane, Piush J

2018-01-01

To examine the association between the age of onset and duration of parent-reported symptoms of sleep-disordered breathing (SDB) and behavioral problems at age 2. Parent-reported SDB symptoms were assessed quarterly between 3 months and 2 years among 583 Canadian Healthy Infant Longitudinal Development Edmonton-site participants. Parent-reported SDB symptoms were clustered into phenotypes using group-based trajectory analysis based on age of onset and duration of symptoms. Home-based polysomnography (PSG) was completed at 1 year. The Child Behavior Checklist preschool-version (Mean T-score 50, standard deviation 10 points) assessed total, externalizing (attention), and internalizing (anxiety, depression) behaviors at 2 years. Four phenotypes were identified: no SDB (64.7%), early-onset SDB (15.7%, peak symptoms at 9 months), late-onset (14.2%, peak symptoms at 18 months), and persistent SDB symptoms (5.3%, peak symptoms from 3 through 24 months). Persistent SDB (9.5 points, 95% CI 1.7, 17.2; p = .02) predicted the greatest magnitude of effect of total behavior problems, compared with children without SDB. Children with early-onset SDB (3.5 points, 95% CI 1.6, 5.4; p ≤ .001) and late-onset SDB (6.1 points 95% CI 4.0, 8.3; p ≤ .001) had increased total behavioral problems than children without SDB to 2 years. Additional analyses showed that the SDB phenotypes' trajectories were important for internalizing but not for externalizing behavior problems. There were no significant associations between home-PSG and parent-reported behavior problems. Findings suggest that the age of onset and duration of parent-reported SDB symptoms prior to age 2 have adverse consequences for overall behavior problems. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Short- and long-term health consequences of sleep disruption.

PubMed

Medic, Goran; Wille, Micheline; Hemels, Michiel Eh

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption.

Short- and long-term health consequences of sleep disruption

PubMed Central

Medic, Goran; Wille, Micheline; Hemels, Michiel EH

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption. PMID:28579842

Solving Sleep Behavior Disorders in Infants and Toddlers: The Munich Research and Intervention Program for Fussy Babies

ERIC Educational Resources Information Center

Papousek, Mechthild

2009-01-01

Sleep behavior disorders do not only affect infants' well-being, they also challenge the parents' physical and emotional resources, promote risks for the growing parent-infant relationships, and burden the parents' co-parenting relationship. Sleep-onset and night waking problems are widely spread among otherwise healthy infants, and they tend to…

Hypersomnia in children: interface with psychiatric disorders.

PubMed

Kotagal, Suresh

2009-10-01

Patients being evaluated in child psychiatry clinics for behavior and mood disturbances frequently exhibit daytime sleepiness. Conversely, patients being evaluated for hypersomnia by sleep specialists may have depressed mood or hyperactive and aggressive behavior. The etiology of daytime sleepiness in children and adolescents is diverse and includes inadequate sleep hygiene, obstructive sleep apnea, delayed sleep phase syndrome, idiopathic hypersomnia, periodic hypersomnia, narcolepsy, and mood disorders per se. Treatment of a sleep disorder can have a favorable impact on alertness and quality of life. A high index of suspicion for sleep problems should be maintained in children and adolescents with psychiatric disorders.

Associations between infant temperament, maternal stress, and infants' sleep across the first year of life.

PubMed

Sorondo, Barbara M; Reeb-Sutherland, Bethany C

2015-05-01

Effects of temperament and maternal stress on infant sleep behaviors were explored longitudinally. Negative temperament was associated with sleep problems, and with longer sleep latency and night wakefulness, whereas maternal stress was associated with day sleep duration, suggesting infant and maternal characteristics affect sleep differentially. Copyright © 2015 Elsevier Inc. All rights reserved.

Sleeping, TV, Cognitively Stimulating Activities, Physical Activity, and Attention-Deficit Hyperactivity Disorder Symptom Incidence in Children: A Prospective Study.

PubMed

Peralta, Gabriela P; Forns, Joan; García de la Hera, Manuela; González, Llúcia; Guxens, Mònica; López-Vicente, Mónica; Sunyer, Jordi; Garcia-Aymerich, Judith

2018-04-01

To analyze associations between time spent sleeping, watching TV, engaging in cognitively stimulating activities, and engaging in physical activity, all at 4 years, and (1) attention-deficit/hyperactivity disorder (ADHD) symptoms and (2) behavior problems, both assessed at 7 years, in ADHD-free children at baseline. In total, 817 participants of the Infancia y Medio Ambiente birth cohort, without ADHD at baseline, were included. At the 4-year follow-up, parents reported the time that their children spent sleeping, watching TV, engaging in cognitively stimulating activities, and engaging in physical activity. At the 7-year follow-up, parents completed the Conners' Parent Rating Scales and the Strengths and Difficulties Questionnaire, which measure ADHD symptoms and behavior problems, respectively. Negative binomial regression models were used to assess associations between the activities at 4 years and ADHD symptoms and behavior problems at 7 years. Children (48% girls) spent a median (p25-p75) of 10 (10-11) hours per day sleeping, 1.5 (0.9-2) hours per day watching TV, 1.4 (0.9-1.9) hours per day engaging in cognitively stimulating activities, and 1.5 (0.4-2.3) hours per day engaging in physical activity. Longer sleep duration (>10 hours per day) was associated with a lower ADHD symptom score (adjusted incidence rate ratio = 0.97, 95% confidence interval, 0.95-1.00). Longer time spent in cognitively stimulating activities (>1 hours per day) was associated with lower scores of both ADHD symptoms (0.96, 0.94-0.98) and behavior problems (0.89, 0.83-0.97). Time spent watching TV and engaging in physical activity were not associated with either outcomes. A shorter sleep duration and less time spent in cognitively stimulating activities were associated with an increased risk of developing ADHD symptoms and behavior problems.

Bullying, sleep/wake patterns and subjective sleep disorders: findings from a cross-sectional survey.

PubMed

Kubiszewski, Violaine; Fontaine, Roger; Potard, Catherine; Gimenes, Guillaume

2014-05-01

The aim of this study was to explore: (a) sleep patterns and disorders possibly associated with adolescent bullying profiles (pure bully, pure victim, bully/victim and neutral) and (b) the effect of sleep on psychosocial problems (externalized and internalized) related to bullying. The sample consisted of 1422 students aged 10-18 (mean = 14.3, SD = 2.7; 57% male) from five socioeconomically diverse schools in France. Bullying profiles were obtained using the revised Bully-Victim Questionnaire. Subjective sleep disorders were assessed using the Athens Insomnia Scale. School-week and weekend sleep/wake patterns were recorded. Internalizing problems were investigated using a Perceived Social Disintegration Scale and a Psychological Distress Scale. Externalizing behaviors were assessed using a General Aggressiveness Scale and an Antisocial Behavior Scale. These questionnaires were administered during individual interviews at school. After controlling for effects of gender and age, victims of bullying showed significantly more subjective sleep disturbances than the pure-bully or neutral groups (p < 0.001). Bullies' sleep schedules were more irregular (p < 0.001 for bedtime irregularity and p<0.01 for wake-up time irregularity) and their sleep duration was shorter than their schoolmates (p < 0.001 for the school week and p < 0.05 for the weekend). There was an effect of sleep on psychosocial problems related to bullying, and our results indicate that sleep has a moderating effect on aggression in bullies (p < 0.001). This would suggest a higher vulnerability of bullies to sleep deprivation. These results show differences in sleep problems and patterns in school-bullying profiles. Findings of this study open up new perspectives for understanding and preventing bullying in schools, with implications for research and clinical applications.

Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer

PubMed Central

Palesh, Oxana; Peppone, Luke; Innominato, Pasquale F; Janelsins, Michelle; Jeong, Monica; Sprod, Lisa; Savard, Josee; Rotatori, Max; Kesler, Shelli; Telli, Melinda; Mustian, Karen

2012-01-01

Sleep problems are highly prevalent in cancer patients undergoing chemotherapy. This article reviews existing evidence on etiology, associated symptoms, and management of sleep problems associated with chemotherapy treatment during cancer. It also discusses limitations and methodological issues of current research. The existing literature suggests that subjectively and objectively measured sleep problems are the highest during the chemotherapy phase of cancer treatments. A possibly involved mechanism reviewed here includes the rise in the circulating proinflammatory cytokines and the associated disruption in circadian rhythm in the development and maintenance of sleep dysregulation in cancer patients during chemotherapy. Various approaches to the management of sleep problems during chemotherapy are discussed with behavioral intervention showing promise. Exercise, including yoga, also appear to be effective and safe at least for subclinical levels of sleep problems in cancer patients. Numerous challenges are associated with conducting research on sleep in cancer patients during chemotherapy treatments and they are discussed in this review. Dedicated intervention trials, methodologically sound and sufficiently powered, are needed to test current and novel treatments of sleep problems in cancer patients receiving chemotherapy. Optimal management of sleep problems in patients with cancer receiving treatment may improve not only the well-being of patients, but also their prognosis given the emerging experimental and clinical evidence suggesting that sleep disruption might adversely impact treatment and recovery from cancer. PMID:23486503

Reducing Bedtime Disturbance and Night Waking Using Positive Bedtime Routines and Sleep Restriction

ERIC Educational Resources Information Center

Christodulu, Kristin V.; Durand, V. Mark

2004-01-01

The purpose of this study was to investigate behavioral interventions designed to reduce sleep difficulties in four young children with developmental disorders. Positive bedtime routines and sleep restriction were successful in eliminating bedtime disturbances and nighttime awakenings in four children with significant sleep problems. Positive…

Sleep Problems and Early Developmental Delay: Implications for Early Intervention Programs

ERIC Educational Resources Information Center

Bonuck, Karen; Grant, Roy

2012-01-01

Sleep disorders negatively impact behavior, cognition, and growth--the same areas targeted by early intervention. Conversely, developmental delays and disabilities may themselves precipitate sleep disorders. Young children with developmental delays experience sleep disorders at a higher rate than do typically developing children; the most common…

The Role of Sleep in Childhood Psychiatric Disorders

ERIC Educational Resources Information Center

Alfano, Candice A.; Gamble, Amanda L.

2009-01-01

Although sleep problems often comprise core features of psychiatric disorders, inadequate attention has been paid to the complex, reciprocal relationships involved in the early regulation of sleep, emotion, and behavior. In this paper, we review the pediatric literature examining sleep in children with primary psychiatric disorders as well as…

Health Behaviors Predict Higher Interleukin-6 levels Among Patients Newly Diagnosed with Head and Neck Squamous Cell Carcinoma

PubMed Central

Duffy, Sonia A.; Teknos, Theodoros; Taylor, Jeremy M.G.; Fowler, Karen E.; Islam, Mozaffarul; Wolf, Gregory T.; McLean, Scott; Ghanem, Tamer A.; Terrell, Jeffrey E.

2013-01-01

Background Health behaviors have been shown to be associated with recurrence risk and survival rates in cancer patients and are also associated with Interleukin-6 levels, but few epidemiologic studies have investigated the relationship of health behaviors and Interleukin-6 among cancer populations. The purpose of the study is to look at the relationship between five health behaviors: smoking, alcohol problems, body mass index (a marker of nutritional status), physical activity, and sleep and pretreatment Interleukin-6 levels in persons with head and neck cancer. Methods Patients (N=409) were recruited in otolaryngology clinic waiting rooms and invited to complete written surveys. A medical record audit was also conducted. Descriptive statistics and multivariate analyses were conducted to determine which health behaviors were associated with higher Interleukin-6 levels controlling for demographic and clinical variables among newly diagnosed head and neck cancer patients. Results While smoking, alcohol problems, body mass index, physical activity, and sleep were associated with Interleukin-6 levels in bivariate analysis, only smoking (current and former) and decreased sleep were independent predictors of higher Interleukin-6 levels in multivariate regression analysis. Covariates associated with higher Interleukin-6 levels were age and higher tumor stage, while comorbidities were marginally significant. Conclusion Health behaviors, particularly smoking and sleep disturbances, are associated with higher Interleukin-6 levels among head and neck cancer patients. Impact Treating health behavior problems, especially smoking and sleep disturbances, may be beneficial to decreasing Interleukin-6 levels which could have a beneficial effect on overall cancer treatment outcomes. PMID:23300019

Health behaviors predict higher interleukin-6 levels among patients newly diagnosed with head and neck squamous cell carcinoma.

PubMed

Duffy, Sonia A; Teknos, Theodoros; Taylor, Jeremy M G; Fowler, Karen E; Islam, Mozaffarul; Wolf, Gregory T; McLean, Scott; Ghanem, Tamer A; Terrell, Jeffrey E

2013-03-01

Health behaviors have been shown to be associated with recurrence risk and survival rates in patients with cancer and are also associated with interleukin-6 (IL-6) levels, but few epidemiologic studies have investigated the relationship of health behaviors and IL-6 among cancer populations. The purpose of the study is to look at the relationship between five health behaviors, viz.: smoking, alcohol problems, body mass index (BMI; a marker of nutritional status), physical activity, and sleep and pretreatment IL-6 levels in persons with head and neck cancer. Patients (N = 409) were recruited in otolaryngology clinic waiting rooms and invited to complete written surveys. A medical record audit was also conducted. Descriptive statistics and multivariate analyses were conducted to determine which health behaviors were associated with higher IL-6 levels controlling for demographic and clinical variables among patients with newly diagnosed head and neck cancer. While smoking, alcohol problems, BMI, physical activity, and sleep were associated with IL-6 levels in bivariate analysis, only smoking (current and former) and decreased sleep were independent predictors of higher IL-6 levels in multivariate regression analysis. Covariates associated with higher IL-6 levels were age and higher tumor stage, whereas comorbidities were marginally significant. Health behaviors, particularly smoking and sleep disturbances, are associated with higher IL-6 levels among patients with head and neck cancer. Treating health behavior problems, especially smoking and sleep disturbances, may be beneficial to decreasing IL-6 levels, which could have a beneficial effect on overall cancer treatment outcomes.

Eczema, Sleep, and Behavior in Children

PubMed Central

Camfferman, Danny; Kennedy, J. Declan; Gold, Michael; Martin, A. James; Winwood, Peter; Lushington, Kurt

2010-01-01

Introduction: There is a general consensus that sleep disruption in children causes daytime behavioral deficits. It is unclear if sleep disruption in children with eczema has similar effects particularly after controlling for known comorbid disorders such as asthma and rhinitis. Methods: Parents of children (6-16 y) with eczema (n = 77) and healthy controls (n = 30) completed a validated omnibus questionnaire which included the Sleep Disturbance Scale for Children, Conners Parent Rating Scale-Revised (S), Child Health Questionnaire, Children's Dermatology Life Quality Index, and additional items assessing eczema, asthma, rhinitis, and demographics. Results: Compared to controls, children with eczema had a greater number of sleep problems with a greater percentage in the clinical range, lower quality of life, and higher levels of ADHD and oppositional behavior. They also had elevated rhinitis and asthma severity scores. Importantly, structural equation modelling revealed that the effect of eczema on the behavioral variables of Hyperactivity, ADHD Index, and Oppositional Behaviors were mediated through sleep with no direct effect of eczema on these behaviors. The comorbid atopic disorders of rhinitis and asthma also had independent effects on behavior mediated through their effects on sleep. Conclusions: The present findings suggest that the daytime behaviors seen in children with eczema are mediated independently by the effects of eczema, asthma, and rhinitis on sleep quality. These findings highlight the importance of sleep in eczematous children and its role in regulating daytime behavior. Citation: Camfferman D; Kennedy JD; Gold M; Martin AJ; Winwood P; Lushington K. Eczema, sleep, and behavior in children. J Clin Sleep Med 2010;6(6):581-588. PMID:21206547

Sleepiness and cognition in young adults who gamble and use alcohol

PubMed Central

HARVANKO, ARIT M.; DERBYSHIRE, KATHERINE L.; SCHREIBER, R.N. LIANA; GRANT, JON E.

2014-01-01

Abstract Background and aims: Past research suggests that sleep problems are associated with increased risky decision-making. Similarly, gambling disorder and alcohol use disorder are also associated with increased risky decision-making. Individuals with gambling disorder or alcohol use disorder have also reported higher rates of sleep problems compared to normal healthy controls. As such, we sought to examine whether sleep problems play a role in the development of alcohol use disorder or gambling disorder. Methods: One hundred and forty-one individuals who gamble and use alcohol, yet do not meet criteria for gambling disorder or alcohol use disorder, were assessed to determine the correlation between sleepiness, amount of sleep obtained, decision-making, and alcohol or gambling behaviors. Results: Our results suggest that inconsistent sleep patterns may be associated with increased frequency of alcohol use and gambling. We did not, however, find a significant correlation between sleep factors and decision-making. Discussion: Further research is needed to examine the specific relationship between sleep patterns and alcohol use and gambling frequency. Overall these data suggest that sleepiness or sleep and risky decision-making is not a significant factor in gambling and alcohol use behaviors in individuals not meeting criteria for alcohol use disorder or gambling disorder. PMID:25317340

Sleep problems and disability retirement: a register-based follow-up study.

PubMed

Lallukka, Tea; Haaramo, Peija; Lahelma, Eero; Rahkonen, Ossi

2011-04-15

Among aging employees, sleep problems are prevalent, but they may have serious consequences that are poorly understood. This study examined whether sleep problems are associated with subsequent disability retirement. Baseline questionnaire survey data collected in 2000-2002 among employees of the city of Helsinki, Finland, were linked with register data on disability retirement diagnoses by the end of 2008 (n = 457) for those with written consent for such linkages (74%; N = 5,986). Sleep problems were measured by the Jenkins Sleep Questionnaire. Cox regression analysis was used to calculate hazard ratios and 95% confidence intervals for disability retirement. Gender- and age-adjusted frequent sleep problems predicted disability retirement due to all causes (hazard ratio (HR) = 3.22, 95% confidence interval (CI): 2.26, 4.60), mental disorders (HR = 9.06, 95% CI: 3.27, 25.10), and musculoskeletal disorders (HR = 3.27, 95% CI: 1.91, 5.61). Adjustments for confounders, that is, baseline sociodemographic factors, work arrangements, psychosocial working conditions, and sleep duration, had negligible effects on these associations, whereas baseline physical working conditions and health attenuated the associations. Health behaviors and obesity did not mediate the examined associations. In conclusion, sleep problems are associated with subsequent disability retirement. To prevent early exit from work, sleep problems among aging employees need to be addressed.

What is occupational therapy’s role in addressing sleep problems among older adults?

PubMed Central

Leland, Natalie E.; Marcione, Nicole; Niemiec, Stacey L. Schepens; Don Fogelberg, Kaivalya Kelkar

2014-01-01

Sleep problems, prevalent among older adults, are associated with poor outcomes and high healthcare costs. In 2008, rest and sleep became its own area of occupation in the AOTA Occupational Therapy Practice Framework. This scoping review examined a broad context of sleep research in order to highlight efficacious interventions for older adults that fall within the occupational therapy scope of practice and present an agenda for research and practice. Four sleep intervention areas clearly aligned with the Practice Framework, including cognitive behavioral therapy for insomnia, physical activity, and multi-component interventions. Occupational therapy is primed to address sleep problems by targeting the context and environment, performance patterns, and limited engagement in evening activities that may contribute to poor sleep. Occupational therapy researchers and clinicians need to work collaboratively to establish the evidence-base for occupation-centered sleep interventions in order to improve the health and quality of life of the older adult. PMID:24844879

Psychometric Properties of a Sleep Questionnaire for Use in Individuals with Intellectual Disabilities

ERIC Educational Resources Information Center

Maas, Anneke P. H. M.; Didden, Robert; Korzilius, Hubert; Braam, Wiebe; Collin, Philippe; Smits, Marcel G.; Curfs, Leopold M. G.

2011-01-01

We examined the psychometric properties of one part of the Sleep Questionnaire developed by Simonds and Parraga (SQ-SP; 1982), a questionnaire that is frequently used to explore sleep problems and behaviors related to sleep in individuals with intellectual disability (ID). The SQ-SP was completed for 345 individuals with ID (sleep clinic n = 146;…

The Role of Sleep in Childhood Psychiatric Disorders

PubMed Central

Alfano, Candice A.; Gamble, Amanda L.

2009-01-01

Although sleep problems often comprise core features of psychiatric disorders, inadequate attention has been paid to the complex, reciprocal relationships involved in the early regulation of sleep, emotion, and behavior. In this paper, we review the pediatric literature examining sleep in children with primary psychiatric disorders as well as evidence for the role of early sleep problems as a risk factor for the development of psychopathology. Based on these cumulative data, possible mechanisms and implications of early sleep disruption are considered. Finally, assessment recommendations for mental health clinicians working with children and adolescents are provided toward reducing the risk of and improving treatments for sleep disorders and psychopathology in children and adolescents. PMID:19960111

Sleep Problems as Possible Predictors of Intensified Symptoms of Autism

ERIC Educational Resources Information Center

Schreck, Kimberly A.; Mulick, James A.; Smith, Angela F.

2004-01-01

Researchers have been placing an increased importance on discovering what variables contribute to better prognosis during behavioral interventions for children with autism. This article preliminarily identifies sleep problems that may exacerbate symptoms of autism; thus, possibly influencing effectiveness of daytime interventions. A data-base of…

The Role of Sleep in the Relationship Between Victimization and Externalizing Problems in Adolescents

PubMed Central

Kliewer, Wendy; Lepore, Stephen J.

2018-01-01

Victimization is linked to externalizing outcomes in adolescents and recent theorizing suggests that sleep plays a role in this relationship; however, there is little evidence examining sleep as a mediator. This study examines associations between victimization experiences and changes in aggression, delinquency, and drug use. Data were obtained from three waves of a school-based study with middle-school youth (n = 785; 55 % female; 20 % African American; M = 12.32, SD = .51 years at T1), and path analyses were used to test the key hypotheses. Analyses controlling for major life events, demographic factors, and school site revealed that victimization indirectly affected delinquency and drug use, but not aggression, through its relationship with sleep problems. Further, the effects of sleep problems on drug use were specific to females. These data suggest that intervening to address sleep problems resulting from victimization may serve to reduce some forms of externalizing behavior. PMID:27216201

Problem Behaviors Associated with 15q- Angelman Syndrome.

ERIC Educational Resources Information Center

Clarke, David J.; Marston, Geoff

2000-01-01

Seventy-three caregivers of persons with Angelman syndrome completed the Aberrant Behavior checklist and Reiss Screen for Maladaptive Behavior. Responses indicate that 15q- Angelman syndrome is associated with problems such as lack of speech, over activity, restlessness, and eating and sleeping problems. Inappropriate laughter was only reported…

Sleep problems in children with prenatal substance exposure: the Maternal Lifestyle study.

PubMed

Stone, Kristen C; LaGasse, Linda L; Lester, Barry M; Shankaran, Seetha; Bada, Henrietta S; Bauer, Charles R; Hammond, Jane A

2010-05-01

To examine the associations between sleep problems and prenatal exposure to cocaine, opiates, marijuana, alcohol, and nicotine in children aged 1 month to 12 years. Sleep data were collected by maternal report in a prospective longitudinal follow-up of children participating in the Maternal Lifestyle multisite study. Hospital-based research centers in Providence, Rhode Island; Miami, Florida; Detroit, Michigan; and Memphis, Tennessee. There were 808 participants, 374 exposed to cocaine and/or opiates, and 434 comparison subjects. Prenatal cocaine, opiate, marijuana, alcohol, and/or nicotine exposure. Sleep problems in early, middle, and/or late childhood, assessed as composites of maternal report items. Of the 5 substances, prenatal nicotine exposure was the only unique predictor of sleep problems (B = 0.074, R(2) change = 0.008, P = .01), with adjustment for covariates, including socioeconomic status, marital status, physical abuse, prenatal medical care, and postnatal cigarette smoke exposure. Prenatal exposure to nicotine was positively associated with children's sleep problems persisting throughout the first 12 years of life. Targeting of this group of children for educational and behavioral efforts to prevent and treat sleep problems is merited given that good sleep may serve as a protective factor for other developmental outcomes.

The Maternal Lifestyle Study: Sleep Problems in Children with Prenatal Substance Exposure

PubMed Central

Stone, Kristen C.; LaGasse, Linda L.; Lester, Barry M.; Shankaran, Seetha; Bada, Henrietta S.; Bauer, Charles R.; Hammond, Jane A.

2010-01-01

Objective To examine the relationships between sleep problems and prenatal exposure to cocaine, opiates, marijuana, alcohol, and nicotine in children 1 month to 12 years of age. Design Sleep data was collected by maternal report in a prospective longitudinal follow-up of children participating in the Maternal Lifestyle multisite study. Setting Hospital based research centers in Providence, RI, Miami, FL, Detroit, MI, and Memphis, TN Participants There were 808 participants: 374 exposed to cocaine and/or opiates; 434 comparison. Main exposure Prenatal cocaine, opiate, marijuana, alcohol, and nicotine exposure. Outcome measure Sleep problems in early, middle, and late childhood, assessed as composites of maternal report items. Results Of the five substances, prenatal nicotine exposure was the only unique predictor of sleep problems (B = .074, R2 Δ = .008, p = .012) with adjustment for covariates including SES, marital status, physical abuse, prenatal medical care, and postnatal cigarette smoke exposure. Conclusion Prenatal exposure to nicotine was positively associated with children's sleep problems persisting throughout the first 12 years of life. Targeting this group of children for educational and behavioral efforts to prevent and treat sleep problems is merited given that good sleep may serve as a protective factor for other developmental outcomes. PMID:20439796

The impact of comorbid mental health symptoms and sex on sleep functioning in children with ADHD.

PubMed

Becker, Stephen P; Cusick, Caroline N; Sidol, Craig A; Epstein, Jeffery N; Tamm, Leanne

2018-03-01

Children with attention-deficit/hyperactivity disorder (ADHD) display more sleep problems than their peers, but it remains unclear whether comorbid mental health symptoms [i.e., anxiety, depression, oppositional-defiant disorder (ODD)] are uniquely related to sleep functioning. It is also largely unknown whether boys and girls with ADHD differ in their sleep functioning. This study (1) examined whether boys or girls with ADHD differ in their sleep functioning, (2) evaluated comorbid symptoms as uniquely related to sleep functioning domains, and (3) explored whether sex moderated associations between comorbid symptoms and sleep. Participants were 181 children (ages 7-13; 69% male; 82% White) diagnosed with ADHD. Parents completed measures assessing their child's ADHD symptoms, comorbid symptoms, and sleep functioning. Girls had poorer sleep functioning than boys across most sleep functioning domains. Sixty percent of children met cutoff criteria for having sleep problems, though rates differed significantly between girls (75%) and boys (53%). No differences in rates of sleep problems were found between ADHD subtypes/presentations or between younger and older children. In path models including ADHD and comorbid symptom dimensions, anxiety symptoms were uniquely associated with increased bedtime resistance and sleep anxiety, ADHD hyperactive-impulsive symptoms were associated with more night wakings and more parasomnia behaviors, and ODD and depressive symptoms were associated with shorter sleep duration. Depression was also uniquely associated with increased daytime sleepiness and overall sleep problems. Sex did not moderate associations between comorbid symptoms and sleep problems. This study provides important preliminary evidence that girls with ADHD experience more sleep problems than boys with ADHD. Findings also demonstrate that the associations between comorbid symptoms and sleep functioning in children with ADHD vary based on both the specific symptoms and sleep domains examined.

Retrospectively reported month-to-month variation in sleeping problems of people naturally exposed to high-amplitude annual variation in daylength and/or temperature.

PubMed

Putilov, Arcady A

2017-01-01

Compared to literature on seasonal variation in mood and well-being, reports on seasonality of trouble sleeping are scarce and contradictive. To extend geography of such reports on example of people naturally exposed to high-amplitude annual variation in daylength and/or temperature. Participants were the residents of Turkmenia, West Siberia, South and North Yakutia, Chukotka, and Alaska. Health and sleep-wake adaptabilities, month-to-month variation in sleeping problems, well-being and behaviors were self-assessed. More than a half of 2398 respondents acknowledged seasonality of sleeping problems. Four of the assessed sleeping problems demonstrated three different patterns of seasonal variation. Rate of the problems significantly increased in winter months with long nights and cold days (daytime sleepiness and difficulties falling and staying asleep) as well as in summer months with either long days (premature awakening and difficulties falling and staying asleep) or hot nights and days (all 4 sleeping problems). Individual differences between respondents in pattern and level of seasonality of sleeping problems were significantly associated with differences in several other domains of individual variation, such as gender, age, ethnicity, physical health, morning-evening preference, sleep quality, and adaptability of the sleep-wake cycle. These results have practical relevance to understanding of the roles playing by natural environmental factors in seasonality of sleeping problems as well as to research on prevalence of sleep disorders and methods of their prevention and treatment in regions with large seasonal differences in temperature and daylength.

Insomnia of childhood.

PubMed

Lipton, Jonathan; Becker, Ronald E; Kothare, Sanjeev V

2008-12-01

Insomnia is a major public health problem and is the most common sleep disturbance in both adults and children. The causes of sleeplessness are age-dependent and have potentially enormous effects on cognitive development, behavior, family dynamics, and the metabolic health of children. Here we review the epidemiology, cause, pathophysiology, and clinical approach to pediatric insomnia. Normal sleep is crucial for brain function, behavior, and normal metabolism. Consistently, sleep loss has been linked to behavioral and attention problems, impaired learning and memory, obesity, and psychiatric disorders. The neurological mechanisms that govern sleep initiation and maintenance are poorly understood. The types of insomnia are age-dependent and can occur as primary disorders, or in the context of another primary sleep disorder such as restless legs syndrome, or secondary to another underlying medical condition. Children with chronic diseases and especially children with neurodevelopmental disorders are at particular risk of insomnia. Pediatric insomnia is common and is a source of potential psychophysiological stress to both children and their caregivers. The causes of insomnia are various. Pediatricians should have a working knowledge of the causes of sleeplessness in order to promptly curtail the chronic effects of sleep loss and effectively screen for underlying, potentially treatable disorders.

The Prospective Association of the Diurnal Cortisol Rhythm With Sleep Duration and Perceived Sleeping Problems in Preschoolers: The Generation R Study.

PubMed

Saridjan, Nathalie S; Kocevska, Desana; Luijk, Maartje P C M; Jaddoe, Vincent W V; Verhulst, Frank C; Tiemeier, Henning

2017-06-01

Cortisol, the end product of the hypothalamic-pituitary-adrenal axis, plays an important role in modulating sleep. Yet, studies investigating the association between diurnal cortisol rhythm and sleep patterns in young children are scarce. We tested the hypothesis that the diurnal cortisol rhythm is associated with shorter sleep duration and more sleep problems across early childhood. This study was embedded in Generation R, a population-based cohort from fetal life onward. Parents collected saliva samples from their infant at five moments during day 1. In 322 infants aged 12 to 20 months, we determined the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Sleep duration and sleep behavior were repeatedly assessed across ages of 14 months to 5 years. Generalized estimating equation models were used to assess related cortisol measures to sleep duration and sleep behavior. The diurnal cortisol slope and the CAR, but not the AUC, were associated with sleep duration across childhood. Children with flatter slopes and children with a more positive CAR were more likely to have shorter nighttime sleep duration (β per nmol/L/h slope = -0.12, 95% confidence interval = -0.19 to -0.05, p = .001; β per nmol/L CAR = -0.01, 95% confidence interval = -0.02 to 0.00, p = .04). Cortisol measures did not predict sleep problems. The present study suggests that a flatter diurnal cortisol slope and a more marked morning rise, which can indicate stress (or hypothalamic-pituitary-adrenal dysregulation), have a long-term association with sleep regulation.

Chronic Snoring and Sleep in Children: A Demonstration of Sleep Disruption

ERIC Educational Resources Information Center

Lopes, M. Cecilia; Guilleminault, Christian

2007-01-01

Objective: Chronic snoring that does not adhere to the criteria for a diagnosis of obstructive sleep apnea syndrome may be associated with learning and behavioral problems. We investigated the sleep structure of chronic snorers who had an apnea-hypopnea index of less than 1 event per hour and analyzed the cyclic alternating pattern. Methods:…

Sleep Disordered Breathing Symptoms and Daytime Sleepiness are Associated with Emotional Problems and Poor School Performance in Children

PubMed Central

Liu, Jianghong; Liu, Xianchen; Ji, Xiaopeng; Wang, Yingjie; Zhou, Guoping; Chen, Xinyin

2016-01-01

This study examined the prevalence of sleep disordered breathing (SDB) symptoms and their associations with daytime sleepiness, emotional problems, and school performance in Chinese children. Participants included 3,979 children (10.99 ± 0.99 years old) from four elementary schools in Jintan City, Jiangsu Province, China. Children completed a self-administered questionnaire on sleep behavior and emotional problems, while parents completed the Child Sleep Habit Questionnaire (CSHQ). SDB symptoms included 3 items: loud snoring, stopped breathing, and snorting/ gasping during sleep. Teachers rated the children's school performance. The prevalence rates of parent- and self-reported SDB symptoms were 17.2% and 10.1% for “sometimes” and 8.9% and 5.6% for “usually”. SDB symptoms, more prevalent in boys than in girls, increased the risks for depression, loneliness, and poor school performance. Daytime sleepiness mediated the relationship between SDB symptoms and depression, loneliness, and poor school performance. This study suggests the importance of early screening and intervention of SDB and daytime sleepiness in child behavioral and cognitive development. PMID:27289327

Early childhood sleep and eating problems as predictors of adolescent and adult mood and anxiety disorders.

PubMed

Ong, Say How; Wickramaratne, Priya; Tang, Min; Weissman, Myrna M

2006-11-01

Recent studies have suggested that eating and sleep problems during early childhood may pose as risk factors for mood and anxiety disorders in later life. We aim to study the associations between early childhood sleep and eating problems, specifically high motor activity during sleep and irregularities in sleep/eating schedules, and lifetime history of mood and anxiety disorders. We followed up 164 offspring, who were at high and low risk for major depression by virtue of their parental history (at least one parent had Major Depressive Disorder). Target sleep and eating problems were measured using Dimensions of Temperament Survey (DOTS). The offspring were blindly assessed at 3 times over 20 years using a structured diagnostic interview. Irregularities in sleeping and eating schedules in childhood (low rhythmicity) was associated with adolescent-onset major depression and anxiety disorder, as well as childhood-onset anxiety disorder. High motor activity level during sleep was associated with both childhood-onset and adolescent-onset dysthymic disorder. Neither childhood sleep nor eating irregularities were associated with adult onset psychopathology. Retrospective reports of childhood sleep and eating patterns were derived from parent-reports. Reported problems may overlap with clinical diagnoses. Clinicians should be alerted to parental reports of children's sleep and eating problems suggesting low rhythmicity, as well as high motor activity levels during sleep. These early behaviors may be predictive of subsequent mood and anxiety disorders in childhood and adolescence.

The effects of cognitive-behavioral therapy for youth anxiety on sleep problems.

PubMed

Peterman, Jeremy S; Carper, Matthew M; Elkins, R Meredith; Comer, Jonathan S; Pincus, Donna B; Kendall, Philip C

2016-01-01

The present study examined (a) whether sleep related problems (SRPs) improved following cognitive-behavioral therapy (CBT) for youth with anxiety disorders, (b) whether variables that may link anxiety and SRPs (e.g., pre-sleep arousal, family accommodation, sleep hygiene) changed during treatment, and (c) whether such changes predicted SRPs at posttreatment. Youth were diagnosed with anxiety at pretreatment and received weekly CBT that targeted their principal anxiety diagnosis at one of two specialty clinics (N=69 completers, Mage=10.86). Results indicated that parent-reported SRPs improved from pre- to post-treatment and that treatment responders with regard to anxiety yielded greater SRP improvements than nonresponders. Parent report of bedtime resistance and sleep anxiety showed significant improvements. Youth reported lower rates of SRPs compared to their parents and did not demonstrate pre- to post-treatment changes in SRPs. Pre-sleep arousal and family accommodation decreased over treatment but did not predict lower SRPs at posttreatment. Higher accommodation was correlated with greater SRPs. Sleep hygiene evidenced no change and did not mediate links between accommodation and posttreatment SRPs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep duration and patterns in adolescents: correlates and the role of daily stressors.

PubMed

Bauducco, S V; Flink, I K; Jansson-Fröjmark, M; Linton, S J

2016-09-01

The first aim of this study was to assess the prevalence of sleep deficit in a large sample of adolescents. Second, the study aimed to assess whether short sleep duration in the sample was associated with emotional and behavioral problems. Lastly, the study aimed to investigate the association between daily stressors--bedtime activities and sleep duration. Cross-sectional survey. The questionnaires were completed during school hours in 17 municipal junior high schools in Sweden. A total of 2767 adolescents aged 12 to 16 years, 48% girls. Sleep measures included total sleep time (TST) for schooldays and weekends, obtained as combined measures of self-reported bed-time, wake-time, and sleep onset latency. We used the new National Sleep Foundation's guidelines to operationalize sleep duration. Overall 12% of younger adolescents (age 12-13 years) and 18% of older adolescents (14-16 years) slept less than recommended (TST < 7 hours). Adolescents reporting nonrecommended TST also reported more behavioral (ie, norm-breaking behaviors) and emotional problems (ie, depression, anxiety, and anger), with effects in the small-medium range. Finally, adolescents reporting bedtime arousal and use of information and communication technology in bed were more likely to report TST < 7 hours. Stress at home (for younger adolescents) and stress of school performance (for older adolescents) were also associated with TST less than 7 hours. The new National Sleep Foundation's recommendations were informative in this context. Future sleep interventions need to target barriers to good sleep practices, such as use of information and communication technology, stress, and worry that may contribute to arousal at bedtime. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family.

PubMed

Sung, Valerie; Hiscock, Harriet; Sciberras, Emma; Efron, Daryl

2008-04-01

To determine the prevalence of sleep problems in children with attention-deficit/hyperactivity disorder (ADHD) and their associations with child quality of life (QOL), daily functioning, and school attendance; caregiver mental health and work attendance; and family functioning. Cross-sectional survey. Pediatric hospital outpatient clinic, private pediatricians' offices, and ADHD support groups in Victoria, Australia. Schoolchildren with ADHD. Main Exposure Attention-deficit/hyperactivity disorder. Primary measure was caregivers' reports of their children's sleep problems (none, mild, or moderate or severe). Secondary outcomes were (1) child QOL (Pediatric Quality of Life Inventory), daily functioning (Daily Parent Rating of Evening and Morning Behavior scale), and school attendance, (2) caregiver mental health (Depression Anxiety Stress Scale) and work attendance, and (3) family functioning (Child Health Questionnaire subscales). Caregivers also reported on how their pediatrician treated their children's sleep problems. Two hundred thirty-nine of 330 (74%) eligible families completed the survey. Child sleep problems were common (mild, 28.5%; moderate or severe, 44.8%). Moderate or severe sleep problems were associated with poorer child psychosocial QOL, child daily functioning, caregiver mental health, and family functioning. After adjusting for confounders, all associations held except for family impacts. Compared with children without sleep problems, those with sleep problems were more likely to miss or be late for school, and their caregivers were more likely to be late to work. Forty-five percent of caregivers reported that their pediatricians had asked about their children's sleep and, of these, 60% reported receiving treatment advice. Sleep problems in children with ADHD are common and associated with poorer child, caregiver, and family outcomes. Future research needs to determine whether management of sleep problems can reduce adverse outcomes.

Sleep disturbances in children with epilepsy compared with their nearest-aged siblings.

PubMed

Wirrell, Elaine; Blackman, Marlene; Barlow, Karen; Mah, Jean; Hamiwka, Lorie

2005-11-01

The aim of the study was to compare sleep patterns in children with epilepsy with those of their non-epileptic siblings and to determine which epilepsy-specific factors predict greater sleep disturbance. We conducted a case-control study of 55 children with epilepsy (mean age 10y, range 4 to 16y; 27 males, 28 females) and their nearest-aged non-epileptic sibling (mean age 10y, range 4 to 18y; 26 males, 29 females). Epilepsy was idiopathic generalized in eight children (15%), symptomatic generalized in seven (13%), and focal in 40 (73%); the mean duration was 5 years 8 months. Parents or caregivers completed the Sleep Behavior Questionnaire (SBQ) and Child Behavior Checklist (CBCL) for patients and controls, and the Quality of Life in Childhood Epilepsy (QOLCE) for patients. Patients had a higher (more adverse) Total Sleep score (p<0.001) and scored worse than controls on nearly all subscales of the SBQ. In patients, higher Total Sleep scores were correlated with higher scores on the Withdrawn, Somatic complaints, Social problems, and Attention subscales of the CBCL, and significantly lower Total Quality of Life Scores. Refractory epilepsy, mental retardation, and remote symptomatic etiology predicted greater sleep problems in those with epilepsy. We conclude that children with epilepsy in this current study had significantly greater sleep problems than their non-epileptic siblings.

Relationship Between Sleep Problems and Quality of Life in Children With ADHD.

PubMed

Yürümez, Esra; Kılıç, Birim Günay

2016-01-01

The purpose of this study is to assess the sleep behaviors, sleep problems and frequency, and relationship with psychiatric comorbidities in ADHD Combined type and to evaluate the effect of sleep problems on quality of life. Forty-six boys, aged 7 to 13 years, with ADHD-combined type and 31 healthy boys were included. ADHD children were never treated for sleep or psychiatric disorders. Intelligence quotient (IQ) test scores were minimum 80, body mass index were normal and did not have medical disorders. Parents completed Children's Sleep Habits Questionnaire, Conners' Parent Rating Scale and The Pediatric Quality of Life Inventory (PedsQL) and participants were asked about sleep behaviors and were administered PedsQL and Schedule for Affective Disorders and Schizophrenia. The frequency of sleep problems in ADHD is 84.8%, higher than the control group (p = .002). Evaluating PedsQL scores, the quality of life is worse in physical, psychosocial health, and total life quality (p < .05). ADHD group with sleep problems have more night wakings than control group with sleep problems (p = .02). The comorbidity do not increase sleep problems. The frequency of parasomnias is increased in group with learning disorders (p = .05). The results of this study, which controls for a number of possible confounders found in previous examinations of ADHD and sleep, support the results of a number of other studies that have found an increased overall prevalence of parent-reported sleep disturbances in children with ADHD compared with healthy control participants. As the ADHD group have more night wakings than the control group through the night, it is thought that night wakings that cause a partitioned sleep may be important signs seen in ADHD. That could be suggested by two hypotheses. First one is that, daytime sleepiness is more common in ADHD and those children present excessive hyperactivity during the day to stay awake and the second one is the improvement of ADHD signs when the drugs for sleepiness are used. Usage of standardized and valid diagnostic criteria, exclusion of adolescence, gender, socioeconomic level, primary sleep problems, medical disorders and low IQ level, making allowances for effect of comorbidities and having compared with the control group are the important methodological features of this study. The most important limitation of this study is small sample size that makes the findings less generalizable to other groups of children with ADHD, and another one is not having used objective measurements together with subjective measurements. In conclusion, these results underscore the importance of screening all children who have a symptom constellation suggestive of ADHD for sleep problems that may either play a causative role or exacerbate the clinical appearance of ADHD in a given child. Correct evaluation and treatment of sleep problems increase the life quality of family and child and also decrease the severity of ADHD symptoms. © The Author(s) 2013.

Differences in Retrospective and Prospective Parental Reports of Diagnosed and Nondiagnosed Children's Behaviors.

ERIC Educational Resources Information Center

Abmayr, Sandra B.; Day, H. D.

1994-01-01

Parents of children with attentional deficit hyperactivity disorder (ADHD), other psychiatric diagnoses, or no history of school or home problems reported the frequency of their children's sleep disturbances before and after observing their children's behaviors for a month. Parents of ADHD children reported higher frequencies of sleep disturbances…

Changing Adolescent Sleep Patterns: Factors Affecting them and the Related Problems.

PubMed

Kaur, Harpreet; Bhoday, Harpreet Singh

2017-03-01

Sleep affects physical growth, behavior and emotional development besides determining cognitive functioning, learning and attention especially of a growing child. Adolescence represents one of the critical transitions in the life span and is characterized by a tremendous pace in growth and change that is second only to that of infancy. Adolescent sleep patterns deserve particular attention because of the potential impact on school performance. Average sleep period in adolescents is reduced during school days to around seven hours. The reasons may be biological mainly the sleep phase delay or psychosocial and environmental. These include academic demands, social activities, sports, internet, television viewing, part-time employment, and use of mobile phone at night, peer and parental influence and socioeconomic status. These changing patterns of sleep in adolescents lead to many behavioral sleep problems like Delayed Sleep-phase Syndrome; Difficulties in falling asleep (insomnia); excessive daytime sleepiness, poor academic performance. Decreased sleep in adolescents also causes obesity and other cardio-metabolic abnormalities. This needs an integrated approach involving adolescents themselves, their parents, teachers and specialized physicians to help improve the sleep quantity and quality and lead to a better quality of life and daytime functioning in adolescents. © Journal of the Association of Physicians of India 2011.

A Randomized Controlled Trial of Problem-Solving Therapy Compared to Cognitive Therapy for the Treatment of Insomnia in Adults

PubMed Central

Pech, Melissa; O'Kearney, Richard

2013-01-01

Study Objectives: To compare the efficacy of problem-solving therapy (PST) combined with behavioral sleep strategies to standard cognitive therapy (CT) combined with behavioral sleep strategies in the treatment of insomnia. Design: A six-week randomized controlled trial with one month follow-up. Setting: The Australian National University Psychology Clinic, Canberra, Australia. Participants: Forty-seven adults aged 18-60 years recruited from the community meeting the Research Diagnostic Criteria for insomnia. Interventions: Participants received 6 weeks of treatment including one group session (sleep education and hygiene, stimulus control instructions and progressive muscle relaxation) followed by 5 weeks of individual treatment of PST or CT. Measurements and Results: Primary outcomes included sleep efficiency (SE) from sleep diaries, the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). Secondary measures assessed dysfunctional sleep beliefs, problem-solving skills and orientations, and worry. Both treatments produced significant post therapy improvements in sleep which were maintained at 1 month follow-up (on SE Cohen d = 1.42, 95% CI 1.02-1.87 for PST; d = 1.26, 95% CI 0.81-1.65 for CT; on ISI d = 1.46, 95% CI 1.03-1.88 for PST; d = 1.95, 95% CI 0.52-2.38 for CT; for PSQI d = 0.97, 95% CI 0.55-1.40 for PST and d = 1.34, 95% CI 0.90-1.79 for the CT). There were no differences in PST and CT in the size or rate of improvement in sleep although CT produced a significant faster rate of decline in negative beliefs about sleep than PST and there was a trend (P = 0.08) for PST to produce a faster rate of improvement in negative problem orientation than CT. Conclusions: The results provide preliminary support for problem solving treatment as an equally efficacious alternative component to cognitive therapy in psychological interventions for insomnia. Citation: Pech M; O'Kearney R. A randomized controlled trial of problem-solving therapy compared to cognitive therapy for the treatment of insomnia in adults. SLEEP 2013;36(5):739-749. PMID:23633757

Maternal stress, well-being, and impaired sleep in mothers of children with developmental disabilities: a literature review.

PubMed

Lee, Jiwon

2013-11-01

Having children with developmental disabilities (DDs) requires a high level of caregiving responsibilities, and existing studies support that mothers of children with DDs experience high levels of maternal stress as well as poor sleep and well-being. Given the fact that the number of children with DDs has increased, an up-to-date literature review is necessary to identify factors associated with maternal stress, sleep, and well-being. In addition, understanding these factors and their relationships may provide better strategies in designing effective interventions that can reduce the burden in mothers of children with DDs. This review summarized 28 scientific research papers that examined maternal stress, sleep, and well-being in mothers of children with DDs in past 12 years. The study findings indicate that mothers of children with DDs experience higher levels of stress than mothers of typically developing children, and it remains high over time. In addition, these mothers often encounter depressive symptoms as well as poor sleep quality. The study results also reveal that there is a bidirectional relationship between maternal stress and depressive symptoms as well as between poor sleep quality and depressive symptoms. For example, higher stress mothers experienced more depressive symptoms. Mothers of children with DDs with poor sleep quality are significantly associated with more depressive symptoms. Child behavior problems were significantly associated with both maternal stress and depressive symptoms, but cautious interpretation is warranted due to the shared variance between child behavior problems, maternal stress, and depressive symptoms. Methodological guidelines for future research involve the use of reliable and valid instruments for the measurement of child behavior problems, maternal stress, and sleep. Recommendations for future research are included. Copyright © 2013 Elsevier Ltd. All rights reserved.

A randomized controlled trial of problem-solving therapy compared to cognitive therapy for the treatment of insomnia in adults.

PubMed

Pech, Melissa; O'Kearney, Richard

2013-05-01

To compare the efficacy of problem-solving therapy (PST) combined with behavioral sleep strategies to standard cognitive therapy (CT) combined with behavioral sleep strategies in the treatment of insomnia. A six-week randomized controlled trial with one month follow-up. The Australian National University Psychology Clinic, Canberra, Australia. Forty-seven adults aged 18-60 years recruited from the community meeting the Research Diagnostic Criteria for insomnia. Participants received 6 weeks of treatment including one group session (sleep education and hygiene, stimulus control instructions and progressive muscle relaxation) followed by 5 weeks of individual treatment of PST or CT. Primary outcomes included sleep efficiency (SE) from sleep diaries, the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). Secondary measures assessed dysfunctional sleep beliefs, problem-solving skills and orientations, and worry. Both treatments produced significant post therapy improvements in sleep which were maintained at 1 month follow-up (on SE Cohen d = 1.42, 95% CI 1.02-1.87 for PST; d = 1.26, 95% CI 0.81-1.65 for CT; on ISI d = 1.46, 95% CI 1.03-1.88 for PST; d = 1.95, 95% CI 0.52-2.38 for CT; for PSQI d = 0.97, 95% CI 0.55-1.40 for PST and d = 1.34, 95% CI 0.90-1.79 for the CT). There were no differences in PST and CT in the size or rate of improvement in sleep although CT produced a significant faster rate of decline in negative beliefs about sleep than PST and there was a trend (P = 0.08) for PST to produce a faster rate of improvement in negative problem orientation than CT. The results provide preliminary support for problem solving treatment as an equally efficacious alternative component to cognitive therapy in psychological interventions for insomnia.

Children's sleep and autonomic function: low sleep quality has an impact on heart rate variability.

PubMed

Michels, Nathalie; Clays, Els; De Buyzere, Marc; Vanaelst, Barbara; De Henauw, Stefaan; Sioen, Isabelle

2013-12-01

Short sleep duration and poor sleep quality in children have been associated with concentration, problem behavior, and emotional instability, but recently also with disrupted autonomic nervous function, which predicts cardiovascular health. Heart rate variability (HRV) was used as noninvasive indicator of autonomic function to examine the influence of sleep. Cross-sectional and longitudinal observational study on the effect of sleep on HRV. Belgian children (5-11 years) of the ChiBS study in 2010 (N = 334) and 2011 (N = 293). N/A. Sleep duration was reported and in a subgroup sleep quality (efficiency, latency, awakenings) was measured with accelerometry. High-frequency (HF) power and autonomic balance (LF/HF) were calculated on supine 5-minute HRV measurements. Stress was measured by emotion and problem behavior questionnaires. Sleep duration and quality were used as HRV predictors in corrected cross-sectional and longitudinal regressions. Stress was tested as mediator (intermediate pathway) or moderator (interaction) in sleep-HRV associations. In both cross-sectional and longitudinal analyses, long sleep latency could predict lower HF (parasympathetic activity), while nocturnal awakenings, sleep latency, low sleep efficiency, and low corrected sleep duration were related to higher LF/HF (sympathetic/parasympathetic balance). Parental reported sleep duration was not associated with HRV. The significances remained after correction for stress. Stress was not a mediator, but a moderator (enhancer) in the relationship between sleep quality and HRV. Low sleep quality but not parent-reported low sleep duration leads to an unhealthier heart rate variability pattern (sympathetic over parasympathetic dominance). This stresses the importance of good sleep quality for cardiovascular health in children.

The Effects of Sleep Problems and Depression on Alcohol-Related Negative Consequences among College Students

ERIC Educational Resources Information Center

Wattenmaker McGann, Amanda

2013-01-01

Previous literature provides an overview of the multiple relationships between alcohol use, protective behavioral strategies (PBS), alcohol-related negative consequences, depression, and sleep problems among college students, as well as differences by individual level characteristics, such as age, gender, and race/ethnicity. The purpose of this…

The prevalence and spectrum of sleep problems in women with transformed migraine.

PubMed

Calhoun, Anne H; Ford, Sutapa; Finkel, Alan G; Kahn, Kevin A; Mann, J Douglas

2006-04-01

It is our clinical observation that patients with transformed migraine (TM) almost invariably report nonrestorative sleep. In this study we sought first to validate that clinical observation, then to describe the prevalence and spectrum of factors that might contribute to nonrestorative sleep in a TM population. Although headaches have been linked with sleep problems for over a century, there is little information about the spectrum or prevalence of specific sleep problems associated with TM in adults. We conducted a detailed sleep interview on 147 consecutive women with TM. Subjective sleep quality was assessed by asking patients to describe their state upon awakening as "refreshed" or "tired." None of the 147 patients reported awakening "refreshed," and 83.7% stated that they awakened "tired." Sleep complaints were prevalent and varied in this population. Although the relationship between pain and sleep is complex and ill understood, we found a very high prevalence of nonrestorative sleep and a similarly high prevalence of modifiable poor sleep habits in patients with TM. Since behavioral approaches have been found effective in improving sleep quality in patients with poor sleep hygiene, we propose that studies be undertaken to assess the impact of such treatment on TM.

Arousal from sleep: The uniqueness of an individual's response and the problem of noise control

NASA Technical Reports Server (NTRS)

Levere, T. E.

1979-01-01

The dynamic nature of sleep is reviewed. Research is then presented concerning two fundamental issues: (1) does an individual react differently to auditory sounds when asleep as compared to when the individual is awake and (2) does sleep disruption necessarily involve behavioral awakening?

Stability and Predictive Validity of the Parent-Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers.

PubMed

Barrios, Chelsey S; Jay, Samantha Y; Smith, Victoria C; Alfano, Candice A; Dougherty, Lea R

2018-01-01

Little research has examined the processes underlying children's persistent sleep problems and links with later psychopathology. The current study examined the stability of parent-child sleep interactions as assessed with the parent-reported Parent-Child Sleep Interactions Scale (PSIS) and examined whether sleep interactions in preschool-age children predict sleep problems and psychiatric symptoms later in childhood. Participants included 108 preschool-age children (50% female) and their parents. Parents completed the PSIS when children were 3-5 years (T1) and again when they were 6-9 years (T2). The PSIS includes three subscales-Sleep Reinforcement (reassurance of child sleep behaviors), Sleep Conflict (parent-child conflict at bedtime), Sleep Dependence (difficulty going to sleep without parent)-and a total score. Higher scores indicate more problematic bedtime interactions. Children's sleep problems and psychiatric symptoms at T1 and T2 were assessed with a clinical interview. PSIS scores were moderately stable from T1 to T2, and the factor structure of the PSIS remained relatively consistent over time. Higher total PSIS scores at T1 predicted increases in children's sleep problems at T2. Higher PSIS Sleep Conflict scores at T1 predicted increases in oppositional defiant disorder symptoms at T2. Children with more sleep problems and higher PSIS Sleep Reinforcement scores at T1 showed increases in attention deficit/hyperactivity disorder, depressive, and anxiety symptoms at T2. These findings provide evidence for the predictive validity of the PSIS and highlight the importance of early parent-child sleep interactions in the development of sleep and psychiatric symptoms in childhood. Parent-child sleep interactions may serve as a useful target for interventions.

Sleep and Self-Regulation from Birth to 7 Years: A Retrospective Study of Children with and Without Attention-Deficit Hyperactivity Disorder at 8 to 9 Years.

PubMed

Williams, Kate E; Sciberras, Emma

2016-06-01

To examine mean level differences and longitudinal and reciprocal relations among behavioral sleep problems, emotional dysregulation, and attentional regulation across early childhood for children with and without attention-deficit hyperactivity disorder (ADHD) at 8 to 9 years. This study used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC)-Infant Cohort (n = 4,109 analyzed). Children with and without ADHD were identified at age 8 to 9 years via parent report of ADHD diagnosis and the 5-item Inattention-Hyperactivity subscale from the Strengths and Difficulties Questionnaire. Maternal report of child sleep problems and self-regulation was collected at 0 to 1, 2 to 3, 4 to 5, and 6 to 7 years of age. Analysis of variance was used to compare mean level differences in sleep problems and emotional and attentional regulation by ADHD group. Longitudinal structural equation modeling examined the relations among sleep and self-regulation across time in children with and without ADHD. Children with ADHD had persistently elevated levels of sleep problems (from infancy) and emotional and attentional dysregulation compared to controls (from 2 to 3 years of age). Sleep problems, emotional dysregulation, and attentional regulation were stable over time for both groups. Sleep problems were associated with greater emotional dysregulation 2 years later from 2 to 3 years of age for both groups, which in turn was associated with poorer attentional regulation. There was no direct relationship between sleep problems and later attentional regulation. Sleep problems in children with and without ADHD are associated with emotional dysregulation, which in turn contributes to poorer attentional functioning. This study highlights the importance of assessing and managing sleep problems in young children.

Understanding and managing sleep disruption in children with fetal alcohol spectrum disorder.

PubMed

Hanlon-Dearman, Ana; Chen, Maida Lynn; Olson, Heather Carmichael

2018-04-01

Accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (FASD). Multiple animal and clinical studies have found a clear association between sleep problems and prenatal alcohol exposure, and recent research is beginning to characterize the types and extent of sleep disruption in FASD. Nevertheless, sleep disruption in children with FASD often goes unrecognized or is treated without referring to an evidence base. Children's disrupted sleep interferes with parental sleep and increases caregiver burden, which is of particular importance for families raising children with FASD, a group with very high levels of caregiving stress. The literature supporting an association between sleep problems and deficits in emotional, behavioral, and cognitive function in children is compelling, but needs further investigation in children with FASD. This paper will review the current state of knowledge on sleep in FASD and recommend a rational approach to sleep interventions for affected children and their families.

Early Menarche and Menstrual Problems Are Associated with Sleep Disturbance in a Large Sample of Chinese Adolescent Girls.

PubMed

Liu, Xianchen; Chen, Hua; Liu, Zhen-Zhen; Fan, Fang; Jia, Cun-Xian

2017-09-01

Little is known about the association between menstruation and sleep disturbance in adolescent girls. This study examined sleep duration, insomnia symptoms, and sleep quality in relation to age at menarche and menstrual problems in a large sample of Chinese adolescent girls. This report represents the baseline data of an ongoing longitudinal study of the Shandong Adolescent Behavior & Health Cohort in Shandong, China. A total of 5800 girls aged 12-18 years (mean age = 15.0, standard deviation = 1.4) participated in the baseline survey. A structured questionnaire was used to assess participants' age at menarche, menstrual cycle interval, menstrual flow length, period irregularity, period pain, body weight and height, and demographics. Internalizing and externalizing problems were measured by the Youth-Self Report of Child Behavioral Checklist. Sleep duration, insomnia symptoms, and sleep quality were assessed by the items adapted from the Pittsburgh Sleep Quality Index. After adjusting for age, school, body mass index, internalizing and externalizing problems, and family covariates, irregular periods (odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.06-2.02), period pain (OR = 1.99, 95% CI = 1.44-2.76), and menstrual flow length ≥7 days (OR = 1.21, 95% CI = 1.00-1.48) were significantly associated with insomnia symptoms. Irregular periods (OR = 1.72, 95% CI = 1.30-2.27) and period pain (OR = 1.78, 95% CI = 1.34-2.37) were significantly associated with poor sleep quality. Age at menarche ≤11 years (OR = 1.62, 95% CI = 1.05-2.50) was significantly associated with insomnia symptoms in 12- to 14-year-old girls. Our results suggest that irregular periods and period pain appear to be associated with sleep disturbance and that early menarche may have short-term impact on sleep in adolescent girls. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Putting Children’s Sleep Problems to Bed: Using Behavior Change Theory to Increase the Success of Children’s Sleep Education Programs and Contribute to Healthy Development

PubMed Central

Blunden, Sarah; Benveniste, Tessa; Thompson, Kirrilly

2016-01-01

Sleep is critical for the healthy development of children, yet most children simply don’t get enough. Whilst school based sleep education programs have been developed for parents and their children, they have had mixed success. We consider how existing school-based sleep education programs can be improved by applying a broader model to behaviour change theory. We find that the mixed success of school-based sleep education programs may be due to a plausible but misleading assumption that simply increasing information about the importance of sleep and the risks of insufficient and/or inefficient sleep, will necessarily result in improved sleep behaviours. We identify the potential benefits of using a more inclusive behavior change theory in the development of sleep education programs with a particular need for theories that incorporate the multiple biological, environmental and social impacts on children’s sleep. Bronfenbrenner’s Bioecological model is presented to illustrate how one such inclusive behavior change theory could significantly improve the success of sleep education programs and ultimately support the healthy development of children. PMID:27417249

Health behaviors of head and neck cancer patients the first year after diagnosis.

PubMed

Duffy, Sonia A; Khan, Mumtaz J; Ronis, David L; Fowler, Karen E; Gruber, Stephen B; Wolf, Gregory T; Terrell, Jeffrey E

2008-01-01

This prospective, cohort study is the first to describe 5 health behaviors of head and neck cancer patients the first year after diagnosis. Patients (N = 283) were recruited in otolaryngology clinic waiting rooms and asked to complete written surveys. A medical record audit was also conducted. Descriptive statistics and multivariate analyses were conducted to determine which variables were associated with the 5 health behaviors. Half of the patients smoked and 25% were problem drinkers. Over half of the smokers and drinkers quit 1 year post-diagnosis. Smoking and problem drinking were highly associated and both were associated with lower body mass index (BMI) (p < .01). Moreover, physical activity and sleep were associated with each other (p < .01). Low SLEEP (Medical Outcomes Study Sleep Scale) scores were common and highly associated with depression (p < .01). The health behaviors of head and neck cancer patients are interrelated, and assessing and treating these behaviors together may be beneficial. Copyright (c) 2007 Wiley Periodicals, Inc.

Joint Occurrence of Pain and Sleep Disturbances in People with Dementia. A Systematic Review.

PubMed

Flo, Elisabeth; Bjorvatn, Bjorn; Corbett, Anne; Pallesen, Stale; Husebo, Bettina S

2017-01-01

Advancing age is associated with high prevalence of pain, sleep problems and dementia. Dementia is frequently accompanied by distressing behavioral and psychological symptoms, including sleep problems. The etiology of sleep problems in dementia is multifactorial. It has been suggested that untreated pain may contribute to sleep problems, and pain treatment has been shown to reduce sleep problems in people with dementia. This systematic review aims to provide an overview of the studies that have investigated the association and/or possible interaction between pain and sleep in dementia. A systematic search was performed in MEDLINE, EMBASE, Cochrane and PsychINFO, including text words and MESH terms covering dementia, pain and sleep. Also, reference lists in the included publications were examined to retrieve publications. Publications had to investigate sleep and pain in relation to dementia to be included in this review. The search produced 1750 independent hits. Out of the 49 publications studied in full text, 11 publications were included. Only one controlled trial was identified and represented the only insights to the possible interactional relationship between pain, sleep and dementia. Pain or pain intensity were related to sleep in 6 of the included studies, while the remaining studies could neither support nor contradict a relationship between sleep and pain in people with dementia. None of the studies employed objective sleep assessment. There is a need for high quality studies investigating the interaction between sleep and pain in people with dementia, using objective sleep measurements and pain assessment suitable for people with dementia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Associations between physical activity and sedentary behavior with sleep quality and quantity in young adults.

PubMed

Kakinami, Lisa; O'Loughlin, Erin K; Brunet, Jennifer; Dugas, Erika N; Constantin, Evelyn; Sabiston, Catherine M; O'Loughlin, Jennifer

2017-02-01

Intensity and duration of physical activity (PA) and sedentary behavior are individually associated with sleep, but their independent associations are poorly characterized. The objectives of this study were to determine if PA and/or sedentary behavior are/is associated with sleep quality and/or quantity in a young adult sample. Cross-sectional. Montreal, Canada. Participants (n=658) from the Nicotine Dependence in Teens Study. PA measures included total minutes of light, moderate, and vigorous PA in the past week; sedentary measures included number of hours per day watching television (TV) and using the computer for leisure activities in the past week. Sleep measures included (1) the Pittsburgh Sleep Quality Index, which assesses sleep quality in the past month, and (2) number of hours of sleep per night in the past month. Data were analyzed using multiple logistic regression adjusting for age, sex, and mother's education. In multivariable analyses, each additional hour of TV and computer use per day was associated with a 17% and 13% increase, respectively, in the odds of reporting poor sleep quality. After additionally adjusting for PA, the association between TV use and poor sleep quality remained significant (odds ratio: 1.15, 95% confidence interval: 1.01-1.28). Sedentary behavior was not associated with sleep quantity. PA intensity and duration were not associated with sleep quality or quantity. More time spent doing sedentary activities was associated with poorer sleep quality, but PA was not associated. Clinicians treating young adults with sleep problems should inquire about sedentary behavior. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Case Series.

PubMed

Vetrayan, Jayachandran; Othman, Suhana; Victor Paulraj, Smily Jesu Priya

2017-01-01

To assess the effectiveness and feasibility of behavioral sleep intervention for medicated children with ADHD. Six medicated children (five boys, one girl; aged 6-12 years) with ADHD participated in a 4-week sleep intervention program. The main behavioral strategies used were Faded Bedtime With Response Cost (FBRC) and positive reinforcement. Within a case-series design, objective measure (Sleep Disturbance Scale for Children [SDSC]) and subjective measure (sleep diaries) were used to record changes in children's sleep. For all six children, significant decrease was found in the severity of children's sleep problems (based on SDSC data). Bedtime resistance and mean sleep onset latency were reduced following the 4-week intervention program according to sleep diaries data. Gains were generally maintained at the follow-up. Parents perceived the intervention as being helpful. Based on the initial data, this intervention shows promise as an effective and feasible treatment.

Anxiety Treatment and Targeted Sleep Enhancement to Address Sleep Disturbance in Pre/Early Adolescents with Anxiety.

PubMed

McMakin, Dana L; Ricketts, Emily J; Forbes, Erika E; Silk, Jennifer S; Ladouceur, Cecile D; Siegle, Greg J; Milbert, Melissa; Trubnick, Laura; Cousins, Jennifer C; Ryan, Neal D; Harvey, Allison G; Dahl, Ronald E

2018-06-06

Sleep disturbance is prevalent in anxious youth and prospectively predicts poor emotional adjustment in adolescence. Study 1 examined whether anxiety treatment improves subjective and objective sleep disturbance in anxious youth. Study 2 examined whether a sleep intervention called Sleeping TIGERS can further improve sleep following anxiety treatment. Study 1 examined 133 youth (ages 9-14; 56% female; 11% ethnic/racial minority) with generalized, social, or separation anxiety over the course of anxiety treatment (cognitive behavioral treatment or client-centered treatment). Sleep-related problems (parent-, child-report) and subjective (diary) and objective (actigraphy) sleep patterns were assessed across treatment in an open trial design. Study 2 included 50 youth (ages 9-14; 68% female; 10% ethnic/racial minority) who continued to report sleep-related problems after anxiety treatment and enrolled in an open trial of Sleeping TIGERS. Pre- and postassessments duplicated Study 1 and included the Focal Interview of Sleep to assess sleep disturbance. Study 1 demonstrated small reductions in sleep problems and improvements in subjective sleep patterns (diary) across anxiety treatment, but outcomes were not deemed clinically significant, and 75% of youth stayed above clinical cutoff. Study 2 showed clinically significant, large reductions in sleep problems and small changes in some subjective sleep patterns (diary). Anxiety treatment improves, but does not resolve, sleep disturbance in peri-pubertal youth, which may portend risk for poor emotional adjustment and mental health. The open trial provides preliminary support that Sleeping TIGERS can improve sleep in anxious youth to a clinically significant degree.

Infant and toddler crying, sleeping and feeding problems and trajectories of dysregulated behavior across childhood.

PubMed

Winsper, Catherine; Wolke, Dieter

2014-01-01

Infant and toddler regulatory problems (RPs) including crying, sleeping and feeding, are a frequent concern for parents and have been associated with negative behavioral outcomes in early and middle childhood. Uncertain is whether infant and toddler RPs predict stable, trait-like dysregulated behavior across childhood. We addressed this gap in the literature using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). RPs at 6, 15-18, & 24-30 months and childhood dysregulated behavior at 4, 7, 8, & 9.5 years were assessed using mother report. Latent Class Growth Analysis (LCGA) indicated that trajectories of childhood dysregulated behavior were stable over time. All single RPs (i.e., crying, sleeping & feeding problems) were significantly associated with childhood dysregulated behavior. For example, crying problems at 6 months after controlling for confounders (Odds Ratios; 95% Confidence Intervals): Moderate dysregulated behavior: OR = 1.50, 95% CI [1.09 to 2.06], high dysregulated behavior: OR = 2.13, 95% CI [1.49 to 3.05] and very high dysregulated behavior: OR = 2.85, 95% CI [1.64 to 4.94]. Multiple RPs were especially strongly associated with dysregulated behavior. For example, the RP composite at 15-18 months: 1 RP, very high dysregulated behavior: OR = 2.79, 95% CI [2.17 to 3.57], 2 RPs, very high dysregulated behavior: OR = 3.46, 95% CI [2.38 to 5.01], 3 RPs, very high dysregulated behavior: OR = 12.57, 95% CI [6.38 to 24.74]. These findings suggest that RPs in infants and toddlers predict stable dysregulated behavior trajectories across childhood. Interventions for early RPs could help prevent the development of chronic, highly dysregulated behavior.

Sleep Disturbances Associated with Parkinson's Disease

PubMed Central

Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Iwanami, Masaoki; Hirata, Koichi

2011-01-01

Sleep disturbances are common problems affecting the quality life of Parkinson's disease (PD) patients and are often underestimated. The causes of sleep disturbances are multifactorial and include nocturnal motor disturbances, nocturia, depressive symptoms, and medication use. Comorbidity of PD with sleep apnea syndrome, restless legs syndrome, rapid eye movement sleep behavior disorder, or circadian cycle disruption also results in impaired sleep. In addition, the involvement of serotoninergic, noradrenergic, and cholinergic neurons in the brainstem as a disease-related change contributes to impaired sleep structures. Excessive daytime sleepiness is not only secondary to nocturnal disturbances or dopaminergic medication but may also be due to independent mechanisms related to impairments in ascending arousal system and the orexin system. Notably, several recent lines of evidence suggest a strong link between rapid eye movement sleep behavior disorder and the risk of neurodegenerative diseases such as PD. In the present paper, we review the current literature concerning sleep disorders in PD. PMID:21876839

Relationship between Subtypes of Restricted and Repetitive Behaviors and Sleep Disturbance in Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hundley, Rachel J.; Shui, Amy; Malow, Beth A.

2016-01-01

We examined the association of two types of restricted and repetitive behaviors, repetitive sensory motor (RSM) and insistence on sameness (IS), with sleep problems in children with autism spectrum disorder (ASD). Participants included 532 children (aged 2-17) who participated in the Autism Speaks Autism Treatment Network research registry.…

APPROACHES TO THE ASSESSMENT OF AROUSALS AND SLEEP DISTURBANCE IN CHILDREN

PubMed Central

Paruthi, Shalini; Chervin, Ronald D.

2010-01-01

Childhood arousals, awakenings, and sleep disturbances during the night are common problems for both patients and their families. Additionally, inadequate sleep may contribute to daytime sleepiness, behavioral problems, and other important consequences of pediatric sleep disorders. Arousals, awakenings, and sleep disturbances can be quantified by routine polysomnography, and arousal scoring is generally performed as part of the standard polysomnogram. Here we review current approaches to quantification of arousals and sleep disturbances and examine outcomes that have been associated with these measures. Initial data suggest that computer-assisted identification of nonvisible arousals, cyclic alternating patterns, or respiratory cycle-related EEG changes may complement what can be accomplished by human scorers. Focus on contiguous bouts of sleep or specific sleep stages may prove similarly useful. Incorporation of autonomic arousal measures—such as heart rate variability, pulse transit time, or peripheral arterial tone—into standard reports may additionally capture subtle sleep fragmentation. PMID:20620104

The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents.

PubMed

Blake, Matthew; Schwartz, Orli; Waloszek, Joanna M; Raniti, Monika; Simmons, Julian G; Murray, Greg; Blake, Laura; Dahl, Ronald E; Bootzin, Richard; McMakin, Dana L; Dudgeon, Paul; Trinder, John; Allen, Nicholas B

2017-06-01

The aim of this study was to test whether a cognitive behavioral and mindfulness-based group sleep intervention would improve sleep and anxiety on school nights in a sample of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and presleep hyperarousal. Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into a sleep improvement intervention (n = 63) or active control "study skills" intervention (n = 60). Preintervention and postintervention, participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Sleep Beliefs Scale (SBS), and Presleep Hyperarousal Scale (PSAS) and wore an actiwatch and completed a sleep diary for five school nights. The sleep intervention condition was associated with significantly greater improvements in actigraphy-measured sleep onset latency (SOLobj), sleep diary measured sleep efficiency (SEsubj), PSQI, SCAS, SBS, and PSAS, with medium to large effect sizes. Improvements in the PSQI and SCAS were specifically mediated by the measured improvements in the PSAS that resulted from the intervention. Improvements in SOLobj and SEsubj were not specifically related to improvements in any of the putative treatment mechanisms. This study provides evidence that presleep arousal but not sleep hygiene awareness is important for adolescents' perceived sleep quality and could be a target for new treatments of adolescent sleep problems. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters.

PubMed

Carey, Mary G; Al-Zaiti, Salah S; Dean, Grace E; Sessanna, Loralee; Finnell, Deborah S

2011-08-01

Little attention has been given to factors contributing to firefighters' psychosomatic well-being. The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters. Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters. Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%). Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being, and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions. The inter-correlation relationships between such behaviors, therefore, need to be explored in further details.

Sleep Problems, Depression, Substance Use, Social Bonding, and Quality of Life in Professional Firefighters

PubMed Central

Carey, Mary G; Al-Zaiti, Salah S; Dean, Grace E; Sessanna, Loralee; Finnell, Deborah S

2011-01-01

Little attention has been given to factors contributing to firefighters' psychosomatic well-being. Objective The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters. Methods Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters. Results Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%). Conclusions Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being, and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions. The inter-correlation relationships between such behaviors, therefore, need to be explored in further details. PMID:21785370

Sleep, Affect, and Social Competence from Preschool to Preadolescence: Distinct Pathways to Emotional and Social Adjustment for Boys and for Girls

PubMed Central

Foley, Joan E.; Weinraub, Marsha

2017-01-01

Using a normative sample of 1,057 children studied across 4 waves over 6 years with multiple informants, we investigated transactional relations for sleep problems, anxious-depressed symptoms, and social functioning from preschool to preadolescence, assessing cumulative effects on children's emotional and social adjustment. To examine sex differences in the developmental processes, we conducted separate analyses for boys and girls. For both boys and girls, longitudinal cross-lagged panel analyses showed that preschool sleep problems directly predicted anxious-depressed symptoms 2 years later; indirect effects continued into preadolescence. For girls, early and later sleep problems directly or indirectly predicted a wide variety of preadolescent emotional and social adjustment domains (e.g., depressive symptoms, school competence, emotion regulation, risk-taking behaviors). For boys, social competence played a more important role than sleep problems in predicting preadolescent adjustment. Among the first set of findings that demonstrate longitudinal relations between sleep problems and social functioning in middle childhood and preadolescence, these results support Dahl's and Walker's neurological models of sleep and emotional functioning. We discuss these findings in light of relations between sleep and affect during pre-pubertal development and discuss differential findings for boys and girls. PMID:28588517

Reward-related brain function and sleep in pre/early pubertal and mid/late pubertal adolescents.

PubMed

Holm, Stephanie M; Forbes, Erika E; Ryan, Neal D; Phillips, Mary L; Tarr, Jill A; Dahl, Ronald E

2009-10-01

The onset of adolescence is a time of dramatic changes, including changes in sleep, and a time of new health concerns related to increases in risk-taking, sensation seeking, depression, substance use, and accidents. As part of a larger study examining puberty-specific changes in adolescents' reward-related brain function, the current article focuses on the relationship between functional neuroimaging measures of reward and measures of sleep. A total of 58 healthy participants 11-13 years of age completed a functional magnetic resonance imaging scan using a guessing task with monetary rewards and 4 days of at-home actigraphy and self-reported sleep ratings. Sleep variables included actigraph measures of mean weekend minutes asleep, sleep onset time, and sleep offset time, as well as self-reported sleep quality. During reward anticipation, less activation in the caudate (part of the ventral striatum) was associated with fewer minutes asleep, later sleep onset time, and lower sleep quality. During reward outcome, less caudate activation was associated with later sleep onset time, earlier sleep offset time, and lower sleep quality. It has been hypothesized that adolescents' low reactivity in reward-related brain areas could lead to compensatory increases in reward-driven behavior. This study's findings suggest that sleep could contribute to such behavior. Because decreased sleep has been associated with risky behavior and negative mood, these findings raise concerns about a negative spiral whereby the effects of puberty and sleep deprivation may have synergistic effects on reward processing, contributing to adolescent behavioral and emotional health problems.

Pathways Linking Adverse Childhood Experiences to Cigarette Smoking Among Young Black Men: a Prospective Analysis of the Role of Sleep Problems and Delayed Reward Discounting.

PubMed

Oshri, Assaf; Kogan, Steven; Liu, Sihong; Sweet, Lawrence; Mackillop, James

2017-12-01

African American men experience increases in smoking during the young adult transition. Exposure to childhood adversity, a risk factor which disproportionately affects African American men, has been identified as a robust precursor to health risk behavior in general and cigarette smoking in particular. The intermediate mechanisms that transmit the influence of early adversity to smoking behavior are not well understood. We tested a model of the escalation of smoking behaviors among young adult African American men, investigating sleep disturbance and delayed reward discounting as intermediate factors linking adverse childhood experiences with smoking. Hypotheses were tested with three waves of data (M age-T1  = 20.34, M age-T2  = 21.92, M age-T3  = 23.02) from 505 African American men living in rural counties in South Georgia. Men provided self-report data on their adverse childhood experiences, sleep problems, and smoking behavior using audio-assisted computer self-interviews. Men also completed a computer-based delayed reward discounting task. Structural equation modeling analyses supported our hypotheses: Adverse childhood experiences predicted poor sleep adequacy, which forecast increases in delayed reward discounting; discounting, in turn, predicted increased smoking. Significant indirect pathways were detected linking adversity to discounting via sleep adequacy and linking sleep adequacy to smoking via discounting. Prevention and intervention researchers can draw on these findings to develop programs that focus on sleep adequacy to reduce smoking in African American men exposed to childhood adversity.

The impact of a healthy media use intervention on sleep in preschool children.

PubMed

Garrison, Michelle M; Christakis, Dimitri A

2012-09-01

Although observational studies have consistently reported an association between media use and child sleep problems, it is unclear whether the relationship is causal or if an intervention targeting healthy media use can improve sleep in preschool-aged children. We conducted a randomized controlled trial of a healthy media use intervention in families of children aged 3 to 5 years. The intervention encouraged families to replace violent or age-inappropriate media content with quality educational and prosocial content, through an initial home visit and follow-up telephone calls over 6 months. Sleep measures were derived from the Child Sleep Habits Questionnaire and were collected at 6, 12, and 18 months after baseline; repeated-measures regression analyses were used. Among the 565 children analyzed, the most common sleep problem was delayed sleep-onset latency (38%). Children in the intervention group had significantly lower odds of "any sleep problem" at follow-up in the repeated-measures analysis (odds ratio = 0.36; 95% confidence interval: 0.16 to 0.83), with a trend toward a decrease in intervention effect over time (P = .07). Although there was no significant effect modification detected by baseline sleep or behavior problems, gender, or low-income status, there was a trend (P = .096) toward an increased effect among those with high levels of violence exposure at baseline. The significant effects of a healthy media use intervention on child sleep problems in the context of a randomized controlled trial suggest that the previously reported relationship between media use and child sleep problems is indeed causal in nature.

The Melatonin Receptor Agonist Ramelteon Effectively Treats Insomnia and Behavioral Symptoms in Autistic Disorder

PubMed Central

Oka, Yasunori

2014-01-01

Children with autism spectrum disorders (ASD), including autistic disorder, frequently suffer from comorbid sleep problems. An altered melatonin rhythm is considered to underlie the impairment in sleep onset and maintenance in ASD. We report three cases with autistic disorder in whom nocturnal symptoms improved with ramelteon, a selective melatonin receptor agonist. Insomnia and behavior, assessed using the Clinical Global Impression-Improvement Scale, improved in two cases with 2 mg ramelteon and in the third case with 8 mg ramelteon. Our findings demonstrate that ramelteon is effective not only for insomnia, but for behavioral problems as well, in patients with autistic disorder. PMID:24955274

The melatonin receptor agonist ramelteon effectively treats insomnia and behavioral symptoms in autistic disorder.

PubMed

Kawabe, Kentaro; Horiuchi, Fumie; Oka, Yasunori; Ueno, Shu-Ichi

2014-01-01

Children with autism spectrum disorders (ASD), including autistic disorder, frequently suffer from comorbid sleep problems. An altered melatonin rhythm is considered to underlie the impairment in sleep onset and maintenance in ASD. We report three cases with autistic disorder in whom nocturnal symptoms improved with ramelteon, a selective melatonin receptor agonist. Insomnia and behavior, assessed using the Clinical Global Impression-Improvement Scale, improved in two cases with 2 mg ramelteon and in the third case with 8 mg ramelteon. Our findings demonstrate that ramelteon is effective not only for insomnia, but for behavioral problems as well, in patients with autistic disorder.

Individual Differences in Childhood Sleep Problems Predict Later Cognitive Executive Control

PubMed Central

Friedman, Naomi P.; Corley, Robin P.; Hewitt, John K.; Wright, Kenneth P.

2009-01-01

Study Objective: To determine whether individual differences in developmental patterns of general sleep problems are associated with 3 executive function abilities—inhibiting, updating working memory, and task shifting—in late adolescence. Participants: 916 twins (465 female, 451 male) and parents from the Colorado Longitudinal Twin Study. Measurements and Results: Parents reported their children's sleep problems at ages 4 years, 5 y, 7 y, and 9–16 y based on a 7-item scale from the Child-Behavior Checklist; a subset of children (n = 568) completed laboratory assessments of executive functions at age 17. Latent variable growth curve analyses were used to model individual differences in longitudinal trajectories of childhood sleep problems. Sleep problems declined over time, with ~70% of children having ≥ 1 problem at age 4 and ~33% of children at age 16. However, significant individual differences in both the initial levels of problems (intercept) and changes across time (slope) were observed. When executive function latent variables were added to the model, the intercept did not significantly correlate with the later executive function latent variables; however, the slope variable significantly (P < 0.05) negatively correlated with inhibiting (r = −0.27) and updating (r = −0.21), but not shifting (r = −0.10) abilities. Further analyses suggested that the slope variable predicted the variance common to the 3 executive functions (r = −0.29). Conclusions: Early levels of sleep problems do not seem to have appreciable implications for later executive functioning. However, individuals whose sleep problems decrease more across time show better general executive control in late adolescence. Citation: Friedman NP; Corley RP; Hewitt JK; Wright KP. Individual differences in childhood sleep problems predict later cognitive executive control. SLEEP 2009;32(3):323-333. PMID:19294952

Sleep Problems and Their Relationship to Maladaptive Behavior Severity in Psychiatrically Hospitalized Children with Autism Spectrum Disorder (ASD).

PubMed

Sannar, Elise M; Palka, Tamara; Beresford, Carol; Peura, Christine; Kaplan, Desmond; Verdi, Mary; Siegel, Matthew; Kaplan, Shir; Grados, Marco

2017-10-30

We examined the relationship between sleep duration and awakenings to Aberrant Behavior Checklist-Community (ABC-C) and Autism Diagnostic Observation Schedule (ADOS-2) scores in hospitalized youth with ASD and behavioral disturbance. Participants included 106 patients with a stay of at least 10 nights. Sleep in the hospital was recorded by staff observation. Higher scores on the ABC-C (irritability, stereotypy, and hyperactivity subscales) at admission were significantly associated with fewer minutes slept during the last five nights of hospitalization. There was no association between total awakenings and ABC-C scores or ADOS-2 comparison scores. Improved understanding of the relationship between sleep quality and maladaptive behavior in this challenging cohort of patients with ASD is vital to the definition and design of future effective interventions.

Exploring the Lived Experience of Difficult Sleep and Good Sleep Among Psychiatric Inpatients.

PubMed

Zust, Barbara Lois; Gruenberg, Marjorie E; Sendelbach, Susan Ellen

2016-01-01

The purpose of this qualitative study was to explore psychiatric inpatients' reflections on their experiences with sleep throughout their lives. Fourteen patients in an acute care behavioral health unit agreed to participate in this study. Participants met individually with a researcher to reflect on times in their lives when they experienced good sleep; times when they had difficulty sleeping; and times when difficult sleep was resolved. The major findings of the study indicated that feeling alone with life problems triggered difficult sleep; while feelings of belonging and purpose were associated with good sleep.

Sleep in Children with Autism Spectrum Disorder

PubMed Central

Zavodny, Stefanie; Eriksen, Whitney; Sinko, Rebecca; Connell, James; Kerns, Connor; Schaaf, Roseann; Pinto-Martin, Jennifer

2018-01-01

The purposes of this paper are to provide an overview of the state of the science of sleep in children with autism spectrum disorder (ASD), present hypotheses for the high prevalence of insomnia in children with ASD, and present a practice pathway for promoting optimal sleep. Approximately two thirds of children with ASD have chronic insomnia, and to date, the strongest evidence on promoting sleep is for sleep education, environmental changes, behavioral interventions, and exogenous melatonin. The Sleep Committee of the Autism Treatment Network (ATN) developed a practice pathway, based on expert consensus, to capture best practices for screening, identification, and treatment for sleep problems in ASD in 2012. An exemplar case is presented to integrate key constructs of the practice pathway and address arousal and sensory dysregulation in a child with ASD and anxiety disorder. This paper concludes with next steps for dissemination of the practice pathway and future directions for research of sleep problems in ASD. PMID:28502070

Sleep in Children with Autism Spectrum Disorder.

PubMed

Souders, Margaret C; Zavodny, Stefanie; Eriksen, Whitney; Sinko, Rebecca; Connell, James; Kerns, Connor; Schaaf, Roseann; Pinto-Martin, Jennifer

2017-06-01

The purposes of this paper are to provide an overview of the state of the science of sleep in children with autism spectrum disorder (ASD), present hypotheses for the high prevalence of insomnia in children with ASD, and present a practice pathway for promoting optimal sleep. Approximately two thirds of children with ASD have chronic insomnia, and to date, the strongest evidence on promoting sleep is for sleep education, environmental changes, behavioral interventions, and exogenous melatonin. The Sleep Committee of the Autism Treatment Network (ATN) developed a practice pathway, based on expert consensus, to capture best practices for screening, identification, and treatment for sleep problems in ASD in 2012. An exemplar case is presented to integrate key constructs of the practice pathway and address arousal and sensory dysregulation in a child with ASD and anxiety disorder. This paper concludes with next steps for dissemination of the practice pathway and future directions for research of sleep problems in ASD.

A gender perspective on sleeplessness behavior, effects of sleep loss, and coping resources in patients with stable coronary artery disease.

PubMed

Edéll-Gustafsson, Ulla; Svanborg, Eva; Swahn, Eva

2006-01-01

The primary aim of this study was to systematically compare perceived sleep quality, sleeplessness behavior, sense of mastery, self-esteem, depression, subjective health, and effects of sleep loss in men and women with stable coronary artery disease (CAD). Further aims were to determine possible predictors of poor sleep quality and sense of mastery, as well as the consequences of too little sleep. Comparative-correlation and predictive design were used. Patients with a history of stable angina pectoris scheduled to undergo coronary angiography at Linköping University Hospital in Sweden were included. There were 47 women and 88 men (mean age 62.4 years) with CAD. Structured interviews using validated questionnaires covered sleep quality and sleep habits, effects of sleep loss, psychologic resources, and depression. Multiple stepwise regression analysis showed that sleeplessness behavior, depressed mood, female gender, and pharmacologic treatments with inflammation inhibitors significantly (P<.0001) accounted for the variance of poorer sleep quality. The analysis also showed that the following factors in descending order significantly accounted (P<.0001) for the outcome of sleep quality: inability to feel refreshed by sleep, difficulty in maintaining sleep, gastrointestinal problems, too little sleep, final morning awakening time, sleep onset latency, lying down because of daytime tiredness, and daytime physical tiredness. Compared with men, women with stable CAD may be especially at risk of experiencing poor sleep quality, even when sleeplessness behavior and pharmacologic treatments with inflammation inhibitors are controlled. It is also possible that they may be more at risk of depressed mood.

Sleep disturbances in children with attention-deficit/hyperactivity disorder

PubMed Central

Spruyt, Karen; Gozal, David

2011-01-01

In this article, we advocate the need for better understanding and treatment of children exhibiting inattentive, hyperactive, impulsive behaviors, by in-depth questioning on sleepiness, sleep-disordered breathing or problematic behaviors at bedtime, during the night and upon awakening, as well as night-to-night sleep duration variability. The relationships between sleep and attention-deficit/hyperactivity disorder (ADHD) are complex and are routinely overlooked by practitioners. Motricity and somnolence, the most consistent complaints and objectively measured sleep problems in children with ADHD, may develop as a consequence of multidirectional and multifactorial pathways. Therefore, subjectively perceived or reported restless sleep should be evaluated with specific attention to restless legs syndrome or periodic limb movement disorder, and awakenings should be queried with regard to parasomnias, dyssomnias and sleep-disordered breathing. Sleep hygiene logs detailing sleep onset and offset quantitatively, as well as qualitatively, are required. More studies in children with ADHD are needed to reveal the 24-h phenotype, or its sleep comorbidities. PMID:21469929

Behavioral sleep modification may revert transformed migraine to episodic migraine.

PubMed

Calhoun, Anne H; Ford, Sutapa

2007-09-01

Sleep problems have been linked with headaches for more than a century, but whether the headaches are the cause or the result of the disrupted sleep is unknown. We previously reported that nonrestorative sleep and poor sleep habits are almost universal in a referral population of women with transformed migraine (TM). Since cognitive behavioral therapy is effective in improving sleep quality in individuals with poor sleep hygiene, we designed a randomized, placebo-controlled study to assess the impact of such treatment on TM. We hypothesized that behavioral sleep modification (BSM) would be associated with improvement in headache frequency and intensity and with reversion to episodic migraine. Subjects were 43 women with TM referred to an academic headache center. After obtaining informed consent, patients were randomized to receive either behavioral sleep instructions or placebo behavioral instructions in addition to usual medical care. Subjects recorded headaches in standardized diaries. The first postintervention visit was scheduled at 6 weeks. At that visit, the blind was broken and all subjects received BSM instructions. A final visit was scheduled 6 weeks later. Compared to the placebo behavioral group, the BSM group reported statistically significant reduction in headache frequency [F (1, 33 = 12.42, P=.001)] and headache intensity [F(1, 33 = 14.39, P= .01)]. They were more likely to revert to episodic migraine chi2 (2, n = 43) = 7.06, P= .029. No member of the control group reverted to episodic migraine by the first postintervention visit. By the final visit, 48.5% of those who had received BSM instructions had reverted to episodic migraine. In this pilot study of women with TM, we found that a targeted behavioral sleep invention was associated with improvement in headache frequency, headache index, and with reversion to episodic migraine.

Factors associated with sleep quality among operating engineers.

PubMed

Choi, Seung Hee; Terrell, Jeffrey E; Pohl, Joanne M; Redman, Richard W; Duffy, Sonia A

2013-06-01

Blue collar workers generally report high job stress and are exposed to loud noises at work and engage in many of risky health behavioral factors, all of which have been associated with poor sleep quality. However, sleep quality of blue collar workers has not been studied extensively, and no studies have focused Operating Engineers (heavy equipment operators) among whom daytime fatigue would place them at high risk for accidents. Therefore, the purpose of this study was to determine variables associated with sleep quality among Operating Engineers. This was a cross-sectional survey design with a dependent variable of sleep quality and independent variables of personal and related health behavioral factors. A convenience sample of 498 Operating Engineers was recruited from approximately 16,000 Operating Engineers from entire State of Michigan in 2008. Linear regression was used to determine personal and related health behavior factors associated with sleep quality. Multivariate analyses showed that personal factors related to poor sleep quality were younger age, female sex, higher pain, more medical comorbidities and depressive symptoms and behavioral factors related to poor sleep quality were nicotine dependence. While sleep scores were similar to population norms, approximately 34 % (n = 143) showed interest in health services for sleep problems. While many personal factors are not changeable, interventions to improve sleep hygiene as well as interventions to treat pain, depression and smoking may improve sleep quality resulting in less absenteeism, fatal work accidents, use of sick leave, work disability, medical comorbidities, as well as subsequent mortality.

Factors Associated With Sleep Quality Among Operating Engineers

PubMed Central

Choi, Seung Hee; Terrell, Jeffrey E.; Pohl, Joanne M.; Redman, Richard W.

2016-01-01

Blue collar workers generally report high job stress and are exposed to loud noises at work and engage in many of the health behavioral factors, all of which have been associated with poor sleep quality. However, sleep quality of blue collar workers has not been studied extensively, and no studies have focused Operating Engineers (heavy equipment operators) among whom daytime fatigue would place them at high risk for accidents. Therefore, the purpose of this study was to determine variables associated with sleep quality among Operating Engineers. This was a cross-sectional survey design with a dependent variable of sleep quality and independent variables of personal and related health behavioral factors. A convenience sample of 498 Operating Engineers was recruited from approximately 16,000 Operating Engineers from entire State of Michigan in 2008. Linear regression was used to determine personal and related health behavior factors associated with sleep quality. Multivariate analyses showed that personal factors related to poor sleep quality were younger age, female sex, higher pain, more medical comorbidities and depressive symptoms and behavioral factors related to poor sleep quality were nicotine dependence. While sleep scores were similar to population norms, approximately 34% (n=143) showed interest in health services for sleep problems. While many personal factors are not changeable, interventions to improve sleep hygiene as well as interventions to treat pain, depression and smoking may improve sleep quality resulting in less absenteeism, fatal work accidents, use of sick leave, work disability, medical comorbidities, as well as subsequent mortality. PMID:23393021

Perceived insufficient rest or sleep among veterans: Behavioral Risk Factor Surveillance System 2009.

PubMed

Faestel, Paul M; Littell, Christopher T; Vitiello, Michael V; Forsberg, Christopher W; Littman, Alyson J

2013-06-15

Sleep problems are of particular concern among the active duty military population as factors such as inconsistent work hours and deployment may compromise adequate sleep and adversely impact performance. However, few prior studies have investigated whether the prevalence of sleep problems differ between Veterans and demographically similar non-Veterans. The purpose of this study is to investigate whether self-reported insufficient rest or sleep varies in relation to Veteran status and to identify high-risk groups of Veterans. This study used data from the 2009 Behavioral Risk Factor Surveillance System (analyzed in 2011), a state based national telephone survey of non-institutionalized US adults. Insufficient rest was assessed in 411,313 adults aged 21 and older, of whom 55,361 were Veterans. Sleep duration was assessed in 6 states (n = 4,936 Veterans and 30,983 non-Veterans). Model-based direct rate adjustment was used to estimate the prevalence of insufficient rest or sleep while controlling for confounding. Multivariable logistic regression was used to estimate odds ratios of insufficient sleep or rest in subgroups of Veterans. After multivariable adjustment, insufficient rest or sleep (22.7% vs. 21.1%, p < 0.001) and short sleep duration (< 7 h/night, 34.9% vs. 31.3%, p = 0.026) were more common among Veterans than non-Veterans. When the Veteran group was further divided among newly transitioned (≤ 12 months) and longer-term Veterans (> 12 months), the overall test for a difference was not statistically significant between groups, mainly because there was little difference in sleep between the two groups of Veterans. High-risk Veteran subgroups included those who were 21-44 years of age (vs. 65-74), women, non-whites, current smokers, obese, unable to work, and those in poor health. This study suggests that Veterans have a high burden of sleep problems and identifies subgroups that should be targeted to receive interventions and enhanced education regarding insufficient sleep.

Repetitive Behaviors in Autism: Relationships with Associated Clinical Features

ERIC Educational Resources Information Center

Gabriels, Robin L.; Cuccaro, Michael L.; Hill, Dina E.; Ivers, Bonnie J.; Goldson, Edward

2005-01-01

Relationships between repetitive behaviors (RBs) and associated clinical features (i.e., cognitive and adaptive functioning levels, sleep problems, medication use, and other behavioral problems) were examined in two groups (High nonverbal IQ greater than or equal to 97 versus Low nonverbal IQ less than or equal to 56) of children with autism…

Sleep problems in university students – an intervention

PubMed Central

Schlarb, Angelika Anita; Friedrich, Anja; Claßen, Merle

2017-01-01

Introduction Up to 60% of all college students suffer from a poor sleep quality, and 7.7% meet all criteria of an insomnia disorder. Sleep problems have a great impact on the students’ daily life, for example, the grade point average. Due to irregular daytime routines, chronotype changes, side jobs and exam periods, they need specialized treatments for improving sleep. “Studieren wie im Schlaf” (SWIS; (studying in your sleep)) is a multicomponent sleep training that combines Cognitive Behavioral Therapy for Insomnia and Hypnotherapy for Insomnia to improve students’ sleep, insomnia symptoms and nightmares. The aim of the present study is to evaluate the acceptance, feasibility and the first effects of SWIS. Methods Twenty-seven students (mean =24.24, standard deviation =3.57) participated in a study of pre–post design. The acceptance and feasibility were measured with questionnaires. In addition, the Pittsburgh Sleep Quality Index (PSQI), sleep logs and actigraphy were implemented. Further variables encompassed daytime sleepiness, sleep-related personality traits and cognitions about sleep. Results Seventy-four percent of the participants reported symptoms of an insomnia disorder, and 51.9% fulfilled all criteria of an insomnia disorder according to the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Correspondingly, the students suffered from clinically relevant sleep problems according to the PSQI. The SWIS sleep training is a well-accepted and feasible program. Significant improvements were observed in the subjective sleep quality and sleep-related personality traits, as well as clinical improvements in objective sleep measures. Discussion Findings showed that SWIS is a feasible program for the treatment of sleep problems in college and university students due to its various effects on sleep and cognitive outcomes. Further evaluation of follow-up measurements and additional variables, that is, cognitive performance and mental health, is needed. PMID:28794633

Sleep Disorders in Childhood Neurological Diseases

PubMed Central

Liu, Zhao

2017-01-01

Sleep problems are frequently addressed as a primary or secondary concern during the visit to the pediatric neurology clinic. Sleep disorders can mimic other neurologic diseases (e.g., epilepsy and movement disorders), and this adds challenges to the diagnostic process. Sleep disorders can significantly affect the quality of life and functionality of children in general and those with comorbid neurological diseases in particular. Understanding the pathophysiology of sleep disorders, recognizing the implications of sleep disorder in children with neurologic diseases and behavioral difficulties, and early intervention continue to evolve resulting in better neurocognitive outcomes. PMID:28937639

Children's Sleep and Autonomic Function: Low Sleep Quality Has an Impact on Heart Rate Variability

PubMed Central

Michels, Nathalie; Clays, Els; De Buyzere, Marc; Vanaelst, Barbara; De Henauw, Stefaan; Sioen, Isabelle

2013-01-01

Objectives: Short sleep duration and poor sleep quality in children have been associated with concentration, problem behavior, and emotional instability, but recently also with disrupted autonomic nervous function, which predicts cardiovascular health. Heart rate variability (HRV) was used as noninvasive indicator of autonomic function to examine the influence of sleep. Design: Cross-sectional and longitudinal observational study on the effect of sleep on HRV Participants: Belgian children (5-11 years) of the ChiBS study in 2010 (N = 334) and 2011 (N = 293). Interventions: N/A. Methods: Sleep duration was reported and in a subgroup sleep quality (efficiency, latency, awakenings) was measured with accelerometry. High-frequency (HF) power and autonomic balance (LF/HF) were calculated on supine 5-minute HRV measurements. Stress was measured by emotion and problem behavior questionnaires. Sleep duration and quality were used as HRV predictors in corrected cross-sectional and longitudinal regressions. Stress was tested as mediator (intermediate pathway) or moderator (interaction) in sleep-HRV associations. Results: In both cross-sectional and longitudinal analyses, long sleep latency could predict lower HF (parasympathetic activity), while nocturnal awakenings, sleep latency, low sleep efficiency, and low corrected sleep duration were related to higher LF/HF (sympathetic/parasympathetic balance). Parental reported sleep duration was not associated with HRV. The significances remained after correction for stress. Stress was not a mediator, but a moderator (enhancer) in the relationship between sleep quality and HRV. Conclusions: Low sleep quality but not parent-reported low sleep duration leads to an unhealthier heart rate variability pattern (sympathetic over parasympathetic dominance). This stresses the importance of good sleep quality for cardiovascular health in children. Citation: Michels N; Clays E; De Buyzere M; Vanaelst B; De Henauw S; Sioen I. Children's sleep and autonomic function: low sleep quality has an impact on heart rate variability. SLEEP 2013;36(12):1939-1946. PMID:24293769

I-CAN SLEEP: rationale and design of a non-inferiority RCT of Mindfulness-based Stress Reduction and Cognitive Behavioral Therapy for the treatment of Insomnia in CANcer survivors.

PubMed

Garland, Sheila N; Carlson, Linda E; Antle, Michael C; Samuels, Charles; Campbell, Tavis

2011-09-01

Individuals with cancer are disproportionately affected by sleep disturbances, relative to the general population. These problems can be a consequence of the psychological, behavioral and physical effects of a cancer diagnosis and treatment. Sleep disturbances often persist for years and, when combined with already high levels of cancer-related distress, may place cancer survivors at a higher risk of future psychopathology, health problems and poorer quality of life. It is important to develop and evaluate treatments that comprehensively address the common symptom profiles experienced by cancer survivors. This study is a randomized controlled non-inferiority trial comparing Cognitive Behavior Therapy for Insomnia (CBT-I; a known efficacious treatment) to Mindfulness-Based Stress Reduction (MBSR; a treatment with demonstrated potential). This design can efficiently compare these two treatments directly and determine whether MBSR performs to the same standard as CBT-I for the treatment of insomnia with additional benefits of reducing cancer-related distress. Participants are randomly assigned to an 8-week CBT-I or MBSR group. Sleep indices are measured using subjective (sleep diaries) and objective (actigraphy) assessment tools. The primary outcome is insomnia severity. Secondary outcomes include sleep quality, symptoms of stress, mood disturbance, mindfulness, and dysfunctional beliefs and attitudes toward sleep. Assessments are completed at three time periods: pre-treatment, post-treatment and at 3month follow up. Considering the high prevalence of distress and sleep disturbances in the cancer population, should MBSR produce sleep effects comparable to CBT-I, it may be more comprehensive - making it the treatment of choice for addressing cancer-related psychological sequelae. Copyright © 2011 Elsevier Inc. All rights reserved.

[Sleep disturbances and nightmares as risk factors for suicidal behavior among men and women].

PubMed

Susánszky, Eva; Hajnal, Agnes; Kopp, Mária

2011-01-01

Today, more and more international studies analyze the connection between sleep disturbances, including nightmares, and the risk of suicide. The majority of these studies focuses on patients with depression and PTSD; a few studies use community samples. The present paper is based on a community sample research; it examines gender differences in the relationship between nightmares and suicidal behavior (ideation and attempt) during the three years preceding the study. The database was derived from the data of the national representative survey Hungaro study 2006, the objective of which was the health status of the Hungarian adult population (N=4642). The five-item version of Athens Insomnia Scale was used for the examination of sleep disturbances; depression was measured with the shortened version of the Beck depression questionnaire. The questions dealing with nightmares were part of the Sleep Quality Questionnaire. Sleep problems, nightmares and depression were considered as risk factors for both suicidal ideation and suicide attempts. Associations were analyzed by logistic regression. The data were corrected for age, gender, education, and financial situation. Our analysis verified the connections between suicidal thoughts and attempts, and nightmares. The results show that the frequent occurrence of nightmares is associated with a nearly four times higher risk of suicide attempts among men (OR=3,89) and a threefold increase among women (OR=1,74). For suicidal thoughts, nightmares correlate with a three times higher risk for men (OR=2,97) and one and the half higher risk for women (OR=1,58). In our sample, frequent nightmares and sleep disorders increase the risk of suicidal behavior more than depression. After clinical studies proved the influence of sleep problems in various patient groups, our epidemiological study seem to confirm that nightmares have an independent role in the formation of suicidal behavior.

Relationship between polysomnographic sleep architecture and behavior in medication-free children with TS, ADHD, TS and ADHD, and controls.

PubMed

Stephens, Robyn J; Chung, Sharon A; Jovanovic, Dragana; Guerra, Randy; Stephens, Brandon; Sandor, Paul; Shapiro, Colin M

2013-01-01

To describe the relationship between sleep architecture and behavioral measures in unmedicated children and adolescents with Tourette syndrome (TS), attention-deficit hyperactivity disorder (ADHD), TS and comorbid ADHD (TS + ADHD), and healthy controls. The study also set out to examine differences in sleep architecture with each diagnosis. A cross-sectional, 2-night consecutive polysomnographic sleep study was conducted in 90 children. All participants were matched for age, gender, and level of intelligence. Scores on the Child Behavior Checklist delinquency measure were modestly but significantly correlated with the number of movements during REM sleep (r = .36, p = .003). Significant correlations were also noted among the number of total arousals and arousals from slow wave sleep (SWS), and scores on the measures of conduct disorder, hyperactivity/immaturity, and restless/disorganized behaviors. There were a few significant differences in sleep architecture among the diagnostic groups. The ADHD-only group exhibited a significantly higher number of total arousals (p < .01) and arousals from SWS (p < .01) compared with the other three study groups. Our findings indicate that children with TS and/or ADHD and who have more arousals from sleep are significantly more likely to have issues with conduct disorder, hyperactivity/immaturity, and restless/disorganized behavior. It was also noted that having ADHD, alone or comorbid with TS, is associated with a significantly greater number of movements during both non-REM and REM sleep. This study underscores the compelling need for the diagnosis and treatment of any sleep disorders in children with TS and/or ADHD so as to facilitate better management of problem behaviors.

The influence of sleep complaints on the association between chronotype and negative emotionality in young adults.

PubMed

Simor, Péter; Zavecz, Zsófia; Pálosi, Vivien; Török, Csenge; Köteles, Ferenc

2015-02-01

A great body of research indicates that eveningness is associated with negative psychological outcomes, including depressive and anxiety symptoms, behavioral dyscontrol and different health impairing behaviors. Impaired subjective sleep quality, increased circadian misalignment and daytime sleepiness were also reported in evening-type individuals in comparison with morning-types. Although sleep problems were consistently reported to be associated with poor psychological functioning, the effects of sleep disruption on the relationship between eveningness preference and negative emotionality have scarcely been investigated. Here, based on questionnaire data of 756 individuals (25.5% males, age range = 18-43 years, mean = 25.3 ± 5.8 years), as well as of the evening-type (N = 211) and morning-type (N = 189) subgroups, we examined the relationship among sleep problems, eveningness and negative emotionality. Subjects completed the Hungarian Version of the Horne and Östberg Morningness-Eveningness Questionnaire (MEQ-14), The Athen Insomnia Scale (AIS) and the Epworth Sleepiness Scale (ESS). Moreover, a composite score of Negative Emotionality (NE) was computed based on the scores of the Short Beck Depression Inventory (BDI-9), the Perceived Stress Scale (PSS-4) and the General Health Questionnaire (GHQ-12). Morning and evening circadian misalignment was calculated based on the difference between preferred and real wake- and bedtimes. Two possible models were tested, hypothesizing that sleep problems (circadian misalignment, insomniac symptoms and daytime sleepiness) moderate or mediate the association between eveningness and negative emotionality. Eveningness preference was correlated with increased NE and increased AIS, ESS and circadian misalignment scores. Our results indicate that eveningness-preference is an independent risk factor for higher negative emotionality regardless of the effects of age, gender, circadian misalignment and sleep complaints. Nevertheless, while chronotype explained ∼6%, sleep problems (AIS and ESS) accounted for a much larger proportion (∼28%) of the variance of NE. We did not find a significant effect of interaction (moderation) between chronotype and sleep problems. In contrast, insomniac symptoms (AIS) emerged as a partial mediator between chronotype and NE. These findings argue against the assumption that indicators of mental health problems in evening-type individuals can be explained exclusively on the basis of disturbed sleep. Nevertheless, negative psychological outcomes seem to be partially attributable to increased severity of insomniac complaints in evening-types.

Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children.

PubMed

Dworak, Markus; Schierl, Thomas; Bruns, Thomas; Strüder, Heiko Klaus

2007-11-01

Television and computer game consumption are a powerful influence in the lives of most children. Previous evidence has supported the notion that media exposure could impair a variety of behavioral characteristics. Excessive television viewing and computer game playing have been associated with many psychiatric symptoms, especially emotional and behavioral symptoms, somatic complaints, attention problems such as hyperactivity, and family interaction problems. Nevertheless, there is insufficient knowledge about the relationship between singular excessive media consumption on sleep patterns and linked implications on children. The aim of this study was to investigate the effects of singular excessive television and computer game consumption on sleep patterns and memory performance of children. Eleven school-aged children were recruited for this polysomnographic study. Children were exposed to voluntary excessive television and computer game consumption. In the subsequent night, polysomnographic measurements were conducted to measure sleep-architecture and sleep-continuity parameters. In addition, a visual and verbal memory test was conducted before media stimulation and after the subsequent sleeping period to determine visuospatial and verbal memory performance. Only computer game playing resulted in significant reduced amounts of slow-wave sleep as well as significant declines in verbal memory performance. Prolonged sleep-onset latency and more stage 2 sleep were also detected after previous computer game consumption. No effects on rapid eye movement sleep were observed. Television viewing reduced sleep efficiency significantly but did not affect sleep patterns. The results suggest that television and computer game exposure affect children's sleep and deteriorate verbal cognitive performance, which supports the hypothesis of the negative influence of media consumption on children's sleep, learning, and memory.

The Origins of Mental Toughness - Prosocial Behavior and Low Internalizing and Externalizing Problems at Age 5 Predict Higher Mental Toughness Scores at Age 14.

PubMed

Sadeghi Bahmani, Dena; Hatzinger, Martin; Gerber, Markus; Lemola, Sakari; Clough, Peter J; Perren, Sonja; von Klitzing, Kay; von Wyl, Agnes; Holsboer-Trachsler, Edith; Brand, Serge

2016-01-01

The concept of mental toughness (MT) has gained increasing importance among groups other than elite athletes by virtue of its psychological importance and explanatory power for a broad range of health-related behaviors. However, no study has focused so far on the psychological origins of MT. Therefore, the aims of the present study were: to explore, to what extent the psychological profiles of preschoolers aged five were associated with both (1) MT scores and (2) sleep disturbances at age 14, and 3) to explore possible gender differences. Nine years after their first assessment at age five (preschoolers), a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females) took part in this follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ), covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, MT, and sleep disturbances. Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, were associated with self-reported higher MT and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbances. The pattern of results suggests that MT traits during adolescence may have their origins in the pre-school years.

Poor Sleep and Its Relation to Impulsivity in Patients with Antisocial or Borderline Personality Disorders.

PubMed

Van Veen, M M; Karsten, J; Lancel, M

2017-01-01

Studies investigating sleep and personality disorders consistently demonstrate a relation between personality disorders characterized by behavioral disinhibition and/or emotional dysregulation (traditionally termed cluster B personality disorders) and poor sleep. This finding is in line with previous studies associating insomnia with impulsive behavior, since this is a core characteristic of both antisocial and borderline personality disorder. The current study investigates a group (n = 112) of forensic psychiatric inpatients with antisocial or borderline personality disorder or traits thereof. Subjective sleep characteristics and impulsivity were assessed with the Pittsburgh Sleep Quality Index, the Sleep Diagnosis List, and the Barratt Impulsiveness Scale, respectively. More than half of the patients (53.6%) report poor sleep quality and 22.3% appears to suffer from severe chronic insomnia. Both poor sleep quality and chronic insomnia are significantly associated with self-reported impulsivity, in particular with attentional impulsiveness. This association was not significantly influenced by comorbid disorders. Actively treating sleep problems in these patients may not only improve sleep quality, mental health, and physical well-being, but may also have impact on impulsivity-related health risks by increasing self-control.

Neural Basis of Brain Dysfunction Produced by Early Sleep Problems.

PubMed

Kohyama, Jun

2016-01-29

There is a wealth of evidence that disrupted sleep and circadian rhythms, which are common in modern society even during the early stages of life, have unfavorable effects on brain function. Altered brain function can cause problem behaviors later in life, such as truancy from or dropping out of school, quitting employment, and committing suicide. In this review, we discuss findings from several large cohort studies together with recent results of a cohort study using the marshmallow test, which was first introduced in the 1960s. This test assessed the ability of four-year-olds to delay gratification and showed how this ability correlated with success later in life. The role of the serotonergic system in sleep and how this role changes with age are also discussed. The serotonergic system is involved in reward processing and interactions with the dorsal striatum, ventral striatum, and the prefrontal cortex are thought to comprise the neural basis for behavioral patterns that are affected by the quantity, quality, and timing of sleep early in life.

Devices for Ambulatory Monitoring of Sleep-Associated Disorders in Children with Neurological Diseases.

PubMed

Ulate-Campos, Adriana; Tsuboyama, Melissa; Loddenkemper, Tobias

2017-12-25

Good sleep quality is essential for a child's wellbeing. Early sleep problems have been linked to the later development of emotional and behavioral disorders and can negatively impact the quality of life of the child and his or her family. Sleep-associated conditions are frequent in the pediatric population, and even more so in children with neurological problems. Monitoring devices can help to better characterize sleep efficiency and sleep quality. They can also be helpful to better characterize paroxysmal nocturnal events and differentiate between nocturnal seizures, parasomnias, and obstructive sleep apnea, each of which has a different management. Overnight ambulatory detection devices allow for a tolerable, low cost, objective assessment of sleep quality in the patient's natural environment. They can also be used as a notification system to allow for rapid recognition and prompt intervention of events like seizures. Optimal monitoring devices will be patient- and diagnosis-specific, but may include a combination of modalities such as ambulatory electroencephalograms, actigraphy, and pulse oximetry. We will summarize the current literature on ambulatory sleep devices for detecting sleep disorders in children with neurological diseases.

Sleep Disturbances, TBI and PTSD: Implications for Treatment and Recovery

PubMed Central

Gilbert, Karina Stavitsky; Kark, Sarah M.; Gehrman, Philip; Bogdanova, Yelena

2015-01-01

Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties. PMID:26164549

Brief Behavioral Sleep Intervention for Adolescents: An Effectiveness Study.

PubMed

Paavonen, E Juulia; Huurre, Taina; Tilli, Maija; Kiviruusu, Olli; Partonen, Timo

2016-01-01

Sleep disturbances are common among adolescents, but there are no brief interventions to treat them. The objective of this study was to evaluate the effectiveness of a brief semistructured, individually delivered sleep intervention to ameliorate adolescents' sleeping difficulties and lengthen sleep duration. All students aged 16-18 years in a high school were screened for sleeping difficulties and 36 students with the highest sleep problem scores were invited to the intervention. Postintervention improvements were observed on self-reported and actiwatch-registered sleep duration, self-reported sleep quality and sleep latency, perceived stress and anxiety (all p values < 0.001). However, objectively measured sleep efficiency and sleep latency did not change (p > 0.05). A brief individual sleep intervention can be effective in lengthening sleep duration and improving subjective sleep quality and well-being among adolescents.

Mental health, sleep quality, drinking motives, and alcohol-related consequences: a path-analytic model.

PubMed

Kenney, Shannon R; Lac, Andrew; Labrie, Joseph W; Hummer, Justin F; Pham, Andy

2013-11-01

Poor mental health, sleep problems, drinking motivations, and high-risk drinking are prevalent among college students. However, research designed to explicate the interrelationships among these health risk behaviors is lacking. This study was designed to assess the direct and indirect influences of poor mental health (a latent factor consisting of depression, anxiety, and stress) to alcohol use and alcohol-related consequences through the mediators of global sleep quality and drinking motives in a comprehensive model. Participants were 1,044 heavy-drinking college students (66.3% female) who completed online surveys. A hybrid structural equation model tested hypotheses involving relations leading from poor mental health to drinking motives and poorer global sleep quality to drinking outcomes. Results showed that poor mental health significantly predicted all four subscales of drinking motivations (social, coping, conformity, and enhancement) as well as poor sleep. Most of the drinking motives and poor sleep were found to explain alcohol use and negative alcohol consequences. Poor sleep predicted alcohol consequences, even after controlling for all other variables in the model. The hypothesized mediational pathways were examined with tests of indirect effects. This is the first study to assess concomitantly the relationships among three vital health-related domains (mental health, sleep behavior, and alcohol risk) in college students. Findings offer important implications for college personnel and interventionists interested in reducing alcohol risk by focusing on alleviating mental health problems and poor sleep quality.

[Non-face-to-face sleep improvement program in a workplace: bibliotherapy with and without behavioral self-control procedure].

PubMed

Adachi, Yoshiko; Kunitsuka, Kouko; Taniyama, Katsuko; Hayashi, Chikako; Tanaka, Minori; Sato, Chifumi

2010-01-01

Sleep hygiene education has been important health issue in the health promotion and the prevention of lifestyle-related diseases. A feasible and effective method is necessary for population approach. To evaluate the effects of a non-face-to-face brief behavioral program for a sleep improvement in workplaces. Research design was a cluster control trial. Three hundred and thirty participants were allocated to the bibliotherapy group (BTG; n=130) or self-control group (SCG; n=200). Two groups were recruited from separated local sections of a Japanese company each other. There was no eligibility criteria and the intervention was open to every worker in the workplaces. All participants received a self-help booklet and information on recent topics of insomnia-related health problems. SCG participants set several behaviors for habit improvement and monitored those behaviors for 4 wk additionally. The replies to the questionnaire showed that almost all of them had any sleep disturbances. A total of 158 participants in SCG (79%) and a total of 106 participants in BTG (82%) responded to the post questionnaire. Sleep parameters of pre and post questionnaires were compared between SCG and BTG. Overall, sleep onset latency was reduced and sleep efficiency was improved. The significant changes were found in only SCG. Re-analysis of pre and post 3-days' sleep diaries showed that the subjects in both group improved significantly in the main variables (total sleep time, number of awakenings, time spent awake, sleep efficiency). Sleep onset latency, wake after sleep onset, and daytime sleepiness improved significantly in only SCG. These results suggest that an additional target setting and self-monitoring could promote the effectiveness for sleep improvement of a bibliotherapy.

Cavities shield birds from effects of artificial light at night on sleep.

PubMed

Raap, Thomas; Pinxten, Rianne; Eens, Marcel

2018-05-20

Light pollution is an ever increasing worldwide problem disrupting animal behavior. Artificial light at night (ALAN) has been shown to affect sleep in wild birds. Even cavity-nesting bird species may be affected when sleeping inside their cavity. Correlational studies suggest that light from outside the cavity/nest box, for example from street lights, may affect sleep. We used an experimental design to study to what extent nest boxes shield animals from effects of ALAN on sleep. We recorded individual sleep behavior of free-living great tits (Parus major) that were roosting in dark nest boxes and exposed their nest box entrance to ALAN the following night (1.6 lux white LED light; a similar light intensity as was found at nest boxes near street lights). Their behavior was compared to that of control birds sleeping in dark nest boxes on both nights. Our experimental treatment did not affect sleep behavior. Sleep behavior of birds in the control group did not differ from that of individuals in the light treated group. Our results suggest that during winter cavities shield birds from some effects of ALAN. Furthermore, given that effects of ALAN and exposure to artificial light are species-, sex-, and season-dependent, it is important that studies using wild animals quantify individual exposure to light pollution, and be cautious in the interpretation and generalization of the effects, or lack thereof, from light pollution. Rigorous studies are necessary to examine individual light exposure and its consequences in cavity- and open-nesting birds. © 2018 Wiley Periodicals, Inc.

A comparison of complex sleep behaviors with two short-acting Z-hypnosedative drugs in nonpsychotic patients

PubMed Central

Chen, Li-Fen; Lin, Ching-En; Chou, Yu-Ching; Mao, Wei-Chung; Chen, Yi-Chyan; Tzeng, Nian-Sheng

2013-01-01

Objective Complex sleep behaviors (CSBs) are classified as “parasomnias” in the International Classifcation of Sleep Disorders, Second Edition (ICSD-2). To realize the potential danger after taking two short-acting Z-hypnosedative drugs, we estimated the incidence of CSBs in nonpsychotic patients in Taiwan. Methods Subjects (N = 1,220) using zolpidem or zopiclone were enrolled from the psychiatric outpatient clinics of a medical center in Taiwan over a 16-month period in 2006–2007. Subjects with zolpidem (N = 1,132) and subjects with zopiclone (N = 88) were analyzed. All subjects completed a questionnaire that included demographic data and complex sleep behaviors after taking hypnotics. Results Among zolpidem and zopiclone users, 3.28% of patients reported incidents of somnambulism or amnesic sleep-related behavior problems. The incidence of CSBs with zolpidem and zopiclone were 3.27%, and 3.41%, respectively, which was signifcantly lower than other studies in Taiwan. Conclusion These results serve as a reminder for clinicians to make inquiries regarding any unusual performance of parasomnic activities when prescribing zolpidem or zopiclone. PMID:23976857

Autism and sleep disorders.

PubMed

Devnani, Preeti A; Hegde, Anaita U

2015-01-01

"Autism Spectrum Disorders" (ASDs) are neurodevelopment disorders and are characterized by persistent impairments in reciprocal social interaction and communication. Sleep problems in ASD, are a prominent feature that have an impact on social interaction, day to day life, academic achievement, and have been correlated with increased maternal stress and parental sleep disruption. Polysomnography studies of ASD children showed most of their abnormalities related to rapid eye movement (REM) sleep which included decreased quantity, increased undifferentiated sleep, immature organization of eye movements into discrete bursts, decreased time in bed, total sleep time, REM sleep latency, and increased proportion of stage 1 sleep. Implementation of nonpharmacotherapeutic measures such as bedtime routines and sleep-wise approach is the mainstay of behavioral management. Treatment strategies along with limited regulated pharmacotherapy can help improve the quality of life in ASD children and have a beneficial impact on the family. PubMed search was performed for English language articles from January 1995 to January 2015. Following key words: Autism spectrum disorder, sleep disorders and autism, REM sleep and autism, cognitive behavioral therapy, sleep-wise approach, melatonin and ASD were used. Only articles reporting primary data relevant to the above questions were included.

Neural reactivations during sleep determine network credit assignment

PubMed Central

Gulati, Tanuj; Guo, Ling; Ramanathan, Dhakshin S.; Bodepudi, Anitha; Ganguly, Karunesh

2018-01-01

A fundamental goal of motor learning is to establish neural patterns that produce a desired behavioral outcome. It remains unclear how and when the nervous system solves this “credit–assignment” problem. Using neuroprosthetic learning where we could control the causal relationship between neurons and behavior, here we show that sleep–dependent processing is required for credit-assignment and the establishment of task-related functional connectivity reflecting the casual neuron-behavior relationship. Importantly, we found a strong link between the microstructure of sleep reactivations and credit assignment, with downscaling of non–causal activity. Strikingly, decoupling of spiking to slow–oscillations using optogenetic methods eliminated rescaling. Thus, our results suggest that coordinated firing during sleep plays an essential role in establishing sparse activation patterns that reflect the causal neuron–behavior relationship. PMID:28692062

Effects of Adenotonsillectomy on Neurocognitive Function in Pediatric Obstructive Sleep Apnea Syndrome

PubMed Central

Horiuchi, Fumie; Oka, Yasunori; Komori, Kenjiro; Tokui, Yasumasa; Matsumoto, Teruhisa; Ueno, Shu-ichi

2014-01-01

Obstructive sleep apnea syndrome (OSAS) in children does not only present with symptoms of sleep disturbances but also with associated symptoms such as growth failure, enuresis, academic learning difficulties, and behavioral problems, including attention deficit/hyperactivity disorder- (ADHD-) like symptoms. We evaluated neurocognitive functions before and after adenotonsillectomy in a patient with OSAS. An 11-year-old boy suspected of having ADHD with nocturnal enuresis was referred for evaluation. He was found to have adenotonsillar hypertrophy. Presence of snoring was evident only after detailed medical interview. Polysomnography confirmed the diagnosis of OSAS, which was subsequently treated by adenotonsillectomy. The apnea/hypopnea index decreased from 21.9 at baseline to 1.8 after surgery, and the frequency of enuresis fell from almost nightly to 2-3 times per month. Neurocognitive and behavioral assessment after the treatment of OSAS showed significant improvement in cognitive functions, especially attention capacity and considerable amelioration of behavioral problems including ADHD-like symptoms. As the most common cause of pediatric OSAS is adenotonsillar hypertrophy, medical interview and oropharyngeal examination should always be performed in children suspected of having ADHD. The necessity of sleep evaluation for children with ADHD-like symptoms was also emphasized. PMID:24971187

Cognitive Behavioral Treatment of Insomnia

PubMed Central

Williams, Jacob; Roth, Alicia; Vatthauer, Karlyn

2013-01-01

Chronic insomnia (symptoms for ≥6 months) is the most common sleep disorder, affecting 6% to 10% of adults in the general population, with even higher rates in patients with comorbid conditions (eg, hypertension, 44%; cardiac disease, 44.1%; breathing problems, 41.5%). Traditionally, chronic insomnia occurring with another condition has been considered secondary and rarely received direct treatment because treatment of the primary condition was expected to improve the insomnia. However, this approach often failed because chronic insomnia is maintained by behaviors, cognitions, and associations that patients adopt as they attempt to cope with poor sleep but that end up backfiring (eg, increasing caffeine, spending more time in bed, trying harder to sleep). Cognitive behavioral treatment of insomnia (CBTi) targets those behaviors, cognitions, and associations and is effective across a variety of populations, including those with medical and psychologic comorbidities. Thus, in 2005, a National Institutes of Health expert consensus panel on chronic insomnia recommended dropping the term ”secondary insomnia” in favor of the term ”comorbid insomnia.” Because CBTi does not carry the risks associated with some sleep medications (eg, dependency, polypharmacy, cognitive and psychomotor impairment), it is an attractive option for patients with other conditions. Through the Society of Behavioral Sleep Medicine (www.behavioralsleep.org) and the American Board of Sleep Medicine (www.absm.org), it is possible to find practitioners with expertise in CBTi (as well as other aspects of behavioral sleep medicine) and other behavioral sleep resources. Given the currently limited number of trained practitioners, exploration of alternative delivery methods (eg, briefer protocols, self-help, Internet) to improve access to this highly effective treatment and expanded training in these treatments are warranted. PMID:23381322

Quality of life in adolescents and adults with CHARGE syndrome.

PubMed

Hartshorne, Nancy; Hudson, Alexandra; MacCuspie, Jillian; Kennert, Benjamin; Nacarato, Tasha; Hartshorne, Timothy; Blake, Kim

2016-08-01

Health-related Quality of Life and the Impact of Childhood Neurologic Disability Scale were collected for 53 patients with CHARGE syndrome aged 13-39 years with a mean academic level of 4th grade. The most prevalent new and ongoing issues included bone health issues, sleep apnea, retinal detachment, anxiety, and aggression. Sleep issues were significantly correlated with anxiety, self-abuse, conduct problems, and autistic-like behaviors. Problems with overall health, behavior, and balance most affected the number of social activities in the individual's life. Sensory impairment most affected relationships with friends. Two contrasting case studies are presented and demonstrate that the quality of life exists on a broad spectrum in CHARGE syndrome, just as its physical features range from mild to very severe. A multitude of factors, including those beyond the physical manifestations, such as anxiety and sleep problems, influence quality of life and are important areas for intervention. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Correlates of suicide ideation and attempts in children and adolescents with eating disorders.

PubMed

Mayes, Susan Dickerson; Fernandez-Mendoza, Julio; Baweja, Raman; Calhoun, Susan; Mahr, Fauzia; Aggarwal, Richa; Arnold, Mariah

2014-01-01

This is the first study determining correlates of suicide behavior in children with eating disorders using multiple sleep, psychological, and demographic variables. Mothers rated suicide ideation and attempts in 90 children ages 7-18 with bulimia nervosa or anorexia nervosa. Suicide ideation was more prevalent in children with bulimia nervosa (43%) than children with anorexia nervosa (20%). All children with bulimia nervosa who experienced ideation attempted suicide, whereas only 3% of children with anorexia nervosa attempted suicide. Correlates of ideation were externalizing behavior problems and sleep disturbances. Correlates of attempts were bulimia nervosa, self-induced vomiting, nightmares, and physical or sexual abuse. These problems should be assessed and targeted for intervention because of their association with suicide behavior.

A Sleep Questionnaire for Children with Severe Psychomotor Impairment (SNAKE)-Concordance with a Global Rating of Sleep Quality.

PubMed

Dreier, Larissa Alice; Zernikow, Boris; Blankenburg, Markus; Wager, Julia

2018-02-01

Sleep problems are a common and serious issue in children with life-limiting conditions (LLCs) and severe psychomotor impairment (SPMI). The "Sleep Questionnaire for Children with Severe Psychomotor Impairment" (Schlaffragebogen für Kinder mit Neurologischen und Anderen Komplexen Erkrankungen, SNAKE) was developed for this unique patient group. In a proxy rating, the SNAKE assesses five different dimensions of sleep(-associated) problems (disturbances going to sleep, disturbances remaining asleep, arousal and breathing disorders, daytime sleepiness, and daytime behavior disorders). It has been tested with respect to construct validity and some aspects of criterion validity. The present study examined whether the five SNAKE scales are consistent with parents' or other caregivers' global ratings of a child's sleep quality. Data from a comprehensive dataset of children and adolescents with LLCs and SPMI were analyzed through correlation coefficients and Mann-Whitney U testing. The results confirmed the consistency of both sources of information. The highest levels of agreements with the global rating were achieved for disturbances in terms of going to sleep and disturbances with respect to remaining asleep. The results demonstrate that the scales and therefore the SNAKE itself is well-suited for gathering information on different sleep(-associated) problems in this vulnerable population.

Zolpidem Overdose: A Dilemma in Mental Health.

PubMed

Jung, Minsoo

Sleeping pills are one of the most common drugs taken by adults when afflicted by insomnia. Adverse effects of pharmacotherapy, however, should not be overlooked, and monitoring is needed to check for an overdose of sleeping pills. We reviewed zolpidem overdose and patient suicide with benefits and disadvantages of pharmacotherapy. Cases of adverse effects concerning the central nervous system, including delirium and hallucination, as well as abnormal behavior during sleep, are commonly reported among patients who have taken zolpidem for more than 1 year. The serious problem of long-term prescription to medication can lead to a higher mortality rate of insomniac patients. An alternative to medication for treating insomnia is cognitive behavioral therapy, which can improve sleeping habits. Cognitive behavioral therapy induces patients to recognize and change the negative thoughts that affect their sleep. Medical providers should be aware of the adverse effects of sleep inducers and provide sufficient information to their patients about them. When establishing treatment plans, they should encourage patients to make the proper decisions and try to reduce the adverse effects of any medication as much as possible.

Circadian Rhythm and Sleep Disruption: Causes, Metabolic Consequences, and Countermeasures.

PubMed

Potter, Gregory D M; Skene, Debra J; Arendt, Josephine; Cade, Janet E; Grant, Peter J; Hardie, Laura J

2016-12-01

Circadian (∼24-hour) timing systems pervade all kingdoms of life and temporally optimize behavior and physiology in humans. Relatively recent changes to our environments, such as the introduction of artificial lighting, can disorganize the circadian system, from the level of the molecular clocks that regulate the timing of cellular activities to the level of synchronization between our daily cycles of behavior and the solar day. Sleep/wake cycles are intertwined with the circadian system, and global trends indicate that these, too, are increasingly subject to disruption. A large proportion of the world's population is at increased risk of environmentally driven circadian rhythm and sleep disruption, and a minority of individuals are also genetically predisposed to circadian misalignment and sleep disorders. The consequences of disruption to the circadian system and sleep are profound and include myriad metabolic ramifications, some of which may be compounded by adverse effects on dietary choices. If not addressed, the deleterious effects of such disruption will continue to cause widespread health problems; therefore, implementation of the numerous behavioral and pharmaceutical interventions that can help restore circadian system alignment and enhance sleep will be important.

Sleep instability and cognitive status in drug-resistant epilepsies.

PubMed

Pereira, Alessandra Marques; Bruni, Oliviero; Ferri, Raffaele; Nunes, Magda Lahorgue

2012-05-01

The aims of this study were to evaluate the sleep habits of children with drug resistant epilepsy and to correlate sleep abnormalities with epilepsy and level of intelligence. Twenty five subjects with drug resistant epilepsy (14 males, age range 2-16.4 years) were recruited for this study. A control group was formed by 23 normal children. Two instruments to assess sleep habits were administered to the patients with epilepsy: a questionnaire on sleep habits (to preschool children) and a questionnaire on sleep behavior (for children aged more than seven years old); a cognitive test (Wechsler Intelligence Scale for Children-WISC) was also performed. Patients underwent a complete polysomnographic study and sleep parameters, including CAP, were analyzed and correlated according to cognitive-behavioral measures in children with epilepsy. Children with drug-resistant epilepsy and severe mental retardation showed sleep abnormalities such as low sleep efficiency, high percentage of wakefulness after sleep onset, reduced slow wave sleep, and reduced REM sleep. Sleep microstructure evaluated by means of CAP analysis showed a decrease in A1 index during N3 in patients with more severe cognitive impairment. Children with epilepsy and cognitive impairment (n=10) had higher Sleep Behavior Questionnaire for Children (SBQC) total scores (65.60 ± 18.56) compared to children with epilepsy and normal IQ (50.00 ± 10.40), p<0.05. Children with drug-resistant epilepsy have a greater incidence of sleep problems regarding qualitative aspects, macrostructure, and CAP. The decrease of CAP rate and of A1, mainly during slow wave sleep (associated to REM sleep reduction), might represent a sleep microstructural pattern of intellectual disability. Copyright © 2012 Elsevier B.V. All rights reserved.

Poor sleep quality and nightmares are associated with non-suicidal self-injury in adolescents.

PubMed

Liu, Xianchen; Chen, Hua; Bo, Qi-Gui; Fan, Fang; Jia, Cun-Xian

2017-03-01

Non-suicidal self-injury (NSSI) is prevalent and is associated with increased risk of suicidal behavior in adolescents. This study examined which sleep variables are associated with NSSI, independently from demographics and mental health problems in Chinese adolescents. Participants consisted of 2090 students sampled from three high schools in Shandong, China and had a mean age of 15.49 years. Participants completed a sleep and health questionnaire to report their demographic and family information, sleep duration and sleep problems, impulsiveness, hopelessness, internalizing and externalizing problems, and NSSI. A series of regression analyses were conducted to examine the associations between sleep variables and NSSI. Of the sample, 12.6 % reported having ever engaged in NSSI and 8.8 % engaged during the last year. Univariate logistic analyses demonstrated that multiple sleep variables including short sleep duration, insomnia symptoms, poor sleep quality, sleep insufficiency, unrefreshed sleep, sleep dissatisfaction, daytime sleepiness, fatigue, snoring, and nightmares were associated with increased risk of NSSI. After adjusting for demographic and mental health variables, NSSI was significantly associated with sleeping <6 h per night, poor sleep quality, sleep dissatisfaction, daytime sleepiness, and frequent nightmares. Stepwise logistic regression model demonstrated that poor sleep quality (OR = 2.18, 95 % CI = 1.37-3.47) and frequent nightmares (OR = 2.88, 95 % CI = 1.45-5.70) were significantly independently associated with NSSI. In conclusion, while multiple sleep variables are associated with NSSI, poor sleep quality and frequent nightmares are independent risk factors of NSSI. These findings may have important implications for further research of sleep self-harm mechanisms and early detection and prevention of NSSI in adolescents.

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: a Review of the Literature

PubMed Central

Chapman, Daniel P.; Croft, Janet B.

2015-01-01

BACKGROUND Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students’ academic performance, reduce engagement in risk behaviors, and improve health. METHODS This paper reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. RESULTS Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. CONCLUSIONS Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. PMID:27040474

Associations of cytokines, sleep patterns, and neurocognitive function in youth with HIV infection.

PubMed

Foster, Samuel B; Lu, Ming; Glaze, Daniel G; Reuben, James M; Harris, Lynnette L; Cohen, Evan N; Lee, Bang-Ning; Zhao, Enxu; Paul, Mary E; Schwarzwald, Heidi; McMullen-Jackson, Chivon; Clark, Charla; Armstrong, F Daniel; Brouwers, Pim Y; Miller, Tracie L; Colin, Andrew A; Scott, Gwendolyn B; Shahzeidi, Shahriar; Willen, Elizabeth J; Asthana, Deshratn; Lipshultz, Steven E; Thompson, Bruce W; Shearer, William T

2012-07-01

Youth infected with HIV at birth often have sleep disturbances, neurocognitive deficits, and abnormal psychosocial function which are associated with and possibly resulted from elevated blood cytokine levels that may lead to a decreased quality of life. To identify molecular pathways that might be associated with these disorders, we evaluated 38 HIV-infected and 35 uninfected subjects over 18-months for intracellular cytokine levels, sleep patterns and duration of sleep, and neurodevelopmental abilities. HIV infection was significantly associated with alterations of intracellular pro-inflammatory cytokines (TNF-α, IFN-γ, IL-12), sleep factors (total time asleep and daytime sleep patterns), and neurocognitive factors (parent and patient reported problems with socio-emotional, behavioral, and executive functions; working memory-mental fatigue; verbal memory; and sustained concentration and vigilance. By better defining the relationships between HIV infection, sleep disturbances, and poor psychosocial behavior and neurocognition, it may be possible to provide targeted pharmacologic and procedural interventions to improve these debilitating conditions. Copyright © 2012 Elsevier Inc. All rights reserved.

Associations of Cytokines, Sleep Patterns, and Neurocognitive Function in Youth with HIV Infection

PubMed Central

Foster, Samuel B.; Lu, Ming; Glaze, Daniel G.; Reuben, James M; Harris, Lynnette L.; Cohen, Evan N.; Lee, Bang-Ning; Zhao, Enxu; Paul, Mary E.; Schwarzwald, Heidi; McMullen-Jackson, Chivon; Clark, Charla; Armstrong, F. Daniel; Brouwers, Pim Y.; Miller, Tracie L.; Colin, Andrew A.; Scott, Gwendolyn B.; Shahzeidi, Shahriar; Willen, Elizabeth J.; Asthana, Deshratn; Lipshultz, Steven E.; Thompson, Bruce; Shearer, William T.

2012-01-01

Youth infected with HIV at birth often have sleep disturbances, neurocognitive deficits, and abnormal psychosocial function which are associated with and possibly resulted from elevated blood cytokine levels that may lead to a decreased quality of life. To identify molecular pathways that might be associated with these disorders, we evaluated 38 HIV-infected and 35 uninfected subjects over 18-months for intracellular cytokine levels, sleep patterns and duration of sleep, and neurodevelopmental abilities. HIV infection was significantly associated with alterations of intracellular pro-inflammatory cytokines (TNF-α, IFN-γ, IL-12), sleep factors (total time asleep and daytime sleep patterns), and neurocognitive factors (parent and patient reported problems with socio-emotional, behavioral, and executive functions; working memory-mental fatigue; verbal memory; and sustained concentration and vigilance. By better defining the relationships between HIV infection, sleep disturbances, and poor psychosocial behavior and neurocognition, it may be possible to provide targeted pharmacologic and procedural interventions to improve these debilitating conditions. PMID:22659030

Sleep problems and sickness absence among middle-aged employees.

PubMed

Rahkonen, Ossi; Lallukka, Tea; Kronholm, Erkki; Vahtera, Jussi; Lahelma, Eero; Laaksonen, Mikko

2012-01-01

The aim of this study was to examine whether sleep problems predict subsequent sickness absence among middle-aged public sector employees. The data included 5391 female and 1454 male employees of the City of Helsinki from questionnaire surveys at baseline in 2000-2002. These data were prospectively linked to the employer's sickness absence register data, with a mean follow-up time of 4.1 years. Using Poisson regression analysis, we examined associations between sleep problems (none, rare, occasional, and frequent), as indicated by the Jenkins Sleep Questionnaire, and self-certified short (1-3 days) and medically confirmed intermediate (4-14 days) and long (≥15 days) sickness absence spells. Sociodemographic factors, working conditions, work-family interface, health behaviors, and health status were obtained from the baseline surveys. At baseline, 21% of women and 17% of men reported frequent sleep problems. Frequent sleep problems were associated with subsequent sickness absence spells irrespective of length of absence among both women and men after adjusting for age. After full adjustment for all covariates, the associations attenuated but remained for self-certified sickness absence [risk ratio (RR) for women 1.40, 95% confidence interval (95% CI) 1.25-1.56 and RR 1.59, 95% CI 1.24-2.03 for men], and medically confirmed intermediate (RR 1.34, 95% CI 1.17-1.52 and RR 1.35, 95% CI 1.02-1.77, for women and men, respectively) and long (RR 1.58, 95% CI 1.29-1.94 and RR 1.44, 95% CI 0.93-2.21, for women and men, respectively) sickness absence spells. Occasional sleep problems were also associated with sickness absence, but the associations were somewhat weaker. In occupational healthcare, sleep problems should be addressed to prevent their occurrence and subsequent ill-health and sickness absence.

Preschoolers’ Genetic, Physiological, and Behavioral Sensitivity Factors Moderate Links Between Parenting Stress and Child Internalizing, Externalizing, and Sleep Problems

PubMed Central

Davis, Molly; Thomassin, Kristel; Bilms, Joanie; Suveg, Cynthia; Shaffer, Anne; Beach, Steven R. H.

2017-01-01

This study examined three potential moderators of the relations between maternal parenting stress and preschoolers’ adjustment problems: a genetic polymorphism - the short allele of the serotonin transporter (5-HTTLPR, ss/sl allele) gene, a physiological indicator - children’s baseline respiratory sinus arrhythmia (RSA), and a behavioral indicator - mothers’ reports of children’s negative emotionality. A total of 108 mothers (Mage = 30.68 years, SDage = 6.06) reported on their parenting stress as well as their preschoolers’ (Mage = 3.50 years, SDage = .51, 61% boys) negative emotionality and internalizing, externalizing, and sleep problems. Results indicated that the genetic sensitivity variable functioned according to a differential susceptibility model; however, the results involving physiological and behavioral sensitivity factors were most consistent with a diathesis-stress framework. Implications for prevention and intervention efforts to counter the effects of parenting stress are discussed. PMID:28295263

Parent-Reported Behavioral and Psychiatric Problems Mediate the Relationship between Sleep-Disordered Breathing and Cognitive Deficits in School-Aged Children.

PubMed

Smith, Dale L; Gozal, David; Hunter, Scott J; Kheirandish-Gozal, Leila

2017-01-01

Numerous studies over the past several decades have illustrated that children who suffer from sleep-disordered breathing (SDB) are at greater risk for cognitive, behavioral, and psychiatric problems. Although behavioral problems have been proposed as a potential mediator between SDB and cognitive functioning, these relationships have not been critically examined. This analysis is based on a community-based cohort of 1,115 children who underwent overnight polysomnography, and cognitive and behavioral phenotyping. Structural model of the relationships between SDB, behavior, and cognition, and two recently developed mediation approaches based on propensity score weighting and resampling were used to assess the mediational role of parent-reported behavior and psychiatric problems in the relationship between SDB and cognitive functioning. Multiple models utilizing two different SDB definitions further explored direct effects of SDB on cognition as well as indirect effects through behavioral pathology. All models were adjusted for age, sex, race, BMI z -score, and asthma status. Indirect effects of SDB through behavior problems were significant in all mediation models, while direct effects of SDB on cognition were not. The findings were consistent across different mediation procedures and remained essentially unaltered when different criteria for SDB, behavior, and cognition were used. Potential effects of SDB on cognitive functioning appear to occur through behavioral problems that are detectable in this pediatric population. Thus, early attentional or behavioral pathology may be implicated in the cognitive functioning deficits associated with SDB, and may present an early morbidity-related susceptibility biomarker.

Media Use and Child Sleep: The Impact of Content, Timing, and Environment

PubMed Central

Liekweg, Kimberly; Christakis, Dimitri A.

2011-01-01

BACKGROUND: Media use has been shown to negatively affect a child's sleep, especially in the context of evening use or with a television in the child's bedroom. However, little is known about how content choices and adult co-use affect this relationship. OBJECTIVE: To describe the impact of media content, timing, and use behaviors on child sleep. METHODS: These data were collected in the baseline survey and media diary of a randomized controlled trial on media use in children aged 3 to 5 years. Sleep measures were derived from the Children's Sleep Habits Questionnaire. Media diaries captured time, content title, and co-use of television, video-game, and computer usage; titles were coded for ratings, violence, scariness, and pacing. Nested linear regression models were built to examine the impact of timing, content, and co-use on the sleep problem score. RESULTS: On average, children consumed 72.9 minutes of media screen time daily, with 14.1 minutes occurring after 7:00 pm. Eighteen percent of parents reported at least 1 sleep problem; children with a bedroom television consumed more media and were more likely to have a sleep problem. In regression models, each additional hour of evening media use was associated with a significant increase in the sleep problem score (0.743 [95% confidence interval: 0.373–1.114]), as was daytime use with violent content (0.398 [95% confidence interval: 0.121–0.676]). There was a trend toward greater impact of daytime violent use in the context of a bedroom television (P = .098) and in low-income children (P = .07). CONCLUSIONS: Violent content and evening media use were associated with increased sleep problems. However, no such effects were observed with nonviolent daytime media use. PMID:21708803

Media use and child sleep: the impact of content, timing, and environment.

PubMed

Garrison, Michelle M; Liekweg, Kimberly; Christakis, Dimitri A

2011-07-01

Media use has been shown to negatively affect a child's sleep, especially in the context of evening use or with a television in the child's bedroom. However, little is known about how content choices and adult co-use affect this relationship. To describe the impact of media content, timing, and use behaviors on child sleep. These data were collected in the baseline survey and media diary of a randomized controlled trial on media use in children aged 3 to 5 years. Sleep measures were derived from the Children's Sleep Habits Questionnaire. Media diaries captured time, content title, and co-use of television, video-game, and computer usage; titles were coded for ratings, violence, scariness, and pacing. Nested linear regression models were built to examine the impact of timing, content, and co-use on the sleep problem score. On average, children consumed 72.9 minutes of media screen time daily, with 14.1 minutes occurring after 7:00 pm. Eighteen percent of parents reported at least 1 sleep problem; children with a bedroom television consumed more media and were more likely to have a sleep problem. In regression models, each additional hour of evening media use was associated with a significant increase in the sleep problem score (0.743 [95% confidence interval: 0.373-1.114]), as was daytime use with violent content (0.398 [95% confidence interval: 0.121-0.676]). There was a trend toward greater impact of daytime violent use in the context of a bedroom television (P=.098) and in low-income children (P=.07). Violent content and evening media use were associated with increased sleep problems. However, no such effects were observed with nonviolent daytime media use. Copyright © 2011 by the American Academy of Pediatrics.

Sleep Characteristics and Daytime Cortisol Levels in Older Adults.

PubMed

Morgan, Ethan; Schumm, L Philip; McClintock, Martha; Waite, Linda; Lauderdale, Diane S

2017-05-01

Older adults frequently report sleep problems and are at increased risk of cardiometabolic disruption. Experimental sleep restriction of younger adults has suggested that cortisol may be on the pathway between sleep restriction and cardiometabolic disease. We investigated whether the natural variation in sleep among older adults is associated with daytime cortisol level. Salivary cortisol samples and actigraphy sleep data were collected from a random subsample of participants in the National Social Life, Health and Aging Project, a nationally representative probability sample of adults aged 62-90 (N = 672). Salivary cortisol was measured with 3 timed samples at the beginning, middle, and end of a 2-hr in-home interview. Sleep characteristics were derived from wrist actigraphy (fragmentation, wake after sleep onset [WASO], and duration) and from survey responses about usual sleep duration and sleep problems. For each individual, a single summary daytime cortisol level was estimated by fitting a marginal longitudinal model for the 3 time-stamped cortisol samples. The resulting estimates were then regressed on each sleep measure, adjusting for sociodemographics, health behaviors, and comorbidities. From actigraphy, both higher fragmentation score (β = 0.02; 95% confidence interval [CI] = 0.00 to 0.03) and longer WASO (β = 0.27; 95% CI = 0.04 to 0.51) were significantly associated with higher daytime cortisol; sleep duration was not. Self-reported sleep duration and sleep problems were also not associated with cortisol. Actigraph measures of sleep disturbance are associated with higher daytime cortisol among older adults. However, cross-sectional data cannot distinguish causal direction or whether cortisol and sleep disruption have a common cause. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

The Origins of Mental Toughness – Prosocial Behavior and Low Internalizing and Externalizing Problems at Age 5 Predict Higher Mental Toughness Scores at Age 14

PubMed Central

Sadeghi Bahmani, Dena; Hatzinger, Martin; Gerber, Markus; Lemola, Sakari; Clough, Peter J.; Perren, Sonja; von Klitzing, Kay; von Wyl, Agnes; Holsboer-Trachsler, Edith; Brand, Serge

2016-01-01

Background: The concept of mental toughness (MT) has gained increasing importance among groups other than elite athletes by virtue of its psychological importance and explanatory power for a broad range of health-related behaviors. However, no study has focused so far on the psychological origins of MT. Therefore, the aims of the present study were: to explore, to what extent the psychological profiles of preschoolers aged five were associated with both (1) MT scores and (2) sleep disturbances at age 14, and 3) to explore possible gender differences. Method: Nine years after their first assessment at age five (preschoolers), a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females) took part in this follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ), covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, MT, and sleep disturbances. Results: Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, were associated with self-reported higher MT and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbances. Conclusion: The pattern of results suggests that MT traits during adolescence may have their origins in the pre-school years. PMID:27605919

Zolpidem-induced amnesia and somnambulism: rare occurrences?

PubMed

Tsai, Jui-Hsiu; Yang, Pinchen; Chen, Cheng-Chung; Chung, Weilum; Tang, Tze-Chun; Wang, Shing-Yaw; Liu, Jong-Kang

2009-01-01

Zolpidem, a non-benzodiazepine hypnotic of the imidazopyridine class, is very effective in treating insomnia with previous claims of little adverse effects. However, zolpidem-induced somnambulism and amnesic sleep-related behavioral problems were begun to be reported in literature but no systemic investigation has been undertaken in non-Western cultures. In our current retrospective survey, 5.1% (13 out of 255) of Taiwanese patients reported change in sleep-related behavior as adverse effects. This serves as a reminder for clinicians to inquire regarding any unusual behavior of parasomniac activities when prescribing zolpidem.

Adolescent Sleepiness: Causes and Consequences.

PubMed

Hansen, Shana L; Capener, Dale; Daly, Christopher

2017-09-01

Insufficient sleep duration and poor sleep quality are common among adolescents. The multidimensional causes of insufficient sleep duration and poor sleep quality include biological, health-related, environmental, and lifestyle factors. The most common direct consequence of insufficient and/or poor sleep quality is excessive daytime sleepiness, which may contribute to poor academic performance, behavioral health problems, substance use, and drowsy driving. Evaluation of sleepiness includes a detailed sleep history and sleep diary, with polysomnography only required for the assessment of specific sleep disorders. Management involves encouraging healthy sleep practices such as having consistent bed and wake times, limiting caffeine and electronics at night before bed, and eliminating napping, in addition to treating any existing sleep or medical disorders. [Pediatr Ann. 2017;46(9):e340-e344.]. Copyright 2017, SLACK Incorporated.

Sleep Environments of Children in an Urban U.S. Setting Exposed to Interpersonal Violence.

PubMed

Spilsbury, James C; Frame, Jennifer; Magtanong, Ruth; Rork, Kristine

2016-01-01

This study investigated how violence influences children's sleep environments. Sixty-five children ages 8-16 years and a parent or guardian were recruited from agencies serving families experiencing violence. At baseline (5 weeks post-violent event), 6 months, and 12 months postbaseline, study staff collected sleep-behavior information and conducted systematic, qualitative assessments of sleep environments. Child sleep problems were generally frequent and persistent. However, 9 children reported improved sleep after the violent event, mainly because perpetrators were no longer present. Sleeping environments were dynamic via changes in location and modifications to improve safety and sleep. Incongruence between children's and parents' perceptions of environmental characteristics influencing sleep was common. Families' motivation to improve children's sleep represents a foundation to build upon when working with families victimized by violence.

Specific Medical Conditions Are Associated with Unique Behavioral Profiles in Autism Spectrum Disorders.

PubMed

Zachor, Ditza A; Ben-Itzchak, Esther

2016-01-01

Autism spectrum disorder (ASD) is a heterogeneous group of disorders which occurs with numerous medical conditions. In previous research, subtyping in ASD has been based mostly on cognitive ability and ASD symptom severity. The aim of the current study was to investigate whether specific medical conditions in ASD are associated with unique behavioral profiles. The medical conditions included in the study were macrocephaly, microcephaly, developmental regression, food selectivity, and sleep problems. The behavioral profile was composed of cognitive ability, adaptive skills, and autism severity, and was examined in each of the aforementioned medical conditions. The study population included 1224 participants, 1043 males and 181 females (M:F ratio = 5.8:1) with a mean age of 49.9 m (SD = 29.4) diagnosed with ASD using standardized tests. Groups with and without the specific medical conditions were compared on the behavioral measures. Developmental regression was present in 19% of the population and showed a more severe clinical presentation, with lower cognitive abilities, more severe ASD symptoms, and more impaired adaptive functioning. Microcephaly was observed in 6.3% of the population and was characterized by a lower cognitive ability and more impaired adaptive functioning in comparison to the normative head circumference (HC) group. Severe food selectivity was found in 9.8% and severe sleep problems in 5.1% of the ASD population. The food selectivity and sleep problem subgroups, both showed more severe autism symptoms only as described by the parents, but not per the professional assessment, and more impaired adaptive skills. Macrocephaly was observed in 7.9% of the ASD population and did not differ from the normative HC group in any of the examined behavioral measures. Based on these findings, two unique medical-behavioral subtypes in ASD that affect inherited traits of cognition and/or autism severity were suggested. The microcephaly phenotype occurred with more impaired cognition and the developmental regression phenotype with widespread, more severe impairments in cognition and autism severity. In contrast, severe food selectivity and sleep problems represent only comorbidities to ASD that affect functioning. Defining specific subgroups in ASD with a unique biological signature and specific behavioral phenotypes may help future genetic and neuroscience research.

Associations Between Sleep Duration Patterns and Behavioral/Cognitive Functioning at School Entry

PubMed Central

Touchette, Évelyne; Petit, Dominique; Séguin, Jean R.; Boivin, Michel; Tremblay, Richard E.; Montplaisir, Jacques Y.

2007-01-01

Objective: The aim of the study was to investigate the associations between longitudinal sleep duration patterns and behavioral/cognitive functioning at school entry. Design, Setting, and Participants: Hyperactivity-impulsivity (HI), inattention, and daytime sleepiness scores were measured by questionnaire at 6 years of age in a sample of births from 1997 to 1998 in a Canadian province (N=1492). The Peabody Picture Vocabulary Test - Revised (PPVT-R) was administered at 5 years of age and the Block Design subtest (WISC-III) was administered at 6 years of age. Sleep duration was reported yearly by the children's mothers from age 2.5 to 6 years. A group-based semiparametric mixture model was used to estimate developmental patterns of sleep duration. The relationships between sleep duration patterns and both behavioral items and neurodevelopmental tasks were tested using weighted multivariate logistic regression models to control for potentially confounding psychosocial factors. Results: Four sleep duration patterns were identified: short persistent (6.0%), short increasing (4.8%),10-hour persistent (50.3%), and 11-hour persistent (38.9%). The association of short sleep duration patterns with high HI scores (P=0.001), low PPVT-R performance (P=0.002), and low Block Design subtest performance (P=0.004) remained significant after adjusting for potentially confounding variables. Conclusions: Shortened sleep duration, especially before the age of 41 months, is associated with externalizing problems such as HI and lower cognitive performance on neurodevelopmental tests. Results highlight the importance of giving a child the opportunity to sleep at least 10 hours per night throughout early childhood. Citation: Touchette E; Petit D; Séguin JR; Boivin M; Tremblay RE; Montplaisir JY. Associations between sleep duration patterns and behavioral/cognitive functioning at school entry. SLEEP 2007;30(9):1213-1219. PMID:17910393

Insufficient sleep syndrome: An unrecognized but important clinical entity.

PubMed

Kohyama, Jun; Anzai, Yuki; Ono, Makoto; Kishino, Ai; Tamanuki, Keita; Takada, Kazuma; Inoue, Kento; Horiuchi, Maho; Hatai, Yoshiho

2018-04-01

A sleep clinic for adults and children was established in the Tokyo Bay Urayasu Ichikawa Medical Centre, in August 2012. Given that few sleep clinics are available in Japan specifically for children, this clinic provides the opportunity to provide data on child patients with sleep problems. Records of patients who visited the sleep clinic at the Tokyo Bay Urayasu Ichikawa Medical Centre aged ≤20 years at the first visit were retrospectively examined, along with the initial and final diagnoses. Of 2,157 patients who visited the sleep clinic at Tokyo Bay Urayasu Ichikawa Medical Centre between August 2012 and March 2017, 181 were ≤20 years old. In these 181 patients, the most frequent final diagnosis was insufficient sleep syndrome (ISS), n = 56, followed by circadian rhythm sleep-wake disorder, n = 28; insomnia, n = 28; and sleep-related movement disorder, n = 15. Insufficient sleep produces various brain dysfunctions in both adults and children, and is associated with behavioral, cognitive and physical problems, as well as with atypical early development. Insufficient sleep has also been reported to cause obesity. Insufficient sleep-induced obesity is often associated with the occurrence of metabolic syndrome. More effort is needed to ensure that children are receiving sufficient sleep. © 2018 Japan Pediatric Society.

Weighted blankets and sleep in autistic children--a randomized controlled trial.

PubMed

Gringras, Paul; Green, Dido; Wright, Barry; Rush, Carla; Sparrowhawk, Masako; Pratt, Karen; Allgar, Victoria; Hooke, Naomi; Moore, Danielle; Zaiwalla, Zenobia; Wiggs, Luci

2014-08-01

To assess the effectiveness of a weighted-blanket intervention in treating severe sleep problems in children with autism spectrum disorder (ASD). This phase III trial was a randomized, placebo-controlled crossover design. Participants were aged between 5 years and 16 years 10 months, with a confirmed ASD diagnosis and severe sleep problems, refractory to community-based interventions. The interventions were either a commercially available weighted blanket or otherwise identical usual weight blanket (control), introduced at bedtime; each was used for a 2-week period before crossover to the other blanket. Primary outcome was total sleep time (TST) recorded by actigraphy over each 2-week period. Secondary outcomes included actigraphically recorded sleep-onset latency, sleep efficiency, assessments of child behavior, family functioning, and adverse events. Sleep was also measured by using parent-report diaries. Seventy-three children were randomized and analysis conducted on 67 children who completed the study. Using objective measures, the weighted blanket, compared with the control blanket, did not increase TST as measured by actigraphy and adjusted for baseline TST. There were no group differences in any other objective or subjective measure of sleep, including behavioral outcomes. On subjective preference measures, parents and children favored the weighted blanket. The use of a weighted blanket did not help children with ASD sleep for a longer period of time, fall asleep significantly faster, or wake less often. However, the weighted blanket was favored by children and parents, and blankets were well tolerated over this period. Copyright © 2014 by the American Academy of Pediatrics.

Hours of sleep in adolescents and its association with anxiety, emotional concerns, and suicidal ideation.

PubMed

Sarchiapone, Marco; Mandelli, Laura; Carli, Vladimir; Iosue, Miriam; Wasserman, Camilla; Hadlaczky, Gergö; Hoven, Christina W; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Haring, Christian; Kaess, Michael; Keeley, Helen; Keresztény, Agnes; Kahn, Jean-Pierre; Postuvan, Vita; Mars, Urša; Saiz, Pilar A; Varnik, Peter; Sisask, Merike; Wasserman, Danuta

2014-02-01

Anxiety and concerns in daily life may result in sleep problems and consistent evidence suggests that inadequate sleep has several negative consequences on cognitive performance, physical activity, and health. The aim of our study was to evaluate the association between mean hours of sleep per night, psychologic distress, and behavioral concerns. A cross-sectional analysis of the correlation between the number of hours of sleep per night and the Zung Self-rating Anxiety Scale (Z-SAS), the Paykel Suicidal Scale (PSS), and the Strengths and Difficulties Questionnaire (SDQ), was performed on 11,788 pupils (mean age±standard deviation [SD], 14.9±0.9; 55.8% girls) from 11 different European countries enrolled in the SEYLE (Saving and Empowering Young Lives in Europe) project. The mean number of reported hours of sleep per night during school days was 7.7 (SD, ±1.3), with moderate differences across countries (r=0.06; P<.001). A reduced number of sleeping hours (less than the average) was more common in girls (β=0.10 controlling for age) and older pupils (β=0.10 controlling for sex). Reduced sleep was found to be associated with increased scores on SDQ subscales of emotional (β=-0.13) and peer-related problems (β=-0.06), conduct (β=-0.07), total SDQ score (β=-0.07), anxiety (Z-SAS scores, β=-10), and suicidal ideation (PSS, β=-0.16). In a multivariate model including all significant variables, older age, emotional and peer-related problems, and suicidal ideation were the variables most strongly associated with reduced sleep hours, though female gender, conduct problems measured by the SDQ, and anxiety only showed modest effects (β=0.03-0.04). Our study supports evidence that reduced hours of sleep are associated with potentially severe mental health problems in adolescents. Because sleep problems are common among adolescents partly due to maturational processes and changes in sleep patterns, parents, other adults, and adolescents should pay more attention to their sleep patterns and implement interventions, if needed. Copyright © 2013 Elsevier B.V. All rights reserved.

Medical management with diazepam for electrical status epilepticus during slow wave sleep in children.

PubMed

Francois, Densley; Roberts, Jessica; Hess, Stephany; Probst, Luke; Eksioglu, Yaman

2014-03-01

Oral diazepam, administered in varying doses, is among the few proposed treatment options for electrical status epilepticus during slow wave sleep in children. We sought to retrospectively evaluate the long-term efficacy of high-dose oral diazepam in reducing electrographic and clinical evidence of electrical status epilepticus during slow wave sleep in children. Additionally, we surveyed caregivers to assess safety and behavioral outcomes related to ongoing therapy. We collected demographic and clinical data on children treated for electrical status epilepticus during slow wave sleep between October 2010 and March 2013. We sought to identify the number of patients who achieved at least a 50% reduction in spike wave index on electroencephalograph after receiving high-dose oral diazepam. We also administered a questionnaire to caregivers to assess for behavioral problems and side effects. We identified 42 evaluable patients who received high-dose diazepam (range 0.23-2.02 mg/kg per day) to treat electrical status epilepticus during slow wave sleep. Twenty-six patients had spike reduction data and 18/26 (69.2%) children achieved a greater than 50% reduction in spike wave count from an average of 15.54 to 5.05 (P = 0.001). We received 28 responses to the questionnaire. Some patients experienced new onset of difficulties with problem-solving and speech and writing development. Sleep disturbances (50%) and irritability (57.1%) were the most frequent side effects reported. There did not appear to be a dose-related effect with electroencephalograph changes, behavioral effects, or side effects. High-dose oral diazepam significantly reduces the spike wave count on electroencephalograph in children with electrical status epilepticus during slow wave sleep. Although this therapy improves electroencephalograph-related findings, it can be associated with concerning neurological and behavioral side effects in some individuals, so further study is warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

Delayed sleep phase disorder: clinical perspective with a focus on light therapy

PubMed Central

Figueiro, Mariana G

2016-01-01

Delayed sleep phase disorder (DSPD) is common among adolescents and further increases their susceptibility to chronic sleep restriction and associated detrimental outcomes, including increased risk of depression, drug and alcohol use, behavioral problems, and poor scholastic performance. DSPD is characterized by sleep onset that occurs significantly later than desired bedtimes and societal norms. Individuals with DSPD exhibit long sleep latencies when attempting to sleep at conventional bedtimes. Circadian sleep disorders such as DSPD can occur when there is misalignment between sleep timing and societal norms. This review discusses studies using light therapy to advance the timing of sleep in adolescents and college students, in particular on those suffering from DSPD. A discussion on how to increase effectiveness of light therapy in the field will also be provided. PMID:27110143

[Sleep paroxysmal events in children in video/polysomnography].

PubMed

Zajac, Anna; Skowronek-Bała, Barbara; Wesołowska, Ewa; Kaciński, Marek

2010-01-01

It is estimated that about 25% of children have sleep disorders, from short problems with falling asleep to severe including primary sleep disorders. Majority of these problems are transitory and self-limiting and usually are not recognized by first care physicians and need education. Analysis of sleep structure at the developmental age and of sleep disorders associated with different sleep phases on the basis of video/polysomnography results. Literature review and illustration of fundamental problems associated with sleep physiology and pathology, with special attention to paroxysmal disorders. Additionally 4 cases from our own experience were presented with neurophysiological and clinical aspects. Discussion on REM and NREM sleep, its phases and alternating share according to child's age was conducted. Sleep disorders were in accordance with their international classification. Parasomnias, occupying most of the space, were divided in two groups: primary and secondary. Among primary parasomnias disorders associated with falling asleep (sleep myoclonus, hypnagogic hallucinations, sleep paralysis, rhythmic movement disorder, restless legs syndrome) are important. Another disorders are parasomians associated with light NREM sleep (bruxism, periodic limb movement disorder) and with deeper NREM sleep (confusional arousals, somnabulism, night terrors), with REM sleep (nightmares, REM sleep behavior disorder) and associated with NREM and REM sleep (catathrenia, sleep enuresis, sleep talking). Obstructive sleep apnea syndrome and epileptic seizures occurring during sleep also play an important role. Frontal lobe epilepsy and Panayiotopoulos syndrome should be considered in the first place in such cases. Our 4 cases document these diagnostic difficulties, requiring video/polysomnography examination 2 of them illustrate frontal lobe epilepsy and single ones myoclonic epilepsy graphy in children is a difficult technique and requires special device, local and trained personnel. It is crucial in gathering objective data about sleep disorders. Correct diagnosis of paroxysmal disorders during sleep in children is possible thanks to video/polysomnography, and enables proper management and pharmacotherpy. It enables improvement or cure disorders during the sleep and moreover enables the obtainment of positive changes in child's every day life.

Co-Sleeping among School-Aged Anxious and Non-Anxious Children: Associations with Sleep Variability and Timing.

PubMed

Palmer, Cara A; Clementi, Michelle A; Meers, Jessica M; Alfano, Candice A

2018-01-05

Little is known about the co-sleeping behaviors of school-aged children, particularly among anxious youth who commonly present for the treatment of sleep problems. The current study examined the occurrence of co-sleeping in both healthy and clinically anxious children and its associated sleep patterns. A total of 113 children (ages 6-12), 75 with primary generalized anxiety disorder and 38 healthy controls, participated along with their primary caregiver. Families completed structured diagnostic assessments, and parents reported on their child's co-sleeping behaviors and anxiety severity. Children provided reports of anxiety severity and completed one week of wrist-based actigraphy to assess objective sleep patterns. A significantly greater proportion of anxious youth compared to healthy children co-slept, and greater anxiety severity was related to more frequent co-sleeping. Co-sleeping in anxious youth was associated with a delay in sleep timing and with greater sleep variability (i.e., more variable nightly sleep duration). All analyses controlled for child age, race/ethnicity, family income, and parental marital status. Co-sleeping is highly common in anxious school-aged children, with more than 1 in 3 found to co-sleep at least sometimes (2-4 times a week). Co-sleeping was even more common for youth with greater anxiety severity. Increased dependence on others to initiate and maintain sleep may contribute to poorer sleep in this population via shifted schedules and more variable sleep patterns.

Sleep patterns and impulse control among Japanese junior high school students.

PubMed

Abe, Takeru; Hagihara, Akihito; Nobutomo, Koichi

2010-10-01

Adolescents with decreased impulse control exhibit behavioral problems. Lifestyles are related to impulse control. However, the relations of sleep patterns and impulse control among adolescents are unknown. Thus we examined how sleep patterns were associated with impulse control among Japanese junior high school students. Surveys were completed by a nationwide sample of 1934 students. A significant association between decreased impulse control and bedtimes after midnight was revealed. Specific lifestyle factors related to bedtimes after midnight were older age, greater numbers of hours spent watching television, lack of participation in an extracurricular activity, greater use of convenience stores, and increased attendance at cram schools. This study revealed that going to sleep after midnight was significantly related to decreased impulse control among adolescents. Data about specific lifestyle factors related to going to sleep after midnight should be useful in preventing those behaviors demonstrated by school children that derive from decreased impulse control.

Sleep, Internalizing Problems, and Social Withdrawal: Unique Associations in Clinic-Referred Youth With Elevated Sluggish Cognitive Tempo Symptoms.

PubMed

Rondon, Ana T; Hilton, Dane C; Jarrett, Matthew A; Ollendick, Thomas H

2018-02-01

We compared clinic-referred youth with ADHD + sluggish cognitive tempo (SCT; n = 34), ADHD Only ( n = 108), and SCT Only ( n = 22) on demographics, co-occurring symptomatology, comorbid diagnoses, and social functioning. In total, 164 youth (age = 6-17 years, M = 9.97) and their parent(s) presented to an outpatient clinic for a psychoeducational assessment. Between-group analyses and regressions were used to examine study variables. SCT groups were older and exhibited more parent-reported internalizing problems, externalizing problems, sleep problems, and social withdrawal on the Child Behavior Checklist. No significant differences emerged between groups on the Teacher Report Form. Regression analyses involving multiple covariates revealed that SCT symptoms were uniquely related to social withdrawal but not general social problems. Based on parent report, SCT symptoms have a unique relationship with internalizing problems, sleep problems, and social withdrawal. Future research should explore correlates of SCT in youth using multiple informants.

Do sleep problems mediate the link between adverse childhood experiences and delinquency in preadolescent children in foster care?

PubMed

Hambrick, Erin P; Rubens, Sonia L; Brawner, Thomas W; Taussig, Heather N

2018-02-01

Adverse childhood experiences (ACEs) are associated with multiple mental and physical health problems. Yet, mechanisms by which ACEs confer risk for specific problems are largely unknown. Children in foster care typically have multiple ACEs and high rates of negative sequelae, including delinquent behaviors. Mechanisms explaining this link have not been explored in this population. Impaired sleep has been identified as a potential mechanism by which ACEs lead to delinquency in adolescents, because inadequate sleep may lead to poor executive function and cognitive control - known risk factors for delinquency. Interviews were conducted with 516 maltreated children in foster care, ages 9-11 years, and their caregivers regarding child exposure to ACEs, sleep problems, engagement in delinquent acts, symptoms of posttraumatic stress disorder, and current psychotropic medication use. ACEs data were also obtained from child welfare case records. After controlling for age, gender, race/ethnicity, placement type (residential, kin, foster), length of time in placement, posttraumatic stress symptoms, and current psychotropic medication use, sleep partially mediated the association between ACEs and delinquency. Although delinquency is likely multiply determined in this population, improving sleep may be one important strategy to reduce delinquency. © 2017 Association for Child and Adolescent Mental Health.

Sleep and Cognitive Decline: A Strong Bidirectional Relationship. It Is Time for Specific Recommendations on Routine Assessment and the Management of Sleep Disorders in Patients with Mild Cognitive Impairment and Dementia.

PubMed

Guarnieri, Biancamaria; Sorbi, Sandro

2015-01-01

Sleep disturbances and disruption of the neural regulation of the sleep-wake rhythm appear to be involved in the cellular and molecular mechanisms of cognitive decline. Although sleep problems are highly prevalent in mild cognitive impairment (MCI) and many types of dementia, they have not been systematically investigated in the clinical setting and are often only investigated by sleep specialists upon individual request. This review discusses sleep disorders in the context of cognitive decline and provides an overview of the clinical diagnosis and management of these disorders in patients with dementia and MCI. Key Messages: Sleep disorders are largely underestimated and do not receive sufficient attention in the global management of dementia patients. Sleep disturbances have a significant impact on cognitive and physical functions in individuals with cognitive decline and may be associated with important psychological distress and depression. They are positively associated with the severity of behavioral problems and cognitive impairment. The recent recommendations by the Sleep Study Group of the Italian Dementia Research Association can be used as a guideline for the clinical assessment and management of sleep disorders in MCI and dementia patients. Sleep disorders should be carefully investigated using an in-depth sleep history, physical examination, questionnaires and clinical scales and should be validated with the support of a direct caregiver. The recommendations for older adults can be used as a framework to guide the diagnosis and treatment of sleep disorders in individuals with dementia and MCI. The management strategy should be based on the choice of different treatments for each sleep problem present in the same patient, while avoiding adverse interactions between treatments. © 2015 S. Karger AG, Basel.

Treatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects.

PubMed

Tilford, J Mick; Payakachat, Nalin; Kuhlthau, Karen A; Pyne, Jeffrey M; Kovacs, Erica; Bellando, Jayne; Williams, D Keith; Brouwer, Werner B F; Frye, Richard E

2015-11-01

Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N = 224) was conducted with registry and postal survey data completed by the primary caregiver. We calculated quality of life outcomes for the child and the primary caregiver associated with treatments to improve sleep in the child based on prior clinical trials. Predicted treatment effects for melatonin and behavioral interventions were similar in magnitude for the child and for the caregiver. Accounting for caregiver spillover effects associated with treatments for the child with ASD increases treatment benefits and improves cost-effectiveness profiles.

TREATMENT FOR SLEEP PROBLEMS IN CHILDREN WITH AUTISM AND CAREGIVER SPILLOVER EFFECTS

PubMed Central

Tilford, J. Mick; Payakachat, Nalin; Kuhlthau, Karen; Pyne, Jeffrey M.; Kovacs, Erica; Bellando, Jayne; Williams, D. Keith; Brouwer, Werner; Frye, Richard E.

2015-01-01

Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N=224) was conducted with registry and postal survey data completed by the primary caregiver. We calculated quality of life outcomes for the child and the primary caregiver associated with treatments to improve sleep in the child based on prior clinical trials. Predicted treatment effects for melatonin and behavioral interventions were similar in magnitude for the child and for the caregiver. Accounting for caregiver spillover effects associated with treatments for the child with ASD increases treatment benefits and improves cost-effectiveness profiles. PMID:26126749

Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia--a randomized controlled trial.

PubMed

Jernelöv, Susanna; Lekander, Mats; Blom, Kerstin; Rydh, Sara; Ljótsson, Brjánn; Axelsson, John; Kaldo, Viktor

2012-01-22

Cognitive behavioral therapy is treatment of choice for insomnia, but availability is scarce. Self-help can increase availability at low cost, but evidence for its efficacy is limited, especially for the typical insomnia patient with co-morbid problems. We hypothesized that a cognitive behaviorally based self-help book is effective to treat insomnia in individuals, also with co-morbid problems, and that the effect is enhanced by adding brief therapist telephone support. Volunteer sample; 133 media-recruited adults with insomnia. History of sleep difficulties (mean [SD]) 11.8 [12.0] years. 92.5% had co-morbid problems (e.g. allergy, pain, and depression). Parallel randomized (block-randomization, n ≥ 21) controlled "open label" trial; three groups-bibliotherapy with (n = 44) and without (n = 45) therapist support, and waiting list control (n = 44). Assessments before and after treatment, and at three-month follow-up. Intervention was six weeks of bibliotherapeutic self-help, with established cognitive behavioral methods including sleep restriction, stimulus control, and cognitive restructuring. Therapist support was a 15-minute structured telephone call scheduled weekly. Main outcome measures were sleep diary data, and the Insomnia Severity Index. Intention-to-treat analyses of 133 participants showed significant improvements in both self-help groups from pre to post treatment compared to waiting list. For example, treatment with and without support gave shorter sleep onset latency (improvement minutes [95% Confidence Interval], 35.4 [24.2 to 46.6], and 20.6 [10.6 to 30.6] respectively), and support gave a higher remission rate (defined as ISI score below 8; 61.4%), than bibliotherapy alone (24.4%, p's < .001). Improvements were not seen in the control group (sleep onset latency 4.6 minutes shorter [-1.5 to 10.7], and remission rate 2.3%). Self-help groups maintained gains at three-month follow-up. Participants receiving self-help for insomnia benefited markedly. Self-help, especially if therapist-supported, has considerable potential to be as effective as individual treatment at lower cost, also for individuals with co-morbid problems. ClinicalTrials.gov: NCT01105052.

Circadian Rhythm and Sleep Disruption: Causes, Metabolic Consequences, and Countermeasures

PubMed Central

Skene, Debra J.; Arendt, Josephine; Cade, Janet E.; Grant, Peter J.; Hardie, Laura J.

2016-01-01

Circadian (∼24-hour) timing systems pervade all kingdoms of life and temporally optimize behavior and physiology in humans. Relatively recent changes to our environments, such as the introduction of artificial lighting, can disorganize the circadian system, from the level of the molecular clocks that regulate the timing of cellular activities to the level of synchronization between our daily cycles of behavior and the solar day. Sleep/wake cycles are intertwined with the circadian system, and global trends indicate that these, too, are increasingly subject to disruption. A large proportion of the world's population is at increased risk of environmentally driven circadian rhythm and sleep disruption, and a minority of individuals are also genetically predisposed to circadian misalignment and sleep disorders. The consequences of disruption to the circadian system and sleep are profound and include myriad metabolic ramifications, some of which may be compounded by adverse effects on dietary choices. If not addressed, the deleterious effects of such disruption will continue to cause widespread health problems; therefore, implementation of the numerous behavioral and pharmaceutical interventions that can help restore circadian system alignment and enhance sleep will be important. PMID:27763782

Understanding sleep problems in children with epilepsy: Associations with quality of life, Attention-Deficit Hyperactivity Disorder and maternal emotional symptoms.

PubMed

Ekinci, Ozalp; Isik, Uğur; Gunes, Serkan; Ekinci, Nuran

2016-08-01

This study aimed to (1) compare sleep problems between children and adolescents with epilepsy and non-epileptic controls, and (2) examine whether there is an association between sleep problems and quality of life, Attention-Deficit Hyperactivity Disorder (ADHD) and mothers' emotional symptoms. Fifty-three patients from a cohort of epilepsy (aged 7-18 years) and 28 controls with minor medical problems (aged 7-18 years) were included. Parents completed Children's Sleep Habits Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R) for patients and controls. Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) parent and teacher forms were used to assess ADHD symptoms for patients. Mothers of the patients completed Beck Depression Inventory and State-Trait Anxiety Inventory (STAI). Neurology clinic charts were reviewed for the epilepsy-related variables. Children with epilepsy had a higher CSHQ Total score than the control group. Those with a CSHQ score >56 (which indicates moderate to severe sleep problems) had lower scores on KINDL-R. Parent-rated T-DSM-IV-S Total and Hyperactivity-Impulsivity scores, STAI trait and Beck scores were found to be higher in those with a CSHQ score >56. Significant positive correlations were found between CSHQ Total score and T-DSM-IV-S, STAI trait and Beck scores. Binary logistic regression analysis revealed that T-DSM-IV-S Total, Inattention and Hyperactivity-Impulsivity scores were significantly associated with a higher CSHQ Total score. None of the epilepsy-related variables were found to be related with the CSHQ Total score. Among children with epilepsy, sleep problems lead to a poor quality of life. The link between sleep problems and psychiatric symptoms must be conceptualized as a bilateral relationship. ADHD appears to be the strongest predictor of sleep problems. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Nonmotor symptoms in patients with Parkinson disease

PubMed Central

Zhang, Tie-mei; Yu, Shu-yang; Guo, Peng; Du, Yang; Hu, Yang; Piao, Ying-shan; Zuo, Li-jun; Lian, Teng-hong; Wang, Rui-dan; Yu, Qiu-jin; Jin, Zhao; Zhang, Wei

2016-01-01

Abstract Parkinson disease (PD) is usually accompanied by numerous nonmotor symptoms (NMS), such as neuropsychiatric symptoms, sleep disorders, autonomic dysfunctions, and sensory disturbances. However, it is not clear that the factors influencing the occurrence of NMS and its sequence with motor symptoms (MS). We conducted comprehensive assessments of NMS by using 13 scales in 1119 PD patients. A total of 70.8% PD patients present NMS. Olfactory dysfunction tends to occur in PD patients with older age, more severe depression, sleep problems, and autonomic dysfunctions. Older patients are more likely to have olfactory dysfunction before MS than younger patients. Rapid eye movement behavior disorder is more prone to happen in patients with older age, older onset age, more severe depression, sleep problems, and autonomic dysfunctions. Patients with rapid eye movement behavior disorder before MS are older in onset age than after group. Olfactory dysfunction, constipation, rapid eye movement behavior disorder, and depression, as early warning NMSs of PD, connected to each other. There is a clinical heterogeneity that older patients are more likely to have NMS before MS, while younger patients are opposite. PMID:27977578

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature.

PubMed

Wheaton, Anne G; Chapman, Daniel P; Croft, Janet B

2016-05-01

Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health. This article reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

An under-diagnosed geriatric syndrome: sleep disorders among older adults.

PubMed

Tufan, Asli; Ilhan, Birkan; Bahat, Gulistan; Karan, Mehmet Akif

2017-06-01

Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. Two hundred and three patients (136 female) older than 75 years of age were included in the study. Patients underwent comprehensive geriatric assessment, including identification of sleep problems using the Sleep Disturbance Scale, Rapid eye movement (REM) sleep behavior disorder (RBD) Single-Question Screen questionnaire (RBD1Q) and The Johns Hopkins Restless Leg Syndrome Severity Scale. Demographic and clinical data including age, sex, medications, comorbid diseases, body mass index and functional scores was noted. The mean age of the patients was 80.92±4.3 years. 35.5% of the patients had findings of REM-SBD and 32.5% of the patients had restless legs syndrome. Ninety-seven percent of the patients answered 'yes' to at least one of the sleep disturbance scale questions. There was no significant difference between male and female groups. We observed that sleep disorders were common among older adults. For this reason, the course and quality of sleep should be examined in all patients as a routine part of comprehensive geriatric assessment.

SLEEP AND CIRCADIAN RHYTHM DISORDERS IN PARKINSON'S DISEASE.

PubMed

Gros, Priti; Videnovic, Aleksandar

2017-09-01

Sleep disorders are among the most challenging non-motor features of Parkinson's disease (PD) and significantly affect quality of life. Research in this field has gained recent interest among clinicians and scientists and is rapidly evolving. This review is dedicated to sleep and circadian dysfunction associated with PD. Most primary sleep disorders may co-exist with PD; majority of these disorders have unique features when expressed in the PD population. We discuss the specific considerations related to the common sleep problems in Parkinson's disease including insomnia, rapid eye movement sleep behavior disorder, restless legs syndrome, sleep disordered breathing, excessive daytime sleepiness and circadian rhythm disorders. Within each of these sleep disorders, we present updated definitions, epidemiology, etiology, diagnosis, clinical implications and management. Furthermore, areas of potential interest for further research are outlined.

Sleeping site selection by proboscis monkeys (Nasalis larvatus) in West Kalimantan, Indonesia.

PubMed

Feilen, Katie L; Marshall, Andrew J

2014-12-01

Primates spend at least half their lives sleeping; hence, sleeping site selection can have important effects on behavior and fitness. As proboscis monkeys (Nasalis larvatus) often sleep along rivers and form bands (aggregations of one male groups) at their sleeping sites, understanding sleeping site selection may shed light on two unusual aspects of this species' socioecology: their close association with rivers and their multilevel social organization. We studied sleeping site selection by proboscis monkeys for twelve months at Sungai Tolak, West Kalimantan, Indonesia to test two main hypotheses regarding the drivers of sleeping site selection: reduction of molestation by mosquitoes and anti-predator behavior. We identified to genus and collected data on the physical structure (diameter at breast height, relative height, branch structure, and leaf coverage) of sleeping trees and available trees in three forest types. We used resource selection function models to test specific predictions derived from our two hypotheses. The monkeys preferred to sleep in large trees with few canopy connections located along rivers. The selection of large emergent trees was consistent with both of our main hypotheses: decreased molestation by mosquitoes and reduced potential entry routes for terrestrial predators. Although we are only beginning to understand how sleeping sites might influence behavior, grouping, and potential survival of this species, our study has shown that proboscis monkeys (at Sungai Tolak) have a very strong preference for large trees located near the river. As these trees are often the first to be logged by local villagers, this may exacerbate the problems of forest loss for these endangered monkeys. © 2014 Wiley Periodicals, Inc.

Evaluation of an mHealth intervention aiming to improve health-related behavior and sleep and reduce fatigue among airline pilots.

PubMed

van Drongelen, Alwin; Boot, Cécile Rl; Hlobil, Hynek; Twisk, Jos Wr; Smid, Tjabe; van der Beek, Allard J

2014-11-01

The aim of this study was to evaluate the effects of an mHealth intervention (intervention using mobile technology) consisting of tailored advice regarding exposure to daylight, sleep, physical activity, and nutrition, and aiming to improve health-related behavior, thereby reducing sleep problems and fatigue and improving health perception of airline pilots. A randomized controlled trial was conducted among 502 airline pilots. The intervention group was given access to both the MORE Energy mobile application (app) with tailored advice and a website with background information. The control group was directed to a website with standard information about fatigue. Health-related behavior, fatigue, sleep, and health perception outcomes were measured through online questionnaires at baseline and at three and six months after baseline. The effectiveness of the intervention was determined using linear and Poisson mixed model analyses. After six months, compared to the control group, the intervention group showed a significant improvement on fatigue (β= -3.76, P<0.001), sleep quality (β= -0.59, P=0.007), strenuous physical activity (β=0.17, P=0.028), and snacking behavior (β= -0.81, P<0.001). No significant effects were found for other outcome measures. The MORE Energy mHealth intervention reduced self-reported fatigue compared to a minimal intervention. Some aspects of health-related behavior (physical activity and snacking behavior) and sleep (sleep quality) improved as well, but most did not. The results show offering tailored advice through an mHealth intervention is an effective means to support employees who have to cope with irregular flight schedules and circadian disruption. This kind of intervention might therefore also be beneficial for other working populations with irregular working hours.

Sleep Disorders: Insomnia.

PubMed

Burman, Deepa

2017-09-01

Insomnia is the most common type of sleep disorder in the family medicine population. It is defined as a persistent difficulty initiating or maintaining sleep, or a report of nonrestorative sleep, accompanied by related daytime impairment. Insomnia is a significant public health problem because of its high prevalence and management challenges. There is increasing evidence of a strong association between insomnia and various medical and psychiatric comorbidities. Diagnosis of insomnia and treatment planning rely on a thorough sleep history to address contributing and precipitating factors as well as maladaptive behaviors resulting in poor sleep. Using a sleep diary or sleep log is more accurate than patient recall to determine sleep patterns. A sleep study is not routinely indicated for evaluation of insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is the mainstay of treatment and is a safe and effective approach. The key challenge of CBT-I is the lack of clinicians to implement it. The newer generation nonbenzodiazepines (eg, zolpidem, zaleplon) are used as first-line pharmacotherapy for chronic insomnia. Newer drugs active on targets other than the gamma-aminobutyric acid receptor are now available, but clear treatment guidelines are needed. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Preschoolers' genetic, physiological, and behavioral sensitivity factors moderate links between parenting stress and child internalizing, externalizing, and sleep problems.

PubMed

Davis, Molly; Thomassin, Kristel; Bilms, Joanie; Suveg, Cynthia; Shaffer, Anne; Beach, Steven R H

2017-05-01

This study examined three potential moderators of the relations between maternal parenting stress and preschoolers' adjustment problems: a genetic polymorphism-the short allele of the serotonin transporter (5-HTTLPR, ss/sl allele) gene, a physiological indicator-children's baseline respiratory sinus arrhythmia (RSA), and a behavioral indicator-mothers' reports of children's negative emotionality. A total of 108 mothers (M age  = 30.68 years, SD age  = 6.06) reported on their parenting stress as well as their preschoolers' (M age  = 3.50 years, SD age  = 0.51, 61% boys) negative emotionality and internalizing, externalizing, and sleep problems. Results indicated that the genetic sensitivity variable functioned according to a differential susceptibility model; however, the results involving physiological and behavioral sensitivity factors were most consistent with a diathesis-stress framework. Implications for prevention and intervention efforts to counter the effects of parenting stress are discussed. © 2017 Wiley Periodicals, Inc.

Restless legs syndrome, rapid eye movement sleep behavior disorder, and hypersomnia in patients with two parkin mutations.

PubMed

Limousin, Nadège; Konofal, Eric; Karroum, Elias; Lohmann, Ebba; Theodorou, Ioannis; Dürr, Alexandra; Arnulf, Isabelle

2009-10-15

Parkin gene mutations cause a juvenile parkinsonism. Patients with these mutations may commonly exhibit REM sleep behaviour disorders, but other sleep problems (insomnia, sleepiness, restless legs syndrome) have not been studied. The aim of this study was to evaluate the sleep-wake phenotype in patients with two parkin mutations, compared with patients with idiopathic Parkinson's disease (iPD). Sleep interview and overnight video-polysomnography, followed by multiple sleep latency tests, were assessed in 11 consecutive patients with two parkin mutations (aged 35-60 years, from seven families) and 11 sex-matched patients with iPD (aged 51-65 years). Sleep complaints in the parkin group included insomnia (73% patients versus 45% in the iPD group), restless legs syndrome (45%, versus none in the iPD group, P = 0.04), and daytime sleepiness (45%, versus 54% in the iPD group). Of the parkin patients, 45% had REM sleep without atonia, but only 9% had a definite REM sleep behavior disorder. All sleep measures were similar in the parkin and iPD groups. Two parkin siblings had a central hypersomnia, characterized by mean daytime sleep latencies of 3 min, no sleep onset REM periods, and normal nighttime sleep. Although the patients with two parkin mutations were young, their sleep phenotype paralleled the clinical and polygraphic sleep recording abnormalities reported in iPD, except that restless legs syndrome was more prevalent and secondary narcolepsy was absent.

Effects of Antidepressants on Sleep.

PubMed

Wichniak, Adam; Wierzbicka, Aleksandra; Walęcka, Małgorzata; Jernajczyk, Wojciech

2017-08-09

The aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment. Complaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder. Moreover, midnocturnal insomnia is the most frequent residual symptom of depression. Thus, all antidepressants should normalize sleep. However, at least in short-term treatment, many antidepressants with so-called activating effects (e.g. fluoxetine, venlafaxine) may disrupt sleep, while others with sedative properties (e.g., doxepin, mirtazapine, trazodone) rapidly improve sleep, but may cause problems in long-term treatment due to oversedation.For sleep-promoting action, the best effects can frequently be achieved with a very low dose, administered early enough before bedtime and importantly, always as a part of more complex interventions based on the cognitive-behavioral protocol to treat insomnia (CBT-I). For successful treatment of depression, it is necessary to understand the effects of antidepressants on sleep. Each physician should also be aware that some antidepressants may worsen or induce primary sleep disorders like restless legs syndrome, sleep bruxism, REM sleep behavior disorder, nightmares, and sleep apnea, which may result from an antidepressant-induced weight gain.

Prevalence and risk factors of poor sleep quality among Inner Mongolia Medical University students: A cross-sectional survey.

PubMed

Wang, Lan; Qin, Peng; Zhao, Yunshan; Duan, Shengyun; Zhang, Qing; Liu, Ying; Hu, Yueling; Sun, Juan

2016-10-30

Medical students face new challenges at the beginning of college life, such as being responsible for oneself, an unfamiliar environment, social obligations, and academic stress, all of which influence or even heavily change their sleep quality and life, leading to sleep-related problems to some degree. This study investigated the relationship between sleep quality and behavior among students at the Inner Mongolia Medical University in China. Self-administered questionnaires were used to collect information on sociodemographic characteristics and lifestyle habits. The Pittsburgh Sleep Quality Index was also used. A total of 6044 and 6085 students completed the questionnaires in 2011 and 2013. According to the index, 27.8% (1694) of students had poor sleep quality with major risk factors being poor academic performance and interpersonal relationships in 2013. Among others, regular exercise less than three times a week, skipping breakfast, and studying in higher grades were associated with poor sleep quality. These results will help university administrators understand the risk factors of poor sleep quality among students, which can be improved through individual efforts, and provide adequate counseling and systematic education to improve their behavior and lifestyle. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Efficacy of an Internet-based behavioral intervention for adults with insomnia.

PubMed

Ritterband, Lee M; Thorndike, Frances P; Gonder-Frederick, Linda A; Magee, Joshua C; Bailey, Elaine T; Saylor, Drew K; Morin, Charles M

2009-07-01

Insomnia is a major health problem with significant psychological, health, and economic consequences. However, availability of one of the most effective insomnia treatments, cognitive behavioral therapy, is significantly limited. The Internet may be a key conduit for delivering this intervention. To evaluate the efficacy of a structured behavioral Internet intervention for adults with insomnia. Forty-five adults were randomly assigned to an Internet intervention (n = 22) or wait-list control group (n = 23). Forty-four eligible participants (mean [SD] age, 44.86 [11.03] years; 34 women) who had a history of sleep difficulties longer than 10 years on average (mean [SD], 10.59 [8.89] years) were included in the analyses. The Internet intervention is based on well-established face-to-face cognitive behavioral therapy incorporating the primary components of sleep restriction, stimulus control, sleep hygiene, cognitive restructuring, and relapse prevention. The Insomnia Severity Index and daily sleep diary data were used to determine changes in insomnia severity and the main sleep variables, including wake after sleep onset and sleep efficiency. Intention-to-treat analyses showed that scores on the Insomnia Severity Index significantly improved from 15.73 (95% confidence interval [CI], 14.07 to 17.39) to 6.59 (95% CI, 4.73 to 8.45) for the Internet group but did not change for the control group (16.27 [95% CI, 14.61 to 17.94] to 15.50 [95% CI, 13.64 to 17.36]) (F(1,42) = 29.64; P < .001). The Internet group maintained their gains at the 6-month follow-up. Internet participants also achieved significant decreases in wake after sleep onset (55% [95% CI, 34% to 76%]) and increases in sleep efficiency (16% [95% CI, 9% to 22%]) compared with the nonsignificant control group changes of wake after sleep onset (8% [95% CI, -17% to 33%) and sleep efficiency (3%; 95% CI, -4% to 9%). Participants who received the Internet intervention for insomnia significantly improved their sleep, whereas the control group did not have a significant change. The Internet appears to have considerable potential in delivering a structured behavioral program for insomnia. clinicaltrials.gov Identifier: NCT00328250.

Sleep complaints and psychiatric symptoms in children evaluated at a pediatric mental health clinic.

PubMed

Ivanenko, Anna; Crabtree, Valerie McLaughlin; Obrien, Louise Margaret; Gozal, David

2006-01-15

To examine the association of sleep problems with psychiatric symptoms in children evaluated at a university-based outpatient child psychiatry clinic. Parents of 174 children attending psychiatric services completed a 47-item Childhood Sleep Questionnaire and the Behavioral Assessment System for Children. Psychiatric diagnosis was obtained through retrospective chart review. Sleep characteristics were compared among 4 diagnostic subcategories: attention-deficit/hyperactivity disorder (ADHD) alone (n=29), ADHD with comorbid mood and anxiety disorders (ADHD+; n=50), mood and anxiety disorders alone (n=67), and other psychiatric disorders (n= 28). Data from sleep habits survey of 174 community children without reported psychiatric history served as controls. Children with psychiatric disorders had a significantly higher prevalence of sleep complaints compared with nonpsychiatric controls. Children with ADHD had frequent nocturnal awakenings, bad dreams, and bedtime struggles. In addition, the presence of leg jerks during sleep was particularly frequent in patients with ADHD compared with any other psychiatric disorder. More frequent nighttime awakenings were present in children with mood and anxiety disorders. Sleep duration and sleep latency strongly correlated with aggression, hyperactivity, and depression. Restless sleep scores highly correlated with all psychiatric symptoms. Sleep problems are highly prevalent among children with psychiatric disorders. Children with ADHD and comorbid anxiety or mood disorders are more likely to report sleep disturbances. Restless sleep, long sleep latency, short sleep duration, and frequent nocturnal awakenings correlate with the severity of psychiatric symptoms.

Classical conditioning for preserving the effects of short melatonin treatment in children with delayed sleep: a pilot study.

PubMed

van Maanen, Annette; Meijer, Anne Marie; Smits, Marcel G; Oort, Frans J

2017-01-01

Melatonin treatment is effective in treating sleep onset problems in children with delayed melatonin onset, but effects usually disappear when treatment is discontinued. In this pilot study, we investigated whether classical conditioning might help in preserving treatment effects of melatonin in children with sleep onset problems, with and without comorbid attention deficit hyperactivity disorder (ADHD) or autism. After a baseline week, 16 children (mean age: 9.92 years, 31% ADHD/autism) received melatonin treatment for 3 weeks and then gradually discontinued the treatment. Classical conditioning was applied by having children drink organic lemonade while taking melatonin and by using a dim red light lamp that was turned on when children went to bed. Results were compared with a group of 41 children (mean age: 9.43 years, 34% ADHD/autism) who received melatonin without classical conditioning. Melatonin treatment was effective in advancing dim light melatonin onset and reducing sleep onset problems, and positive effects were found on health and behavior problems. After stopping melatonin, sleep returned to baseline levels. We found that for children without comorbidity in the experimental group, sleep latency and sleep start delayed less in the stop week, which suggests an effect of classical conditioning. However, classical conditioning seems counterproductive in children with ADHD or autism. Further research is needed to establish these results and to examine other ways to preserve melatonin treatment effects, for example, by applying morning light.

Risk of Behavioral and Adaptive Functioning Difficulties in Youth with Previous and Current Sleep Disordered Breathing

PubMed Central

Perfect, Michelle M.; Archbold, Kristen; Goodwin, James L.; Levine-Donnerstein, Deborah; Quan, Stuart F.

2013-01-01

Objectives: To examine the rates of behavioral and adaptive functioning difficulties among youth who never had sleep disordered breathing (SDB), had remitted SDB, had incident SDB, or had persistent SDB; and to determine if there were increased odds of behavioral difficulties among youth with varying SDB histories relative to those who never had SDB. Methods: 263 youth had valid polysomnography and neurobehavioral data at two time points approximately 5 years apart from the prospective Tucson Children's Assessment of Sleep Apnea study. Primary outcomes were the Behavior Assessment Scale for Children-2nd Edition Parent Report Form (BASC-PRF) and Self-Report of Personality (SRP), and the Adaptive Behavior Assessment System-2nd Edition (ABAS-2). Results: Compared to those who never had SDB, individuals with persistent SDB had significant odds and met more cutoff scores on the BASC-2-PRF Externalizing Problems Composite (odds ratio [OR] 3.29; 8.92% vs. 35.3%), Behavioral Symptoms Index (OR 6.82; 7.4% vs. 35.3%) and Hyperactivity subscale (OR 6.82; 11.1% vs. 41.2%). Similarly, greater difficulties was seen for the group with persistent SDB (relative to never) on the ABAS-2 Social Domain (OR 3.39; 22% vs. 50%), and Communication (OR 4.26; 15% vs. 42.9%) and Self-Care subscales (OR = 2.97; 25.2% vs. 50%). Relative to youth who never had SDB, youth who developed SDB at Time 2 had compromised adaptive skills as evidenced by the BASC-2 PRF Adaptive Behavior Composite (OR 3.34; 15.6% vs. 38.1%) and the ABAS-2 General Adaptive Composite (OR 2.83; 20.5% vs. 42.1%). Conclusions: Youth with current SDB exhibited hyperactivity, attention problems, aggressivity, lower social competency, poorer communication, and/or diminished adaptive skills. Citation: Perfect MM; Archbold K; Goodwin JL; Levine-Donnerstein D; Quan SF. Risk of behavioral and adaptive functioning difficulties in youth with previous and current sleep disordered breathing. SLEEP 2013;36(4):517-525. PMID:23543901

Mental health and sleep of older wife caregivers for spouses with Alzheimer's disease and related disorders.

PubMed

Willette-Murphy, Karen; Todero, Catherine; Yeaworth, Rosalee

2006-10-01

This descriptive study examined sleep and mental health variables in 37 older wife caregivers for spouses with dementia compared to 37 age-matched controls. The relationships among selected caregiving variables (behavioral problems, caregiving hours, and years of caregiving), appraisal of burden, self-reported sleep efficiency for the past week, and mental health outcomes were examined. Lazarus and Folkman's stress and coping framework guided the study. Mental health and sleep were poorer for caregivers. Caregiving and appraisal of burden variables showed direct and indirect effects on mental health. However, caregiving and appraisal of burden variables were not significant for predicting sleep efficiency. Sleep efficiency was a good predictor of mental health in this sample of wife caregivers.

The association of mothers' and fathers' insomnia symptoms with school-aged children's sleep assessed by parent report and in-home sleep-electroencephalography.

PubMed

Urfer-Maurer, Natalie; Weidmann, Rebekka; Brand, Serge; Holsboer-Trachsler, Edith; Grob, Alexander; Weber, Peter; Lemola, Sakari

2017-10-01

Sleep plays an essential role for children's well-being. Because children's sleep is associated with parental sleep patterns, it must be considered in the family context. As a first aim of the present study, we test whether parental insomnia symptoms are related to children's in-home sleep-electroencephalography (EEG). Second, we examine the association between parental insomnia symptoms and maternal and paternal perception of children's sleep using actor-partner interdependence models. A total of 191 healthy children enrolled in public school and aged 7-12 years took part in the study. Ninety-six were formerly very preterm born children. Children underwent in-home sleep-EEG, and parents reported children's sleep-related behavior by using the German version of the Children's Sleep Habits Questionnaire. Further, parents completed the Insomnia Severity Index to report their own insomnia symptoms. Maternal but not paternal insomnia symptoms were related to less children's EEG-derived total sleep time, more stage 2 sleep, less slow wave sleep, later sleep onset time, and later awakening time. Mothers' and fathers' own insomnia symptoms were related to their reports of children's bedtime resistance, sleep duration, sleep anxiety, night wakings, and/or daytime sleepiness. Moreover, maternal insomnia symptoms were associated with paternal reports of children's bedtime resistance, sleep anxiety, and sleep-disordered breathing. The associations between parental insomnia symptoms and parents' perception of children's sleep could not be explained by children's objectively measured sleep. Mothers' insomnia symptoms and children's objective sleep patterns are associated. Moreover, the parents' own insomnia symptoms might bias their perception of children's sleep-related behavior problems. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical relevance of cannabis tolerance and dependence.

PubMed

Jones, R T; Benowitz, N L; Herning, R I

1981-01-01

Psychoactive drugs are often widely used before tolerance and dependence is fully appreciated. Tolerance to cannabis-induced cardiovascular and autonomic changes, decreased intraocular pressure, sleep and sleep EEG, mood and behavioral changes is acquired and, to a great degree, lost rapidly with optimal conditions. Mechanisms appear more functional than metabolic. Acquisition rate depends on dose and dose schedule. Dependence, manifested by withdrawal symptoms after as little as 7 days of THC administration, is characterized by irritability, restlessness, insomnia, anorexia, nausea, sweating, salivation, increased body temperature, altered sleep and waking EEG, tremor, and weight loss. Mild and transient in the 120 subjects studied, the syndrome was similar to sedative drug withdrawal. Tolerance to drug side effects can be useful. Tolerance to therapeutic effects or target symptoms poses problems. Clinical significance of dependence is difficult to assess since drug-seeking behavior has many determinants. Cannabis-induced super sensitivity should be considered wherever chronic drug administration is anticipated in conditions like epilepsy, glaucoma or chronic pain. Cannabis pharmacology suggests ways of minimizing tolerance and dependence problems.

Prevalence of Sleep Disorders Among Children 4 - 6 Years Old in Tehran Province, Iran

PubMed Central

Ozgoli, Giti; Sheikhan, Zohre; Soleimani, Farin; Nasiri, Malihe; Amiri, Saba

2016-01-01

Background Sleep patterns may change over a person’s lifetime; however, the quantity and quality of sleep always depend on individual factors such as age, sex, and psychological and environmental factors. In children, sleep is as important as development. Quantitative sleep problems related to sleep onset and qualitative sleep disorders such as frequent awakenings may lead to insufficient sleep. Objectives This study aimed to assess the prevalence of sleep disorders among children 4 - 6 years old attending the health centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2013. Patients and Methods This was a cross-sectional study on 400 children selected using a multistage sampling method. Data were collected by interviews. The questionnaire included two sections: a demographic section with questions about the demographic characteristics of the children and parents and a children’s sleep habit questionnaire (CSHQ). Data were analyzed by SPSS 16 and different statistical tests were used (P < 0.05). Results The mean age of the children was 64.27 ± 9.3 months. The prevalence of sleep disorders was 36.25%. Sleep disorders were significantly associated with age, height, body mass index, residence of children, father’s occupation, mother’s diseases, father’s drug abuse, and parents’ marital status (P < 0.05). Conclusions Sleep disorders in children threaten growth and development, and are dangerous for their health. Sleep disorders should be considered in the differential diagnosis of children’s learning and behavioral problems. PMID:27651942

Slow oscillating transcranial direct current stimulation during non-rapid eye movement sleep improves behavioral inhibition in attention-deficit/hyperactivity disorder

PubMed Central

Munz, Manuel T.; Prehn-Kristensen, Alexander; Thielking, Frederieke; Mölle, Matthias; Göder, Robert; Baving, Lioba

2015-01-01

Background: Behavioral inhibition, which is a later-developing executive function (EF) and anatomically located in prefrontal areas, is impaired in attention-deficit and hyperactivity disorder (ADHD). While optimal EFs have been shown to depend on efficient sleep in healthy subjects, the impact of sleep problems, frequently reported in ADHD, remains elusive. Findings of macroscopic sleep changes in ADHD are inconsistent, but there is emerging evidence for distinct microscopic changes with a focus on prefrontal cortical regions and non-rapid eye movement (non-REM) slow-wave sleep. Recently, slow oscillations (SO) during non-REM sleep were found to be less functional and, as such, may be involved in sleep-dependent memory impairments in ADHD. Objective:By augmenting slow-wave power through bilateral, slow oscillating transcranial direct current stimulation (so-tDCS, frequency = 0.75 Hz) during non-REM sleep, we aimed to improve daytime behavioral inhibition in children with ADHD. Methods: Fourteen boys (10–14 years) diagnosed with ADHD were included. In a randomized, double-blind, cross-over design, patients received so-tDCS either in the first or in the second experimental sleep night. Inhibition control was assessed with a visuomotor go/no-go task. Intrinsic alertness was assessed with a simple stimulus response task. To control for visuomotor performance, motor memory was assessed with a finger sequence tapping task. Results: SO-power was enhanced during early non-REM sleep, accompanied by slowed reaction times and decreased standard deviations of reaction times, in the go/no-go task after so-tDCS. In contrast, intrinsic alertness, and motor memory performance were not improved by so-tDCS. Conclusion: Since behavioral inhibition but not intrinsic alertness or motor memory was improved by so-tDCS, our results suggest that lateral prefrontal slow oscillations during sleep might play a specific role for executive functioning in ADHD. PMID:26321911

Slow oscillating transcranial direct current stimulation during non-rapid eye movement sleep improves behavioral inhibition in attention-deficit/hyperactivity disorder.

PubMed

Munz, Manuel T; Prehn-Kristensen, Alexander; Thielking, Frederieke; Mölle, Matthias; Göder, Robert; Baving, Lioba

2015-01-01

Behavioral inhibition, which is a later-developing executive function (EF) and anatomically located in prefrontal areas, is impaired in attention-deficit and hyperactivity disorder (ADHD). While optimal EFs have been shown to depend on efficient sleep in healthy subjects, the impact of sleep problems, frequently reported in ADHD, remains elusive. Findings of macroscopic sleep changes in ADHD are inconsistent, but there is emerging evidence for distinct microscopic changes with a focus on prefrontal cortical regions and non-rapid eye movement (non-REM) slow-wave sleep. Recently, slow oscillations (SO) during non-REM sleep were found to be less functional and, as such, may be involved in sleep-dependent memory impairments in ADHD. By augmenting slow-wave power through bilateral, slow oscillating transcranial direct current stimulation (so-tDCS, frequency = 0.75 Hz) during non-REM sleep, we aimed to improve daytime behavioral inhibition in children with ADHD. Fourteen boys (10-14 years) diagnosed with ADHD were included. In a randomized, double-blind, cross-over design, patients received so-tDCS either in the first or in the second experimental sleep night. Inhibition control was assessed with a visuomotor go/no-go task. Intrinsic alertness was assessed with a simple stimulus response task. To control for visuomotor performance, motor memory was assessed with a finger sequence tapping task. SO-power was enhanced during early non-REM sleep, accompanied by slowed reaction times and decreased standard deviations of reaction times, in the go/no-go task after so-tDCS. In contrast, intrinsic alertness, and motor memory performance were not improved by so-tDCS. Since behavioral inhibition but not intrinsic alertness or motor memory was improved by so-tDCS, our results suggest that lateral prefrontal slow oscillations during sleep might play a specific role for executive functioning in ADHD.

Variations in sleep characteristics and sleep-related impairment in at-risk college drinkers: a latent profile analysis.

PubMed

DeMartini, Kelly S; Fucito, Lisa M

2014-10-01

Sleep disturbance and heavy drinking increase risk of negative consequences in college students. Limited research exists on how they act synergistically, and the overall nature of sleep and sleep-related impairment in college student drinkers is poorly understood. A latent profile analysis was conducted on the sleep characteristics and daytime sleep-related consequences of college student drinkers who were at-risk based on Alcohol Use Disorders Identification Test-Consumption scores. Participants (N = 312, mean age = 18.90 (0.97) years) consumed a mean (SD) of 20.93 (13.04) drinks per week. Scores on the 10 items of the Sleep/Wake Behavior Problems Scale (SWPS) were the class indicators. Four classes best described the sleep and sleep-related consequences of at-risk college drinkers. Classes represented different gradients and types of sleep patterns and sleep-related impairment; nearly half the sample reported late bedtimes and daytime consequences of insufficient sleep. Subsequent validation analyses indicated that these classes were directly correspondent with severity of alcohol consumption, alcohol-related consequences illicit substance use, and perceived health. These findings indicate the presence of significant heterogeneity in college drinkers' sleep patterns and experiences of sleep-related impairment. Class differences significantly impact the level of alcohol and drug use and the consequences members experience. Greater alcohol use and sleep/wake problems are associated with increased risk for negative consequences for certain classes. These results suggest that college drinking interventions could benefit from the incorporation of sleep-related content and the value in adding brief alcohol assessments and interventions to other college health treatments.

Sleep education improves the sleep duration of adolescents: a randomized controlled pilot study.

PubMed

Kira, Geoff; Maddison, Ralph; Hull, Michelle; Blunden, Sarah; Olds, Timothy

2014-07-15

To determine the feasibility and pilot a sleep education program in New Zealand high school students. A parallel, two-arm randomized controlled pilot trial was conducted. High school students (13 to 16 years) were randomly allocated to either a classroom-based sleep education program intervention (n = 15) or to a usual curriculum control group (n = 14). The sleep education program involved four 50-minute classroom-based education sessions with interactive groups. Students completed a 7-day sleep diary, a sleep questionnaire (including sleep hygiene, knowledge and problems) at baseline, post-intervention (4 weeks) and 10 weeks follow-up. An overall treatment effect was observed for weekend sleep duration (F 1,24 = 5.21, p = 0.03). Participants in the intervention group slept longer during weekend nights at 5 weeks (1:37 h:min, p = 0.01) and 10 weeks: (1:32 h:min, p = 0.03) compared to those in the control group. No differences were found between groups for sleep duration on weekday nights. No significant differences were observed between groups for any of the secondary outcomes (sleep hygiene, sleep problems, or sleep knowledge). A sleep education program appears to increase weekend sleep duration in the short term. Although this program was feasible, most schools are under time and resource pressure, thus alternative methods of delivery should be assessed for feasibility and efficacy. Larger trials of longer duration are needed to confirm these findings and determine the sustained effect of sleep education on sleep behavior and its impact on health and psychosocial outcomes. A commentary on this article appears in this issue on page 793.

Chronotype-related differences in childhood and adolescent aggression and antisocial behavior--a review of the literature.

PubMed

Schlarb, Angelika A; Sopp, Roxanne; Ambiel, David; Grünwald, Julia

2014-02-01

Eveningness has been found to negatively affect adolescents' sleep and daytime functioning. Furthermore, eveningness is associated with greater impulsivity than morningness. Externalizing behavior could be chronotype-related, implying that the alteration of the circadian rhythm itself is connected to aspects of emotion and emotion regulation. The present study investigated chronotype-related differences in emotional and behavioral problems, especially aggression and antisocial behavior in children and adolescents. We conducted a comprehensive search via web of knowledge (MEDLINE, web of science), EBSCO, Ovid, PubMed, Google Scholar and PsycINDEX using the keywords: chronotype, chronobiology, morningness, eveningness, owls and larks as well as diurnal preference to fully capture every aspect of chronotype. For aggression we used the search terms: aggression, anger, hostility, violence, anti-social behavior, conduct disorder, oppositional defiant disorder, delinquency, social adjustment and externalizing behavior. N = 13 studies were included concerning chronotype, childhood, adolescence and antisocial behavior. Results showed that children and adolescents being E-types were more affected by daytime impairments. Additionally, behavioral and emotional problems as aggression or antisocial behavior were more pronounced in E- than in M-types. Our findings support an association of eveningness and the impact of aggression on children and adolescents. Longitudinal investigations should be conducted in order to insure causality of the effects in question. In addition, the elevated vulnerability toward aggression in evening types demonstrates the need for prevention and intervention programs that educate youths in proper sleep hygiene and evoke an awareness of the consequences of a habitually diminished sleep quality.

Maternal Sensitivity and Children's Behavior Problems: Examining the Moderating Role of Infant Sleep Duration

ERIC Educational Resources Information Center

Bordeleau, Stephanie; Bernier, Annie; Carrier, Julie

2012-01-01

The current study aimed to examine infant sleep duration as a moderator of the relations between maternal sensitivity and child externalizing and internalizing symptoms, in a prospective longitudinal design. Fifty-five Caucasian infants (33 girls) took part in 2 assessments, at 1 and 4 years. Maternal sensitivity was rated at 1 year, based on…

Using an innovative multiple regression procedure in a cancer population (Part 1): detecting and probing relationships of common interacting symptoms (pain, fatigue/weakness, sleep problems) as a strategy to discover influential symptom pairs and clusters

PubMed Central

Francoeur, Richard B

2015-01-01

Background The majority of patients with advanced cancer experience symptom pairs or clusters among pain, fatigue, and insomnia. Improved methods are needed to detect and interpret interactions among symptoms or diesease markers to reveal influential pairs or clusters. In prior work, I developed and validated sequential residual centering (SRC), a method that improves the sensitivity of multiple regression to detect interactions among predictors, by conditioning for multicollinearity (shared variation) among interactions and component predictors. Materials and methods Using a hypothetical three-way interaction among pain, fatigue, and sleep to predict depressive affect, I derive and explain SRC multiple regression. Subsequently, I estimate raw and SRC multiple regressions using real data for these symptoms from 268 palliative radiation outpatients. Results Unlike raw regression, SRC reveals that the three-way interaction (pain × fatigue/weakness × sleep problems) is statistically significant. In follow-up analyses, the relationship between pain and depressive affect is aggravated (magnified) within two partial ranges: 1) complete-to-some control over fatigue/weakness when there is complete control over sleep problems (ie, a subset of the pain–fatigue/weakness symptom pair), and 2) no control over fatigue/weakness when there is some-to-no control over sleep problems (ie, a subset of the pain–fatigue/weakness–sleep problems symptom cluster). Otherwise, the relationship weakens (buffering) as control over fatigue/weakness or sleep problems diminishes. Conclusion By reducing the standard error, SRC unmasks a three-way interaction comprising a symptom pair and cluster. Low-to-moderate levels of the moderator variable for fatigue/weakness magnify the relationship between pain and depressive affect. However, when the comoderator variable for sleep problems accompanies fatigue/weakness, only frequent or unrelenting levels of both symptoms magnify the relationship. These findings suggest that a countervailing mechanism involving depressive affect could account for the effectiveness of a cognitive behavioral intervention to reduce the severity of a pain, fatigue, and sleep disturbance cluster in a previous randomized trial. PMID:25565865

Using an innovative multiple regression procedure in a cancer population (Part 1): detecting and probing relationships of common interacting symptoms (pain, fatigue/weakness, sleep problems) as a strategy to discover influential symptom pairs and clusters.

PubMed

Francoeur, Richard B

2015-01-01

The majority of patients with advanced cancer experience symptom pairs or clusters among pain, fatigue, and insomnia. Improved methods are needed to detect and interpret interactions among symptoms or diesease markers to reveal influential pairs or clusters. In prior work, I developed and validated sequential residual centering (SRC), a method that improves the sensitivity of multiple regression to detect interactions among predictors, by conditioning for multicollinearity (shared variation) among interactions and component predictors. Using a hypothetical three-way interaction among pain, fatigue, and sleep to predict depressive affect, I derive and explain SRC multiple regression. Subsequently, I estimate raw and SRC multiple regressions using real data for these symptoms from 268 palliative radiation outpatients. Unlike raw regression, SRC reveals that the three-way interaction (pain × fatigue/weakness × sleep problems) is statistically significant. In follow-up analyses, the relationship between pain and depressive affect is aggravated (magnified) within two partial ranges: 1) complete-to-some control over fatigue/weakness when there is complete control over sleep problems (ie, a subset of the pain-fatigue/weakness symptom pair), and 2) no control over fatigue/weakness when there is some-to-no control over sleep problems (ie, a subset of the pain-fatigue/weakness-sleep problems symptom cluster). Otherwise, the relationship weakens (buffering) as control over fatigue/weakness or sleep problems diminishes. By reducing the standard error, SRC unmasks a three-way interaction comprising a symptom pair and cluster. Low-to-moderate levels of the moderator variable for fatigue/weakness magnify the relationship between pain and depressive affect. However, when the comoderator variable for sleep problems accompanies fatigue/weakness, only frequent or unrelenting levels of both symptoms magnify the relationship. These findings suggest that a countervailing mechanism involving depressive affect could account for the effectiveness of a cognitive behavioral intervention to reduce the severity of a pain, fatigue, and sleep disturbance cluster in a previous randomized trial.

Cigarette smoking and sleep disturbance.

PubMed

Phillips, B A; Danner, F J

1995-04-10

Individuals with sleep complaints often exhibit unhealthy lifestyles, including obesity, excessive alcohol use, lack of physical exercise, and cigarette smoking. We sought to explore the relationship between cigarette smoking, poor sleep habits, and sleep complaints. Several lines of evidence suggest a relationship between cigarette smoking and sleep disturbance, including the effects of nicotine and nicotine withdrawal on sleep, a tendency for nonsmokers to be more alert in the morning, an association between cigarette smoking and snoring, and a tendency for individuals who engage in one unhealthy behavior also to engage in others. A total of 484 individuals aged 14 to 84 years completed a comprehensive sleep and health questionnaire. There were 99 high school students from grades 9 through 12 (45 boys and 54 girls, of whom 38 [38%] were smokers), who completed an in-class survey. In addition, 385 adults aged 20 to 84 years (122 men and 263 women, of whom 77 [20%] were smokers) from a random sample of 1000 completed a mail survey. The effects of age and smoking status on sleep, health, and daytime function were assessed by multivariate analysis of variance. Cigarette smokers were significantly more likely than nonsmokers to report problems going to sleep, problems staying asleep, daytime sleepiness, minor accidents, depression, and high daily caffeine intake. Individuals with sleep complaints should be queried about tobacco use. Those who are smokers should be advised that there is a relationship between cigarette smoking and sleep disturbance.

Atypical Behaviors in Children with Autism and Children with a History of Language Impairment

ERIC Educational Resources Information Center

Dominick, Kelli C.; Davis, Naomi Ornstein; Lainhart, Janet; Tager-Flusberg, Helen; Folstein, Susan

2007-01-01

The frequency, course, and inter-relationships of atypical eating, sleeping, self-injurious behavior, aggression and temper tantrums in children with autism and children with a history of language impairment (HLI), was investigated using a parent interview that was created to examine these problem behaviors. The relationships between these…

[Changes in behaviors and indicators of mental health between 2006 and 2010 in the French working population].

PubMed

Malard, L; Chastang, J-F; Niedhammer, I

2017-08-01

The 2008 economic crisis may have had an impact on mental health but the studies on this topic are sparse, in particular among the working population. However, mental health at work is a crucial issue involving substantial costs and consequences. The aim of the study was to assess changes in behaviors and indicators of mental health in the French working population between 2006 and 2010, and to explore the differential changes according to age, origin, occupation, activity sector, public/private sector, self-employed/employee status and work contract. The data came from the prospective national representative Santé et itinéraire professionnel (SIP) survey, including a sample of 5600 French workers interviewed in 2006 and 2010. The behaviors and indicators of mental health studied were excessive alcohol consumption, smoking, sleep problems (sleep disorders and/or insufficient sleep duration), psychotropic drug use (antidepressants, anxiolytics and/or hypnotics), and poor self-reported health. Generalized estimating equations were used to analyze changes in behaviors and indicators of mental health, and the analyses were adjusted for age. Covariates (age, origin, occupation, activity sector, public/private sector, self-employed/employee status and type of contract) were added separately to assess differential changes. Increases in excessive alcohol consumption among women, sleep problems among men, and smoking, insufficient sleep duration and poor self-reported health for both genders were observed in the French working population between 2006 and 2010. Some differential changes were observed, negative changes being more likely to affect young workers and workers with a permanent contract. Prevention policies should consider that behavior and indicators of mental health may deteriorate in times of economic crisis, especially among some sub-groups of the working population, such as young workers and workers with a permanent contract. These changes might foreshadow a forthcoming increase in mental disorders. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Impact of sleep, fatigue, and systemic inflammation on neurocognitive and behavioral outcomes in long-term survivors of childhood acute lymphoblastic leukemia.

PubMed

Cheung, Yin Ting; Brinkman, Tara M; Mulrooney, Daniel A; Mzayek, Yasmin; Liu, Wei; Banerjee, Pia; Panoskaltsis-Mortari, Angela; Srivastava, Deokumar; Pui, Ching-Hon; Robison, Leslie L; Hudson, Melissa M; Krull, Kevin R

2017-09-01

Long-term survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for neurocognitive impairment, which may be associated with fatigue, sleep problems, systemic inflammation, and oxidative stress. We examined these associations among survivors of childhood ALL treated with chemotherapy only. Survivors of childhood ALL (male, n = 35 and female, n = 35; mean age, 14.3 years [standard deviation, 4.7 years] and mean years from diagnosis, 7.4 years [standard deviation, 1.9 years]) completed neurocognitive testing, behavioral ratings, and reported sleep quality and fatigue symptoms 5 years after diagnosis. Serum was collected concurrently and assayed for interleukin (IL)-1β and IL-6, tumor necrosis factor α (TNF-α), high-sensitivity C-reactive protein (hsCRP), malondialdehyde, myeloperoxidase, and oxidized low-density lipoprotein. General linear modeling was used to assess associations among biomarkers and functional outcomes, adjusting for age and stratified by sex. Survivors performed worse than population norms on executive function and processing speed and reported more behavioral problems (P < .05 adjusted for multiple comparison). In female survivors, fatigue was associated with poor executive function (r = 0.41; P = .02), processing speed (r = 0.56; P < .001), and attention (r = 0.36-0.55; P < .05). Female survivors with frequent nighttime awakening displayed more inattention (P = .01), hyperactivity (P = .03), and aggression (P = .01). Worse executive function, processing speed, and behavioral symptoms were observed in female survivors with higher levels of IL-6, IL-1β, and hsCRP (P < .05). Male survivors with high levels of TNF-α demonstrated worse organization (P = .03), but no significant associations between neurocognitive outcomes and sleep/fatigue measures were observed. Neurocognitive function in female survivors of childhood ALL appears more susceptible to the effects of sleep disturbance and fatigue. Systemic inflammation may play a role in neurocognitive impairment and behavioral symptoms. Cancer 2017;123:3410-9. © 2017 American Cancer Society. © 2017 American Cancer Society.

Using an innovative multiple regression procedure in a cancer population (Part II): fever, depressive affect, and mobility problems clarify an influential symptom pair (pain-fatigue/weakness) and cluster (pain-fatigue/weakness-sleep problems).

PubMed

Francoeur, Richard B

2015-01-01

Most patients with advanced cancer experience symptom pairs or clusters among pain, fatigue, and insomnia. However, only combinations where symptoms are mutually influential hold potential for identifying patient subgroups at greater risk, and in some contexts, interventions with "cross-over" (multisymptom) effects. Improved methods to detect and interpret interactions among symptoms, signs, or biomarkers are needed to reveal these influential pairs and clusters. I recently created sequential residual centering (SRC) to reduce multicollinearity in moderated regression, which enhances sensitivity to detect these interactions. I applied SRC to moderated regressions of single-item symptoms that interact to predict outcomes from 268 palliative radiation outpatients. I investigated: 1) the hypothesis that the interaction, pain × fatigue/weakness × sleep problems, predicts depressive affect only when fever presents, and 2) an exploratory analysis, when fever is absent, that the interaction, pain × fatigue/weakness × sleep problems × depressive affect, predicts mobility problems. In the fever context, three-way interactions (and derivative terms) of the four symptoms (pain, fatigue/weakness, fever, sleep problems) are tested individually and simultaneously; in the non-fever context, a single four-way interaction (and derivative terms) is tested. Fever interacts separately with fatigue/weakness and sleep problems; these comoderators each magnify the pain-depressive affect relationship along the upper or full range of pain values. In non-fever contexts, fatigue/weakness, sleep problems, and depressive affect comagnify the relationship between pain and mobility problems. Different mechanisms contribute to the pain × fatigue/weakness × sleep problems interaction, but all depend on the presence of fever, a sign/biomarker/symptom of proinflammatory sickness behavior. In non-fever contexts, depressive affect is no longer an outcome representing malaise from the physical symptoms of sickness, but becomes a fourth symptom of the interaction. In outpatient subgroups at heightened risk, single interventions could potentially relieve multiple symptoms when fever accompanies sickness malaise and in non-fever contexts with mobility problems. SRC strengthens insights into symptom pairs/clusters.

The Association Between Sleep Disordered Breathing, Academic Grades, and Cognitive and Behavioral Functioning Among Overweight Subjects During Middle to Late Childhood

PubMed Central

Beebe, Dean W.; Ris, M. Douglas; Kramer, Megan E.; Long, Elizabeth; Amin, Raouf

2010-01-01

Study Objectives: (1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning. Design: Cross-sectional correlative study. Setting: Office/hospital, plus reported functioning at home and at school. Participants: 163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n = 26), and No SDB (AHI < 1 and nonsnoring, n = 37). Measurements: Inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing. Results: The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning. Conclusions: SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school. Citation: Beebe DW; Ris MD; Kramer ME; Long E; Amin R. The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood. SLEEP 2010;33(11):1447-1456. PMID:21102986

Sleep, attention, and executive functioning in children with attention-deficit/hyperactivity disorder.

PubMed

Moreau, Vincent; Rouleau, Nancie; Morin, Charles M

2013-11-01

The objective of this study was to investigate potential relationships between two measures of sleep impairments (i.e., sleep duration and sleep efficiency [SE]) and attention and executive functioning in children with attention-deficit/hyperactivity disorder (ADHD). Parents of 43 children (mean age = 10 ± 1.8 years) with ADHD completed sleep and behavioral questionnaires. Children also wore a wrist actigraph for seven nights and were subsequently assessed with the Conners' continuous performance test (CPT)-2. A significant relationship was found between lower SE and increased variability in reaction time on the CPT. Shorter sleep duration was associated with a range of executive functioning problems as reported by the parents. The relationships between sleep duration and the executive functioning measures held even after controlling for age, gender, and use of medication, but not the relationships with SE. These results suggest that sleep quantity is an important correlate of executive functioning in children with ADHD.

Chronic stress, catecholamines, and sleep disturbance at Three Mile Island.

PubMed

Davidson, L M; Fleming, R; Baum, A

1987-01-01

The present study was concerned with the relationship between chronic stress and sleep disturbance. Previous research has provided evidence of chronic stress responding among people living near the Three Mile Island nuclear generating facility. Compared to control subjects, the TMI group has exhibited greater symptom reporting, poorer performance on behavioral measures of concentration, and elevated levels of urinary norepinephrine and epinephrine. Other research has suggested a relationship between arousal and insomnia. The extent to which stress and sleep disturbances were experienced by residents at TMI was examined and compared to levels of stress and sleep disturbance among a group of control subjects. The relationship between stress and sleep disturbances was also examined. Results indicated that TMI area residents exhibited more stress than the controls and reported greater disturbance of sleep. Modest relationships among stress and sleep measures suggested that the symptoms of stress measured in this study were not primary determinants of sleep problems.

GABA-BZD Receptor Modulating Mechanism of Panax quinquefolius against 72-h Sleep Deprivation Induced Anxiety like Behavior: Possible Roles of Oxidative Stress, Mitochondrial Dysfunction and Neuroinflammation

PubMed Central

Chanana, Priyanka; Kumar, Anil

2016-01-01

Rationale: Panax quinquefolius (American Ginseng) is known for its therapeutic potential against various neurological disorders, but its plausible mechanism of action still remains undeciphered. GABA (Gamma Amino Butyric Acid) plays an important role in sleep wake cycle homeostasis. Thus, there exists rationale in exploring the GABA-ergic potential of Panax quinquefolius as neuroprotective strategy in sleep deprivation induced secondary neurological problems. Objective: The present study was designed to explore the possible GABA-ergic mechanism in the neuro-protective effect of Panax quinquefolius against 72-h sleep deprivation induced anxiety like behavior, oxidative stress, mitochondrial dysfunction, HPA-axis activation and neuroinflammation. Materials and Methods: Male laca mice were sleep deprived for 72-h by using Grid suspended over water method. Panax quinquefolius (American Ginseng 50, 100, and 200 mg/kg) was administered alone and in combination with GABA modulators (GABA Cl− channel inhibitor, GABA-benzodiazepine receptor inhibitor and GABAA agonist) for 8 days, starting 5 days prior to 72-h sleep deprivation period. Various behavioral (locomotor activity, mirror chamber test), biochemical (lipid peroxidation, reduced glutathione, catalase, nitrite levels), mitochondrial complexes, neuroinflammation marker (Tumor Necrosis Factor, TNF-alpha), serum corticosterone, and histopathological sections of brains were assessed. Results: Seventy two hours sleep deprivation significantly impaired locomotor activity, caused anxiety-like behavior, conditions of oxidative stress, alterations in mitochondrial enzyme complex activities, raised serum corticosterone levels, brain TNFα levels and led to neuroinflammation like signs in discrete brain areas as compared to naive group. Panax quinquefolius (100 and 200 mg/kg) treatment restored the behavioral, biochemical, mitochondrial, molecular and histopathological alterations. Pre-treatment of GABA Cl− channel inhibitor as well as GABA-benzodiazepine receptor inhibitor, significantly reversed the protective effect of P. quinquefolius (100 mg/kg) in 72-h sleep deprived animals (P < 0.05). However, pretreatment with GABAA agonist, potentiated Panax quinquefolius's protective effect which was significant as compared to their effect per se (p < 0.05). Conclusion: GABA-ergic mechanism could be involved in the neuroprotective effect of P.quinquefolius against sleep deprivation induced anxiety-like behavior, oxidative stress, mitochondrial dysfunction, HPA axis activation and neuroinflammation. PMID:27013946

Technology Use and Sleep Quality in Preadolescence and Adolescence.

PubMed

Bruni, Oliviero; Sette, Stefania; Fontanesi, Lilybeth; Baiocco, Roberto; Laghi, Fiorenzo; Baumgartner, Emma

2015-12-15

The purpose of this study was to analyze differences between preadolescents and adolescents on the use of technology and to test the contribution of using Internet and mobile phone, and circadian preference on sleep quality. We recruited a sample of 850 (364 males) preadolescents and adolescents. Self-report questionnaires about sleep schedule, sleep wake behavior problems, circadian preferences, and the use of technology (e.g., Internet and mobile phone) were administered. Students were asked to fill out the School Sleep Habits Survey, a self-report questionnaire on the use of technology, the Mobile Phone Involvement Questionnaire (MPIQ), and the Shorter Promis Questionnaire (SPQ). Adolescents reported more sleep problems, a tendency toward eveningness, and an increase of Internet and phone activities, as well as social network activities, while preadolescents were more involved in gaming console and television viewing. The regression analysis performed separately in the two age groups showed that sleep quality was affected by the circadian preference (eveningness) in both groups. Adolescents' bad sleep quality was consistently associated with the mobile phone use and number of devices in the bedroom, while in preadolescents, with Internet use and turning-off time. The evening circadian preference, mobile phone and Internet use, numbers of other activities after 21:00, late turning off time, and number of devices in the bedroom have different negative influence on sleep quality in preadolescents and adolescents. © 2015 American Academy of Sleep Medicine.

Perceived insufficient rest or sleep among adults - United States, 2008.

PubMed

2009-10-30

The importance of chronic sleep insufficiency is under-recognized as a public health problem, despite being associated with numerous physical and mental health problems, injury, loss of productivity, and mortality. Approximately 29% of U.S. adults report sleeping <7 hours per night and 50-70 million have chronic sleep and wakefulness disorders. A CDC analysis of 2006 data from the Behavioral Risk Factor Surveillance System (BRFSS) in four states showed that an estimated 10.1% of adults reported receiving insufficient rest or sleep on all days during the preceding 30 days. To examine the prevalence of insufficient rest or sleep in all states, CDC analyzed BRFSS data for all 50 states, the District of Columbia (DC), and three U.S. territories (Guam, Puerto Rico, and U.S. Virgin Islands) in 2008. This report summarizes the results, which showed that among 403,981 respondents, 30.7% reported no days of insufficient rest or sleep and 11.1% reported insufficient rest or sleep every day during the preceding 30 days. Females (12.4%) were more likely than males (9.9%) and non-Hispanic blacks (13.3%) were more likely than other racial/ethnic groups to report insufficient rest or sleep. State estimates of 30 days of insufficient rest or sleep ranged from 7.4% in North Dakota to 19.3% in West Virginia. Health-care providers should consider adding an assessment of chronic rest or sleep insufficiency to routine office visits so they can make needed interventions or referrals to sleep specialists.

Sickness absenteeism is associated with sleep problems independent of sleep disorders: results of the 2016 Sleep Health Foundation national survey.

PubMed

Reynolds, Amy C; Appleton, Sarah L; Gill, Tiffany K; Taylor, Anne W; McEvoy, R Douglas; Ferguson, Sally A; Adams, Robert J

2017-10-01

Sleep disorders are associated with sickness absenteeism (SA), at significant economic cost. Correlates of absenteeism are less well described in nonclinical samples. We determined the relationship between markers of inadequate sleep and SA in a sample of 551 working adults aged ≥18 years across Australia. We considered diagnosed obstructive sleep apnea (OSA) and insomnia symptoms, daytime symptoms, and sleepiness with respect to sickness absenteeism (missing ≥1 day of work in the past 28 days because of problems with physical or mental health). Sickness absenteeism was reported by 27.0% of participants and was more frequent in younger participants, university graduates, and those experiencing financial stress. Sickness absenteeism was independently associated with insomnia (odds ratio [OR]=2.5, confidence interval [CI]=1.5-4.0], OSA (OR=9.8, CI=4.7-20.7), sleep aid use (OR=3.0, CI=1.9-4.7), and daytime symptoms (OR=3.0, CI=2.0-4.6) and inversely associated with perception of getting adequate sleep (OR=0.6, CI=0.4-0.9). Associations persisted in the population free of insomnia and/or OSA. In adults without clinical sleep disorders, sleep behaviors are contributing to sickness absenteeism. An increased focus at an organizational level on improvement of sleep hygiene is important to reduce lost work performance. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Mexican American Adolescents’ Sleep Patterns: Contextual Correlates and Implications for Health and Adjustment in Young Adulthood

PubMed Central

Kuo, Sally I-Chun; Updegraff, Kimberly A.; Zeiders, Katharine H.; McHale, Susan M.; Umaña-Taylor, Adriana J.; De Jesús, Sue A. Rodríguez

2014-01-01

Late adolescence is a period of substantial risk for unhealthy sleep patterns. This study investigated the contextual correlates and health and adjustment implications of sleep patterns among Mexican American youth (N = 246; 51% female). We focused on Mexican American youth because they represent a large and rapidly increasing subgroup of the U.S. population that is at higher risk for health and adjustment problems; this higher risk may be explained, in part, by sleep patterns. Using data from 7 phone diary interviews conducted when youth averaged 18 years of age, we assessed average nighttime sleep duration and night-to-night variability in sleep duration. Guided by socio-ecological models, we first examined how experiences in the family context (time spent and quality of relationships with parents, parents’ familism values) and in extra-familial contexts (school, work, peers) were related to sleep duration and variability. The findings revealed that time spent in school, work, and with peers linked to less sleep. Further, conflict with mothers was related to greater sleep variability. Next, we tested the implications of sleep in late adolescence for health (perceived physical health, body mass index) and adjustment (depressive symptoms, risky behaviors) in young adulthood. These findings indicated that more sleep variability predicted relative decreases in health and increases in risky behaviors, and shorter sleep duration predicted relative decreases in poorer perceived health for males. The discussion highlights the significance of the transition to young adulthood as a target for sleep research and the importance of studying sleep within its socio-cultural context. PMID:25047598

Sleep Problems

MedlinePlus

... Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Consumer Information by Audience For ... effects like: Severe allergic reactions Severe face swelling Behaviors like making phone calls, eating, having sex or ...

Sleep Apnea Detection

MedlinePlus

... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... the night Sleepiness during the day Difficulty paying attention Behavior problems If you notice any of these ...

Evidence for similarities between adolescents and parents in sleep patterns.

PubMed

Brand, Serge; Gerber, Markus; Hatzinger, Martin; Beck, Johannes; Holsboer-Trachsler, Edith

2009-12-01

Sleep in adolescence may vary according to strain and environmental factors. In particular, parents' behavior may affect their children's psychological functioning and sleep. However, no data have been gathered with respect to parents and their adolescent children's concurrent sleep patterns. This was the aim of the present study, together with exploration of the possible influence of parenting style on adolescents' sleep. A total of 293 adolescents (mean age: 17.55; 214 females, 79 males) completed several questionnaires regarding their own psychological functioning as well as a sleep log for seven consecutive days. Additionally, adolescents rated parents' sleep and parenting styles. Adolescents' and parents' sleep patterns proved to be correlated. Moreover, mother's sleep was related to adolescents' psychological functioning. However, SEM showed that mother's sleep influenced adolescents' sleep not directly, but indirectly, via parenting style and adolescents' psychological functioning. Sleep patterns of parents and their adolescent children show similarities. Moreover, mother's poor sleep has a direct impact on parenting style, which in turn affects adolescents' psychological functioning and sleep. Therefore, sleep problems in adolescents may mirror an unfavorable parenting style and sleep complaints among mothers. These conclusions might usefully inform family counseling and treatment of adults' and adolescents' sleep complaints.

Impact of pediatric epilepsy on sleep patterns and behaviors in children and parents.

PubMed

Larson, Anna M; Ryther, Robin C C; Jennesson, Melanie; Geffrey, Alexandra L; Bruno, Patricia L; Anagnos, Christina J; Shoeb, Ali H; Thibert, Ronald L; Thiele, Elizabeth A

2012-07-01

Disrupted sleep patterns in children with epilepsy and their parents are commonly described clinically. A number of studies have shown increased frequency of sleep disorders among pediatric epilepsy patients; however, few have characterized the association between epilepsy and parental sleep quality and household sleeping arrangements. The purpose of this study was to explore the effect of pediatric epilepsy on child sleep, parental sleep and fatigue, and parent-child sleeping arrangements, including room sharing and cosleeping. Parents of children 2 to 10 years of age with and without epilepsy completed written questionnaires assessing seizure history, child and parent sleep, and household sleeping arrangements. Children's Sleep Habits Questionnaire (CSHQ) scores were used to evaluate sleep disturbances for the child. The Pittsburgh Sleep Quality Index (PSQI) and the Iowa Fatigue Scale (IFS) were used to evaluate parental sleep and fatigue, respectively. The Early Childhood Epilepsy Severity Scale (E-Chess) was used to assess epilepsy severity. One hundred five households with a child with epilepsy and 79 controls participated in this study. Households with a child with epilepsy reported increased rates of both parent-child room sharing (p < 0.001) and cosleeping (p = 0.005) compared to controls. Children with epilepsy were found to have greater sleep disturbance by total CSHQ score (p < 0.001) and the following subscores: parasomnias (p < 0.001), night wakings (p < 0.001), sleep duration (p < 0.001), daytime sleepiness (<0.001), sleep onset delay (p = 0.009), and bedtime resistance (p = 0.023). Parents of children with epilepsy had increased sleep dysfunction (p = 0.005) and were more fatigued (p < 0.001). Severity of epilepsy correlated positively with degree of child sleep dysfunction (0.192, p = 0.049), parental sleep dysfunction (0.273, p = 0.005), and parental fatigue (0.324, p = 0.001). Antiepileptic drug polytherapy was predictive of greater childhood sleep disturbances. Nocturnal seizures were associated with parental sleep problems, whereas room sharing and cosleeping behavior were associated with child sleep problems. Within the epilepsy cohort, 69% of parents felt concerned about night seizures and 44% reported feeling rested rarely or never. Finally, 62% of parents described decreased sleep quality and/or quantity with cosleeping. Pediatric epilepsy can significantly affect sleep patterns for both the affected child and his or her parents. Parents frequently room share or cosleep with their child, adaptations which may have detrimental effects for many households. Clinicians must not only be attentive to the sleep issues occurring in pediatric patients with epilepsy, but also for the household as a whole. These data provide evidence of a profound clinical need for improved epilepsy therapeutics and the development of nocturnal seizure monitoring technologies. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

"They silently live in terror…" why sleep problems and night-time related quality-of-life are missed in children with a fetal alcohol spectrum disorder.

PubMed

Ipsiroglu, Osman S; McKellin, William H; Carey, Norma; Loock, Christine

2013-02-01

Children and adolescents with a Fetal Alcohol Spectrum Disorder (FASD) are at high-risk for developing sleep problems (SPs) triggering daytime behavioral co-morbidities such as inattention, hyperactivity, and cognitive and emotional impairments. However, symptoms of sleep deprivation are solely associated with typical daytime diagnosis, such as attention deficit hyperactivity disorder (ADHD) and treated with psychotropic medications. To understand how and why SPs are missed, we conducted qualitative interviews (QIs) with six parents and seven health care professionals (HCPs), and performed comprehensive clinical sleep assessments (CCSAs) in 27 patients together with their caregivers referred to our clinic for unresolved SPs. We used narrative schema and therapeutic emplotment in conjunction with analyzes of medical records to appropriately diagnose SPs and develop treatment strategies. The research was conducted at British Columbia Children's Hospital in Vancouver (Canada) between 2008 and 2011. In the QIs, parents and HCPs exhibited awareness of the significance of SPs and the effects of an SP on the daytime behaviors of the child and the associated burdens on the parents. HCPs' systemic inattention to the sequelae of SPs and the affected family's wellbeing appears due to an insufficient understanding of the various factors that contribute to nighttime SPs and their daytime sequelae. In the CCSAs, we found that the diagnostic recognition of chronic SPs in children and adolescents was impaired by the exclusive focus on daytime presentations. Daytime behavioral and emotional problems were targets of pharmacological treatment rather than the underlying SP. Consequently, SPs were also targeted with medications, without investigating the underlying problem. Our study highlights deficits in the diagnostic recognition of chronic SPs among children with chronic neurodevelopmental disorders/disabilities and proposes a clinical practice strategy, based on therapeutic emplotment that incorporates patients and parents' contributions in recognizing SPs and related sequelae in designing appropriate treatment and care. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Sleep Disruption in Hematopoietic Cell Transplant Recipients: Prevalence, Severity, and Clinical Management

PubMed Central

Jim, Heather S.L.; Evans, Bryan; Jeong, Jiyeon M.; Gonzalez, Brian D.; Johnston, Laura; Nelson, Ashley M.; Kesler, Shelli; Phillips, Kristin M.; Barata, Anna; Pidala, Joseph; Palesh, Oxana

2014-01-01

Sleep disruption is common among hematopoietic cell transplant (HCT) recipients, with over 50% of patients experiencing sleep disruption pre-transplant, up to 82% experiencing moderate to severe sleep disruption during hospitalization for transplant, and up to 43% in the post-transplant period. These rates of sleep disruption are substantially higher than the general population. Although sleep disruption can be distressing to patients and contribute to diminished quality of life, it is rarely discussed during clinical visits. The goal of the current review is to draw attention to sleep disruption as a clinical problem in HCT in order to facilitate patient education, intervention, and research. The review opens with a discussion of sleep disruption measurement and clinical diagnosis of sleep disorders. An overview of the prevalence, severity, and chronicity of sleep disruption and disorders in patients receiving HCT follows. Current evidence regarding sociodemographic and clinical predictors of sleep disruption and disorders is summarized. The review concludes with suggestions for behavioral and pharmacologic management of sleep disruption and disorders as well as directions for future research. PMID:24747335

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion.

PubMed

Paruthi, Shalini; Brooks, Lee J; D'Ambrosio, Carolyn; Hall, Wendy A; Kotagal, Suresh; Lloyd, Robin M; Malow, Beth A; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F; Rosen, Carol L; Troester, Matthew M; Wise, Merrill S

2016-11-15

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. A commentary on this article apears in this issue on page 1439. © 2016 American Academy of Sleep Medicine

Sleep-wake patterns reported by parents in hyperactive children diagnosed according to ICD-10, as compared to paired controls.

PubMed

Gomes, Ana Allen; Parchão, Carla; Almeida, Anabela; Clemente, Vanda; Pinto de Azevedo, Maria Helena

2014-10-01

This study aimed primarily to compare the parent-reported sleep of children with ICD-10 hyperkinetic disorder (HKD) versus community children. Thirty children aged 5-13 years (83.3% boys) diagnosed with HKD by their child and adolescent psychiatrists took part in this study, plus 30 community children, matched for sex, age, and school year. Compared to the controls, the HKD children showed significantly later bedtimes, stronger bedtime resistance, longer sleep latency, shorter sleep; more frequent behaviors and symptoms concerning falling asleep into parents bed, needing something special to initiate sleep, nightmares, sleep talking, sleep bruxism, fear from darkness, bedwetting, and, most notably, loud snoring (26.7%); they also tended to show higher daytime somnolence. Attention deficit/hyperactivity disorder (ADHD)/HKD children may thus have more sleep-related problems than typically developing children. Alternatively, our results may reflect misdiagnoses; thus, special attention should be directed to comorbidity and differential diagnosis issues between sleep disturbances and ADHD/HKD.

Who benefits from adolescent sleep interventions? Moderators of treatment efficacy in a randomized controlled trial of a cognitive-behavioral and mindfulness-based group sleep intervention for at-risk adolescents.

PubMed

Blake, Matthew J; Blake, Laura M; Schwartz, Orli; Raniti, Monika; Waloszek, Joanna M; Murray, Greg; Simmons, Julian G; Landau, Elizabeth; Dahl, Ronald E; McMakin, Dana L; Dudgeon, Paul; Trinder, John; Allen, Nicholas B

2018-06-01

The aim of this study was to test moderators of therapeutic improvement in an adolescent cognitive-behavioral and mindfulness-based group sleep intervention. Specifically, we examined whether the effects of the program on postintervention sleep outcomes were dependent on participant gender and/or measures of sleep duration, anxiety, depression, and self-efficacy prior to the interventions. Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 59.34%; mean age = 14.48 years, range 12.04-16.31 years) who had elevated levels of sleep problems and anxiety symptoms. Participants were randomized into either a group sleep improvement intervention (n = 63) or group active control 'study skills' intervention (n = 60). The sleep intervention ('Sleep SENSE') was cognitive behavioral in approach, incorporating sleep education, sleep hygiene, stimulus control, and cognitive restructuring, but also had added anxiety-reducing, mindfulness, and motivational interviewing elements. Components of the active control intervention ('Study SENSE') included personal organization, persuasive writing, critical reading, referencing, memorization, and note taking. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Center for Epidemiologic Studies Depression Scale (CES-D), and General Self-Efficacy Scale (GSE) and wore an actigraph and completed a sleep diary for five school nights prior to the interventions. Sleep assessments were repeated at postintervention. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612001177842; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001177842&isBasic=True). The results showed that compared with the active control intervention, the effect of the sleep intervention on self-reported sleep quality (PSQI global score) at postintervention was statistically significant among adolescents with relatively moderate to high SCAS, CES-D, and GSE prior to the intervention, but not among adolescents with relatively low SCAS, CES-D, and GSE prior to the intervention. The results were consistent across genders. However, the effects of the sleep intervention on actigraphy-measured sleep onset latency and sleep diary-measured sleep efficiency at postintervention were not dependent on actigraphy-measured total sleep time, SCAS, CES-D, or GSE prior to the intervention. This study provides evidence that some sleep benefits of adolescent cognitive-behavioral sleep interventions are greatest among those with higher levels of anxiety and depressive symptoms, suggesting that this may be an especially propitious group to whom intervention efforts could be targeted. Furthermore, adolescents with lower levels of self-efficacy may need further targeted support (e.g. additional motivational interviewing) to help them reach treatment goals. © 2017 Association for Child and Adolescent Mental Health.

Regional Brain Tissue Changes and Associations with Disease Severity in Children with Sleep Disordered Breathing.

PubMed

Horne, Rosemary S C; Roy, Bhaswati; Walter, Lisa M; Biggs, Sarah N; Tamanyan, Knarik; Weichard, Aidan; Nixon, Gillian M; Davey, Margot J; Ditchfield, Michael; Harper, Ronald M; Kumar, Rajesh

2017-12-15

Children with sleep-disordered breathing (SDB) exhibit behavioral, cognitive, and autonomic deficits, suggestive of neural injury. We assessed whether the tissue alterations resulted from acute or chronic processes, and if alterations correlated with disease severity. Brain tissue integrity was examined with mean diffusivity (MD) (3.0-Tesla scanner) in 20 non-snoring controls (mean age±sem, 12.2±0.6y; 10 male) and 18 children with SDB (12.3±0.7y; 11 male). Sleep, cognitive, and behavioral measures were compared between groups following overnight polysomnography using Student's t-tests. Whole-brain MD maps were realigned and averaged, normalized, smoothed, and compared between groups using ANCOVA (covariates; age, gender, and socioeconomic status). Partial correlations were calculated between whole-brain smoothed MD maps and obstructive apnea hypopnea indices (OAHI). Age, gender, and sleep variables did not differ between groups. The SDB group showed higher OAHI, body mass indices, and systolic blood pressure. Significantly reduced MD values (acute changes) appeared in the hippocampus, insula, thalamus, temporal and occipital cortices, and cerebellum, but were increased (chronic damage) in the frontal and prefrontal cortices in the SDB group over controls. Both positive and negative correlations appeared with extent of tissue changes and disease severity. Externalizing and Total Problem Behaviors were significantly higher in SDB children. Verbal, performance and total IQ scores trended lower, and behavioral scores trended higher. Pediatric SDB is accompanied by predominantly acute brain changes in areas that regulate autonomic, cognitive, and mood functions, and chronic changes in frontal cortices essential for behavioral control. Interventions need to be keyed to address acute vs chronic injury. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Cognition and behavior in pre-pubertal children with Prader-Willi syndrome and associations with sleep-related breathing disorders.

PubMed

Festen, Dederieke A M; Wevers, Maaike; de Weerd, Al W; van den Bossche, Renilde A S; Duivenvoorden, Hugo J; Hokken-Koelega, Anita C S

2008-12-01

Prader-Willi syndrome (PWS) is characterized by hypotonia, hypogonadism, obesity, and short stature. Neurobehavioral abnormalities, cognitive impairment, and sleep-related breathing disorders (SRBD) are common. In the general population associations between neurobehavioral and cognitive abnormalities and SRBD have been found. We investigated cognition, behavior, and SRBD in children with PWS. Thirty-one pre-pubertal PWS children were evaluated (5 with paternal deletion, 14 with maternal disomy, 4 with imprinting-center mutation, and in 8 the defect was not specified). Cognition was assessed by Wechsler scale subtests, and behavior by parent-questionnaires. Polysomnography was performed. Cognition, behavior, and associations with SRBD were evaluated. All cognitive subtests were significantly below O SDS, with the lowest median (interquartile range) scores for the Block design subtest (-2.7 SDS (-3.0 to -0.3)). In 60%, verbal subtests were less affected than performance subtests. Parents reported problem behavior related to "emotions/behavior not adapted to the social situation" and "insensitivity to social information." All children had SRBD, with an Apnea Hypopnea Index of 4.1/hr (2.6-7.9). One performance subtest score was significantly higher in children with better sleep efficiency, and daytime sleepiness was associated with more autistic-like social impairment. In contrast to our expectations, behavior was worse in children with better sleep-related breathing. In pre-pubertal PWS children, cognition is impaired. Neurobehavioral abnormalities are common, particularly autistic-like social impairment. Sleep efficiency was associated with better performance on one of the performance subtests, and neurobehavioral abnormalities were associated with daytime sleepiness. In contrast, we could not confirm a positive association of neurobehavioral abnormalities with SRBD in PWS. Copyright (c) 2008 Wiley-Liss, Inc.

Sleep problems during the menopausal transition: prevalence, impact, and management challenges

PubMed Central

de Zambotti, Massimiliano; Colrain, Ian M; Bei, Bei

2018-01-01

A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years. PMID:29445307

Sleep-Related Behaviors and Beliefs Associated With Race/Ethnicity in Women

PubMed Central

Grandner, Michael A.; Patel, Nirav P.; Jean-Louis, Girardin; Jackson, Nicholas; Gehrman, Philip R.; Perlis, Michael L.; Gooneratne, Nalaka S.

2013-01-01

Explore how social factors influence sleep, especially sleep-related beliefs and behaviors. Sleep complaints, sleep hygiene behaviors, and beliefs about sleep were studied in 65 black/African American and white/European American women. Differences were found for snoring and discrepancy between sleep duration and need. Sleep behaviors differed across groups for napping, methods for coping with sleep difficulties, and nonsleep behaviors in bed. Beliefs also distinguished groups, with differences in motivation for sleep and beliefs about sleep being important for health and functioning. These findings have important public health implications in terms of developing effective sleep education interventions that include consideration of cultural aspects. PMID:23862291

Construct validity of the parent-child sleep interactions scale (PSIS): associations with parenting, family stress, and maternal and child psychopathology.

PubMed

Smith, Victoria C; Leppert, Katherine A; Alfano, Candice A; Dougherty, Lea R

2014-08-01

Using a multi-method design, this study examined the construct validity of the Parent-Child Sleep Interactions Scale (PSIS; Alfano et al., 2013), which measures sleep-related parenting behaviors and interactions that contribute to preschoolers' sleep problems. Participants included a community sample of 155 preschoolers (ages 3-5years; 51.6% female). Primary caregivers completed the PSIS. Parenting styles and behaviors were assessed with laboratory observations and parent reports. Parent and child psychopathology and family life stress were assessed with clinical interviews and parent reports. Bivariate correlations revealed significant associations between the PSIS and a number of variables, including lower observed parental support and quality of instruction; higher observed parental intrusiveness; authoritative, authoritarian, and permissive parenting styles; current maternal depressive and/or anxiety disorders and depressive symptomatology; increased stressful life events; lower marital satisfaction; and higher child depressive, anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms. The patterns of association varied based on the specific PSIS scale. The PSIS demonstrates meaningful associations with parenting, maternal psychopathology, family stress, and child psychopathology and functioning. Findings suggest that the PSIS is a valid measure for assessing sleep-related parent/child behaviors and interactions among preschoolers, suited to real-world settings. Copyright © 2014 Elsevier B.V. All rights reserved.

Short Sleep Duration Among Middle School and High School Students - United States, 2015.

PubMed

Wheaton, Anne G; Jones, Sherry Everett; Cooper, Adina C; Croft, Janet B

2018-01-26

Insufficient sleep among children and adolescents is associated with increased risk for obesity, diabetes, injuries, poor mental health, attention and behavior problems, and poor academic performance (1-4). The American Academy of Sleep Medicine has recommended that, for optimal health, children aged 6-12 years should regularly sleep 9-12 hours per 24 hours and teens aged 13-18 years should sleep 8-10 hours per 24 hours (1). CDC analyzed data from the 2015 national, state, and large urban school district Youth Risk Behavior Surveys (YRBSs) to determine the prevalence of short sleep duration (<9 hours for children aged 6-12 years and <8 hours for teens aged 13-18 years) on school nights among middle school and high school students in the United States. In nine states that conducted the middle school YRBS and included a question about sleep duration in their questionnaire, the prevalence of short sleep duration among middle school students was 57.8%, with state-level estimates ranging from 50.2% (New Mexico) to 64.7% (Kentucky). The prevalence of short sleep duration among high school students in the national YRBS was 72.7%. State-level estimates of short sleep duration for the 30 states that conducted the high school YRBS and included a question about sleep duration in their questionnaire ranged from 61.8% (South Dakota) to 82.5% (West Virginia). The large percentage of middle school and high school students who do not get enough sleep on school nights suggests a need for promoting sleep health in schools and at home and delaying school start times to permit students adequate time for sleep.

Sleep hygiene education: efficacy on sleep quality in working women.

PubMed

Chen, Pao-Hui; Kuo, Hung-Yu; Chueh, Ke-Hsin

2010-12-01

Although sleep hygiene education represents a promising approach for patients with poor sleep quality, little research has been devoted in understanding the sleep hygiene behavior and knowledge of working women. The purpose of this study was to investigate the efficacy of a short-term sleep hygiene education program on working women with poor sleep quality. This pilot study was a prospective and an exploratory intervention study. The intervention was tested on 37 selected working women with poor sleep quality in the community. The Pittsburgh Sleep Quality Index (score > 5) was used to identify working women with poor sleep quality. After a pretest to assess sleep quality, researchers implemented a 5-week sleep hygiene education program that addressed good sleep environments/habits, emotional stress, the influence of diet/alcohol/tobacco on sleep, exercise, and alternative therapies. Tests administered midway through the program and after program completion provided the data used to analyze effective sleep quality changes. Results showed sleep hygiene education to improve participant sleep quality significantly (p < .001). The sleep quality of all participants improved over both the 3- and the 5-week education program. The six components of the Pittsburgh Sleep Quality Index (i.e., subjective sleep quality, sleep latency, sleep duration, sleep disturbances, use of sleeping medication, and daytime dysfunction) also improved. A brief and effective sleep hygiene education program delivered by a nurse can improve sleep quality in working women with sleeping problems.

Forecasting Behavior in Smart Homes Based on Sleep and Wake Patterns

PubMed Central

Williams, Jennifer A.; Cook, Diane J.

2017-01-01

Background The goal of this research is to use smart home technology to assist people who are recovering from injuries or coping with disabilities to live independently. Objective We introduce an algorithm to model and forecast wake and sleep behaviors that are exhibited by the participant. Furthermore, we propose that sleep behavior is impacted by and can be modeled from wake behavior, and vice versa. Methods This paper describes the Behavior Forecasting (BF) algorithm. BF consists of 1) defining numeric values that reflect sleep and wake behavior, 2) forecasting wake and sleep values from past behavior, 3) analyzing the effect of wake behavior on sleep and vice versa, and 4) improving prediction performance by using both wake and sleep scores. Results The BF method was evaluated with data collected from 20 smart homes. We found that regardless of the forecasting method utilized, wake behavior and sleep behavior can be modeled with a minimum accuracy of 84%. Additionally, normalizing the wake and sleep scores drastically improves the accuracy to 99%. Conclusions The results show that we can effectively model wake and sleep behaviors in a smart environment. Furthermore, wake behaviors can be predicted from sleep behaviors and vice versa. PMID:27689555

Forecasting behavior in smart homes based on sleep and wake patterns.

PubMed

Williams, Jennifer A; Cook, Diane J

2017-01-01

The goal of this research is to use smart home technology to assist people who are recovering from injuries or coping with disabilities to live independently. We introduce an algorithm to model and forecast wake and sleep behaviors that are exhibited by the participant. Furthermore, we propose that sleep behavior is impacted by and can be modeled from wake behavior, and vice versa. This paper describes the Behavior Forecasting (BF) algorithm. BF consists of 1) defining numeric values that reflect sleep and wake behavior, 2) forecasting wake and sleep values from past behavior, 3) analyzing the effect of wake behavior on sleep and vice versa, and 4) improving prediction performance by using both wake and sleep scores. The BF method was evaluated with data collected from 20 smart homes. We found that regardless of the forecasting method utilized, wake behavior and sleep behavior can be modeled with a minimum accuracy of 84%. Additionally, normalizing the wake and sleep scores drastically improves the accuracy to 99%. The results show that we can effectively model wake and sleep behaviors in a smart environment. Furthermore, wake behaviors can be predicted from sleep behaviors and vice versa.

Sleep, executive functioning and behaviour in children and adolescents with type 1 diabetes.

PubMed

Caruso, Nicole C; Radovanovic, Branka; Kennedy, J Declan; Couper, Jennifer; Kohler, Mark; Kavanagh, Phillip S; Martin, A James; Lushington, Kurt

2014-12-01

The aim of the study was to examine sleep, neurocognitive and behavioural functioning in children and adolescents with type 1 diabetes (T1D) compared to controls and to test whether sleep quality mediates the relationship between diabetes and neurocognitive and behavioural deficits. Participants include 49 children and adolescents with T1D (recruited from a hospital clinic) and 36 healthy controls (age range = 6-16 years). Parents completed a survey consisting of the Sleep Disturbances Scale for Children, the Behavior Rating Inventory of Executive Functions, and the Behavior Assessment System for Children-2. Diabetic and demographic parameters were collated from medical records. The survey was posted to participants. Children with T1D compared to controls reported a higher frequency of sleep problems, and mild deficits in executive and behavioural functioning. Mediational analyses revealed that sleep quality fully mediated metacognitive functioning, externalised problematic behaviour, and internalised problematic behaviour, but not behavioural regulation. Rather than the direct impact of T1D on daytime functioning, it is the consequent impact of T1D on sleep and the resulting sleep disruption which can explain much of the neurocognitive and behavioural deficits reported in children with T1D. Maintaining good nocturnal glycaemic control may play a much larger role than previously thought in regulating daytime functioning in children with T1D. Copyright © 2014 Elsevier B.V. All rights reserved.

Chronic stress, catecholamines, and sleep disturbance at Three Mile Island

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davidson, L.M.; Fleming, R.; Baum, A.

The present study was concerned with the relationship between chronic stress and sleep disturbance. Previous research has provided evidence of chronic stress responding among people living near the Three Mile Island nuclear generating facility. Compared to control subjects, the TMI group has exhibited greater symptom reporting, poorer performance on behavioral measures of concentration, and elevated levels of urinary norepinephrine and epinephrine. Other research has suggested a relationship between arousal and insomnia. The extent to which stress and sleep disturbances were experienced by residents at TMI was examined and compared to levels of stress and sleep disturbance among a group ofmore » control subjects. The relationship between stress and sleep disturbances was also examined. Results indicated that TMI area residents exhibited more stress than the controls and reported greater disturbance of sleep. Modest relationships among stress and sleep measures suggested that the symptoms of stress measured in this study were not primary determinants of sleep problems.« less

Research on the relationship between the structural properties of bedding layer in spring mattress and sleep quality.

PubMed

Shen, Liming; Chen, Yu-xia; Guo, Yong; Zhong, ShiLu; Fang, Fei; Zhao, Jing; Hu, Tian-Yi

2012-01-01

Mattress, as a sleep platform, its types and physical properties has an important effect on sleep quality and rest efficiency. In this paper, by subjective evaluations, analysis of sleeping behaviors and tests of depth of sleep, the relationship between characteristics of the bedding materials, the structure of mattress, sleep quality and sleep behaviors were studied. The results showed that: (1) Characteristics of the bedding materials and structure of spring mattress had a remarkable effect on sleep behaviors and sleep quality. An optimum combination of the bedding materials, the structure of mattress and its core could improve the overall comfort of mattress, thereby improving the depth of sleep and sleep quality. (2) Sleep behaviors had a close relationship with sleeping postures and sleep habits. The characteristics of sleep behaviors vary from person to person.

Sleep duration's association with diet, physical activity, mental status, and weight among Korean high school students.

PubMed

Lee, Jounghee

2017-01-01

Sleep deprivation is a critical public health problem, especially in Korean adolescents. This study aimed to identify the association between sleep duration and dietary behaviors, physical activity, mental status, and nutritional status among high school students in South Korea. Based on the data collected from the 2014 Korea Youth Risk Behavior Web-based Survey, 31,407 high school students who met the inclusion criteria were selected and the association between sleep duration and selected health risk factors was identified using multivariable logistic regression models. The average daily sleep duration was 5.7 hours, and the mean BMI was 21.3 kg/m2. Participants with shorter durations of sleep (<7 hours versus >=7 hours of sleep) were more likely to feel sad or hopeless (adjusted OR, 1.09; 95% CI, 1.00-1.18), have suicidal ideation (adjusted OR, 1.13; 95% CI, 1.01-1.27), and feel much or very much stressed (adjusted OR, 1.82; 95% CI, 1.66-2.00). Moreover, shorter sleep was associated with less frequent muscle-strengthening exercises, >=3 times per week (adjusted OR, 0.86; 95% CI, 0.78-0.94), and more frequent cracker consumption, >=3 times per week (adjusted OR, 1.24; 95% CI, 1.13-1.35). High school students in South Korea suffer from extreme sleep deprivation; only 16% of the students were found to have >=7 hours of sleep during weekdays. Sleep education should be provided to students to improve their physical and mental health.

Sleep violence--forensic science implications: polygraphic and video documentation.

PubMed

Mahowald, M W; Bundlie, S R; Hurwitz, T D; Schenck, C H

1990-03-01

During the past century, infrequent, anecdotal reports of sleep-related violence with forensic science implications have appeared. Recent rapid developments in the field of sleep-disorders medicine have resulted in greater understanding of a variety of sleep-related behaviors, and formal sleep-behavior monitoring techniques have permitted their documentation and classification. Sleep-related violence can be associated with a number of diagnosable and treatable sleep disorders, including (1) night terrors/sleepwalking, (2) nocturnal seizures, (3) rapid eye movement (REM) sleep-behavior disorder, (4) sleep drunkenness, and (5) psychogenic dissociative states occurring during the sleep period. Potentially violent automatized behavior, without consciousness, can and does occur during sleep. The violence resulting from these disorders may be misinterpreted as purposeful suicide, assault, or even homicide. Sleep-related violence must be added to the list of automatisms. A classification system of both waking and sleep-related automatic behavior is proposed, with recommendations for assessment of such behavior.

Technology Use and Sleep Quality in Preadolescence and Adolescence

PubMed Central

Bruni, Oliviero; Sette, Stefania; Fontanesi, Lilybeth; Baiocco, Roberto; Laghi, Fiorenzo; Baumgartner, Emma

2015-01-01

Study Objectives: The purpose of this study was to analyze differences between preadolescents and adolescents on the use of technology and to test the contribution of using Internet and mobile phone, and circadian preference on sleep quality. Methods: We recruited a sample of 850 (364 males) preadolescents and adolescents. Self-report questionnaires about sleep schedule, sleep wake behavior problems, circadian preferences, and the use of technology (e.g., Internet and mobile phone) were administered. Students were asked to fill out the School Sleep Habits Survey, a self-report questionnaire on the use of technology, the Mobile Phone Involvement Questionnaire (MPIQ), and the Shorter Promis Questionnaire (SPQ). Results: Adolescents reported more sleep problems, a tendency toward eveningness, and an increase of Internet and phone activities, as well as social network activities, while preadolescents were more involved in gaming console and television viewing. The regression analysis performed separately in the two age groups showed that sleep quality was affected by the circadian preference (eveningness) in both groups. Adolescents' bad sleep quality was consistently associated with the mobile phone use and number of devices in the bedroom, while in preadolescents, with Internet use and turning-off time. Conclusions: The evening circadian preference, mobile phone and Internet use, numbers of other activities after 21:00, late turning off time, and number of devices in the bedroom have different negative influence on sleep quality in preadolescents and adolescents. Citation: Bruni O, Sette S, Fontanesi L, Baiocco R, Laghi F, Baumgartner E. Technology use and sleep quality in preadolescence and adolescence. J Clin Sleep Med 2015;11(12):1433–1441. PMID:26235161

Bedtime Routines for Young Children: A Dose-Dependent Association with Sleep Outcomes

PubMed Central

Mindell, Jodi A.; Li, Albert M.; Sadeh, Avi; Kwon, Robert; Goh, Daniel Y.T.

2015-01-01

Background: Establishment of a consistent bedtime routine (the activities that occur right before lights out) is often recommended as part of healthy sleep habits. However, no studies have investigated the dose-dependent association of a bedtime routine with sleep outcomes, especially in young children for whom they are particularly recommended. Thus, the aim of this study was to examine the associations of a consistent bedtime routine with sleep outcomes in young children (ages 0 through 5 y) in a large global sample and assess whether there is a dose-dependent relationship between the frequency of a bedtime routine both concurrently and retrospectively with sleep outcomes. Participants: Mothers of 10,085 children (Australia-New Zealand, Canada, China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand, United Kingdom, United States) completed the Brief Infant/Child Sleep Questionnaire. Results: A consistent bedtime routine was associated with better sleep outcomes, including earlier bedtimes, shorter sleep onset latency, reduced night wakings, and increased sleep duration. Decreased parent-perceived sleep problems and daytime behavior problems were also related to institution of a regular bedtime routine. Furthermore, there was a dose-dependent relationship, with better outcomes associated with increased “doses” of having a bedtime routine, both currently and retrospectively, and was found within both predominantly Asian and predominantly Caucasian cultural regions. Conclusions: These results indicate that having a regular nightly bedtime routine is associated with improved sleep in young children, and suggests that the more consistently a bedtime routine is instituted and the younger started the better. Citation: Mindell JA, Li AM, Sadeh A, Kwon R, Goh DY. Bedtime routines for young children: a dose-dependent association with sleep outcomes. SLEEP 2015;38(5):717–722. PMID:25325483

Wandering in a dementia special care unit: behavioral aspects and the risk of falling.

PubMed

Merims, Doron; Nahari, Havazelet; Ben-Ari, Giora; Jamal, Samira; Vigder, Carola; Ben-Israel, Joshua

2013-07-01

Wandering is a common phenomenon among patients with dementia. While traditionally considered to be a behavioral problem, it also includes fundamental aspects of motor performance (e.g., gait and falls). To examine the difference in motor function and behavioral symptoms between patients with severe dementia who wander and those who do not. We conducted a retrospective study reviewing the medical records of 72 patients with severe dementia, all residents of a dementia special care unit. Motor and behavioral aspects were compared between "wanderers" and "non-wanderers." No difference was found in motor performance including the occurrence of falls between the wanderers and non-wanderers. A significant difference was found in aggressiveness and sleep disturbances, which were more frequent among the wanderers. There was no preference to wandering at a certain period of the day among the patients with sleep disturbances who wander. In a protected environment wandering is not a risk factor for falls. Sleep disturbances and wandering co-occur, but there is no circumstantial association between the two symptoms.

Sleep disturbances as an evidence-based suicide risk factor.

PubMed

Bernert, Rebecca A; Kim, Joanne S; Iwata, Naomi G; Perlis, Michael L

2015-03-01

Increasing research indicates that sleep disturbances may confer increased risk for suicidal behaviors, including suicidal ideation, suicide attempts, and death by suicide. Despite increased investigation, a number of methodological problems present important limitations to the validity and generalizability of findings in this area, which warrant additional focus. To evaluate and delineate sleep disturbances as an evidence-based suicide risk factor, a systematic review of the extant literature was conducted with methodological considerations as a central focus. The following methodologic criteria were required for inclusion: the report (1) evaluated an index of sleep disturbance; (2) examined an outcome measure for suicidal behavior; (3) adjusted for presence of a depression diagnosis or depression severity, as a covariate; and (4) represented an original investigation as opposed to a chart review. Reports meeting inclusion criteria were further classified and reviewed according to: study design and timeframe; sample type and size; sleep disturbance, suicide risk, and depression covariate assessment measure(s); and presence of positive versus negative findings. Based on keyword search, the following search engines were used: PubMed and PsycINFO. Search criteria generated N = 82 articles representing original investigations focused on sleep disturbances and suicide outcomes. Of these, N = 18 met inclusion criteria for review based on systematic analysis. Of the reports identified, N = 18 evaluated insomnia or poor sleep quality symptoms, whereas N = 8 assessed nightmares in association with suicide risk. Despite considerable differences in study designs, samples, and assessment techniques, the comparison of such reports indicates preliminary, converging evidence for sleep disturbances as an empirical risk factor for suicidal behaviors, while highlighting important, future directions for increased investigation.

Sleepiness and health in midlife women: results of the National Sleep Foundation's 2007 Sleep in America poll.

PubMed

Chasens, Eileen R; Twerski, Sarah R; Yang, Kyeongra; Umlauf, Mary Grace

2010-01-01

The 2007 Sleep in America poll, a random-sample telephone survey, provided data for this study of sleep in community-dwelling women aged 40 to 60 years. The majority of the respondents were post- or perimenopausal, overweight, married or living with someone, and reported good health. A subsample (20%) reported sleepiness that consistently interfered with daily life; the sleepy subsample reported more symptoms of insomnia, restless legs syndrome, obstructive sleep apnea, depression and anxiety, as well as more problems with health-promoting behaviors, drowsy driving, job performance, household duties, and personal relationships. Hierarchical regression showed that sleepiness along with depressive symptoms, medical comorbidities, obesity, and lower education were associated with poor self-rated health, whereas menopause status (pre-, peri- or post-) was not. These results suggest that sleep disruptions and daytime sleepiness negatively affect the daily life of midlife women.

Disruption of adolescents' circadian clock: The vicious circle of media use, exposure to light at night, sleep loss and risk behaviors.

PubMed

Touitou, Yvan; Touitou, David; Reinberg, Alain

2016-11-01

Although sleep is a key element in adolescent development, teens are spending increasing amounts of time online with health risks related to excessive use of electronic media (computers, smartphones, tablets, consoles…) negatively associated with daytime functioning and sleep outcomes. Adolescent sleep becomes irregular, shortened and delayed in relation with later sleep onset and early waking time due to early school starting times on weekdays which results in rhythm desynchronization and sleep loss. In addition, exposure of adolescents to the numerous electronic devices prior to bedtime has become a great concern because LEDs emit much more blue light than white incandescent bulbs and compact fluorescent bulbs and have therefore a greater impact on the biological clock. A large number of adolescents move to evening chronotype and experience a misalignment between biological and social rhythms which, added to sleep loss, results in e.g. fatigue, daytime sleepiness, behavioral problems and poor academic achievement. This paper on adolescent circadian disruption will review the sensitivity of adolescents to light including LEDs with the effects on the circadian system, the crosstalk between the clock and the pineal gland, the role of melatonin, and the behavior of some adolescents(media use, alcohol consumption, binge drinking, smoking habits, stimulant use…). Lastly, some practical recommendations and perspectives are put forward. The permanent social jet lag resulting in clock misalignment experienced by a number of adolescents should be considered as a matter of public health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stress Symptoms: Effects on Your Body and Behavior

MedlinePlus

... heart disease, obesity and diabetes. Common effects of stress on your body Headache Muscle tension or pain ... drive Stomach upset Sleep problems Common effects of stress on your mood Anxiety Restlessness Lack of motivation ...

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion

PubMed Central

Paruthi, Shalini; Brooks, Lee J.; D'Ambrosio, Carolyn; Hall, Wendy A.; Kotagal, Suresh; Lloyd, Robin M.; Malow, Beth A.; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F.; Rosen, Carol L.; Troester, Matthew M.; Wise, Merrill S.

2016-01-01

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. Commentary: A commentary on this article apears in this issue on page 1439. Citation: Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: methodology and discussion. J Clin Sleep Med 2016;12(11):1549–1561. PMID:27707447

[The relationship between the abnormal behavior and serum C-reactive protein in children with obstructive sleep apnea-hypopnea syndrome].

PubMed

Wang, Yan; Li, Yanzhong; Wang, Xin

2009-12-01

To explore the pathogenesis of abnormal behavior in children with obstructive sleep apnea-hypopnea syndrome (OSAHS). The behavioral problems and C-reactive protein were measured in 40 children with OSAHS and 30 children with habitual snoring who underwent overnight Polysomnography, 40 cases of healthy children for the control group. The ratio of abnormal behavior in OSAHS and habitual snoring children was significantly higher than that of the healthy control group, while no significant difference between the two groups. The content of C-reactive protein in OSAHS children (4.24 mg/L) was significantly higher than habitual snoring (2.76 mg/L) and healthy control group (1.27 mg/L); in habitual snoring children C-reactive protein was higher than in healthy control group. The content of serum C-reactive protein in OSAHS children accompanied by abnormal behavior (4.63 mg/L) was significantly higher than that without abnormal behavior (3.23 mg/L). The content of serum C-reactive protein content in habitual snoring children accompanied by abnormal behavior (3.63 mg/L) was significantly higher than that without abnormal behavior (1.76 mg/L). OSAHS and habitual snoring children have more behavior problems. C-reactive protein levels are higher in children with OSAHS and habitual snoring, and the levels of C-reactive protein are related to the abnormal behavior in these children.

Sleep disturbances in young and middle-aged adults - Empirical patterns and related factors from an epidemiological survey.

PubMed

Rössler, Wulf; AjdacicGross, Vladeta; Glozier, Nick; Rodgers, Stephanie; Haker, Helene; Müller, Mario

2017-10-01

Previous research suggests that sleep disorders are highly associated with other mental health problems. However, sleep problems even below the diagnostic threshold of sleep disorders are very common in the general population, which highly affects wellbeing and functioning. In order to broaden the focus beyond those severe cases we explored empirical patterns across the whole spectrum of sleep problems as well as associated clinical and other factors. A representative community sample of N=1274 residents from the canton of Zurich was interviewed for sleep problems and diagnostic criteria for mental disorders as well as was given a number of mental health-related psychometrical checklists. Based on a broader spectrum of sleep problems we conducted a latent class analysis (LCA) to derive distinct classes of such disturbances. Classes were compared regarding their associations to mental health-relevant and other risk factors. The LCA revealed four classes - no sleep disturbances (72.6%), difficulties initiating and maintaining sleep (15.8%), delayed sleep (5.3%), and severe sleep problems (6.4%). Severe sleep problems were related to female gender and generalized anxiety disorder, while depression was linked to all sleep problem classes. Persons with difficulties initiating and maintaining sleep and severe sleep problems reported higher levels of psychopathology, burnout and neuroticism, while all sleep problem types were tied to stress-related variables, but not alcohol use disorder. Sleep problems are highly prevalent among the young and middle-aged adults in our representative sample of young and middle-aged adults and as such represent a serious public mental health problem. Our findings indicate sleep problems to have a multi-dimensional structure with some differential associations. While all subtypes were associated with poorer mental health and particularly more depression, severe sleep problems appeared to be the sleep subtype seen in agoraphobia and GAD, while delayed sleep had no specific associations. The variety of associations assessed leads one to assume that likewise a variety of sleep interventions is required. Copyright © 2017 Elsevier Inc. All rights reserved.

Unhealthy sleep practices, conduct problems, and daytime functioning during adolescence.

PubMed

Lin, Wen-Hsu; Yi, Chin-Chun

2015-02-01

Although sleep has been linked to activities in various domains of life, one under-studied link is the relationship between unhealthy sleep practices and conduct problems among adolescents. The present study investigates the influence of adolescents' unhealthy sleep practices-short sleep (e.g., less than 6 h a day), inconsistent sleep schedule (e.g., social jetlag), and sleep problems-on conduct problems (e.g., substance use, fighting, and skipping class). In addition, this study examines unhealthy sleep practices in relationship to adolescent emotional well-being, defiant attitudes, and academic performance, as well as these three domains as possible mediators of the longitudinal association between sleep practices and conduct problems. Three waves of the Taiwan Youth Project (n = 2,472) were used in this study. At the first time-point examined in this study, youth (51% male) were aged 13-17 (M = 13.3). The results indicated that all three measures of unhealthy sleep practices were related to conduct problems, such that short sleep, greater social jetlag, and more serious sleep problems were concurrently associated with greater conduct problems. In addition, short sleep and sleep problems predicted conduct problems one year later. Furthermore, these three unhealthy sleep practices were differently related to poor academic performance, low levels of emotional well-being, and defiant attitudes, and some significant indirect effects on later conduct problems through these three attributes were found. Cultural differences and suggestions for prevention are discussed.

Global sleep quality as a moderator of alcohol consumption and consequences in college students.

PubMed

Kenney, Shannon R; LaBrie, Joseph W; Hummer, Justin F; Pham, Andy T

2012-04-01

The authors examined the relationship between global sleep quality and alcohol risk, including the extent to which global sleep quality moderated the relationship between alcohol use and drinking-related consequences. Global sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and alcohol-related consequences were assessed using the Rutgers Alcohol Problem Index (RAPI). The sample consisted of 261 college students (61.3% female, 58.2% Caucasian) who completed online surveys. Using a four-step hierarchical multiple regression model, global sleep quality was found to predict alcohol consequences, over and above assessed covariates (demographics and weekly drinking). Further, global sleep quality emerged as a strong moderator in the drinking-consequences relationship such that among heavier drinkers, those with poorer global sleep quality experienced significantly greater alcohol-related harm. Campus health education and alcohol interventions may be adapted to address the importance of maintaining a healthy lifestyle, both in terms of healthful sleeping and drinking behaviors, which appear to play a strong synergistic role in alcohol-related risk. Copyright © 2012 Elsevier Ltd. All rights reserved.

Child temperament, parenting discipline style, and daytime behavior in childhood sleep disorders.

PubMed

Owens-Stively, J; Frank, N; Smith, A; Hagino, O; Spirito, A; Arrigan, M; Alario, A J

1997-10-01

Fifty-two children without significant sleep disturbance seen at a primary care clinic for well-child care were compared on measures of temperament, parenting style, daytime behavior, and overall sleep disturbance to three diagnostic subgroups identified in a pediatric sleep clinic: children with obstructive sleep apnea (n = 33), parasomnias (night terrors, sleepwalking, etc.) (n = 16), and behavioral sleep disorders (limit-setting disorder, etc.) (n = 31). The mean age of the entire sample was 5.7 years. Temperamental emotionality in the behavioral sleep disorders group was associated with a higher level of sleep disturbance (p < .001); parenting laxness was associated with sleep disturbance in the general pediatric population (p < .01); and intense and negative temperament characteristics seemed to be associated with clinically significant behavioral sleep disturbances. Ineffective parenting styles and daytime disruptive behaviors were more likely to be associated with the milder sleep disturbances found in children in a primary care setting.

Evaluating physical and behavioral changes in older adults.

PubMed

Walton, J C; Miller, J M

1998-04-01

In older adults, subtle and sometime not so subtle physical or behavior changes can act as early warning signs of changing status. Nonspecific signs and symptoms occurring in older adults such as decline in previous functional capacity, urinary incontinence, anorexia, confusion, or unexplained falls may be signs of infection, medication interaction, dehydration, constipation, or sleep deprivation. Nurses, by critically assessing the situation early, may identify a developing problem. Prompt and early diagnosis of the underlying problem may save costly extended hospitalization or even prevent life-threatening complications.

Effects of Methylphenidate on Sleep Functioning in Children with Attention-Deficit/Hyperactivity Disorder.

PubMed

Becker, Stephen P; Froehlich, Tanya E; Epstein, Jeffery N

2016-06-01

To examine the effects of stimulant medication on the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) and identify predictors of sleep problems as a side effect of taking stimulant medication. One hundred sixty-three stimulant-naïve children (72% boys) aged 7 to 11 years diagnosed with ADHD (120 with ADHD predominantly inattentive type, 43 with ADHD combined type) participated in a 4-week, randomized, double-blind, placebo-controlled trial of once-daily (long-acting) methylphenidate (MPH). Parents completed weekly side-effect ratings including an item related to sleep problems. Ten percent of patients had parent-rated sleep problems before the initiation of medication. Rates of parent-rated sleep problems during MPH titration generally increased with increasing MPH dose (placebo: 8%; low dose: 18%; medium dose: 15%; high dose: 25%). Differences emerged between children with (n = 16) or without (n = 147) preexisting sleep problems. Although 23% of children without preexisting sleep problems went on to have sleep problems at the highest MPH dose, only 37.5% of children with preexisting sleep problems still had sleep problems at the highest MPH dose. Lower weight and lower body mass index (BMI) were associated with increased sleep problems during MPH titration. This study demonstrated a general association between increased MPH dose and increased sleep problems in children with ADHD, particularly for children of lower weight/BMI. However, a substantial proportion of children with preexisting sleep difficulties no longer had sleep problems on the highest MPH dose, which may help explain mixed findings reported to date in studies examining the impact of MPH on sleep functioning in children with ADHD and suggests that MPH dose titration should not be avoided solely on the basis of a child's premorbid sleep problems. Future research is needed to replicate and extend these findings to more specific domains of sleep functioning and to identify differences between children with persistent or improved sleep functioning as a result of MPH use.

Quality of Sleep and its Relationship to Quality of Life in Hemodialysis Patients

PubMed Central

Parvan, Kobra; lakdizaji, Sima; Roshangar, Fariborz; Mostofi, Mahtab

2013-01-01

Introduction: Despite many advances in the treatment of chronic renal failure, the quality of sleep in patients who suffer from this disease is at the risk. The high prevalence of sleep disorders in hemodialysis patients, which is concomitant with physical, behavioral, and psychological problems, has always affected these patients' quality of life (QOL). This study aimed to determine the relationship between quality of sleep and quality of life in hemodialysis patients. Methods: By using a descriptive and correlational design, this study was conducted on 245 hemodialysis patients in 2012. Patients were selected by convenience sampling from the hemodialysis ward of four training hospitals of Tabriz and Maragheh. Quality of sleep was measured by the Pittsburgh Sleep Quality Index (PSQI), and the quality of life for patients was measured by the Kidney Disease Quality Of Life questionnaire (KDQOL-SF). Results: 83.3% of hemodialysis patients had poor quality of sleep. Poor quality of life was significantly associated with poor quality of sleep. There was a significant negative correlation between global PSQI and important aspects of quality of life including physical health, symptoms and problems, the impact of kidney disease on daily life, burden of kidney disease, mental health, social support, and sexual function. Conclusion: The low quality of sleep in hemodialysis patients has an effect on the deterioration of their quality of life. Therefore, training, counseling, and advocacy programs should be developed to improve the patients' quality of sleep and quality of life, especially those with lower education level and income, and older people. PMID:25276738

Mechanism of Sleep Disturbance in Children with Atopic Dermatitis and the Role of the Circadian Rhythm and Melatonin

PubMed Central

Chang, Yung-Sen; Chiang, Bor-Luen

2016-01-01

Sleep disturbance is common in children with atopic dermatitis (AD). It is a major factor leading to impaired quality of life in these patients and could have negative effects on neurocognitive function and behavior. However, the pathophysiology of sleep disturbance in children with AD is poorly understood, and there is no consensus on how to manage sleep problems in these patients. Pruritus and scratching could lead to sleep disruption but is unlikely the sole etiology. The circadian rhythm of cytokines, the immune system, and skin physiology such as transcutaneous water loss and skin blood flow might also play a role. Recent studies have suggested that melatonin could also be involved due to its multiple effects on sleep, immunomodulation, and anti-oxidant ability. Environmental factors should also be considered. In this review, we summarize the current understanding of the pathophysiology of sleep disturbance in children with AD, and discuss possible therapeutic implications. PMID:27043528

Physical Pain and History of Suicidal Behaviors in Alcohol-Dependent Patients Entering Treatment in Poland.

PubMed

Jakubczyk, Andrzej; Ashrafioun, Lisham; Ilgen, Mark; Kopera, Maciej; Klimkiewicz, Anna; Krasowska, Aleksandra; Solowiej, Malgorzata; Brower, Kirk J; Wojnar, Marcin

2016-08-23

Individuals with alcohol use disorders have been shown to be at increased risk for suicidal behaviors and chronic pain. The aim of this study was to conduct initial analyses of the association between current physical pain and the likelihood of suicidal behavior history in alcohol-dependent patients entering treatment in Poland. A sample of 366 (73.5% men and 26.5% women) participants were recruited from alcohol treatment centers in Warsaw, Poland. Information was obtained about a history of lifetime suicidal behavior, past 4-week pain level, demographics, social functioning, childhood abuse, depressive symptoms, severity of alcohol and sleep problems. A total of 118 individuals (32.2%) reported at least one suicidal behavior during their lifetime. In unadjusted analyses, there was a significant association between a history of lifetime suicidal behavior and a moderate or greater experience of physical pain during the last four weeks. Other variables that were significantly associated with suicidal behaviors were: younger age, history of childhood abuse, depressive symptoms, sleep problems, consequences of drinking, and lower social support. In the multivariate logistic regression analysis, only experience of moderate or greater pain, age, and depressive symptoms remained significantly associated with a history of suicidal behavior. The experience of physical pain is significantly associated with a lifetime history of suicidal behavior in alcohol-dependent patients. Clinicians should be aware of these associations when conducting assessments and treating alcohol use disorders.

"My child has a sleep problem": a cross-cultural comparison of parental definitions.

PubMed

Sadeh, Avi; Mindell, Jodi; Rivera, Luis

2011-05-01

Sleep problems are highly prevalent in early childhood. In many cases, parents seek professional help when they suspect their child suffers from a sleep problem. The aim of this study was to explore sleep, demographic and cultural factors associated with parental definition of child sleep problem in a large-scale, cross cultural study. Parents (or caregivers) of 29,287 infants and toddlers (aged 0-3 years) from 17 countries completed a questionnaire on their child's sleep patterns, sleep setting, and demographic variables. The results indicated that, in comparison to parents from predominantly Caucasian (PC) countries, parents from predominantly Asian (PA) countries were significantly more likely to identify a sleep problem in their children (26% vs 52% overall; 2% vs 17% "severe" sleep problem). Furthermore, whereas infant sleep variables were strong predictors of a sleep problem definition in PC countries, they were significantly less predictive in PA countries where demographic variables played a significant role. These results highlight the need to further explore the role of demographic and cultural variables in determining parental perception of a sleep problem, a perception that relates to help seeking professional treatment for infant sleep problems. Our findings also emphasize the need to educate parents about infant and toddler sleep and to provide parents information and screening tools to help them identify sleep problems in a more evidence-based approach. Copyright © 2011 Elsevier B.V. All rights reserved.

Bedtime procrastination: introducing a new area of procrastination

PubMed Central

Kroese, Floor M.; De Ridder, Denise T. D.; Evers, Catharine; Adriaanse, Marieke A.

2014-01-01

Background: Procrastination is a prevalent and problematic phenomenon that has mostly been studied in the domain of academic behavior. The current study shows that procrastination may also lead to harmful outcomes in the area of health behavior, introducing bedtime procrastination as an important factor related to getting insufficient sleep and consequently affecting individual well-being. Bedtime procrastination is defined as failing to go to bed at the intended time, while no external circumstances prevent a person from doing so. Methods: To empirically support the conceptual introduction of bedtime procrastination, an online survey study was conducted among a community sample (N = 177). The relationship between bedtime procrastination and individual difference variables related to self-regulation and general procrastination was assessed. Moreover, it was investigated whether bedtime procrastination was a predictor of self-reported sleep outcomes (experienced insufficient sleep, hours of sleep, fatigue during the day). Results: Bedtime procrastination was negatively associated with self-regulation: people who scored lower on self-regulation variables reported more bedtime procrastination. Moreover, self-reported bedtime procrastination was related to general reports of insufficient sleep above and beyond demographics and self-regulation. Conclusions: Introducing a novel domain in which procrastinators experience problems, bedtime procrastination appears to be a prevalent and relevant issue that is associated with getting insufficient sleep. PMID:24994989

Bedtime procrastination: introducing a new area of procrastination.

PubMed

Kroese, Floor M; De Ridder, Denise T D; Evers, Catharine; Adriaanse, Marieke A

2014-01-01

Procrastination is a prevalent and problematic phenomenon that has mostly been studied in the domain of academic behavior. The current study shows that procrastination may also lead to harmful outcomes in the area of health behavior, introducing bedtime procrastination as an important factor related to getting insufficient sleep and consequently affecting individual well-being. Bedtime procrastination is defined as failing to go to bed at the intended time, while no external circumstances prevent a person from doing so. To empirically support the conceptual introduction of bedtime procrastination, an online survey study was conducted among a community sample (N = 177). The relationship between bedtime procrastination and individual difference variables related to self-regulation and general procrastination was assessed. Moreover, it was investigated whether bedtime procrastination was a predictor of self-reported sleep outcomes (experienced insufficient sleep, hours of sleep, fatigue during the day). Bedtime procrastination was negatively associated with self-regulation: people who scored lower on self-regulation variables reported more bedtime procrastination. Moreover, self-reported bedtime procrastination was related to general reports of insufficient sleep above and beyond demographics and self-regulation. Introducing a novel domain in which procrastinators experience problems, bedtime procrastination appears to be a prevalent and relevant issue that is associated with getting insufficient sleep.

Physical Activity, Mind Wandering, Affect, and Sleep: An Ecological Momentary Assessment.

PubMed

Fanning, Jason; Mackenzie, Michael; Roberts, Sarah; Crato, Ines; Ehlers, Diane; McAuley, Edward

2016-08-31

A considerable portion of daily thought is spent in mind wandering. This behavior has been related to positive (eg, future planning, problem solving) and negative (eg, unhappiness, impaired cognitive performance) outcomes. Based on previous research suggesting future-oriented (ie, prospective) mind wandering may support autobiographical planning and self-regulation, this study examined associations between hourly mind wandering and moderate-to-vigorous physical activity (MVPA), and the impact of affect and daily sleep on these relations. College-aged adults (N=33) participated in a mobile phone-delivered ecological momentary assessment study for 1 week. Sixteen hourly prompts assessing mind wandering and affect were delivered daily via participants' mobile phones. Perceived sleep quality and duration was assessed during the first prompt each day, and participants wore an ActiGraph accelerometer during waking hours throughout the study week. Study findings suggest present-moment mind wandering was positively associated with future MVPA (P=.03), and this relationship was moderated by affective state (P=.04). Moreover, excessive sleep the previous evening was related to less MVPA across the following day (P=.007). Further, mind wandering was positively related to activity only among those who did not oversleep (P=.007). Together, these results have implications for multiple health behavior interventions targeting physical activity, affect, and sleep. Researchers may also build on this work by studying these relationships in the context of other important behaviors and psychosocial factors (eg, tobacco use, depression, loneliness).

A community-based study of sleep and behaviour problems in 12- to 36-month-old children.

PubMed

Hall, W A; Scher, A; Zaidman-Zait, A; Espezel, H; Warnock, F

2012-05-01

While evidence suggests sleep problems are common in young children and linked to behavioural problems, studies of toddlers are rare. This community-based cross-sectional study examined associations between sleep problems and daytime behaviour among 58 children aged 1 to 3 years who attended daycare centres. Mothers and daycare providers completed four and three questionnaires, respectively, about children's sleep patterns and behaviour. Two hypotheses were tested: (1) children with higher sleep problem scores would have more behavioural problems by parental and daycare provider report; (2) problematic napping behaviours would be associated with night sleep problems. Mothers' reports of sleep problems were positively associated with children's behavioural problems at home and daycare providers' reports of nap problems were positively correlated with children's behavioural problems at daycare. Daycare providers' reports of children's behavioural problems at daycare were associated with maternal reports of behavioural problems. Older children in the sleep problem group had maternal reports of more behavioural problems. Daycare providers reported that children with sleep problems were less happy at daycare. Children who were happier following naps had less reported night settling difficulties. Children with difficulty settling for naps at daycare had maternal reports of more behavioural problems. Napping in daycare settings is an important component of toddlers' sleep. Crossover effects between children's sleep and behaviour at daycare and home indicate similarities in mothers' and daycare providers' perceptions. Findings suggest parent and daycare provider interactions include discussions about sleep problems and settling at home and in daycares. Parents and daycare providers would benefit from education about relationships between sleep and behavioural problems. © 2011 Blackwell Publishing Ltd.

Behavioral Parent-Training Approaches for the Treatment of Bedtime Noncompliance in Young Children

ERIC Educational Resources Information Center

Ortiz, Camilo; McCormick, Lauren

2007-01-01

Bedtime noncompliance is one of the most common and treatable types of child sleep problems. Children who are noncompliant at bedtime are more likely to exhibit daytime somnolescence, which may in turn lead children to exhibit daytime misbehavior, impaired social functioning and poorer school achievement. In addition, these bedtime problems can…

The Role of Day-to-Day Emotions, Sleep, and Social Interactions in Pediatric Anxiety Treatment

PubMed Central

Wallace, Meredith L.; McMakin, Dana L.; Tan, Patricia Z.; Rosen, Dana; Forbes, Erika E.; Ladouceur, Cecile D.; Ryan, Neal D.; Siegle, Greg J.; Dahl, Ronald E.; Kendall, Philip C.; Mannarino, Anthony; Silk, Jennifer S.

2016-01-01

Do day-to-day emotions, social interactions, and sleep play a role in determining which anxious youth respond to supportive child-centered therapy (CCT) versus cognitive behavioral therapy (CBT)? We explored whether measures of day-to-day functioning (captured through ecological momentary assessment, sleep diary, and actigraphy), along with clinical and demographic measures, were predictors or moderators of treatment outcome in 114 anxious youth randomized to CCT or CBT. We statistically combined individual moderators into a single, optimal composite moderator to characterize subgroups for which CCT or CBT may be preferable. The strongest predictors of better outcome included: (a) experiencing higher positive affect when with one’s mother and (b) fewer self-reported problems with sleep duration. The composite moderator indicated that youth for whom CBT was indicated had: (a) more day-to-day sleep problems related to sleep quality, efficiency, and waking, (b) day-to-day negative events related to interpersonal concerns, (c) more DSM-IV anxiety diagnoses, and (d) college-educated parents. These findings illustrate the value of both day-to-day functioning characteristics and more traditional sociodemographic and clinical characteristics in identifying optimal anxiety treatment assignment. Future studies will need to enhance the practicality of real-time measures for use in clinical decision making and evaluate additional anxiety treatments. PMID:28013054

New approaches in the management of insomnia: weighing the advantages of prolonged-release melatonin and synthetic melatoninergic agonists

PubMed Central

Hardeland, Rüdiger

2009-01-01

Hypnotic effects of melatonin and melatoninergic drugs are mediated via MT1 and MT2 receptors, especially those in the circadian pacemaker, the suprachiasmatic nucleus, which acts on the hypothalamic sleep switch. Therefore, they differ fundamentally from GABAergic hypnotics. Melatoninergic agonists primarily favor sleep initiation and reset the circadian clock to phases allowing persistent sleep, as required in circadian rhythm sleep disorders. A major obstacle for the use of melatonin to support sleep maintenance in primary insomnia results from its short half-life in the circulation. Solutions to this problem have been sought by developing prolonged-release formulations of the natural hormone, or melatoninergic drugs of longer half-life, such as ramelteon, tasimelteon and agomelatine. With all these drugs, improvements of sleep are statistically demonstrable, but remain limited, especially in primary chronic insomnia, so that GABAergic drugs may be indicated. Melatoninergic agonists do not cause next-day hangover and withdrawal effects, or dependence. They do not induce behavioral changes, as sometimes observed with z-drugs. Despite otherwise good tolerability, the use of melatoninergic drugs in children, adolescents, and during pregnancy has been a matter of concern, and should be avoided in autoimmune diseases and Parkinsonism. Problems and limits of melatoninergic hypnotics are compared. PMID:19557144

Insomnia in childhood and adolescence: clinical aspects, diagnosis, and therapeutic approach.

PubMed

Nunes, Magda Lahorgue; Bruni, Oliviero

2015-01-01

To review the clinical characteristics, comorbidities, and management of insomnia in childhood and adolescence. This was a non-systematic literature review carried out in the PubMed database, from where articles published in the last five years were selected, using the key word "insomnia" and the pediatric age group filter. Additionally, the study also included articles and classic textbooks of the literature on the subject. During childhood, there is a predominance of behavioral insomnia as a form of sleep-onset association disorder (SOAD) and/or limit-setting sleep disorder. Adolescent insomnia is more associated with sleep hygiene problems and delayed sleep phase. Psychiatric (anxiety, depression) or neurodevelopmental disorders (attention deficit disorder, autism, epilepsy) frequently occur in association with or as a comorbidity of insomnia. Insomnia complaints in children and adolescents should be taken into account and appropriately investigated by the pediatrician, considering the association with several comorbidities, which must also be diagnosed. The main causes of insomnia and triggering factors vary according to age and development level. The therapeutic approach must include sleep hygiene and behavioral techniques and, in individual cases, pharmacological treatment. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Sleeping with technology: cognitive, affective, and technology usage predictors of sleep problems among college students.

PubMed

Rosen, Larry; Carrier, Louis M; Miller, Aimee; Rokkum, Jeffrey; Ruiz, Abraham

2016-03-01

Sleep problems related to technology affect college students through several potential mechanisms including displacement of sleep due to technology use, executive functioning abilities, and the impact of emotional states related to stress and anxiety about technology availability. In the present study, cognitive and affective factors that influence technology usage were examined for their impact upon sleep problems. More than 700 US college students completed an online questionnaire addressing technology usage, anxiety/dependence, executive functioning, nighttime phone usage, bedtime phone location, and sleep problems. A path model controlling for background variables was tested using the data. The results showed that executive dysfunction directly predicted sleep problems as well as affected sleep problems through nighttime awakenings. In addition, anxiety/dependence increased daily smartphone usage and also increased nighttime awakenings, which, in turn, affected sleep problems. Thus, both the affective and cognitive factors that influence technology usage affected sleep problems. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Clinical management of sleep disturbances in Alzheimer’s disease: current and emerging strategies

PubMed Central

Urrestarazu, Elena; Iriarte, Jorge

2016-01-01

Sleep and circadian disorders in Alzheimer’s disease (AD) are more frequent than in the general population and appear early in the course of the disease. Quality of sleep and quality of life are parallel in these patients, and such disorders also represent a heavy burden for caregivers. Although alterations in melatonin and hypocretins (orexins) seem to play a key role in the origin of these disturbances, the etiology of these disorders is multifactorial, including many factors such as environment, behavior, treatments, and comorbidities, among others. A comprehensive evaluation of sleep in each patient is essential in the design of the treatment that includes nonpharmacological and pharmacological approaches. One particularly interesting point is the possibility of a role of sleep disorders in the pathogenesis of AD, raising the possibility that treating the sleep disorder may alter the course of the disease. In this review, we present an update on the role of sleep disorders in AD, the bidirectional influence of sleep problems and AD, and treatment options. Behavioral measures, bright light therapy (BLT), melatonin, and other drugs are likely well known and correctly managed by the physicians in charge of these patients. In spite of the multiple treatments used, evidence of efficacy is scarce and more randomized double-blind placebo-controlled studies are needed. Future directions for treatment are the establishment of BLT protocols and the development of drugs with new mechanisms of action, especially hypocretin receptor antagonists, melatonin receptor agonists, and molecules that modulate the circadian clock. PMID:26834500

[Application of music therapy for managing agitated behavior in older people with dementia].

PubMed

Sung, Huei-Chuan; Chang, Anne M; Abbey, Jennifer

2006-10-01

Older people with dementia may display negative emotions, memory problems, sleep disturbance, and agitated behavior. Among these symptoms, agitated behavior has been identified by families and nursing staff as the care problem that presents the greatest challenge. Several studies have found that music therapy reduced agitated behaviors in those with dementia and recommended use of music as an effective strategy in managing this behavioral problem. Music therapy represents a lower cost, effective care approach that nursing staff can easily learn and apply to those with dementia. Furthermore, reductions in agitated behavior in dementia patients that result from music therapy can also alleviate caregiver stress and burden of care, leading to improvements in the health and quality of life of both dementia patients and their caregivers. This paper aims to introduce the principles and application of music therapy in the management of agitated behavior in those with dementia.

Externalizing Behaviors and Callous-Unemotional Traits: Different Associations With Sleep Quality.

PubMed

Denis, Dan; Akhtar, Reece; Holding, Benjamin C; Murray, Christina; Panatti, Jennifer; Claridge, Gordon; Sadeh, Avi; Barclay, Nicola L; O'Leary, Rachael; Maughan, Barbara; McAdams, Tom A; Rowe, Richard; Eley, Thalia C; Viding, Essi; Gregory, Alice M

2017-08-01

Sleep quality is associated with different aspects of psychopathology, but relatively little research has examined links between sleep quality and externalizing behaviors or callous-unemotional traits. We examined: (1) whether an association exists between sleep quality and externalizing behaviors; (2) whether anxiety mediates this association; (3) whether callous-unemotional traits are associated with sleep quality. Data from two studies were used. Study 1 involved 1556 participants of the G1219 study aged 18-27 years (62% female). Questionnaire measures assessed sleep quality, anxiety, externalizing behaviors, and callous-unemotional traits. Study 2 involved 338 participants aged 18-66 years (65% female). Questionnaires measured sleep quality, externalizing behaviors, and callous-unemotional traits. In order to assess objective sleep quality, actigraphic data were also recorded for a week from a subsample of study 2 participants (n = 43). In study 1, poorer sleep quality was associated with greater externalizing behaviors. This association was partially mediated by anxiety and moderated by levels of callous-unemotional traits. There was no significant relationship between sleep quality and callous-unemotional traits. In study 2, poorer sleep quality, as assessed via self-reported but not objective measures, was associated with higher levels of externalizing behaviors. Furthermore, in study 2, better sleep quality (indicated in both questionnaires and actigraphy measures: lower mean activity, and greater sleep efficiency) was associated with higher levels of callous-unemotional traits. Self-reports of poorer sleep quality are associated with externalizing behaviors, and this association is partially mediated by anxiety. Callous-unemotional traits are not associated with poor sleep and may even be related to better sleep quality. This is an exceptional finding given that poor sleep quality appears to be a characteristic of most psychopathology. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence.

PubMed

Armstrong, Jeffrey M; Ruttle, Paula L; Klein, Marjorie H; Essex, Marilyn J; Benca, Ruth M

2014-05-01

To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. Community. A total of 396 children (51% female). N/A. Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9-10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18.

Characteristics of chronic pain associated with sleep difficulty in the older population: The MOBILIZE Boston Study

PubMed Central

Chen, Qian; Hayman, Laura L.; Shmerling, Robert H.; Bean, Jonathan F.; Leveille, Suzanne G.

2012-01-01

Objectivers To evaluate pain severity and distribution in relation to sleep difficulty in older adults. Design Population-based cross-sectional study Setting Community within a 5-mile radius of the study center at the Institute for Aging Research, Hebrew SeniorLife (HSL) in Boston Participants 765 participants of the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston Study, aged 64 and older. Measurements Pain severity was measured using the Brief Pain Inventory (BPI), Pain Severity Subscale. Musculoskeletal pain distribution was grouped according to no pain, single site, ≥2 sites, and widespread pain (upper and lower extremities and back pain). We measured 3 aspects of sleep difficulty using items from the CESD-R (trouble getting to sleep, sleep more than usual, and restless sleep). Results Prevalence of trouble getting to sleep according to BPI severity was 17.8%, 19.7%, 32.0%, and 37.0% for the lowest to highest pain severity quartiles, respectively. Similar relationships between pain and sleep were observed across sleep measures according to pain severity and distribution. Adjusted for sociodemographic characteristics, chronic conditions and health behaviors, chronic pain was strongly associated with trouble sleeping (≥1d/week), (single site pain, OR=1.77, 95%CI, 1.10–2.87; multisite pain OR=2.38, 95% CI, 1.48–3.83; and widespread pain, OR=2.55, 95% CI, 1.43–4.54, each compared with no pain). Similar associations were observed for restless sleep and sleeping more than usual. With specific pain sites alone or in combination with other sites of pain, only modest associations were observed with sleep problems. Conclusion Widespread or other multisite pain and moderate to severe pain are strongly associated with sleep difficulty in older adults. Further research is needed to better understand the burden and consequences of pain-related sleep problems in the older population. PMID:21806564

Nonimpact brain injury: neuropsychological and behavioral correlates with consideration of physiological findings.

PubMed

Henry, G K; Gross, H S; Herndon, C A; Furst, C J

2000-01-01

This retrospective clinical study investigated the neuropsychological, physiological, and behavioral functioning of 32 adult outpatients up to 65 months following nonimpact brain injury (i.e., whiplash). All participants were administered a flexible battery of cognitive tests, and some underwent neurodiagnostic procedures and sleep studies. Compared with published norms, neuropsychological data revealed significant and persistent age-adjusted cognitive deficits, primarily in the area of executive functioning. Participants frequently complained of problems with behavioral control, sleep, and sexuality. Although structural neuroimaging was not sensitive in detecting brain pathology, quantitative electroencephalography was abnormal in all the participants evaluated, showing frontocentral slowing and increased spike wave activity. We propose that whiplash injury can produce wide-ranging circuitry dysfunction and that test selection is critical in identifying cognitive deficits.

Dealing with Behavioral Problems: Rules of Comportment in the Science Lecture.

ERIC Educational Resources Information Center

Druger, Marvin

2001-01-01

Highlights some ways that instructors of large lecture classes can effectively deal with such issues as inappropriate talking; tardiness; leaving early; sleeping, eating, or drinking during class; listening to music; or simply being discourteous. (SAH)

Sleep problems and daytime tiredness in Finnish preschool-aged children-a community survey.

PubMed

Simola, P; Niskakangas, M; Liukkonen, K; Virkkula, P; Pitkäranta, A; Kirjavainen, T; Aronen, E T

2010-11-01

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. 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. 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). 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. 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. © 2010 Blackwell Publishing Ltd.

Periodic Limb Movements During Sleep Mimicking REM Sleep Behavior Disorder: A New Form of Periodic Limb Movement Disorder.

PubMed

Gaig, Carles; Iranzo, Alex; Pujol, Montserrat; Perez, Hernando; Santamaria, Joan

2017-03-01

To describe a group of patients referred because of abnormal sleep behaviors that were suggestive of rapid eye movement (REM) sleep behavior disorder (RBD) in whom video-polysomnography ruled out RBD and showed the reported behaviors associated with vigorous periodic limb movements during sleep (PLMS). Clinical history and video-polysomnography review of patients identified during routine visits in a sleep center. Patients were 15 men and 2 women with a median age of 66 (range: 48-77) years. Reported sleep behaviors were kicking (n = 17), punching (n = 16), gesticulating (n = 8), falling out of bed (n = 5), assaulting the bed partner (n = 2), talking (n = 15), and shouting (n = 10). Behaviors resulted in injuries in 3 bed partners and 1 patient. Twelve (70.6%) patients were not aware of displaying abnormal sleep behaviors that were only noticed by their bed partners. Ten (58.8%) patients recalled unpleasant dreams such as being attacked or chased. Video-polysomnography showed (1) frequent and vigorous stereotyped PLMS involving the lower limbs, upper limbs, and trunk (median PLMS index 61.2; median PLMS index in NREM sleep 61.9; during REM sleep only 8 patients had PLMS and their median PLMS index in REM sleep was 39.5); (2) abnormal behaviors (e.g., punching, groaning) during some of the arousals that immediately followed PLMS in NREM sleep; and (3) ruled out RBD and other sleep disorders such as obstructive sleep apnea. Dopaminergic agents were prescribed in 14 out of the 17 patients and resulted in improvement of abnormal sleep behaviors and unpleasant dreams in all of them. After dopaminergic treatment, follow-up video-polysomnography in 7 patients showed a decrease in the median PLMS index from baseline (108.9 vs. 19.2, p = .002) and absence of abnormal behaviors during the arousals. Abnormal sleep behaviors and unpleasant dreams simulating RBD symptomatology may occur in patients with severe PLMS. In these cases, video-polysomnography ruled out RBD and identified prominent PLMS followed by arousals containing abnormal behaviors. Our cases represent an objectively documented subtype of periodic limb movement disorder causing abnormal sleep behaviors. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders

PubMed Central

2015-01-01

Background Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention. Objective This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone–delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt. Methods Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually. Results Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation. Conclusions This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention. PMID:26187404

The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood.

PubMed

Beebe, Dean W; Ris, M Douglas; Kramer, Megan E; Long, Elizabeth; Amin, Raouf

2010-11-01

(1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning. cross-sectional correlative study. Office/hospital, plus reported functioning at home and at school. 163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n = 26), and No SDB (AHI < 1 and nonsnoring, n = 37). inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing. The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning. SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school.

[Institutional Prevalence and Context of Severe Sleep Disorders in Psychosomatic Rehabilitation].

PubMed

Linden, Michael

2015-07-01

In cases of burnout, chronic fatigue, depression, somatization, overtaxation, or impairment in wellbeing and work capacity, the cause can be sleep problems. Goal of the present study was to estimate the prevalence of sleep problems in psychosomatic inpatients. Included were 1325 unselected patients from a psychosomatic rehabilitation hospital. They filled in the SCL-90, the PSQI and were assessed in respect to their clinical, social and occupational status. At admission 13.4% of patients had a PSQI score of 5 at maximum (no sleep problem), 34.6% 6 to 10 (moderate sleep problem) und 52.1% over 10 (severe sleep problem). At discharge there was a reduction of sleep problems with 32.7% of patients over 10. Sleep problems were significantly associated with more severe mental problems, older age, women, lower socioeconomic status, and also incapacity to work or early retirement. Mental disorders can cause sleep problems and sleep problems mental disorders and incapacity to work, with a negative interaction. The high rate of severe sleep problems in rehabilitation patients shows that this problem is in need of special diagnostic and therapeutic attention. Also, the equipment of hospitals and the qualification of therapists should allow adequate care. © Georg Thieme Verlag KG Stuttgart · New York.

Using the integrative model of behavioral prediction to identify promising message strategies to promote healthy sleep behavior among college students.

PubMed

Robbins, Rebecca; Niederdeppe, Jeff

2015-01-01

This research used the Integrative Model of Behavioral Prediction (IMBP) to examine cognitive predictors of intentions to engage in healthy sleep behavior among a population of college students. In doing so, we identify promising message strategies to increase healthy sleep behavior during college. In Phase 1, members of a small sample of undergraduates (n = 31) were asked to describe their beliefs about expected outcomes, norms, and perceived behavioral control associated with sleep on an open-ended questionnaire. We analyzed these qualitative responses to create a closed-ended survey about sleep-related attitudes, perceived norms, control beliefs, behavioral intentions, and behavior. In Phase 2, a larger sample of undergraduate students (n = 365) completed the survey. Attitudes and perceived behavioral control were the strongest predictors of both intentions to engage in sleep behavior and self-reported sleep behavior. Control beliefs associated with time management and stress also had substantial room to change, suggesting their potential as message strategies to better promote healthy sleep behavior in college. We conclude with a broader discussion of the study's implications for message design and intervention.

Children's Sleep Comic: development of a new diagnostic tool for children with sleep disorders.

PubMed

Schwerdtle, Barbara; Kanis, Julia; Kahl, Lena; Kübler, Andrea; Schlarb, Angelika A

2012-01-01

A solid diagnosis of sleep disorders in children should include both self-ratings and parent ratings. However, there are few standardized self-assessment instruments to meet this need. The Children's Sleep Comic is an adapted version of the unpublished German questionnaire "Freiburger Kinderschlafcomic" and provides pictures for items and responses. Because the drawings were outdated and allowed only for qualitative analysis, we revised the comic, tested its applicability in a target sample, and suggest a procedure for quantitative analysis. All items were updated and pictures were newly drawn. We used a sample of 201 children aged 5-10 years to test the applicability of the Children's Sleep Comic in young children and to run a preliminary analysis. The Children's Sleep Comic comprises 37 items covering relevant aspects of sleep disorders in children. Application took on average 30 minutes. The procedure was well accepted by the children, as reflected by the absence of any dropouts. First comparisons with established questionnaires indicated moderate correlations. The Children's Sleep Comic is appropriate for screening sleep behavior and sleep problems in children. The interactive procedure can foster a good relationship between the investigator and the child, and thus establish the basis for successful intervention if necessary.

[Sleep deprivation in somnambulism. Effect of arousal, deep sleep and sleep stage changes].

PubMed

Mayer, G; Neissner, V; Schwarzmayr, P; Meier-Ewert, K

1998-06-01

Diagnosis of parasomnias in the sleep laboratory is difficult since the nocturnal behavior reported by the patients often does not show up in the laboratory. To test the efficacy of sleep deprivation as a tool to provoke somnambulism we investigated ten patients (three women and seven men, mean age 27 +/- 3.4) with somnambulism. Their standard polysomnographies and videomonitored nocturnal behavior was compared to that of sex- and age-matched controls and to polysomnography and behavior after sleep deprivation. Patients with parasomnias and controls did not show significant differences in sleep parameters with the exception of longer arousal duration in controls, which was nonsignificant. In magnetic resonance tomography, patients with parasomnias did not reveal abnormality of the brain that might explain release of nocturnal behavior. Sleep deprivation led to significantly reduced number of arousals, reduced arousal index, significantly prolonged arousal duration and more stage shifts from all sleep stages (nonsignificant). Complex behavior during sleep increased under sleep deprivation, whereas sleepwalking did not increase. The majority of complex behavior during sleep is triggered by stage shifts and not by arousal in the sense of the arousal definition of the American Sleep Disorder Society. Complex behavior in sleep is stereotypical and nonviolent. Its complexity seems to depend on the duration and intensity of arousals. Sleep deprivation can be recommended as an efficacious method of increasing complex behavior in sleep, which is a preliminary stage of sleepwalking. Concerning the underlying pathology it seems to be important to register the quality and duration of stimuli that trigger arousals instead of focusing the number of arousals alone.

Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies

PubMed Central

Moore, Vivienne M; Van Ryswyk, Emer M; Varcoe, Tamara J; Rodgers, Raymond J; March, Wendy A; Moran, Lisa J; Avery, Jodie C; McEvoy, R Doug; Davies, Michael J

2018-01-01

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting the reproductive, metabolic and psychological health of women. Clinic-based studies indicate that sleep disturbances and disorders including obstructive sleep apnea and excessive daytime sleepiness occur more frequently among women with PCOS compared to comparison groups without the syndrome. Evidence from the few available population-based studies is supportive. Women with PCOS tend to be overweight/obese, but this only partly accounts for their sleep problems as associations are generally upheld after adjustment for body mass index; sleep problems also occur in women with PCOS of normal weight. There are several, possibly bidirectional, pathways through which PCOS is associated with sleep disturbances. The pathophysiology of PCOS involves hyperandrogenemia, a form of insulin resistance unique to affected women, and possible changes in cortisol and melatonin secretion, arguably reflecting altered hypothalamic–pituitary–adrenal function. Psychological and behavioral pathways are also likely to play a role, as anxiety and depression, smoking, alcohol use and lack of physical activity are also common among women with PCOS, partly in response to the distressing symptoms they experience. The specific impact of sleep disturbances on the health of women with PCOS is not yet clear; however, both PCOS and sleep disturbances are associated with deterioration in cardiometabolic health in the longer term and increased risk of type 2 diabetes. Both immediate quality of life and longer-term health of women with PCOS are likely to benefit from diagnosis and management of sleep disorders as part of interdisciplinary health care. PMID:29440941

Sleep-Dependent Consolidation of Rewarded Behavior Is Diminished in Children with Attention Deficit Hyperactivity Disorder and a Comorbid Disorder of Social Behavior

PubMed Central

Wiesner, Christian D.; Molzow, Ina; Prehn-Kristensen, Alexander; Baving, Lioba

2017-01-01

Children suffering from attention-deficit hyperactivity disorder (ADHD) often also display impaired learning and memory. Previous research has documented aberrant reward processing in ADHD as well as impaired sleep-dependent consolidation of declarative memory. We investigated whether sleep also fosters the consolidation of behavior learned by probabilistic reward and whether ADHD patients with a comorbid disorder of social behavior show deficits in this memory domain, too. A group of 17 ADHD patients with comorbid disorders of social behavior aged 8–12 years and healthy controls matched for age, IQ, and handedness took part in the experiment. During the encoding task, children worked on a probabilistic learning task acquiring behavioral preferences for stimuli rewarded most often. After a 12-hr retention interval of either sleep at night or wakefulness during the day, a reversal task was presented where the contingencies were reversed. Consolidation of rewarded behavior is indicated by greater resistance to reversal learning. We found that healthy children consolidate rewarded behavior better during a night of sleep than during a day awake and that the sleep-dependent consolidation of rewarded behavior by trend correlates with non-REM sleep but not with REM sleep. In contrast, children with ADHD and comorbid disorders of social behavior do not show sleep-dependent consolidation of rewarded behavior. Moreover, their consolidation of rewarded behavior does not correlate with sleep. The results indicate that dysfunctional sleep in children suffering from ADHD and disorders of social behavior might be a crucial factor in the consolidation of behavior learned by reward. PMID:28228742

[A novel proposal explaining sleep disturbance of children in Japan--asynchronization].

PubMed

Kohyama, Jun

2008-07-01

It has been reported that more than half of the children in Japan suffer from daytime sleepiness. In contrast, about one quarter of junior high-school students in Japan complain of insomnia. According to the International Classification of Sleep Disorders (Second edition), these children could be diagnosed as having behaviorally-induced insufficient sleep syndrome due to inadequate sleeping habits. Getting on adequate amount of sleep should solve such problems;however, such a therapeutic approach often fails. Although social factors are involved in these sleep disturbances, I feel that a novel notion - asynchronization - leads to an understanding of the pathophysiology of disturbances in these children. Further, it could contribute to resolve their problems. The essence of asynchronization is a disturbance of various aspects (e.g., cycle, amplitude, phase, and interrelationship) of the biological rhythms that normally exhibits circadian oscillation. The main cause of asynchronization is hypothesized to be the combination of light exposure during night and the lack of light exposure in the morning. Asynchronization results in the disturbance of variable systems. Thus, symptoms of asynchronization include disturbances of the autonomic nervous system (sleepiness, insomnia, disturbance of hormonal excretion, gastrointestinal problems, etc.) and higher brain function (disorientation, loss of sociality, loss of will or motivation, impaired alertness and performance, etc.). Neurological (attention deficit, aggression, impulsiveness, hyperactivity, etc.), psychiatric (depressive disorders, personality disorders, anxiety disorders, etc.) and somatic (tiredness, fatigue, etc.) disturbances could also be symptoms of asynchronization. At the initial phase of asynchronization, disturbances are functional and can be resolved relatively easily, such as by the establishment of a regular sleep-wakefulness cycle;however, without adequate intervention the disturbances could gradually worsen and become hard to resolve.

Attitudes towards treatment among patients suffering from sleep disorders. A Latin American survey.

PubMed

Blanco, Margarita; Kriguer, Norberto; Pérez Lloret, Santiago; Cardinali, Daniel P

2003-11-20

Although sleep disorders are common, they frequently remain unnoticed by the general practitioner. Few data are available about the willingness and reasons of patients with sleep disturbances to seek for medical assistance. The results of a cross-sectional community-based multinational survey in three major Latin American urban areas, i.e. Buenos Aires, Mexico City and Sao Paulo, are reported. Two-hundred subjects suffering sleep disturbances and 100 non-sufferers were selected from the general population in each city (total number: 600 sufferers vs. 300 non-sufferers). A structured interview was conducted, sleep characteristics, feelings about sleep disturbances and strategies to cope with those problems being recorded. Data were analyzed by employing either t-test or analysis of variance (ANOVA) to the Z-transformed proportions. 22.7 +/- 3.5 % (mean +/- SEM) of subjects reported to suffer from sleep disturbances every night. About 3 out of 4 (74.2 +/- 2.0 %) considered their disorder as mild and were not very concerned about it. Only 31 +/- 2 % of sufferers reported to have sought for medical help. Although 45 +/- 2 % of sufferers reported frequent daily sleepiness, trouble to remember things, irritability and headaches, they did not seek for medical assistance. Among those patients who saw a physician with complaints different from sleep difficulties only 1 out of 3 (33 +/- 2 % of patients) were asked about quality of their sleep by the incumbent practitioner. Strategies of patients to cope with sleep problems included specific behaviors (taking a warm bath, reading or watching TV) (44 +/- 1.6 %), taking herbal beverages (17 +/- 1.2 %) or taking sleeping pills (10 +/- 1.1 %). Benzodiazepines were consumed by 3 +/- 0.6 % of sufferers. Public educational campaigns on the consequences of sleep disorders and an adequate training of physicians in sleep medicine are needed to educate both the public and the general practitioners about sleep disorders.

Racial discrimination mediates race differences in sleep problems: A longitudinal analysis.

PubMed

Fuller-Rowell, Thomas E; Curtis, David S; El-Sheikh, Mona; Duke, Adrienne M; Ryff, Carol D; Zgierska, Aleksandra E

2017-04-01

To examine changes in sleep problems over a 1.5-year period among Black or African American (AA) and White or European American (EA) college students and to consider the role of racial discrimination as a mediator of race differences in sleep problems over time. Students attending a large, predominantly White university (N = 133, 41% AA, 57% female, mean age = 18.8, SD = .90) reported on habitual sleep characteristics and experiences of racial discrimination at baseline and follow-up assessments. A latent variable for sleep problems was assessed from reports of sleep latency, duration, efficiency, and quality. Longitudinal models were used to examine race differences in sleep problems over time and the mediating role of perceived discrimination. Covariates included age, gender, parent education, parent income, body mass index, self-rated physical health, and depressive symptoms. Each of the individual sleep measures was also examined separately, and sensitivity analyses were conducted using alternative formulations of the sleep problems measure. AAs had greater increases in sleep problems than EAs. Perceived discrimination was also associated with increases in sleep problems over time and mediated racial disparities in sleep. This pattern of findings was similar when each of the sleep indicators was considered separately and held with alternative sleep problems measures. The findings highlight the importance of racial disparities in sleep across the college years and suggest that experiences of discrimination contribute to group disparities. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Behavioral Sleep-Wake Homeostasis and EEG Delta Power Are Decoupled By Chronic Sleep Restriction in the Rat

PubMed Central

Stephenson, Richard; Caron, Aimee M.; Famina, Svetlana

2015-01-01

Study Objectives: Chronic sleep restriction (CSR) is prevalent in society and is linked to adverse consequences that might be ameliorated by acclimation of homeostatic drive. This study was designed to test the hypothesis that the sleep-wake homeostat will acclimatize to CSR. DESIGN: A four-parameter model of proportional control was used to quantify sleep homeostasis with and without recourse to a sleep intensity function. Setting: Animal laboratory, rodent walking-wheel apparatus. Subjects: Male Sprague-Dawley rats. Interventions: Acute total sleep deprivation (TSD, 1 day × 18 or 24 h, N = 12), CSR (10 days × 18 h TSD, N = 6, or 5 days × 20 h TSD, N = 5). Measurements and Results: Behavioral rebounds were consistent with model predictions for proportional control of cumulative times in wake, nonrapid eye movement sleep (NREM) and rapid eye movement sleep (REM). Delta (Δ) energy homeostasis was secondary to behavioral homeostasis; a biphasic NREM Δ power rebound contributed to the dynamics (rapid response) but not to the magnitude of the rebound in Δ energy. REM behavioral homeostasis was little affected by CSR. NREM behavioral homeostasis was attenuated in proportion to cumulative NREM deficit, whereas the biphasic NREM Δ power rebound was only slightly suppressed, indicating decoupled regulatory mechanisms following CSR. Conclusions: We conclude that sleep homeostasis is achieved through behavioral regulation, that the nonrapid eye movement sleep behavioral homeostat is susceptible to attenuation during chronic sleep restriction and that the concept of sleep intensity is not essential in a model of sleep-wake regulation. Citation: Stephenson R, Caron AM, Famina S. Behavioral sleep-wake homeostasis and EEG delta power are decoupled by chronic sleep restriction in the rat. SLEEP 2015;38(5):685–697. PMID:25669184

Externalizing Behaviors and Callous-Unemotional Traits: Different Associations With Sleep Quality

PubMed Central

Akhtar, Reece; Holding, Benjamin C; Murray, Christina; Panatti, Jennifer; Claridge, Gordon; Sadeh, Avi; Barclay, Nicola L; O’Leary, Rachael; Maughan, Barbara; McAdams, Tom A; Rowe, Richard; Eley, Thalia C; Viding, Essi

2017-01-01

Abstract Study Objectives Sleep quality is associated with different aspects of psychopathology, but relatively little research has examined links between sleep quality and externalizing behaviors or callous-unemotional traits. We examined: (1) whether an association exists between sleep quality and externalizing behaviors; (2) whether anxiety mediates this association; (3) whether callous-unemotional traits are associated with sleep quality. Methods Data from two studies were used. Study 1 involved 1556 participants of the G1219 study aged 18–27 years (62% female). Questionnaire measures assessed sleep quality, anxiety, externalizing behaviors, and callous-unemotional traits. Study 2 involved 338 participants aged 18–66 years (65% female). Questionnaires measured sleep quality, externalizing behaviors, and callous-unemotional traits. In order to assess objective sleep quality, actigraphic data were also recorded for a week from a subsample of study 2 participants (n = 43). Results In study 1, poorer sleep quality was associated with greater externalizing behaviors. This association was partially mediated by anxiety and moderated by levels of callous-unemotional traits. There was no significant relationship between sleep quality and callous-unemotional traits. In study 2, poorer sleep quality, as assessed via self-reported but not objective measures, was associated with higher levels of externalizing behaviors. Furthermore, in study 2, better sleep quality (indicated in both questionnaires and actigraphy measures: lower mean activity, and greater sleep efficiency) was associated with higher levels of callous-unemotional traits. Conclusions Self-reports of poorer sleep quality are associated with externalizing behaviors, and this association is partially mediated by anxiety. Callous-unemotional traits are not associated with poor sleep and may even be related to better sleep quality. This is an exceptional finding given that poor sleep quality appears to be a characteristic of most psychopathology. PMID:28575510

Copy number variations in patients with electrical status epilepticus in sleep.

PubMed

Kevelam, Sietske H G; Jansen, Floor E; Binsbergen, Ellen van; Braun, Kees P J; Verbeek, Nienke E; Lindhout, Dick; Poot, Martin; Brilstra, Eva H

2012-02-01

Electrical status epilepticus in sleep syndrome is the association of the electroencephalographic pattern and deficits in language or global cognitive function and behavioral problems. The etiology is often unknown, but genetic risk factors have been implicated. Array-based comparative genomic hybridization was used to identify copy number variations in 13 children with electrical status epilepticus in sleep syndrome to identify possible underlying risk factors. Seven copy number variations were detected in 4 of the 13 patients, which consisted of 6 novel gains and 1 loss, the recurrent 15q13.3 microdeletion. Two patients carried a probable pathogenic copy number variation containing a gene involved in the cholinergic pathway. Genetic aberrations in patients with electrical status epilepticus in sleep syndrome can provide an entry in the investigation of the etiology of electrical status epilepticus in sleep. However, further studies are needed to confirm our findings.

Relations among Menopausal Symptoms, Sleep Disturbance and Depressive Symptoms in Midlife

PubMed Central

Brown, Jessica P.; Gallicchio, Lisa; Flaws, Jodi F.; Tracy, J. Kathleen

2009-01-01

Objectives To investigate the relations among hot flashes, other menopausal symptoms, sleep quality and depressive symptoms in midlife women Methods A large population-based cross-sectional study of 639 women (ages 45 to 54 years) consisting of a questionnaire including the Center for Epidemiologic Studies-Depression Scale (CES-D), demographics, health behaviors, menstrual history, and menopausal symptoms Results After controlling for menopausal status, physical activity level, smoking status and current self-reported health status elevated CES-D score is associated with frequent nocturnal hot flashes, frequent trouble sleeping, experiencing hot flashes, nausea, headaches, weakness, visual problems, vaginal discharge, irritability, muscle stiffness, and incontinence. Conclusions The present study found significant links between depressive symptoms and several menopausal symptoms including hot flashes, sleep disturbance, irritability, muscle stiffness, and incontinence after controlling for covariates. These findings suggest that a potential mechanism in which bothersome menopausal symptoms may influence depressed mood during the midlife is through sleep disturbance. PMID:19128903

Sleep disruption among cancer patients following autologous hematopoietic cell transplantation.

PubMed

Nelson, Ashley M; Jim, Heather S L; Small, Brent J; Nishihori, Taiga; Gonzalez, Brian D; Cessna, Julie M; Hyland, Kelly A; Rumble, Meredith E; Jacobsen, Paul B

2018-03-01

Despite a high prevalence of sleep disruption among hematopoietic cell transplant (HCT) recipients, relatively little research has investigated its relationships with modifiable cognitive or behavioral factors or used actigraphy to characterize sleep disruption in this population. Autologous HCT recipients who were 6-18 months post transplant completed self-report measures of cancer-related distress, fear of cancer recurrence, dysfunctional sleep cognitions, and inhibitory sleep behaviors upon enrollment. Patients then wore an actigraph for 7 days and completed a self-report measure of sleep disruption on day 7 of the study. Among the 84 participants (age M = 60, 45% female), 41% reported clinically relevant sleep disruption. Examination of actigraph data confirmed that, on average, sleep was disrupted (wake after sleep onset M = 66 min) and sleep efficiency was less than recommended (sleep efficiency M = 78%). Cancer-related distress, fear of recurrence, dysfunctional sleep cognitions, and inhibitory sleep behaviors were related to self-reported sleep disruption (p values<0.05) but not objective sleep indices. Results suggest that many HCT recipients experience sleep disruption after transplant. Cancer-related distress, fear of recurrence, dysfunctional sleep cognitions, and maladaptive sleep behaviors are related to self-reported sleep disruption and should be considered targets for cognitive behavioral intervention in this population.

Targeted Behavioral Therapy for childhood generalized anxiety disorder: a time-series analysis of changes in anxiety and sleep.

PubMed

Clementi, Michelle A; Alfano, Candice A

2014-03-01

This study examined the efficacy of Targeted Behavioral Therapy (TBT), a newly developed intervention targeting features of childhood generalized anxiety disorder (GAD). Using a time-series design, 4 children (7-12 years) with primary GAD were treated with TBT, which includes sleep improvement strategies, systematic desensitization for reducing intolerance of uncertainty, and in vivo exposures for anxiety. Diagnostic interviews and questionnaires were administered at baseline, post-treatment and 3 months follow-up. Anxiety symptoms and sleep characteristics/problems were rated weekly during a 4-week baseline and 14-weeks of treatment. Two children remitted at post-treatment and no child had a GAD diagnosis at follow-up. Child but not parent report revealed improvements in both worry and sleep. Despite improvements from pre- to post-assessment, considerable symptom fluctuation observed during the baseline period preclude conclusion that symptom changes are specifically attributable to the course of treatment. Overall, preliminary support is provided for the efficacy of TBT for childhood GAD. Copyright © 2013 Elsevier Ltd. All rights reserved.

Nonparametric Signal Extraction and Measurement Error in the Analysis of Electroencephalographic Activity During Sleep

PubMed Central

Crainiceanu, Ciprian M.; Caffo, Brian S.; Di, Chong-Zhi; Punjabi, Naresh M.

2009-01-01

We introduce methods for signal and associated variability estimation based on hierarchical nonparametric smoothing with application to the Sleep Heart Health Study (SHHS). SHHS is the largest electroencephalographic (EEG) collection of sleep-related data, which contains, at each visit, two quasi-continuous EEG signals for each subject. The signal features extracted from EEG data are then used in second level analyses to investigate the relation between health, behavioral, or biometric outcomes and sleep. Using subject specific signals estimated with known variability in a second level regression becomes a nonstandard measurement error problem. We propose and implement methods that take into account cross-sectional and longitudinal measurement error. The research presented here forms the basis for EEG signal processing for the SHHS. PMID:20057925

Sleep in infants and children with prenatal alcohol exposure.

PubMed

Inkelis, Sarah M; Thomas, Jennifer D

2018-05-31

Prenatal exposure to alcohol can result in a range of neurobehavioral impairments and physical abnormalities. The term fetal alcohol spectrum disorders (FASD) encompasses the outcomes of prenatal alcohol exposure (PAE), the most severe of which is fetal alcohol syndrome (FAS). These effects have lifelong consequences, placing a significant burden on affected individuals, caregivers, and communities. Caregivers of affected children often report that their child has sleep problems, and many symptoms of sleep deprivation overlap with the cognitive and behavioral deficits characteristic of FASD. Alcohol-exposed infants and children demonstrate poor sleep quality based on measures of electroencephalography (EEG), actigraphy, and questionnaires. These sleep studies indicate a common theme of disrupted sleep pattern, more frequent awakenings, and reduced total sleep time. However, relatively little is known about circadian rhythm disruption, and the neurobehavioral correlates of sleep disturbance in individuals with PAE. Furthermore, there is limited information available to healthcare providers about identification and treatment of sleep disorders in patients with FASD. This review consolidates the findings from studies of infant and pediatric sleep in this population, providing an overview of typical sleep characteristics, neurobehavioral correlates of sleep disruption, and potential avenues for intervention in the context of PAE. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Presence and persistence of sleep-related symptoms and suicidal ideation in psychiatric inpatients.

PubMed

Nadorff, Michael R; Ellis, Thomas E; Allen, Jon G; Winer, E Samuel; Herrera, Steve

2014-01-01

Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

Behavioral and psychosocial factors associated with suicidal ideation among adolescents.

PubMed

Lee, GyuYoung; Ham, Ok Kyung

2018-04-10

Suicidal ideation poses a serious threat to the well-being of adolescents and is the strongest risk factor for suicide. Indeed, Korea ranks first among Organisation for Economic Cooperation and Development countries regarding the age-standardized suicide rates. In the present study, we examined multiple levels of factors associated with the suicidal ideation of adolescents in Korea by applying the Ecological Models of Health Behavior. A cross-sectional study was conducted with a convenience sample of 860 adolescents. The instruments included the Beck Depression Inventory and the Adolescent Mental Health and Problem Behavior Questionnaire. The data were analyzed using hierarchical multiple regression. Sixteen percent of participants reported suicidal ideation. Intrapersonal (sleep disturbance, Internet game addiction, destructive behavior, and depressive symptoms) and interpersonal factors (family conflicts and peer victimization) were associated with suicidal ideation. Because multiple factors were associated with suicidal ideation among adolescents, both intrapersonal (sleep disturbance, Internet game addiction, and depression) and interpersonal factors (family conflicts and peer problems) should be considered in the development of suicide-prevention programs. These programs could include campaigns changing the norms (permissive attitudes toward school violence) and the development of strict and rigorous school non-violence policies. © 2018 John Wiley & Sons Australia, Ltd.

Workplace bullying, sleep problems and leisure-time physical activity: a prospective cohort study.

PubMed

Hansen, Åse Marie; Gullander, Maria; Hogh, Annie; Persson, Roger; Kolstad, Henrik A; Willert, Morten Vejs; Bonde, Jens Peter; Kaerlev, Linda; Rugulies, Reiner; Grynderup, Matias Brødsgaard

2016-01-01

Workplace bullying is a potent stressor that may increase sleep problems. Since physical fitness improves resilience to stress, it seems plausible that recreational physical activities may moderate the association between bullying and sleep. The study aimed to examine prospectively whether (i) bullying increases the risk of sleep problems, and (ii) the association between bullying and sleep problems is moderated by leisure-time physical activity (LTPA). The study sample comprised a cohort of public and private sector employees, who were enrolled into the Work Bullying and Harassment (WBH) cohort (N=3278) or the Psychosocial Risk Factors for Stress and Mental Disease (PRISME) cohort (N=4455). We measured workplace bullying using one question that was preceded by a definition of bullying. We used the Karolinska sleep questionnaire to assess sleep problems. The number of hours per week spent on LTPA estimated the degree of physical activity. Workplace bullying at baseline (T1) was associated with awakening problems and lack of restful sleep at follow-up (T2) but not with overall sleep problems and disturbed sleep. T1-LTPA did not moderate the association between T1-workplace bullying and T2-sleep problems. We found support that workplace bullying is related to development of T2-sleep problems, but this association seems not to be modified by LTPA.

Treatment guidelines for Circadian Rhythm Sleep - Wake Disorders of the Polish Sleep Research Society and the Section of Biological Psychiatry of the Polish Psychiatric Association. Part II. Diagnosis and treatment.

PubMed

Wichniak, Adam; Jankowski, Konrad S; Skalski, Michał; Skwarło-Sońta, Krystyna; Zawilska, Jolanta B; Żarowski, Marcin; Poradowska, Ewa; Jernajczyk, Wojciech

2017-10-29

Circadian rhythm sleep-wake disorders (CRSWD) are a group of disorders, in which the timing of sleep and wakefulness significantly differs from a patient's expectations or socially acceptable times. The aimof the article is to present the current principles for the diagnosis and treatment of CRSWD in adults and children. Guidelines proposed as CRSWD treatment standard are based on the recommendations from the scientific societies involved in the sleep research and medicine. Researchers participating in the guidelines preparation were invited by the Polish Sleep Research Society and the Section of Biological Psychiatry of the Polish Psychiatric Association based on their significant contribution to the circadian rhythm research and/or clinical experience in the treatment of these disorders. Finally, the guidelines were adjusted to the questions and comments given by the members of both Societies. Patients with endogenous CRSWD are often misdiagnosed and treated for insomnia or hypersomnia. Therefore, each patient reporting sleep-wake disorders should be interviewed about the quality of sleep and its timing during free days (e.g. weekends, holidays). Avalid CRSWD diagnosis can be also established by using sleep diaries/logs and actigraphy. The treatment of choice for CRSWD is chronotherapy, which involves melatonin application, light therapy, and behavioral interventions. Sleep disorders associated with shift work and time zone changes are a growing health problem. Interventions for these disorders should primarily focus on prevention. The main problem in the treatment of CRSWD is an invalid diagnosis. Hypnotics and/or psychostimulants are often used instead of chronotherapeutic interventions, what can alleviate symptoms but is not an effective treatment.

Unihemispheric sleep and asymmetrical sleep: behavioral, neurophysiological, and functional perspectives.

PubMed

Mascetti, Gian Gastone

2016-01-01

Sleep is a behavior characterized by a typical body posture, both eyes' closure, raised sensory threshold, distinctive electrographic signs, and a marked decrease of motor activity. In addition, sleep is a periodically necessary behavior and therefore, in the majority of animals, it involves the whole brain and body. However, certain marine mammals and species of birds show a different sleep behavior, in which one cerebral hemisphere sleeps while the other is awake. In dolphins, eared seals, and manatees, unihemispheric sleep allows them to have the benefits of sleep, breathing, thermoregulation, and vigilance. In birds, antipredation vigilance is the main function of unihemispheric sleep, but in domestic chicks, it is also associated with brain lateralization or dominance in the control of behavior. Compared to bihemispheric sleep, unihemispheric sleep would mean a reduction of the time spent sleeping and of the associated recovery processes. However, the behavior and health of aquatic mammals and birds does not seem at all impaired by the reduction of sleep. The neural mechanisms of unihemispheric sleep are unknown, but assuming that the neural structures involved in sleep in cetaceans, seals, and birds are similar to those of terrestrial mammals, it is suggested that they involve the interaction of structures of the hypothalamus, basal forebrain, and brain stem. The neural mechanisms promoting wakefulness dominate one side of the brain, while those promoting sleep predominates the other side. For cetaceans, unihemispheric sleep is the only way to sleep, while in seals and birds, unihemispheric sleep events are intermingled with bihemispheric and rapid eye movement sleep events. Electroencephalogram hemispheric asymmetries are also reported during bihemispheric sleep, at awakening, and at sleep onset, as well as being associated with a use-dependent process (local sleep).

Pediatric sleep problems and social-emotional problems. A population-based study.

PubMed

Hysing, Mari; Sivertsen, Børge; Garthus-Niegel, Susan; Eberhard-Gran, Malin

2016-02-01

To examine the association between sleep and social-emotional development in two-year-old toddlers. The study is part of a longitudinal cohort study, the Akershus Birth Cohort Study, which targeted all women giving birth at Akershus University Hospital in Norway. The current study is from the fourth round of the study, including 2014 women two years after delivery. The Brief Infant Sleep Questionnaire (BISQ) and the Ages and Stages Questionnaire: Social Emotional (ASQ:SE) were filled out by the mothers and were used to assess toddler sleep, and social-emotional development, respectively. Other domains of development (communication problems, gross motor problems, and fine motor problems) were assessed with the Ages and Stages Questionnaire (ASQ). Confirmatory factor analysis was conducted on the ASQ:SE, and logistic regression analyses were used to examine both crude associations between sleep variables and social-emotional problems, and adjusting for potential confounders. The mean sleep duration of the toddlers was 12h and 27 min; the majority of the children (54%) had 1-2 awakenings per night, while 10% of the children had a sleep onset latency of more than 30 min. All sleep parameters, including short sleep duration, nocturnal awakenings and sleep onset problems, were significantly associated with social-emotional problems in a dose-response manner. For example, sleeping less than 11h per night was associated with a five-fold increase in the odds of social-emotional problems, compared to sleeping 13-14 h per night. Adjusting for potential confounders, including maternal age, maternal education, marital status, parity, gestational age, child birth-weight and other developmental problems, did not, or only slightly, attenuate the associations between any of the sleep variables and social-emotional problems. Short sleep duration, nocturnal awakenings and sleep onset problems were all associated with higher odds of social-emotional problems, even after accounting for developmental problems and demographic factors. Thus, a broad assessment of sleep and social-emotional problems when toddlers present with either can be useful. Copyright © 2016. Published by Elsevier Inc.

Sleep is an eye-opener: Behavioral causes and consequences of hypersomnolence in children.

PubMed

Thomas, Jocelyn H; Burgers, Darcy E

2018-01-01

The most common behavioral cause of hypersomnia in children is insufficient sleep. Behavioral causes of insufficient sleep for children, ages six months through 12 years, include inadequate sleep hygiene, bedtime struggles, prolonged sleep onset latency, nighttime fears, and nightmares. Behavioral interventions are efficacious and should be individualized to meet the needs of the child and family. Insufficient sleep affects many areas of child development, including academic, cognitive, and psychosocial, as well as parents and caregivers. Behavioral causes of sleepiness in children are best identified through a clinical interview, sleep diary, and actigraphy. Copyright © 2016. Published by Elsevier Ltd.

Sleep, Glucose, and Daytime Functioning in Youth with Type 1 Diabetes

PubMed Central

Perfect, Michelle M.; Patel, Priti G.; Scott, Roxanne E.; Wheeler, Mark D.; Patel, Chetanbabu; Griffin, Kurt; Sorensen, Seth T.; Goodwin, James L.; Quan, Stuart F.

2012-01-01

Study Hypotheses: 1) Youth with evidence of SDB (total apnea-hypopnea index [Total-AHI] ≥ 1.5) would have significantly worse glucose control than those without SDB; 2) Elevated self-reported sleepiness in youth with T1DM would be related to compromised psychosocial functioning; and 3) Youth with T1DM would have significantly less slow wave sleep (SWS) than controls. Design: The study utilized home-based polysomnography, actigraphy, and questionnaires to assess sleep, and continuous glucose monitors and hemoglobin A1C (HbA1C) values to assess glucose control in youth with T1DM. We compared sleep of youth with T1DM to sleep of a matched control sample. Setting: Diabetic participants were recruited in a pediatric endocrinology clinic. Participants: Participants were youth (10 through 16 years) with T1DM. Controls, matched for sex, age, and BMI percentile, were from the Tucson Children's Assessment of Sleep Apnea study. Results: Participants with a Total-AHI ≥ 1.5 had higher glucose levels. Sleepiness and/or poor sleep habits correlated with reduced quality of life, depressed mood, lower grades, and lower state standardized reading scores. Diabetic youth spent more time (%) in stage N2 and less time in stage N3. Findings related to sleep architecture included associations between reduced SWS and higher HbA1C, worse quality of life, and sleepiness. More time (%) spent in stage N2 related to higher glucose levels/hyperglycemia, behavioral difficulties, reduced quality of life, lower grades, depression, sleep-wake behavior problems, poor sleep quality, sleepiness, and lower state standardized math scores. Conclusions: Sleep should be routinely assessed as part of diabetes management in youth with T1DM. Citation: Perfect MM; Patel PG; Scott RE; Wheeler MD; Patel C; Griffin K; Sorensen ST; Goodwin JL; Quan SF. Sleep, glucose, and daytime functioning in youth with type 1 diabetes. SLEEP 2012;35(1):81-88. PMID:22215921

Unusual Sleep Experiences, Dissociation, and Schizotypy: Evidence for a Common Domain

PubMed Central

Koffel, Erin; Watson, David

2009-01-01

This paper reviews studies that have examined associations between unusual sleep experiences (including nightmares, vivid dreaming, narcolepsy symptoms, and complex nighttime behaviors) and dissociation and schizotypy. Using correlational studies and structural analyses, evidence is provided that unusual sleep experiences, dissociation, and schizotypy belong to a common domain. It is demonstrated that unusual sleep experiences show specificity to dissociation and schizotypy compared to other daytime symptoms (e.g., anxiety, depression, substance use) and other sleep disturbances (e.g., insomnia, lassitude/fatigue). The paper also outlines the methodological limitations of the existing evidence and makes suggestions for future research. Finally, three models for the overlap of daytime and nighttime symptoms are reviewed, including biological abnormalities, trauma, and personality traits. Although further research is needed, it is suggested that daytime and nighttime symptoms result from problems with sleep-wake state boundaries, which may be precipitated by stress or trauma. In addition, association between daytime and nighttime symptoms can be attributed to the higher order personality trait of Oddity. PMID:19581031

Prevalence of mood and sleep problems in chronic skin diseases: a pilot study.

PubMed

Mostaghimi, Ladan

2008-05-01

The relationship between chronic skin problems and mood and sleep disorders merits more attention. Mood and sleep problems add to comorbidity of chronic skin diseases and affect patient compliance with dermatologic treatment. A pilot study was conducted to determine the prevalence of mood and sleep problems in participants with chronic skin diseases in outpatient dermatology clinics at the University of Wisconsin, Madison, using 4 self-assessment questionnaires. Study participants included willing adults with any skin problem of at least 6 months' duration. The participants were asked to complete the questionnaires, which included Current Life Functioning, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory. In summary, 15 of 16 participants had poor sleep quality. Six participants had poor sleep quality without any mood problems (depression or anxiety). Mood problems worsened the quality of sleep and functioning. Nine of 16 participants (56.25%) reported mood problems (depression or anxiety). The results show a high prevalence of depression and anxiety and a very high prevalence of poor sleep quality. Considering the negative effect of comorbid psychiatric and sleep problems on treatment and prognosis of chronic skin diseases, this study demonstrates the need for further evaluation and eventual screening of all patients with chronic skin diseases for mood and sleep problems.

Sleep phenotypes in infants and toddlers with neurogenetic syndromes.

PubMed

Abel, Emily A; Tonnsen, Bridgette L

2017-10-01

Although sleep problems are well characterized in preschool- and school-age children with neurogenetic syndromes, little is known regarding the early emergence of these problems in infancy and toddlerhood. To inform syndrome-specific profiles and targets for intervention, we compared parent-reported sleep problems in infants and toddlers with Angelman syndrome (AS), Williams syndrome (WS), and Prader-Willi syndrome (PWS) with patterns observed among same-aged typically developing (TD) controls. Mothers of 80 children (18 AS, 19 WS, 19 PWS, and 24 TD) completed the Brief Infant Sleep Questionnaire. Primary dependent variables included (1) sleep onset latency, (2) total sleep duration, (3) daytime and nighttime sleep duration, and (4) sleep problem severity, as measured by both maternal impression and National Sleep Foundation guidelines. Sleep problems are relatively common in children with neurogenetic syndromes, with 41% of mothers reporting problematic sleep and 29% of children exhibiting abnormal sleep durations as per national guidelines. Across genetic subgroups, problems are most severe in children with AS and WS, particularly in relation to nighttime sleep duration. Although atypical sleep is characteristically reported in each syndrome later in development, infants and toddlers with PWS exhibited largely typical patterns, potentially indicating delayed onset of sleep problems in concordance with other medical features of PWS. Our findings suggest that sleep problems in neurogenetic syndromes emerge as early as infancy and toddlerhood, with variable profiles across genetic subgroups. This work underscores the importance of early sleep screenings as part of routine medical care of neurosyndromic populations and the need for targeted, syndrome-sensitive treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Psychosocial Profile and Quality of Life in Children With Type 1 Narcolepsy: A Case-Control Study

PubMed Central

Rocca, Francesca Letizia; Finotti, Elena; Pizza, Fabio; Ingravallo, Francesca; Gatta, Michela; Bruni, Oliviero; Plazzi, Giuseppe

2016-01-01

Study Objectives: To investigate behavioral aspects and quality of life in children and adolescents with type 1 narcolepsy (NT1). Methods: We performed a case-control study comparing 29 patients with NT1 versus sex- and age-matched patients with idiopathic epilepsy (n = 39) and healthy controls (n = 39). Behavior and quality of life were evaluated by self-administered questionnaires (Child Behavior Checklist, Pediatric Quality of Life Inventory). Patient groups were contrasted and scale results were correlated with clinical and polysomnographic parameters, and cerebrospinal fluid hypocretin-1 levels. Results: Young patients with NT1 showed increased internalizing problems associated with aggressive behavior. Emotional profile in patients with NT1 positively correlated with age at onset, diagnostic delay, and subjective sleepiness, whereas treatment and disease duration were associated with fewer behavioral problems (attention problems, aggressive behavior, and attention deficit/hyperactivity disorder). Psychosocial health domains of pediatric NT1 were worse than in healthy controls, whereas the physical health domains were comparable. Conclusions: Young NT1 patients show a discrete pattern of altered behavioral, thought, and mood profile in comparison with healthy controls and with idiopathic epilepsy patients thus suggesting a direct link with sleepiness. Further studies investigating behavior in patients with idiopathic hypersomnia or type 2 narcolepsy are needed to disentangle the role of REM sleep dysfunction and hypocretin deficiency in psychiatric disorders. Symptoms of withdrawal, depression, somatic complaints, thought problems, and aggressiveness were common, NT1 children perceived lower school competencies than healthy children, and their parents also reported worse psychosocial health. Our data suggest that early effective treatment and disease self-awareness should be promoted in NT1 children for their positive effect on behavior and psychosocial health. Citation: Rocca FL, Finotti E, Pizza F, Ingravallo F, Gatta M, Bruni O, Plazzi G. Psychosocial profile and quality of life in children with type 1 narcolepsy: a case-control study. SLEEP 2016;39(7):1389–1398. PMID:27166243

Associations between sleep duration and physical activity and dietary behaviors in Chinese adolescents: results from the Youth Behavioral Risk Factor Surveys of 2015.

PubMed

Gong, Qing Hai; Li, Hui; Zhang, Xiao Hong; Zhang, Tao; Cui, Jun; Xu, Guo Zhang

2017-09-01

To assess the association between sleep duration and physical activity and dietary behaviors among adolescents in a representative sample. The analysis was performed using data from the 2015 Ningbo Youth Risk Behavior Survey. Associations between physical activity and dietary behaviors and sleep duration were examined on weighted data using logistic regression. Of the 10726 students, roughly 40% reported sleep duration <8 h. Longer sleep duration was associated with higher likelihood of milk intake, fruit consumption, vegetable consumption, water consumption, moderate physical activity, and muscle-strengthening physical activity, and with a lower likelihood of cigarette use, alcohol use, sweets intake, Western fast food intake, and breakfast skipping. Insufficient sleep may be common among Chinese adolescents. Sleep duration was associated with dietary behaviors, physical activity, and other health-related behaviors. These findings suggest that sleep duration could be a potential target for many health-risk behaviors in young adolescents. Copyright © 2017. Published by Elsevier B.V.

A longitudinal examination of the bidirectional association between sleep problems and social ties at university: the mediating role of emotion regulation.

PubMed

Tavernier, Royette; Willoughby, Teena

2015-02-01

Despite the growing body of research linking sleep problems and social ties, research investigating the direction of effects between these two constructs is lacking. Furthermore, there remains a dearth of research examining the mechanisms that may explain the association between sleep problems and social ties within a longitudinal design. The present 3-year longitudinal study addressed two research questions: (1) Is there a bidirectional association between sleep problems and social ties at university? and (2) Does emotion regulation mediate the association between sleep problems and social ties at university? Participants (N = 942, 71.5% female; M = 19.01 years at Time 1, SD = 0.90) were university students who completed annual assessments of sleep problems, social ties, and emotion regulation, for three consecutive years. Results of path analysis indicated that the bidirectional association between sleep problems and social ties was statistically significant (controlling for demographics, sleep-wake inconsistency, sleep duration, and alcohol). Analyses of indirect effects indicated that emotion regulation mediated this link, such that better sleep quality (i.e., less sleep problems) led to more effective emotion regulation, which, subsequently, led to more positive social ties. In addition, more positive social ties led to more effective emotion regulation, which, in turn, led to less sleep problems. The findings highlight the critical role that emotional regulation plays in the link between sleep problems and social ties, and emphasize the need for students as well as university administration to pay close attention to both the sleep and social environment of university students.

The diagnosis and management of common sleep disorders in adolescents.

PubMed

Reiter, Joel; Rosen, Dennis

2014-08-01

Sleep problems in adolescents are very common and negatively impact the quality of their health and lives, yet often go undiagnosed. This review is meant to familiarize pediatricians with some of the more commonly encountered sleep disorders in this age group, and to review their diagnosis and management. Recent findings reinforce the ubiquity of insufficient and poor-quality sleep in teens and their consequences on physical and mental health, cognition, and behavior. Increasing use of technology by teens, especially at night, plays a growing role in this. Parentally set bedtimes can be effective in increasing the sleep duration, thereby diminishing the consequences of insufficient sleep. Parasomnias, common in early childhood, usually diminish with the transition into adolescence. An almost 10-fold increase in the incidence of narcolepsy has been reported following the use of one type of vaccination against influenza H1N1 in Europe. Recent guidelines for the diagnosis and management of obstructive sleep apnea are reviewed, as are recent guidelines pertaining to the management of sleep disorders of children on the autism spectrum. Sleep disorders in adolescents are both very common and underdiagnosed, adversely affecting their overall well being.

Associations of Child Insomnia, Sleep Movement, and Their Persistence With Mental Health Symptoms in Childhood and Adolescence

PubMed Central

Armstrong, Jeffrey M.; Ruttle, Paula L.; Klein, Marjorie H.; Essex, Marilyn J.; Benca, Ruth M.

2014-01-01

Study Objectives: To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. Design: A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. Setting: Community. Participants: A total of 396 children (51% female). Interventions: N/A. Measurements and Results: Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9–10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. Conclusions: Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18. Citation: Armstrong JM, Ruttle PL, Klein MH, Essex MJ, Benca RM. Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence. SLEEP 2014;37(5):901-909. PMID:24790268

Involvement of the α1-adrenoceptor in sleep-waking and sleep loss-induced anxiety behavior in zebrafish.

PubMed

Singh, A; Subhashini, N; Sharma, S; Mallick, B N

2013-08-15

Sleep is a universal phenomenon in vertebrates, and its loss affects various behaviors. Independent studies have reported that sleep loss increases anxiety; however, the detailed mechanism is unknown. Because sleep deprivation increases noradrenalin (NA), which modulates many behaviors and induces patho-physiological changes, this study utilized zebrafish as a model to investigate whether sleep loss-induced increased anxiety is modulated by NA. Continuous behavioral quiescence for at least 6s was considered to represent sleep in zebrafish; although some authors termed it as a sleep-like state, in this study we have termed it as sleep. The activity of fish that signified sleep-waking was recorded in light-dark, during continuous dark and light; the latter induced sleep loss in fish. The latency, number of entries, time spent and distance travelled in the light chamber were assessed in a light-dark box test to estimate the anxiety behavior of normal, sleep-deprived and prazosin (PRZ)-treated fish. Zebrafish showed increased waking during light and complete loss of sleep upon continuous exposure to light for 24h. PRZ significantly increased sleep in normal fish. Sleep-deprived fish showed an increased preference for dark (expression of increased anxiety), and this effect was prevented by PRZ, which increased sleep as well. Our findings suggest that sleep loss-induced anxiety-like behavior in zebrafish is likely to be mediated by NA's action on the α1-adrenoceptor. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

Physical neighborhood and social environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality among African Americans.

PubMed

Nam, Soohyun; Whittemore, Robin; Jung, Sunyoung; Latkin, Carl; Kershaw, Trace; Redeker, Nancy S

2018-06-01

African Americans (AAs) have a higher prevalence of sleep disorders than other racial/ethnic groups. However, little is known about the relationships among individual and neighborhood factors related to sleep quality in AAs. The purposes of this study were to (1) describe beliefs about sleep, sleep hygiene behaviors, and sleep quality among AAs; and (2) examine the relationships among sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality. We conducted a cross-sectional study of 252 AA men and women in the Greater New Haven, CT, USA community. We assessed their sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene, and sleep quality with the following measures, respectively: the Neighborhood Environment Scale, the brief version of Dysfunctional Beliefs and Attitudes about Sleep, the Sleep Hygiene Practice Scale, the Pittsburgh Sleep Quality Index. We performed descriptive statistics, correlations and multiple hierarchical regression. About 72% of the participants (mean age: 53.88 ± 14.17 years, 77.8% women) reported experiencing sleep disturbance. People with poor sleep quality were more likely to report poorer neighborhood social environment (social cohesion), poorer overall neighborhood environment, more dysfunctional beliefs toward sleep, and poorer sleep hygiene than those who had good sleep quality. In the final multivariate model that controlled for a number of chronic comorbid conditions, neighborhood environment, beliefs about sleep, and sleep hygiene behaviors were significantly associated with sleep quality. Future efforts are needed to improve sleep among AAs by considering both the individual's belief about sleep, sleep hygiene behaviors and neighborhood factors. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Atypical sexual behavior during sleep.

PubMed

Guilleminault, Christian; Moscovitch, Adam; Yuen, Kin; Poyares, Dalva

2002-01-01

This article reports a case series of atypical sexual behavior during sleep, which is often harmful to patients or bed partners. Eleven subjects underwent clinical evaluation of complaints of sleep-related atypical sexual behavior. Complaints included violent masturbation, sexual assaults, and continuous (and loud) sexual vocalizations during sleep. One case was a medical-legal case. Sleep logs, clinical evaluations, sleep questionnaires, structured psychiatric interviews, polysomnography, actigraphy, home electroencephalographic monitoring during sleep, and clinical electroencephalographic monitoring while awake and asleep were used to determine clinical diagnoses. Atypical sexual behaviors during sleep were associated with feelings of guilt, shame, and depression. Because of these feelings, patients and bed partners often tolerated the abnormal behavior for long periods of time without seeking medical attention. The following pathologic sleep disorders were demonstrated on polysomnography: partial complex seizures, sleep-disordered breathing, stage 3 to 4 non-rapid eye movement (REM) sleep parasomnias, and REM sleep behavior disorder. These findings were concurrent with morning amnesia. The atypical behaviors were related to different syndromes despite the similarity of complaints from bed partners. In most cases the disturbing and often harmful symptoms were controlled when counseling was instituted and sleep disorders were treated. In some cases treatment of seizures or psychiatric disorders was also needed. Clonazepam with simultaneous psychotherapy was the most common successful treatment combination. The addition of antidepressant or antiepileptic medications was required in specific cases.

Relationships of Sleep Duration With Weight-Related Behaviors of U.S. College Students.

PubMed

Quick, Virginia; Byrd-Bredbenner, Carol; Shoff, Suzanne; White, Adrienne A; Lohse, Barbara; Horacek, Tanya; Colby, Sarah; Brown, Onikia; Kidd, Tandalayo; Greene, Geoffrey

2016-01-01

This study describes sleep behaviors of U.S. college students (N = 1,252; 18-24 years old; 59% female) and examines associations of sleep duration with weight-related behaviors. More than one quarter of participants slept < 7 hr/night and had mean Pittsburgh Sleep Quality Index (PSQI) scores indicating poor sleep quality. There were significant differences for all PSQI scales among sleep duration categories, < 7 hr (n = 344), 7-8 hr (n = 449), ≥ 8 hr (n = 459) sleep/night. Compared to those who slept ≥ 8 hr, those who slept < 8 hr had significantly more negative eating attitudes (2% higher), poorer internal regulation of food (4% lower), and greater binge eating (4% higher) scores. Findings advocate for health care professionals to evaluate sleep behaviors of college students during office visits and promote good sleep behaviors.

Sleep and youth suicidal behavior: a neglected field.

PubMed

Liu, Xianchen; Buysse, Daniel J

2006-05-01

Sleep undergoes substantial changes during adolescence and suicide risk begins to increase during this period as well. This review focuses on recent literature on the relationship between sleep and suicidal behavior and proposes directions for future research. Adolescent sleep is characterized by widespread sleep restriction, irregular sleep schedules, daytime sleepiness, and elevated risk for sleep disturbances. More research on adolescent sleep and psychosocial impairment, psychiatric disorders, and suicidal behavior has been conducted. Suicidal psychiatric patients had more sleep disturbances including insomnia, hypersomnia, or nightmares than nonsuicidal patients. Shorter rapid eye movement latency and increased rapid eye movement activity have been noted to be a marker of suicidality in psychiatric patients. Epidemiological studies have demonstrated that insomnia, nightmares, and sleep insufficiency are associated with elevated risk for suicide. Although the link between insomnia and suicidal behavior appears to be mediated by depression, existing data suggest an independent predictive role of nightmares in future suicidal behavior. Sleep loss or disturbances are likely to signal an increased risk of future suicidal action in adolescents. Large-scale prospective studies and neurobiological studies are needed for a better understanding of the complex relationship between sleep, psychopathology, and youth suicidal behavior.

Sleep in Neurodevelopmental Disorders

PubMed Central

Esbensen, Anna J; Schwichtenberg, Amy J

2017-01-01

Individuals with intellectual and developmental disabilities (IDD) experience sleep problems at higher rates than the general population. Although individuals with IDD are a heterogeneous group, several sleep problems cluster within genetic syndromes or disorders. This review summarizes the prevalence of sleep problems experienced by individuals with Angelman syndrome, Cornelia de Lange syndrome, Cri du Chat syndrome, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Smith-Magenis syndrome, Williams syndrome, autism spectrum disorder, and idiopathic IDD. Factors associated with sleep problems and the evidence for sleep treatments are reviewed for each neurodevelopmental disorder. Sleep research advancements in neurodevelopmental disorders are reviewed, including the need for consistency in defining and measuring sleep problems, considerations for research design and reporting of results, and considerations when evaluating sleep treatments. PMID:28503406

Physical Activity, Mind Wandering, Affect, and Sleep: An Ecological Momentary Assessment

PubMed Central

Mackenzie, Michael; Roberts, Sarah; Crato, Ines; Ehlers, Diane; McAuley, Edward

2016-01-01

Background A considerable portion of daily thought is spent in mind wandering. This behavior has been related to positive (eg, future planning, problem solving) and negative (eg, unhappiness, impaired cognitive performance) outcomes. Objective Based on previous research suggesting future-oriented (ie, prospective) mind wandering may support autobiographical planning and self-regulation, this study examined associations between hourly mind wandering and moderate-to-vigorous physical activity (MVPA), and the impact of affect and daily sleep on these relations. Methods College-aged adults (N=33) participated in a mobile phone-delivered ecological momentary assessment study for 1 week. Sixteen hourly prompts assessing mind wandering and affect were delivered daily via participants’ mobile phones. Perceived sleep quality and duration was assessed during the first prompt each day, and participants wore an ActiGraph accelerometer during waking hours throughout the study week. Results Study findings suggest present-moment mind wandering was positively associated with future MVPA (P=.03), and this relationship was moderated by affective state (P=.04). Moreover, excessive sleep the previous evening was related to less MVPA across the following day (P=.007). Further, mind wandering was positively related to activity only among those who did not oversleep (P=.007). Conclusions Together, these results have implications for multiple health behavior interventions targeting physical activity, affect, and sleep. Researchers may also build on this work by studying these relationships in the context of other important behaviors and psychosocial factors (eg, tobacco use, depression, loneliness). PMID:27580673

Light therapy as treatment of dyschronosis in brain impaired children.

PubMed

Guilleminault, C; McCann, C C; Quera-Salva, M; Cetel, M

1993-09-01

Fourteen children aged 9 months-4 years with moderate to severe mental retardation and varying neurologic lesions were referred for severe and continuous nocturnal sleep disturbances and very abnormal day/night schedules. All children had previously been given hypnotic medications and behavioral treatments which had little or no effect on nocturnal sleep. The severity of the sleep disturbances significantly affected family life and was a major handicap to the children. All children were treated with light therapy (minimum 4000 lux). Five children responded to treatment and had normal sleep-wake cycles at the most recent post-treatment evaluation (2-5 years after the first treatment). Two of the patients' families were unable to follow the prescribed regimen. Treatment failed in 7 children. One of these seven children spontaneously improved 3 years later. In three of the failure children the neurologic problem progressively worsened, leading to death in one of them. Phototherapy is a treatment worth pursuing in children with very significant sleep/wake disruption which is unresponsive to behavioral or other treatments. It has few side-effects and may lead to normalization of the sleep-wake cycle. Recent improvement in the technology used to monitor the 24-h temperature rhythm over several days and the present commercial availability of "light boxes" should render these therapeutic trials easier than at the time of these initial investigations.

Sleep, chronic pain, and opioid risk for apnea.

PubMed

Marshansky, Serguei; Mayer, Pierre; Rizzo, Dorrie; Baltzan, Marc; Denis, Ronald; Lavigne, Gilles J

2017-07-19

Pain is an unwelcome sleep partner. Pain tends to erode sleep quality and alter the sleep restorative process in vulnerable patients. It can contribute to next-day sleepiness and fatigue, affecting cognitive function. Chronic pain and the use of opioid medications can also complicate the management of sleep disorders such as insomnia (difficulty falling and/or staying asleep) and sleep-disordered breathing (sleep apnea). Sleep problems can be related to various types of pain, including sleep headache (hypnic headache, cluster headache, migraine) and morning headache (transient tension type secondary to sleep apnea or to sleep bruxism or tooth grinding) as well as periodic limb movements (leg and arm dysesthesia with pain). Pain and sleep management strategies should be personalized to reflect the patient's history and ongoing complaints. Understanding the pain-sleep interaction requires assessments of: i) sleep quality, ii) potential contributions to fatigue, mood, and/or wake time functioning; iii) potential concomitant sleep-disordered breathing (SDB); and more importantly; iv) opioid use, as central apnea may occur in at-risk patients. Treatments include sleep hygiene advice, cognitive behavioral therapy, physical therapy, breathing devices (continuous positive airway pressure - CPAP, or oral appliance) and medications (sleep facilitators, e.g., zolpidem; or antidepressants, e.g., trazodone, duloxetine, or neuroleptics, e.g., pregabalin). In the presence of opioid-exacerbated SDB, if the dose cannot be reduced and normal breathing restored, servo-ventilation is a promising avenue that nevertheless requires close medical supervision. Copyright © 2017 Elsevier Inc. All rights reserved.

Transitions in sleep problems from late adolescence to young adulthood: A longitudinal analysis of the effects of peer victimization.

PubMed

Chang, Ling-Yin; Chang, Hsing-Yi; Lin, Linen Nymphas; Wu, Chi-Chen; Yen, Lee-Lan

2018-01-01

Adolescence is a developmental period with high vulnerability to sleep problems. However, research identifying distinct patterns and underlying determinants of sleep problems is scarce. This study investigated discrete subgroups of, changes in, and stability of sleep problems. We also examined whether peer victimization influenced sleep problem subgroups and transitions in patterns of sleep problems from late adolescence to young adulthood. Sex differences in the effects of peer victimization were also explored. In total, 1,455 male and 1,399 female adolescents from northern Taiwan participated in this longitudinal study. Latent transition analysis was used to examine changes in patterns of sleep problems and the effects of peer victimization on these changes. We identified three subgroups of sleep problems in males and two in females, and found that there was a certain level of instability in patterns of sleep problems during the study period. For both sexes, those with greater increases in peer victimization over time were more likely to change from being a good sleeper to a poor sleeper. The effects of peer victimization on baseline status of sleep problems, however, was only significant for males, with those exposed to higher levels of peer victimization more likely to be poor sleepers at baseline. Our findings reveal an important role of peer victimization in predicting transitions in patterns of sleep problems. Intervention programs aimed at decreasing peer victimization may help reduce the development and escalation of sleep problems among adolescents, especially in males. © 2017 Wiley Periodicals, Inc.

Associations of sleep disturbance with ADHD: implications for treatment.

PubMed

Hvolby, Allan

2015-03-01

Attention-deficit/hyperactivity disorder (ADHD) is commonly associated with disordered or disturbed sleep. The relationships of ADHD with sleep problems, psychiatric comorbidities and medications are complex and multidirectional. Evidence from published studies comparing sleep in individuals with ADHD with typically developing controls is most concordant for associations of ADHD with: hypopnea/apnea and peripheral limb movements in sleep or nocturnal motricity in polysomnographic studies; increased sleep onset latency and shorter sleep time in actigraphic studies; and bedtime resistance, difficulty with morning awakenings, sleep onset difficulties, sleep-disordered breathing, night awakenings and daytime sleepiness in subjective studies. ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian-rhythm sleep disorders). Psychostimulant medications are associated with disrupted or disturbed sleep, but also 'paradoxically' calm some patients with ADHD for sleep by alleviating their symptoms. Long-acting formulations may have insufficient duration of action, leading to symptom rebound at bedtime. Current guidelines recommend assessment of sleep disturbance during evaluation of ADHD, and before initiation of pharmacotherapy, with healthy sleep practices the first-line option for addressing sleep problems. This review aims to provide a comprehensive overview of the relationships between ADHD and sleep, and presents a conceptual model of the modes of interaction: ADHD may cause sleep problems as an intrinsic feature of the disorder; sleep problems may cause or mimic ADHD; ADHD and sleep problems may interact, with reciprocal causation and possible involvement of comorbidity; and ADHD and sleep problems may share a common underlying neurological etiology.

Trouble sleeping and anxiety/depression in childhood.

PubMed

Johnson, E O; Chilcoat, H D; Breslau, N

2000-05-15

The purpose of this report was to estimate the association between children's trouble sleeping and anxiety/depression at ages 6 and 11, cross-sectionally and prospectively. Data come from a study of the psychiatric sequelae of low birth weight (LBW: <2500 g). LBW and normal birth weight children were randomly selected from the 1983-1985 newborn lists of an urban and a suburban hospital. Eight hundred and twenty-three children participated at age 6 and, of those, 717 (87.1%) participated at age 11. Achenbach's Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) were used to obtain ratings of psychiatric problems. The CBCL asked if the child had trouble sleeping during the past 6 months. Children with trouble sleeping had significantly increased odds of anxiety/depression based on mothers' reports (OR=6.9, 95% CI 4.1-11. 4) but not teachers' reports (OR=1.1, 95% CI 0.4-2.7). There was a greater association between sleep and depression at age 11 than at age 6, and among suburban than among urban children. These findings remained when adjusted for birthweight, sex, and mother's history of major depressive disorder. Profile analysis indicated a stronger association of trouble sleeping with anxiety/depression than other psychiatric problems. The association of trouble sleeping at age 6 with incidence of depression at age 11 was not statistically significant (suburban children RR=2.22, 95% CI 0.53-9.23; urban children RR=0.92, 95% CI 0.20-4.18).

Pre-Sleep Arousal and Sleep Problems of Anxiety-Disordered Youth

ERIC Educational Resources Information Center

Alfano, Candice A.; Pina, Armando A.; Zerr, Argero A.; Villalta, Ian K.

2010-01-01

The current study examined sleep problems and pre-sleep arousal among 52 anxious children and adolescents, aged 7-14 years, in relation to age, sex, ethnicity, and primary anxiety disorder. Assessment included structured diagnostic interviews and parent and child completed measures of sleep problems and pre-sleep arousal. Overall, 85% of parents…

Forced sex: a critical factor in the sleep difficulties of young Australian women.

PubMed

Astbury, Jill; Bruck, Dorothy; Loxton, Deborah

2011-01-01

The prevalence of forced sex and its contribution to sleep difficulties among young Australian women aged 24-30 years (n=9,061) was examined using data from the 2003 Australian Longitudinal Study of Women's Health. The lifetime prevalence of reported forced sex was 8.7%. Significantly higher levels of recurrent sleep difficulties, prescription sleep medication, clinical depression, anxiety disorder, self-harm, and substance use, as well as lower socioeconomic status (SES) indicators, were reported by the forced sex group compared to the no forced sex group. Hierarchical logistic regression revealed the high odds (OR=1.95, CI=1.66-2.26) of recurrent sleep difficulty in such women becomes partially attenuated, but remains statistically significant, after adjusting for key psychological, SES, and behavioral variables. Clinical implications for primary care providers and sleep specialists are discussed. Sleep difficulties are highly prevalent and affect more than 30% of those seeking primary health care (Kushida et al., 2005). They negatively impact on the way a person feels and functions (Dinges et al., 1997) and make a significant contribution to accidents, health care costs, and problems at work (Roth, 2005).

Behavioral observation differentiates the effects of an intervention to promote sleep in premature infants: a pilot study.

PubMed

Lacina, Linda; Casper, Tammy; Dixon, Melodie; Harmeyer, Joann; Haberman, Beth; Alberts, Jeffrey R; Simakajornboon, Narong; Visscher, Marty O

2015-02-01

Sleep and ongoing cycling of sleep states are required for neurosensory processing, learning, and brain plasticity. Many aspects of neonatal intensive care environments such as handling for routine and invasive procedures, bright lighting, and noise can create stress, disrupt behavior, and interfere with sleep in prematurely born infants. The study empirically investigated whether a 30-minute observation of infant sleep states and behavior could differentiate an intervention to promote sleep in premature infants with feeding difficulties relative to conventional care (standard positioning, standard crib mattress [SP]). We included an intervention to determine the ability of the method to discriminate treatments and generate a benchmark for future improvements. The intervention, a conformational positioner (CP), is contoured around the infant to provide customized containment and boundaries. To more fully verify the 30-minute observational sleep results, standard polysomnography was conducted simultaneously and sleep outcomes for the 2 modalities were compared. In a randomized crossover clinical trial, 25 infants, 31.5 ± 0.6 weeks' gestational age and 38.4 ± 0.6 weeks at the study, with gastrointestinal conditions or general feeding difficulties used each intervention during an overnight neonatal intensive care unit sleep study. Infant sleep states and behaviors were observed during two 30-minute periods--that is, on the positioner and mattress--using the naturalistic observation of newborn behavior. Two certified developmental care nurses assessed sleep state, self-regulatory, and stress behaviors during 2-minute intervals and summed over 30 minutes. Sleep characteristics from standard polysomnography were measured at the time of behavior observations. Infants on CP spent significantly less time in alert, active awake, or crying states by observation compared with SP. Surgical subjects spent more time awake, active awake, or crying and displayed a higher number of behavior state changes than the nonsurgical infants. The percentage of time in observed deep sleep and quiet sleep was correlated with both percentage sleep efficiency (r = 0.78) and fewer state shifts per hour (r = -0.65) from electroencephalogram (EEG). Sleep efficiency by EEG was greater on CP versus SP. The CP enabled sleep compared with the standard mattress (SP) over 30-minute observation periods. Sleep status from behavioral observation was verified by standard EEG-based sleep techniques. Behavioral observation of sleep states may be a useful strategy for measuring the effectiveness of strategies to facilitate sleep in premature infants. Surgical subjects may benefit from additional interventions to promote sleep.

Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study.

PubMed

Littlewood, Donna L; Kyle, Simon D; Carter, Lesley-Anne; Peters, Sarah; Pratt, Daniel; Gooding, Patricia

2018-04-26

Sleep problems are a modifiable risk factor for suicidal thoughts and behaviors. Yet, sparse research has examined temporal relationships between sleep disturbance, suicidal ideation, and psychological factors implicated in suicide, such as entrapment. This is the first in-the-moment investigation of relationships between suicidal ideation, objective and subjective sleep parameters, and perceptions of entrapment. Fifty-one participants with current suicidal ideation completed week-long ecological momentary assessments. An actigraph watch was worn for the duration of the study, which monitored total sleep time, sleep efficiency, and sleep latency. Daily sleep diaries captured subjective ratings of the same sleep parameters, with the addition of sleep quality. Suicidal ideation and entrapment were measured at six quasi-random time points each day. Multi-level random intercept models and moderation analyses were conducted to examine the links between sleep, entrapment, and suicidal ideation, adjusting for anxiety and depression severity. Analyses revealed a unidirectional relationship whereby short sleep duration (both objective and subjective measures), and poor sleep quality, predicted the higher severity of next-day suicidal ideation. However, there was no significant association between daytime suicidal ideation and sleep the following night. Sleep quality moderated the relationship between pre-sleep entrapment and awakening levels of suicidal ideation. This is the first study to report night-to-day relationships between sleep disturbance, suicidal ideation, and entrapment. Findings suggest that sleep quality may alter the strength of the relationship between pre-sleep entrapment and awakening suicidal ideation. Clinically, results underscore the importance of assessing and treating sleep disturbance when working with those experiencing suicidal ideation.

The role of day-to-day emotions, sleep, and social interactions in pediatric anxiety treatment.

PubMed

Wallace, Meredith L; McMakin, Dana L; Tan, Patricia Z; Rosen, Dana; Forbes, Erika E; Ladouceur, Cecile D; Ryan, Neal D; Siegle, Greg J; Dahl, Ronald E; Kendall, Philip C; Mannarino, Anthony; Silk, Jennifer S

2017-03-01

Do day-to-day emotions, social interactions, and sleep play a role in determining which anxious youth respond to supportive child-centered therapy (CCT) versus cognitive behavioral therapy (CBT)? We explored whether measures of day-to-day functioning (captured through ecological momentary assessment, sleep diary, and actigraphy), along with clinical and demographic measures, were predictors or moderators of treatment outcome in 114 anxious youth randomized to CCT or CBT. We statistically combined individual moderators into a single, optimal composite moderator to characterize subgroups for which CCT or CBT may be preferable. The strongest predictors of better outcome included: (a) experiencing higher positive affect when with one's mother and (b) fewer self-reported problems with sleep duration. The composite moderator indicated that youth for whom CBT was indicated had: (a) more day-to-day sleep problems related to sleep quality, efficiency, and waking, (b) day-to-day negative events related to interpersonal concerns, (c) more DSM-IV anxiety diagnoses, and (d) college-educated parents. These findings illustrate the value of both day-to-day functioning characteristics and more traditional sociodemographic and clinical characteristics in identifying optimal anxiety treatment assignment. Future studies will need to enhance the practicality of real-time measures for use in clinical decision making and evaluate additional anxiety treatments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Isolated Cataplexy and REM Sleep Behavior Disorder After Pontine Stroke

PubMed Central

Reynolds, Thomas Q.; Roy, Asim

2011-01-01

Cataplexy is a complex neurologic phenomenon during wakefulness probably resulting from impairment of pontine and hypothalamic control over muscle tone. REM sleep behavior disorder (RSBD) is characterized by the presence of REM sleep without atonia manifesting clinically as disruptive or injurious behaviors. We present here a patient with both cataplexy and RSBD following pontine encephalomalacia. The clinical presentation provides insight into the possible pathobiology of both waking and sleeping disorders of REM sleep regulation. Citation: Reynolds TQ; Roy A. Isolated cataplexy and REM sleep behavior disorder after pontine stroke. J Clin Sleep Med 2011;7(2):211-213. PMID:21509338

Sleep problems in children with attention-deficit hyperactivity disorder: associations with parenting style and sleep hygiene.

PubMed

Sciberras, Emma; Song, Jie Cheng; Mulraney, Melissa; Schuster, Tibor; Hiscock, Harriet

2017-09-01

We aimed to examine the association between sleep problems and parenting and sleep hygiene in children with attention-deficit/hyperactivity disorder (ADHD). Participants included 5-13-year-old children with DSM 5 defined ADHD and a parent-reported moderate-to-severe sleep problem (N = 361). Sleep was assessed using the parent-reported Children's Sleep Habits Questionnaire. Parents also completed checklists assessing sleep hygiene, parenting consistency, and parenting warmth. Linear regression established prediction models controlling for confounding variables including child age and sex, ADHD symptom severity, comorbidities, medication use, and socio-demographic factors. More consistent parenting was associated with decreased bedtime resistance (β = -0.16) and decreased sleep anxiety (β = -0.14), while greater parental warmth was associated with increased parasomnias (β = +0.18) and sleep anxiety (β = +0.13). Poorer sleep hygiene was associated with increased bedtime resistance (β = +0.20), increased daytime sleepiness (β = +0.12), and increased sleep duration problems (β = +0.13). In conclusion, sleep hygiene and parenting are important modifiable factors independently associated with sleep problems in children with ADHD. These factors should be considered in the management of sleep problems in children with ADHD.

Side Effects: Sleep Problems

Cancer.gov

Sleep problems are a common side effect during cancer treatment. Learn how a polysomnogram can assess sleep problems. Learn about the benefits of managing sleep disorders in men and women with cancer.

Sleep Strategies of Night-Shift Nurses on Days Off: Which Ones are Most Adaptive?

PubMed

Petrov, Megan E; Clark, C Brendan; Molzof, Hylton E; Johnson, Russell L; Cropsey, Karen L; Gamble, Karen L

2014-01-01

To determine the off-shift sleep strategies of bi-ethnic night-shift nurses, the relationship between these sleep strategies and adaptation to shift work, and identify the participant-level characteristics associated with a given sleep strategy. African-American and non-Hispanic White female, night-shift nurses from an academic hospital were recruited to complete a survey on sleep-wake patterns (n = 213). Participants completed the standard shiftwork index and the biological clocks questionnaire to determine sleep strategies and adaptation to night-shift work. In addition, chronotype was determined quantitatively with a modified version of the Munich ChronoType Questionnaire. Most participants worked ~3 consecutive 12-h night-shifts followed by several days off. Five sleep strategies used on days off were identified: (a) night stay, (b) nap proxy, (c) switch sleeper, (d) no sleep, and (e) incomplete switcher. Nap proxy and no sleep types were associated with poorer adaptation to night-shift work. The switch sleeper and incomplete switcher types were identified as more adaptive strategies that were associated with less sleep disturbance, a later chronotype, and less cardiovascular problems. Behavioral sleep strategies are related to adaptation to a typical night-shift schedule among hospital nurses. Nurses are crucial to the safety and well-being of their patients. Therefore, adoption of more adaptive sleep strategies may reduce sleep/wake dysregulation in this population, and improve cardiovascular outcomes.

Pathways between childhood/adolescent adversity, adolescent socioeconomic status, and long-term cardiovascular disease risk in young adulthood.

PubMed

Doom, Jenalee R; Mason, Susan M; Suglia, Shakira F; Clark, Cari Jo

2017-09-01

The current study investigated mediators between childhood/adolescent adversities (e.g., dating violence, maltreatment, homelessness, and parental death), low socioeconomic status (SES) during adolescence, and cardiovascular disease (CVD) risk in young adulthood. The purpose of these analyses was to understand whether SES during adolescence and childhood/adolescent adversities affect CVD risk through similar pathways, including maternal relationship quality, health behaviors, financial stress, medical/dental care, educational attainment, sleep problems, and depressive symptoms. Using the National Longitudinal Study of Adolescent to Adult Health (N = 14,493), which has followed US adolescents (Wave 1; M = 15.9 years) through early adulthood (Wave 4; M = 28.9 years), associations were examined between childhood/adolescent adversity and SES to 30-year CVD risk in young adulthood. The outcome was a Framingham-based prediction model of CVD risk that included age, sex, body mass index, smoking, systolic blood pressure, diabetes, and antihypertensive medication use at Wave 4. Path analysis was used to examine paths through the adolescent maternal relationship to young adult mediators of CVD risk. Childhood/adolescent adversity significantly predicted greater adult CVD risk through the following pathways: maternal relationship, health behaviors, financial stress, lack of medical/dental care, and educational attainment; but not through depressive symptoms or sleep problems. Lower SES during adolescence significantly predicted greater adult CVD risk through the following pathways: health behaviors, financial stress, lack of medical/dental care, and educational attainment, but not maternal relationship, depressive symptoms, or sleep problems. Childhood/adolescent adversities and SES affected CVD risk in young adulthood through both similar and unique pathways that may inform interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study.

PubMed

Lissak, Gadi

2018-07-01

A growing body of literature is associating excessive and addictive use of digital media with physical, psychological, social and neurological adverse consequences. Research is focusing more on mobile devices use, and studies suggest that duration, content, after-dark-use, media type and the number of devices are key components determining screen time effects. Physical health effects: excessive screen time is associated with poor sleep and risk factors for cardiovascular diseases such as high blood pressure, obesity, low HDL cholesterol, poor stress regulation (high sympathetic arousal and cortisol dysregulation), and Insulin Resistance. Other physical health consequences include impaired vision and reduced bone density. Psychological effects: internalizing and externalizing behavior is related to poor sleep. Depressive symptoms and suicidal are associated to screen time induced poor sleep, digital device night use, and mobile phone dependency. ADHD-related behavior was linked to sleep problems, overall screen time, and violent and fast-paced content which activates dopamine and the reward pathways. Early and prolonged exposure to violent content is also linked to risk for antisocial behavior and decreased prosocial behavior. Psychoneurological effects: addictive screen time use decreases social coping and involves craving behavior which resembles substance dependence behavior. Brain structural changes related to cognitive control and emotional regulation are associated with digital media addictive behavior. A case study of a treatment of an ADHD diagnosed 9-year-old boy suggests screen time induced ADHD-related behavior could be inaccurately diagnosed as ADHD. Screen time reduction is effective in decreasing ADHD-related behavior. Components crucial for psychophysiological resilience are none-wandering mind (typical of ADHD-related behavior), good social coping and attachment, and good physical health. Excessive digital media use by children and adolescents appears as a major factor which may hamper the formation of sound psychophysiological resilience. Copyright © 2018 Elsevier Inc. All rights reserved.

Insomnia treatment experience and preferences among veterans affairs primary care patients.

PubMed

Shepardson, Robyn L; Funderburk, Jennifer S; Pigeon, Wilfred R; Maisto, Stephen A

2014-10-01

Insomnia is common, but undertreated, among primary care patients. Within the Veterans Health Administration (VA), increasing attention has been given to the treatment of insomnia within primary care settings, but little research has examined Veterans' treatment preferences. We examined preferences for sleep treatment among VA primary care patients. Participants (N = 126: 98% male, 89% white; M age = 60 years) completed a brief survey. On the basis of Insomnia Severity Index scores, 22% reported subthreshold and 13% moderate insomnia. Fifty percent reported having issues with sleep (falling asleep, staying asleep, or sleeping too much) in the past 12 months; among these, only 44% reported any discussion of medication (34%) or other strategies (32%) to improve sleep with medical providers. The most preferred treatment approach was to work it out on one's own, followed by consulting the primary care provider (PCP). The most preferred modality was a one-on-one meeting with the PCP, followed by a one-on-one meeting with the behavioral health provider. In conclusion, VA primary care patients preferred handling sleep problems on their own, but if seeking help, they preferred working with PCPs over behavioral health providers. The majority of Veterans preferred individual treatment and strategies other than medication. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Suicidal ideation in Veterans misusing alcohol: Relationships with insomnia symptoms and sleep duration

PubMed Central

Chakravorty, Subhajit; Grandner, Michael A.; Mavandadi, Shahrzad; Perlis, Michael L.; Sturgis, Elliott B.; Oslin, David W.

2015-01-01

Objective The aim of this investigation was to assess the relationships between suicidal ideation and insomnia symptoms in Veterans misusing alcohol. Method Data were extracted in this retrospective chart review of Veterans referred from primary care for a behavioral health evaluation (N = 161) based on evidence of heavy drinking, drug use or another behavioral problem. Suicidal ideation (SI) was assessed using the Paykel questionnaire. Insomnia symptoms were assessed with standard diary questions in an interview format and pertained to sleep latency (SL), wake after sleep onset time (WASO), sleep quality (SQ), and habitual sleep duration (HSD). The relations between suicidal ideation and insomnia symptoms were assessed using ordinal regression analyses adjusted for socio-demographic, psychiatric and addiction-related variables. Results Suicidal ideation was reported in 62 (39%) of the Veterans interviewed. In a multivariable model, only inadequate SQ was associated with suicidal ideation. Short sleepers were more likely to endorse suicidal ideation and have attempted suicide in the past year. In addition, older age, inadequate financial status, and the presence of a psychiatric disorder were also significantly associated with suicidal ideation in most of the adjusted models. Conclusion Given their association with suicidal ideation, insomnia symptoms in Veterans misusing alcohol should prompt an assessment of underlying psychiatric and social factors. PMID:24169371

Frequent nocturnal awakening in children: prevalence, risk factors, and associations with subjective sleep perception and daytime sleepiness.

PubMed

Li, Liwen; Ren, Jiwei; Shi, Lei; Jin, Xinming; Yan, Chonghuai; Jiang, Fan; Shen, Xiaoming; Li, Shenghui

2014-07-30

Nocturnal awakening is the most frequent insomnia complaint in the general population. In contrast to a growing knowledge based on adults, little is known about its prevalence, correlated factors, and associations with subjective sleep perception and daytime sleepiness in children. This study was designed to assess the prevalence and the correlate factors of frequent nocturnal awakening (FNA) among Chinese school-aged children. Furthermore, the associations of FNA with subjective sleep perception and daytime sleepiness were examined. A random sample of 20,505 children aged 5.00 to 11.92 years old (boys: 49.5% vs. girls: 50.5%) participated in a cross-sectional survey, which was conducted in eight cities of China. Parent-administered questionnaires were used to collect information on children's sleep behaviors, sleep perception, and potential influential factors of FNA from six domains. Univariate and multivariate logistic regression models were performed. The prevalence of FNA was 9.8% (10.0% for boys vs. 8.9% for girls) in our sampled children. The prominent FNA-related factors inclued biological health problems, such as overweight/obesity (OR = 1.70), chronic pain during night (OR = 2.47), and chronic respiratory condition (OR = 1.23), poor psychosocial condition, such as poor mental and emotional functioning (OR = 1.34), poor sleep hygiene, such as frequently doing exciting activities before bedtime (OR = 1.24) and bedtime resistance (OR = 1.42), and parents' history of insomnia (OR = 1.31). FNA was associated with subjective poor sleep quality (OR = 1.24), subjective insufficient sleep (OR = 1.21), and daytime sleepiness (OR = 1.35). FNA was associated with poor sleep and daytime sleepiness. Compared to sleep environment and family susceptibility, chronic health problems, poor psychosocial condition, and poor sleep hygiene had greater impact on FNA, indicating childhood FNA could be partly prevented by health promotion, by psychological intervention, and by improving sleep hygiene routine.

Behavioral and neural concordance in parent-child dyadic sleep patterns.

PubMed

Lee, Tae-Ho; Miernicki, Michelle E; Telzer, Eva H

2017-08-01

Sleep habits developed in adolescence shape long-term trajectories of psychological, educational, and physiological well-being. Adolescents' sleep behaviors are shaped by their parents' sleep at both the behavioral and biological levels. In the current study, we sought to examine how neural concordance in resting-state functional connectivity between parent-child dyads is associated with dyadic concordance in sleep duration and adolescents' sleep quality. To this end, we scanned both parents and their child (N=28 parent-child dyads; parent M age =42.8years; adolescent M age =14.9years; 14.3% father; 46.4% female adolescent) as they each underwent a resting-state scan. Using daily diaries, we also assessed dyadic concordance in sleep duration across two weeks. Our results show that greater daily concordance in sleep behavior is associated with greater neural concordance in default-mode network connectivity between parents and children. Moreover, greater neural and behavioral concordances in sleep is associated with more optimal sleep quality in adolescents. The current findings expand our understanding of dyadic concordance by providing a neurobiological mechanism by which parents and children share daily sleep behaviors. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Efficacy of Brief Behavioral Treatment for Chronic Insomnia in Older Adults

PubMed Central

Buysse, Daniel J.; Germain, Anne; Moul, Douglas E.; Franzen, Peter L.; Brar, Laurie K.; Fletcher, Mary E.; Begley, Amy; Houck, Patricia R.; Mazumdar, Sati; Reynolds, Charles F.; Monk, Timothy H.

2011-01-01

Background Chronic insomnia is a common health problem with substantial consequences in older adults. Cognitive behavioral treatments are efficacious but not widely available. The aim of this study was to test the efficacy of brief behavioral treatment for insomnia (BBTI) vs an information control (IC) condition. Methods A total of 79 older adults (mean age, 71.7 years; 54 women [70%]) with chronic insomnia and common comorbidities were recruited from the community and 1 primary care clinic. Participants were randomly assigned to either BBTI, consisting of individualized behavioral instructions delivered in 2 intervention sessions and 2 telephone calls, or IC, consisting of printed educational material. Both interventions were delivered by a nurse clinician. The primary outcome was categorically defined treatment response at 4 weeks, based on sleep questionnaires and diaries. Secondary outcomes included self-report symptom and health measures, sleep diaries, actigraphy, and polysomnography. Results Categorically defined response (67% [n=26] vs 25% [n=10]; χ2=13.8) (P<.001) and the proportion of participants without insomnia (55% [n=21] vs 13% [n=5]; χ2=15.5) (P<.001) were significantly higher for BBTI than for IC. The number needed to treat was 2.4 for each outcome. No differential effects were found for subgroups according to hypnotic or antidepressant use, sleep apnea, or recruitment source. The BBTI produced significantly better outcomes in self-reported sleep and health (group × time interaction, F5,73=5.99, P<.001), sleep diary (F8,70= 4.32, P<.001), and actigraphy (F4,74=17.72, P<.001), but not polysomnography. Improvements were maintained at 6months. Conclusion We found that BBTI is a simple, efficacious, and durable intervention for chronic insomnia in older adults that has potential for dissemination across medical settings. PMID:21263078

Sleep disturbances are associated with reduced health-related quality of life in patients with substance use disorders.

PubMed

Magnée, Ellis H B; de Weert-van Oene, Gerdien H; Wijdeveld, Toon A G M; Coenen, Anton M L; de Jong, Cor A J

2015-09-01

Sleep problems and substance use are strongly linked. Sleep problems play a role in the etiology of substance use, but also may be a result of it. After detoxification, sleep problems may worsen leading to relapse. Nowadays, most substance dependence treatment programs aim at recovery rather than total abstinence, and in that view health-related quality of life (HRQL) is a relevant construct. This article describes the association between self-perceived sleep problems and HRQL in a naturalistic population of polydrug-using inpatients. At the start of treatment, 388 polydrug-using inpatients completed questionnaires concerning their sleep quality and HRQL. Three categories were established based on reported sleep problems: patients without sleep problems (21.6%), those with clinically relevant sleep problems (34.5%), and patients with sleep disorders (43.8%). Mean grades for quality of sleep were M = 7.3 (sd 1.7), M = 6.6 (sd 1.7) and M = 5.3 (sd 1.9) for the three categories, respectively. In addition, patients in the disorder category perceived a lower HRQL than those in the other categories. In the explanation of HRQL, both sleep problems and sleep disorders added significantly to the model when controlling for baseline characteristics. Our findings stress the need for clinicians to pay attention to the quality of sleep of recovering polydrug users, since this may play an important role in the recovery process. Monitoring sleep during treatment is advocated. This study adds to the knowledge about the way HRQL and sleep are related in a naturalistic sample of substance-dependent patients. © American Academy of Addiction Psychiatry.

[Evaluation and treatment of sleep problems in children diagnosed with attention deficit hyperactivity disorder: an update of the evidence].

PubMed

Chamorro, M; Lara, J P; Insa, I; Espadas, M; Alda-Diez, J A

2017-05-01

Attention deficit hyperactivity disorder (ADHD) affects approximately 5% of all children and adolescents, and these patients frequently suffer from sleep problems. The association between sleep disorders and ADHD, however, is multifaceted and complex. To explore the relationship between sleep disorders and ADHD. Sleep problems in children with ADHD include altered sleep and specific disorders per se or that may be due to comorbid psychiatric disorders or to the stimulants they receive as treatment for their ADHD. Today, an evaluation of the sleep conditions in children with ADHD is recommended before starting pharmacological treatment. The first step in managing their sleep problems is good sleep hygiene and cognitive-behavioural psychotherapy. Another option is to consider modifying the dosage and formulation of the stimulants. Atomoxetine and melatonin are therapeutic alternatives for children with ADHD and more severe sleep problems. Specific treatments exist for respiratory and movement disorders during sleep. It is important to evaluate sleep in children who present symptoms suggestive of ADHD, since problems during sleep can play a causal role or exacerbate the clinical features of ADHD. Correct evaluation and treatment of sleep disorders increase the family's and the child's quality of life and can lessen the severity of the symptoms of ADHD.

Children’s Sleep Comic: development of a new diagnostic tool for children with sleep disorders

PubMed Central

Schwerdtle, Barbara; Kanis, Julia; Kahl, Lena; Kübler, Andrea; Schlarb, Angelika A

2012-01-01

Background A solid diagnosis of sleep disorders in children should include both self-ratings and parent ratings. However, there are few standardized self-assessment instruments to meet this need. The Children’s Sleep Comic is an adapted version of the unpublished German questionnaire “Freiburger Kinderschlafcomic” and provides pictures for items and responses. Because the drawings were outdated and allowed only for qualitative analysis, we revised the comic, tested its applicability in a target sample, and suggest a procedure for quantitative analysis. Methods All items were updated and pictures were newly drawn. We used a sample of 201 children aged 5–10 years to test the applicability of the Children’s Sleep Comic in young children and to run a preliminary analysis. Results The Children’s Sleep Comic comprises 37 items covering relevant aspects of sleep disorders in children. Application took on average 30 minutes. The procedure was well accepted by the children, as reflected by the absence of any dropouts. First comparisons with established questionnaires indicated moderate correlations. Conclusion The Children’s Sleep Comic is appropriate for screening sleep behavior and sleep problems in children. The interactive procedure can foster a good relationship between the investigator and the child, and thus establish the basis for successful intervention if necessary. PMID:23620683

[Effects of a non-face-to-face behavioral intervention on poor sleepers and factors affecting improvement of sleep].

PubMed

Amamoto, Yuko; Adachi, Yoshiko; Kunituka, Kouko; Kumagai, Shuzo

2010-03-01

The purposes of this study were 1) to re-examine effects obtained from previous research of a non-face-to-face behavioral intervention in poorer sleepers and 2) to examine the factors impacting on improvement of sleep. The subjects were 178 poor sleepers who participated in an intervention for sleep improvement. The educational procedures comprised a minimal behavioral self-help package for one month that featured self- learning and self- monitoring of practical target habits for change. It was non face-to-face program conducted by only one member of staff. Subjects were asked to answer a questionnaire before and after the intervention. To reexamine the effects of this program found in our previous research, 9 sleep indices, sleep quality, and sleep-related behaviors were compared between before and after intervention. The sleep indices were total sleep time, sleep onset latency, sleep efficiency etc. Subjects were divided into an improvement group (n = 63) and a non-improvement group (n = 115) using a cutoff value for average change in sleep onset latency and sleep efficiency. After comparison of sleep and behavior between the two groups, logistic regression analysis was conducted to select parameters affecting improvement with this program. Total sleep time was significantly increased from 5.7 h to 6.1 h, sleep onset time decreased 18 minutes, and sleep efficiency improved 5.6 points. With 8 of 9 sleep-related behaviors, the proportion of subjects having an undesirable habit significantly decreased. The mean total number of desirable habit' changes was 2.63 in the improvement group and significantly higher than the 2.06 in the non-improvement group. Logistic regression analysis demonstrated that large sleep onset latency at baseline and beginning of regular exercise significantly affected the improvement of sleep in the subjects, after adjusting for all other parameters. The effects revealed by our previous research were reconfirmed. It is suggested that this program is more useful for persons having severe sleep onset difficulties, and regular exercise is particularly important in improvement of sleep. It is possible that even simple behavioral intervention is feasible with many subjects to improve sleep and related habits in poor sleepers.

Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits

PubMed Central

Milojevich, Helen M.; Lukowski, Angela F.

2016-01-01

Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning. PMID:27280714

Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits.

PubMed

Milojevich, Helen M; Lukowski, Angela F

2016-01-01

Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning.

Assessment of sleep in pediatric cancer patients.

PubMed

İnce, Dilek; Demirağ, Bengü; Karapınar, Tuba Hilkay; Oymak, Yeşim; Ay, Yılmaz; Kaygusuz, Arife; Töret, Ersin; Vergin, Canan

2017-01-01

İnce D, Demirağ B, Karapınar TH, Oymak Y, Ay Y, Kaygusuz A, Töret E, Vergin C. Assessment of sleep in pediatric cancer patients. Turk J Pediatr 2017; 59: 379-386. The purpose of the study is to describe sleep habits, assess the prevalence of sleep disturbances in pediatric cancer patients and healthy controls, and to compare sleep patterns, sleep problems. One hundred-thirty-five patients and 190 healthy controls were evaluated. Healthy children matched for age, sex, economic status, parental education and family structure constituted the control group. Sleep was evaluated by using the Children`s Sleep Habits Questionnaire (CSHQ). Sleep problems were detected in half of patients. There were no significant differences in total sleep score and subscale scores between patients and controls. Solely the wake-time was found significantly different between patients and controls. Although our results indicated that neither childhood cancer survivors nor patients with cancer during treatment period had more sleep problems than their healthy peers, sleep problems were not uncommon in whole study group. This study underlines the need to screen, assess and manage sleep problems in children with diagnosis of cancer.

Sleeping problems and suicide in 75,000 Norwegian adults: a 20 year follow-up of the HUNT I study.

PubMed

Bjørngaard, Johan Håkon; Bjerkeset, Ottar; Romundstad, Pål; Gunnell, David

2011-09-01

To investigate the association of sleeping problems with suicide risk. Prospective cohort study linking health survey information on sleep problems to Norway's national mortality registry. Participants were followed up from 1984-6 until December 31, 2004. Residents of Nord-Trøndelag County, Norway, aged 20 years or older in 1984-6. Altogether 87,285 people were eligible for the survey and 74,977 (86%) took part in one or more aspects of the study. N/A. Three percent of participants experienced sleeping problems every night, 5% experienced problems "often" and 31% reported problems "sometimes." There were 188 suicides during follow-up. Sleeping problems at baseline were strongly associated with subsequent suicide risk. Compared to participants who reported no sleeping problems the age- and sex- adjusted hazard ratios for suicide were 1.9 (CI 1.3-2.6), 2.7 (CI 1.4-5.0), and 4.3 (CI 2.3-8.3) for reporting sleeping problems sometimes, often, or almost every night, respectively. Associations were stronger in younger (< 50 years) participants, but we found no statistical evidence for gender differences. Adjusting for measures of common mental disorder and alcohol use at baseline weakened the associations, but the 3% of subjects with the worst sleep patterns remained at two fold increased risk of suicide. Sleeping problems are a marker of suicide risk, mainly due to the presence of both sleeping problems and mixed anxiety and depression. Physicians should be aware of the possible vulnerability for people affected by sleeping problems.

Psychosocial work factors and sleep problems: findings from the French national SIP survey.

PubMed

Chazelle, Emilie; Chastang, Jean-François; Niedhammer, Isabelle

2016-04-01

This study aimed at exploring the cross-sectional and prospective associations between psychosocial work factors and sleep problems. The study population consisted of a national representative sample of the French working population (SIP survey). The sample sizes were 7506 and 3555 for the cross-sectional and prospective analyses. Sleep problems were defined by either sleep disturbances or insufficient sleep duration at least several times a week. Psychosocial work factors included classical (job strain model factors) and emergent factors (recognition, insecurity, role/ethical conflict, emotional demands, work-life imbalance, etc.). Occupational factors related to working time/hours and physical work environment were also included as well as covariates related to factors outside work. Statistical analyses were performed using weighted Poisson regression analysis. In the cross-sectional analyses, psychological demands, low social support, low recognition, emotional demands, perception of danger, work-life imbalance and night work were found to be associated with sleep problems. In the prospective analyses, psychological demands and night work were predictive of sleep problems. Using a less conservative method, more factors were found to be associated with sleep problems. Dose-response associations were observed, showing that the more frequent the exposure to these factors, the higher the risk of sleep problems. No effect of repeated exposure was found on sleep problems. Classical and emergent psychosocial work factors were associated with sleep problems. More prospective studies and prevention policies may be needed.

Sleep Problems, Comorbid Mental Disorders, and Role Functioning in the National Comorbidity Survey Replication (NCS-R)

PubMed Central

Roth, Thomas; Jaeger, Savina; Jin, Robert; Kalsekar, Anupama; Stang, Paul E.; Kessler, Ronald C.

2007-01-01

Background Little is known about the population prevalence of sleep problems or whether the associations of sleep problems with role impairment are due to comorbid mental disorders. Methods The associations of four 12-month sleep problems (difficulty initiating or maintaining sleep, early morning awakening, nonrestorative sleep) with role impairment were analyzed in the National Comorbidity Survey Replication controlling 12-month DSM-IV anxiety, mood, impulse-control, and substance disorders. The WHO Composite International Diagnostic Interview was used to assess sleep problems and DSM-IV disorders. The WHO Disability Schedule-II (WHO-DAS) was used to assess role impairment. Results Prevalence estimates of the separate sleep problems were in the range 16.4-25.0%, with 36.3% reporting at least one of the four. Mean 12-month duration was 24.4 weeks. All four problems were significantly comorbid with all the 12-month DMS-IV disorders assessed in the survey (median OR: 3.4; 25th-75th percentile: 2.8-3.9) and significantly related to role impairment. Relationships with role impairment generally remained significant after controlling comorbid mental disorders. Nonrestorative sleep was more strongly and consistently related to role impairment than were the other sleep problems. Conclusions The four sleep problems considered here are of public health significance because of their high prevalence and significant associations with role impairment. PMID:16952333

Sleep Items in the Child Behavior Checklist: A Comparison with Sleep Diaries, Actigraphy, and Polysomnography

ERIC Educational Resources Information Center

Gregory, Alice M.; Cousins, Jennifer C.; Forbes, Erika E.; Trubnick, Laura; Ryan, Neal D.; Axelson, David A.; Birmaher, Boris; Sadeh, Avi; Dahl, Ronald E.

2011-01-01

Objective: The Child Behavior Checklist is sometimes used to assess sleep disturbance despite not having been validated for this purpose. This study examined associations between the Child Behavior Checklist sleep items and other measures of sleep. Method: Participants were 122 youth (61% female, aged 7 through 17 years) with anxiety disorders…

Association of TV watching with sleep problems in a church-going population.

PubMed

Serrano, Salim; Lee, Jerry W; Dehom, Salem; Tonstad, Serena

2014-01-01

Sensory stimuli/inactivity may affect sleep. Sleep problems are associated with multiple health problems. We assessed TV habits in the Adventist Health Study-2 at baseline and sleep problems in the Biopsychosocial Religion and Health Study 1 to 4 years later. After exclusions, 3914 subjects split equally into TV watchers less than 2 hours per day or 2 or more hours per day. Watching TV 2 or more hours per day predicted problems falling asleep, middle of the night awakening, and waking early with inability to sleep again in multiple logistic regression. Excess TV watching disturbed sleep induction and quality, though the relationship may be bidirectional. TV habits should be considered in individuals with sleep problems.

Sleep deprivation suppresses aggression in Drosophila

PubMed Central

Kayser, Matthew S; Mainwaring, Benjamin; Yue, Zhifeng; Sehgal, Amita

2015-01-01

Sleep disturbances negatively impact numerous functions and have been linked to aggression and violence. However, a clear effect of sleep deprivation on aggressive behaviors remains unclear. We find that acute sleep deprivation profoundly suppresses aggressive behaviors in the fruit fly, while other social behaviors are unaffected. This suppression is recovered following post-deprivation sleep rebound, and occurs regardless of the approach to achieve sleep loss. Genetic and pharmacologic approaches suggest octopamine signaling transmits changes in aggression upon sleep deprivation, and reduced aggression places sleep-deprived flies at a competitive disadvantage for obtaining a reproductive partner. These findings demonstrate an interaction between two phylogenetically conserved behaviors, and suggest that previous sleep experiences strongly modulate aggression with consequences for reproductive fitness. DOI: http://dx.doi.org/10.7554/eLife.07643.001 PMID:26216041

Genetics Home Reference: dementia with Lewy bodies

MedlinePlus

... in behavior and intellectual ability, and acting out dreams while asleep (REM sleep behavior disorder). This condition ... with REM sleep behavior disorder act out their dreams, talking and moving in their sleep. This behavior ...

Associations of sleep bruxism with age, sleep apnea, and daytime problematic behaviors in children.

PubMed

Tachibana, M; Kato, T; Kato-Nishimura, K; Matsuzawa, S; Mohri, I; Taniike, M

2016-09-01

The aims of this study were to investigate the prevalence of sleep bruxism in children in Japan, and its relationships with sleep-related factors and daytime problematic behavior. Guardians of 6023 children aged 2-12 years completed the Japanese Sleep Questionnaire. Multiple regression analysis and structural equation modeling were performed. Sleep bruxism was reported in 21.0% children (n = 1263): the prevalence was highest in the age group of 5-7 years (27.4%). Multiple regression analysis showed that sleep bruxism had significant correlations with age 5-7 years (OR: 1.72; P < 0.0001), 'Moves a lot during sleep' (OR: 1.47; P < 0.0001), 'sleeps with mouth open' (OR: 1.56; P < 0.0001), and 'snores loudly' (OR: 1.80; P < 0.0001). In structural equation modeling, sleep bruxism had a significant but weak direct effect on daytime problematic behavior, while sleep bruxism significantly correlated with obstructive sleep apnea, which had a higher direct effect on daytime problematic behavior. Sleep bruxism was reported in 21.0% of Japanese children and had independent relationships with age, movements during sleep, and snoring. A comorbidity of sleep-disordered breathing might be related to daytime problematic behavior in children with sleep bruxism. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevalence and Correlates of Sleep Problems in Adult Israeli Jews Exposed to Actual or Threatened Terrorist or Rocket Attacks

PubMed Central

Palmieri, Patrick A.; Chipman, Katie J.; Canetti, Daphna; Johnson, Robert J.; Hobfoll, Stevan E.

2010-01-01

Study Objectives: To estimate the prevalence of, and to identify correlates of clinically significant sleep problems in adult Israeli citizens exposed to chronic terrorism and war trauma or threat thereof. Methods: A population-based, cross-sectional study of 1001 adult Israeli citizens interviewed by phone between July 15 and August 26, 2008. The phone survey was conducted in Hebrew and assessed demographics, trauma/stressor exposure, probable posttraumatic stress disorder (PTSD), probable depression, and sleep problems. Probable PTSD and depression were assessed with the PTSD Symptom Scale (PSS) and Patient Health Questionnaire (PHQ-9), respectively, following DSM-IV diagnostic criteria. Sleep problems in the past month were assessed with the Pittsburgh Sleep Quality Index (PSQI), on which a global composite score ≥ 6 indicates a clinical-level sleep problem. Results: Prevalence of probable PTSD and depression was 5.5% and 5.8%, respectively. Prevalence of clinically significant sleep problems was 37.4% overall, but was significantly higher for probable PTSD (81.8%) and probable depression (79.3%) subgroups. Independent correlates of poor sleep included being female, older, less educated, experiencing major life stressors, and experiencing psychosocial resource loss. Psychosocial resource loss due to terrorist attacks emerged as the strongest potentially modifiable risk factor for sleep problems. Conclusions: Sleep problems are common among Israeli adults living under chronic traumatic threat and trauma exposure. Given the continuing threat of war, interventions that bolster psychosocial resources may play an important role in preventing or alleviating sleep problems in this population. Citation: Palmieri PA; Chipman KJ; Canetti D; Johnson RJ; Hobfoll SE. Prevalence and correlates of sleep problems in adult Israeli Jews exposed to actual or threatened terrorist or rocket attacks. J Clin Sleep Med 2010;6(6):557-564. PMID:21206544

Sleep problems are associated with poor outcomes in remedial teaching programmes: a preliminary study.

PubMed

Blunden, Sarah L; Chervin, Ron D

2008-05-01

Problematic behaviour and deficient academic performance have been reported in children with sleep problems, but whether sleep problems are common among children presenting with primary behavioural and performance concerns in remedial programmes is not well studied. We studied this possibility in 80 Australian school children aged 6-15 years and then compared 15 of these children from mainstream schools to 15 demographically matched children in specialist behavioural programmes for problematic behaviour and academic difficulties. Parents completed the Child Behaviour Checklist and the Sleep Disorders Scale for Children. Questionnaires assessed behaviour, academic performance and symptoms of diverse sleep disorders, expressed as T-scores (mean (SD) = 50 (10)). Teachers rated students' academic performance (A, B, C, D, E). When compared with the 15 controls, the 15 index children had significantly more sleep problems, in addition to parental concerns about school performance. In the total sample (n = 80), poor sleep including symptoms of daytime sleepiness, parasomnias, behavioural sleep problems and combined sleep problems was associated with poor academic performance and daytime behavioural issues. This preliminary study suggests that children in remedial school programmes may have poor sleep compared with those in mainstream schools. Sleep problems were associated with problematic behaviour and poor academic performance. If sleep disturbances worsen daytime behaviour, then diagnosis and treatment of underlying sleep disorders could offer a novel therapeutic opportunity.

Relationships Between Smoking and Sleep Problems in Black and White Adolescents.

PubMed

Bellatorre, Anna; Choi, Kelvin; Lewin, Daniel; Haynie, Denise; Simons-Morton, Bruce

2017-01-01

The relationship between sleeping and smoking during adolescence remains unclear and is likely complex. We aim to evaluate the longitudinal reciprocal associations between sleep problems, sleep duration, and smoking among non-Hispanic white (NHW) and non-Hispanic black (NHB) youth. Prospective cohort study. NEXT Generation Health Study. A national sample (N = 1394) of NHB and NHW 10th graders were surveyed annually between 2009 (Wave 1) and 2012 (Wave 3). N/A. Past 30-day smoking, chronic difficulty falling asleep, recent difficulty falling asleep, difficulty staying asleep, and weekday and weekend sleep duration were measured at each wave. Using structural equation models, we observed significant autocorrelations over time for sleep problems and sleep duration. We found significant reciprocal, prospective relationships between smoking and sleep problems. The strengths of the relationships differed by race, with a stronger association between sleep problems and subsequent smoking for NHB than NHW youth. Conversely, a stronger association between smoking and subsequent sleep problems for NHW than NHB youth was observed. These association were independent of demographics, snoring or sleep apnea, body mass index, depressive symptoms, alcohol use, and soda consumption. Reciprocal and prospective relationships exist for youth smoking and sleep problems and duration in both NHW and NHB youth. Further research is needed to unravel the complex relationship between the direct effects of nicotine, lifestyle choices that may link smoking and sleep problems, and racial differences. Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Understanding Sleep Disorders in a College Student Population.

ERIC Educational Resources Information Center

Jensen, Dallas R.

2003-01-01

College students' sleep habits are changing dramatically, and related sleep problems are increasing. Reviews the current literature on sleep problems, focusing on the college student population. The unique challenges of college settings are discussed as they apply to understanding sleep problems, and suggestions are made for professionals who work…

Pain-related and Psychological Symptoms in Adolescents With Musculoskeletal and Sleep Problems

PubMed Central

Wilson, Sue; Munafò, Marcus R.

2016-01-01

Objectives: Two-thirds of adolescents with chronic musculoskeletal pain report a concurrent sleep problem. Both musculoskeletal pain and sleep problems can have deleterious effects on physiological and psychological well-being. We explored the prevalence of sleep problems and musculoskeletal pain, using data on 3568 adolescents from the Avon Longitudinal Study of Children. Materials and Methods: A comprehensive battery of questionnaires was administered to derive clinical phenotypes of musculoskeletal pain. Adolescents with single symptoms were compared with those reporting both musculoskeletal pain and sleep problems. Linear and logistic regression analyses were used to compare groups on pain-related variables and psychological complaints. The association between sociodemographic variables and comorbid musculoskeletal pain and sleep problems was assessed using logistic regression. Results: Over half the sample was female (n=2076, 58.2%) and the majority of European ancestry (n=3174, 97.7%). Only 5.5% (n=196) of participants were identified as having a pain condition, while 21.2% (n=749) reported a significant sleep problem, and 2.8% (n=99) reported comorbid musculoskeletal pain and sleep problems. Adolescents with comorbid problems experienced greater pain intensity and pain-related anxiety. Other psychological complaints were also higher in those who experienced concurrent problems, including depression, fatigue, concentration, and overall severity of psychological symptoms. Discussion: Comorbid sleep and pain problems were associated with a higher incidence of pain-related and psychological symptoms. Sleep problems may therefore be an important modifiable risk factor for alleviating distress in adolescents with musculoskeletal pain. PMID:25974623

Deprivation and Recovery of Sleep in Succession Enhances Reflexive Motor Behavior

PubMed Central

Sprenger, Andreas; Weber, Frederik D.; Machner, Bjoern; Talamo, Silke; Scheffelmeier, Sabine; Bethke, Judith; Helmchen, Christoph; Gais, Steffen; Kimmig, Hubert; Born, Jan

2015-01-01

Sleep deprivation impairs inhibitory control over reflexive behavior, and this impairment is commonly assumed to dissipate after recovery sleep. Contrary to this belief, here we show that fast reflexive behaviors, when practiced during sleep deprivation, is consolidated across recovery sleep and, thereby, becomes preserved. As a model for the study of sleep effects on prefrontal cortex-mediated inhibitory control in humans, we examined reflexive saccadic eye movements (express saccades), as well as speeded 2-choice finger motor responses. Different groups of subjects were trained on a standard prosaccade gap paradigm before periods of nocturnal sleep and sleep deprivation. Saccade performance was retested in the next morning and again 24 h later. The rate of express saccades was not affected by sleep after training, but slightly increased after sleep deprivation. Surprisingly, this increase augmented even further after recovery sleep and was still present 4 weeks later. Additional experiments revealed that the short testing after sleep deprivation was sufficient to increase express saccades across recovery sleep. An increase in speeded responses across recovery sleep was likewise found for finger motor responses. Our findings indicate that recovery sleep can consolidate motor disinhibition for behaviors practiced during prior sleep deprivation, thereby persistently enhancing response automatization. PMID:26048955

Multi-method assessments of sleep over the transition to college and the associations with depression and anxiety symptoms.

PubMed

Doane, Leah D; Gress-Smith, Jenna L; Breitenstein, Reagan S

2015-02-01

A growing body of research has demonstrated links between sleep problems and symptoms of depression and anxiety in community and clinical samples of adolescents and young adults. Scant longitudinal research, however, has examined reciprocal associations over socio-contextual shifts such as the transition to college. Using multiple methods of assessment (e.g., actigraphy, subjective report), the current study assessed whether sleep quantity, quality or variability changed over the transition to college and investigated the potential cross-lagged relationships between adolescents' sleep and symptoms of anxiety and depression. The participants (N = 82; 24% male) were studied at three time points over approximately 1 year: spring of their senior year of high school (T1), fall of their first year of college (T2), and spring of their first year of college (T3). Sleep minutes, sleep efficiency, wake time variability and anxiety increased over the transition to college. Subjective reports of sleep problems decreased. Cross-lagged panel models indicated significant relationships between subjective sleep quality and anxiety symptoms over time where subjective sleep problems at T1 were associated with anxiety at T2, and anxiety at T2 was associated with subjective sleep problems at T3. In contrast, greater depressive symptoms at T1 preceded increases in subjective sleep problems, sleep latency and sleep start time variability at T2. Importantly, there were concurrent associations between symptoms of anxiety or depression at T2 and sleep efficiency, sleep start time variability, and subjective sleep problems. These findings suggest that, overall, sleep quantity and quality improved over the transition to college, although the overall amounts of sleep were still below developmental recommendations. However, for some youth, the first semester of college may be a sensitive period for both sleep problems and symptoms of anxiety. In contrast, depressive symptoms were stable across time but were associated with worsening sleep problems in the first semester of college. Implications for future prevention and intervention programs should include strategies to help youth cope effectively with adjustment like increased sleep variability and symptoms of anxiety associated with the transition to college.

Statistical analysis and modeling of the temperature-dependent sleep behavior of drosophila

NASA Astrophysics Data System (ADS)

Shih, Chi-Tin; Lin, Hsuan-Wen; Chiang, Ann-Shyn

2011-01-01

The sleep behavior of drosophila is analyzed under different temperatures. The activity per minute of the flies is recorded automatically. Sleep for a fruit fly is defined as the periods without any activity and longer than 5 minutes. Several parameters such as total sleep time, circadian sleep profile, quality of sleep are analyzed. The sleep behaviors are significantly different for flies at different temperature. Interestingly, the durations of daytime sleep periods show a common scale-free power law distribution. We propose a stochastic model to simulate the activities of the population of neurons which regulate the dynamics of sleep-wake process to explain the distribution of daytime sleep.

Why did adolescents have sleep problems after earthquakes? Understanding the role of traumatic exposure, fear, and PTSD.

PubMed

Zhou, Xiao; Wu, Xinchun; Chen, Qiuyan; Zhen, Rui

2017-06-01

To examine the relationships between trauma exposure, fear, post-traumatic stress disorder, and sleep problems in adolescents, 746 adolescent survivors of the 2008 Wenchuan earthquake in China were assessed at 1 year (T1) and 1.5 years (T2) after the earthquake using a trauma exposure questionnaire, a fear questionnaire, a child posttraumatic stress disorder symptom scale, and a subscale on child sleep problems. The results showed that T1 trauma exposure were not directly associated with sleep problems at T1 and T2, but played a positive role in sleep problems at both T1 and T2 indirectly through T1 posttraumatic stress disorder and T1 fear. T1 trauma exposure was also positively and indirectly associated with T2 sleep problems through T1 posttraumatic stress disorder via T1 sleep problems, or through T1 fear via the path from T1 posttraumatic stress disorder to T1 sleep problems. These findings indicated that fear and posttraumatic stress disorder 1 year after the earthquake played a mediating role in the relationship between trauma exposure at 1 year after the earthquake, and sleep problems at both 1 year and 1.5 years after the earthquake, respectively. In particular, posttraumatic stress disorder also had a multiple mediating effect in the path from trauma exposure to sleep problems via fear. Furthermore, the findings indicated that sleep problems were relatively stable between 1 and 1.5 years after an earthquake. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Increased risk for school violence-related behaviors among adolescents with insufficient sleep.

PubMed

Hildenbrand, Aimee K; Daly, Brian P; Nicholls, Elizabeth; Brooks-Holliday, Stephanie; Kloss, Jacqueline D

2013-06-01

School violence is associated with significant acute and long-term negative health outcomes. Previous investigations have largely neglected the role of pertinent health behaviors in school violence, including sleep. Insufficient sleep is associated with adverse physical, behavioral, and psychosocial consequences among adolescents, many of which are concurrently implicated in youth violence. This study examined the relationship between insufficient sleep and school violence behaviors in a nationally representative sample of high school students. We used data from the 2009 National Youth Risk Behavior Survey (YRBS). Logistic regression analyses evaluated the association between insufficient sleep and school violence behaviors, controlling for demographic factors. In addition to examining main effects, interaction terms were entered into the models to examine whether potential associations varied by sex or race/ethnicity. Students with insufficient sleep had higher odds of engaging in the majority of school violence-related behaviors examined compared to students with sufficient sleep. Males with insufficient sleep were at increased risk of weapon carrying at school, a finding not observed for females with insufficient sleep. White students with insufficient sleep had higher odds of missing school because of safety concerns, a pattern that did not emerge among Black and Hispanic/Latino students. Results highlight the potential value of incorporating sleep education interventions into school-based violence prevention programs and underline the need for further examination of the relationship between sleep and school violence among adolescents. © 2013, American School Health Association.

An analysis of attitude toward infant sleep safety and SIDS risk reduction behavior among caregivers of newborns and infants.

PubMed

Varghese, S; Gasalberti, D; Ahern, K; Chang, J C

2015-11-01

To explore beliefs and attitude toward infant sleep safety and sudden infant death syndrome (SIDS) risk reduction behaviors among caregivers of newborns and infants. A convenience sample comprised of 121 caregivers of newborns at Staten Island University Hospital completed a questionnaire. Despite an overall favorable attitude toward safe sleep practices, a majority disagreed with use of pacifiers (53%) and believed that swaddling (62%) as well as the use of home monitors (59%) are acceptable practices. The caregivers who recalled being taught about safe sleep had higher perception of infant vulnerability (P<0.001), more confidence in their ability to implement safe sleep behaviors (P<0.0006) and stronger belief that safe sleep behaviors are effective (P<0.01). Active caregiver education may result in more effective demonstration of safe sleep and SIDS risk reduction behaviors. Further study is needed to assess if favorable attitudes toward safe sleep practices correlate with actual demonstrated behaviors.

Web survey of sleep problems associated with early-onset bipolar spectrum disorders.

PubMed

Lofthouse, Nicholas; Fristad, Mary; Splaingard, Mark; Kelleher, Kelly; Hayes, John; Resko, Susan

2008-05-01

As research on sleep difficulties associated with Early-Onset Bipolar Spectrum Disorders (EBSD) is limited, a web-based survey was developed to further explore these problems. 494 parents of 4-to-12 year-olds, identified by parents as being diagnosed with EBSD, completed a web survey about past and current EBSD-related sleep problems. The survey included Children's Sleep Habits Questionnaire (CSHQ) items and sleep problems from the International Classification of Sleep Disorders 2nd edition. Nearly all parents reported some type of past or current EBSD-sleep problem. Most occurred during a worst mood period, particularly with mixed manic-depressive symptoms. Symptoms caused impairments at home, school, or with peers in 96.9% of the sample and across all three contexts in 64.0% of children. Sleep problems were also noted after three-day weekends and Spring and Fall Daylight Savings time changes. Findings, study limitations, and implications for treatment and etiology are discussed.

ADHD subtypes and comorbid anxiety, depression, and oppositional-defiant disorder: differences in sleep problems.

PubMed

Mayes, Susan Dickerson; Calhoun, Susan L; Bixler, Edward O; Vgontzas, Alexandros N; Mahr, Fauzia; Hillwig-Garcia, Jolene; Elamir, Belal; Edhere-Ekezie, Linda; Parvin, Matthew

2009-04-01

Sleep problems were analyzed in children with ADHD (Attention-deficit hyperactivity disorder). Scales were completed by parents of 135 control children and 681 children with ADHD combined type (ADHD-C) or inattentive type (ADHD-I) with or without comorbid oppositional defiant disorder (ODD), anxiety, or depression. Children with ADHD-I alone had the fewest sleep problems and did not differ from controls. Children with ADHD-C had more sleep problems than controls and children with ADHD-I. Comorbid anxiety/depression increased sleep problems, whereas ODD did not. Daytime sleepiness was greatest in ADHD-I and was associated with sleeping more (not less) than normal. Medicated children had greater difficulty falling asleep than unmedicated children. Differences in sleep problems were found as a function of ADHD subtype, comorbidity, and medication.

Behavioral sleep-wake homeostasis and EEG delta power are decoupled by chronic sleep restriction in the rat.

PubMed

Stephenson, Richard; Caron, Aimee M; Famina, Svetlana

2015-05-01

Chronic sleep restriction (CSR) is prevalent in society and is linked to adverse consequences that might be ameliorated by acclimation of homeostatic drive. This study was designed to test the hypothesis that the sleep-wake homeostat will acclimatize to CSR. A four-parameter model of proportional control was used to quantify sleep homeostasis with and without recourse to a sleep intensity function. Animal laboratory, rodent walking-wheel apparatus. Male Sprague-Dawley rats. Acute total sleep deprivation (TSD, 1 day × 18 or 24 h, N = 12), CSR (10 days × 18 h TSD, N = 5, or 5 days × 20 h TSD, N = 6). Behavioral rebounds were consistent with model predictions for proportional control of cumulative times in wake, nonrapid eye movement (NREM) and rapid eye movement (REM). Delta (D) energy homeostasis was secondary to behavioral homeostasis; a biphasic NREM D power rebound contributed to the dynamics (rapid response) but not to the magnitude of the rebound in D energy. REM behavioral homeostasis was little affected by CSR. NREM behavioral homeostasis was attenuated in proportion to cumulative NREM deficit, whereas the biphasic NREM D power rebound was only slightly suppressed, indicating decoupled regulatory mechanisms following CSR. We conclude that sleep homeostasis is achieved through behavioral regulation, that the NREM behavioral homeostat is susceptible to attenuation during CSR and that the concept of sleep intensity is not essential in a model of sleep-wake regulation. Chronic sleep restriction (CSR) is prevalent in society and is linked to adverse consequences that might be ameliorated by acclimation of homeostatic drive. This study was designed to test the hypothesis that the sleep-wake homeostat will acclimatize to CSR. A four-parameter model of proportional control was used to quantify sleep homeostasis with and without recourse to a sleep intensity function. Animal laboratory, rodent walking-wheel apparatus. Male Sprague-Dawley rats. Acute total sleep deprivation (TSD, 1 day × 18 or 24 h, N = 12), CSR (10 days × 18 h TSD, N = 5, or 5 days × 20 h TSD, N = 6). Behavioral rebounds were consistent with model predictions for proportional control of cumulative times in wake, nonrapid eye movement (NREM) and rapid eye movement (REM). Delta (D) energy homeostasis was secondary to behavioral homeostasis; a biphasic NREM D power rebound contributed to the dynamics (rapid response) but not to the magnitude of the rebound in D energy. REM behavioral homeostasis was little affected by CSR. NREM behavioral homeostasis was attenuated in proportion to cumulative NREM deficit, whereas the biphasic NREM D power rebound was only slightly suppressed, indicating decoupled regulatory mechanisms following CSR. We conclude that sleep homeostasis is achieved through behavioral regulation, that the NREM behavioral homeostat is susceptible to attenuation during CSR and that the concept of sleep intensity is not essential in a model of sleep-wake regulation. © 2015 Associated Professional Sleep Societies, LLC.

Parental Sleep Concerns in Autism Spectrum Disorders: Variations from Childhood to Adolescence

ERIC Educational Resources Information Center

Goldman, Suzanne E.; Richdale, Amanda L.; Clemons, Traci; Malow, Beth A.

2012-01-01

Sleep problems of adolescents and older children with Autism Spectrum Disorder (ASD) were compared to toddlers and young children in 1,859 children. Sleep was measured with the Children's Sleep Habits Questionnaire. Total sleep problems were significant across all age groups, however the factors contributing to these problems differed. Adolescents…

Parental Report of Sleep Problems in Down Syndrome

ERIC Educational Resources Information Center

Breslin, J. H.; Edgin, J. O.; Bootzin, R. R.; Goodwin, J. L.; Nadel, L.

2011-01-01

Background: Children with Down syndrome (DS) suffer from sleep problems, including sleep maintenance problems, as well as snoring, and other symptoms of disordered breathing. To examine sleep in DS, we gave parents a questionnaire assessing their child's sleep. Materials and methods: The parents of 35 children with DS (mean age = 12.65 years,…

Sleep-related problems and minor psychiatric disorders among Brazilian shift workers.

PubMed

Olinto, Maria Teresa Anselmo; Garcez, Anderson; Henn, Ruth Liane; Macagnan, Jamile Block Araldi; Paniz, Vera Maria Vieira; Pattussi, Marcos Pascoal

2017-11-01

The aim of this study was to explore the association between sleep-related problems with the occurrence of minor psychiatric disorders in shift workers of southern Brazil. A cross-sectional study with 1202 workers (785 females) aged 18-50 years was carried out. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20), and four sleep problems were collected and analyzed: sleep deprivation (≤ 5h), difficulty falling asleep, waking up during sleep, and sleep medication use. Results show that the overall prevalence of minor psychiatric disorders was 26.8%, but it was more prevalent among females than males (30.2% vs. 20.4%). Nightshift work was significantly associated with the occurrence of sleep-related problems. After adjusting for confounding factors, the number of sleep-related problems showed a positive linear trend with psychiatric disorders in both sexes. Having two or more sleep-related problems was associated with increased probability of psychiatric disorders approximately three-fold among males and two-fold among females, when compared with those without sleep problems. In conclusion, this study demonstrated that sleep-related problems have a strong and independent association with psychiatric disorders among shift workers. Furthermore, the prevalence of both conditions was higher among females than males; however, the strength of these associations was higher in males. Copyright © 2017 Elsevier B.V. All rights reserved.

Childhood abuse as a risk factor for sleep problems in adulthood: evidence from a U.S. national study.

PubMed

Greenfield, Emily A; Lee, Chioun; Friedman, Elliot L; Springer, Kristen W

2011-10-01

Accumulating evidence indicates that stress impairs sleep quality. Few studies, however, have examined the extent to which early life stress can jeopardize sleep in adulthood. Guided by a life course epidemiological perspective on health, this study examined associations between childhood abuse and adult sleep problems. We used data from 835 respondents in the National Survey of Midlife Development in the United States (MIDUS). Self-report measures assessed the frequency of physical, emotional, and sexual abuse in childhood, as well as global and component indicators of sleep problems in adulthood. Having experienced all three types of childhood abuse-even infrequently-was associated with global sleep pathology, as well as specific types of sleep problems. Reports of both frequent physical and frequent emotional abuse-even in the absence of sexual abuse-were also associated with poor sleep. Childhood abuse is a risk factor for individuals' long-term sleep problems.

Sleep problems and temperament in young children with Down syndrome and typically developing controls.

PubMed

Lukowski, A F; Milojevich, H M

2017-03-01

Although group differences have been found between children with Down syndrome (DS) and typically developing (TD) children when considering sleep problems and temperament independently, none of the research conducted to date has examined sleep-temperament associations in children with DS. The present research was conducted to determine (1) whether the sleep problems experienced by children with DS are associated with temperament or (2) if the demonstrated relations between sleep and temperament differ from those that are observed in TD children. The present study included examination of relations between parent-reported sleep problems and temperament in 19 children with DS and 20 TD controls matched on developmental age. The results revealed group differences in temperament and sleep problems. Mediation models indicated that temperament (effortful control and inhibitory control) mediated the association between group and sleep problems; sleep problems also mediated the association between group and temperament (effortful and inhibitory control). Findings indicated that sleep problems may serve as both cause and consequence of variability in effortful and inhibitory control and provide insight as to future experimental studies that should be conducted to better elucidate these relations. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Sleep problems and mental health in primary school new entrants: cross-sectional community-based study.

PubMed

Quach, Jon; Hiscock, Harriet; Wake, Melissa

2012-12-01

To determine at school entry (i) the prevalence and types of child sleep problems; (ii) sleep difficulties and hygiene practices associated with sleep problems; and (iii) their associations with child health-related quality of life, mental health and parent mental health. We conducted a cross-sectional community-based study at 22 primary schools in Melbourne, Australia. One thousand five hundred and twelve (70%) parents of children in the first 6 months of the child's first year of primary school took part. Parent report of child sleep problems (none, mild, and moderate/severe); sleep difficulties; pre-bedtime activities (television in bedroom, television or electronic games before bedtime, television or electronic games >2 h/day) and caffeine intake; child mental health (Strengths and Difficulties Questionnaire), health-related quality of life (Pediatric Quality of Life Inventory); and parent mental health (Depression Anxiety Stress Scale-21). 38.6% of children had a parent-reported sleep problem (27.9% mild, 10.8% moderate/severe). Sleep problems were characterised by problematic sleep difficulties but not poor sleep hygiene practices. Moderate/severe sleep problems were associated with poorer child mental health (mean difference -0.8; 95% confidence interval (CI) -1.1 to -0.5, P < 0.001), health-related quality of life (mean difference -9.9; 95% CI -11.9 to -7.9, P < 0.001) and parent mental health (mean difference 9.8; 95% CI 7.7-11.9, P < 0.001). In new school entrants, sleep problems are common and associated with poorer child mental health, health-related quality of life and parent mental health. Future research needs to determine if systematically addressing sleep problems improves these outcomes. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Sleep problems, short sleep and a combination of both increase the risk of depressive symptoms in older people: a 6-year follow-up investigation from the English Longitudinal Study of Ageing.

PubMed

Jackowska, Marta; Poole, Lydia

2017-09-01

This study investigated whether sleep problems, sleep duration and a combination of short or long sleep with sleep problems were predictive of depressive symptoms six years later. Participants were 4545 men and women aged 50 years or older from the English Longitudinal Study of Ageing. Sleep problems were indexed through self-report enquiring about the most frequent insomnia symptoms including difficulties falling asleep, waking up several times a night and waking up in the morning feeling tired. Sleep duration was ascertained by asking about average sleep in the weeknight. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale. Sleep problems were predictive of elevated depressive symptoms at follow-up (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.19-1.56). When explored separately, waking up in the morning feeling tired (OR = 1.71, 95% CI = 1.24-2.37) followed by difficulties falling asleep (OR = 1.49, 95% CI = 1.06-2.11) were also predictors of future depressive symptoms. Compared to optimal duration, short (OR = 1.90, 95% CI = 1.34-2.71) but not long sleep hours were also linked to elevated depressive symptoms. Participants reporting short sleep hours combined with high sleep problems also had an elevated risk of depressive symptoms six years later (OR = 1.85, 95% CI = 1.15-3.00). Long sleep combined with high sleep problems was not predictive of depressive symptoms. Short and disturbed sleep and their combination increase the risk of future depressive symptoms in older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Behavioral Hyperventilation and Central Sleep Apnea in Two Children

PubMed Central

Johnston, Thomas P.; Tam-Williams, Jade; Schmandt, Margaret; Patel, Anand C.; Cleveland, Claudia; Coste, Ferdinand; Kemp, James S.

2015-01-01

Behavioral hyperventilation is a rarely recognized cause of central sleep apnea (CSA) among children. We report two pediatric patients who presented with prolonged central sleep apnea secondary to behavioral hyperventilation. One patient also had a prolonged corrected QT (QTC) interval resulting from hyperventilation. Citation: Johnston TP, Tam-Williams J, Schmandt M, Patel AC, Cleveland C, Coste F, Kemp JS. Behavioral hyperventilation and central sleep apnea in two children. J Clin Sleep Med 2015;11(4):487–489. PMID:26106657

Perspectives on the rapid eye movement sleep switch in rapid eye movement sleep behavior disorder.

PubMed

Ramaligam, Vetrivelan; Chen, Michael C; Saper, Clifford B; Lu, Jun

2013-08-01

Rapid eye movement (REM) sleep in mammals is associated with wakelike cortical and hippocampal activation and concurrent postural muscle atonia. Research during the past 5 decades has revealed the details of the neural circuitry regulating REM sleep and muscle atonia during this state. REM-active glutamatergic neurons in the sublaterodorsal nucleus (SLD) of the dorsal pons are critical for generation for REM sleep atonia. Descending projections from SLD glutamatergic neurons activate inhibitory premotor neurons in the ventromedial medulla (VMM) and in the spinal cord to antagonize the glutamatergic supraspinal inputs on the motor neurons during REM sleep. REM sleep behavior disorder (RBD) consists of simple behaviors (i.e., twitching, jerking) and complex behaviors (i.e., defensive behavior, talking). Animal research has lead to the hypothesis that complex behaviors in RBD are due to SLD pathology, while simple behaviors of RBD may be due to less severe SLD pathology or dysfunction of the VMM, ventral pons, or spinal cord. Copyright © 2013 Elsevier B.V. All rights reserved.

Sleep Problem of Children with Autistic Spectrum Disorder Assessed by Children Sleep Habits Questionnaire-Abbreviated in Indonesia and Japan.

PubMed

Irwanto; Rehatta, Nancy Margarita; Hartini, Sri; Takada, Satoshi

2016-07-04

Sleep problems are associated with problems of cognitive functioning, learning, attention and school performance. It has been found that sleep problems are highly prevalent in children with Autistic spectrum disorders (ASD), with rates ranging from 40% to 80%. We aimed to identify the prevalence of sleep problems on children with ASD in Indonesia and Japan. A cross-sectional study was conducted in Surabaya, Indonesia and Kobe, Japan. Children aged 4 -10 years old were enrolled using stratified cluster sampling. Children's Sleep Habits Questionnaire-Abbreviated (CSHQ-A) was used in this research to assess the sleep problems, consisted of 22 questions (NICHD SECCYD-Wisconsin). Data were analyzed with Mann-Whitney U test to compare the CSHQ-A scores between Indonesian and Japanese children, while the proportion of sleep problems was evaluated by chi-square test with 95% confidence interval. Fifty children with ASD were included in this study, 25 children from Kobe, Japan and 25 children from Surabaya, Indonesia. The prevalence of sleep problems on children with ASD was 60% (15 children) in Indonesia and 16% (4 children) in Japan respectively. There were significant differences in total waking during the night and in morning wake for the CSHQ-A between children from Indonesia and Japan (p<0.005). The prevalence of sleep problems on children with ASD was higher in children from Indonesia than from Japan.

Distress Tolerance Links Sleep Problems with Stress and Health in Homeless.

PubMed

Reitzel, Lorraine R; Short, Nicole A; Schmidt, Norman B; Garey, Lorra; Zvolensky, Michael J; Moisiuc, Alexis; Reddick, Carrie; Kendzor, Darla E; Businelle, Michael S

2017-11-01

We examined associations between sleep problems, distress intolerance, and perceived stress and health in a convenience sample of homeless adults. Participants (N = 513, 36% women, Mage = 44.5 ±11.9) self-reported sleep adequacy, sleep duration, unintentional sleep during the daytime, distress tolerance, urban stress, and days of poor mental health and days of poor physical health over the last month. The indirect effects of sleep problems on stress and health through distress tolerance were examined using a non-parametric, bias-corrected bootstrapping procedure. Sleep problems were prevalent (eg, 13.0 ±11.4 days of inadequate sleep and 4.7 ±7.9 days of unintentionally falling asleep during the preceding month). Distress intolerance partially accounted for the associations of inadequate sleep and unintentionally falling asleep, but not sleep duration, with urban stress and more days of poor mental and physical health. Many homeless individuals endure sleep problems. Given the connections between sleep and morbidity and mortality, results further support the need for more attention directed toward facilitating improvements in sleep quality to improve the quality of life of homeless adults, potentially including attention to improving distress tolerance skills.

Toddler’s Self-Regulation Strategies in a Challenge Context are Nap-Dependent

PubMed Central

Miller, Alison L.; Seifer, Ronald; Crossin, Rebecca; LeBourgeois, Monique K.

2015-01-01

SUMMARY Early childhood represents a time of developmental changes in both sleep and self-regulation, a construct reflecting the ability to control one’s behavior, attention, and emotion when challenged. Links between sleep and self-regulation processes have been proposed, but experimental evidence with young children is lacking. In the current study, we tested the effects of acute sleep restriction (nap deprivation) on toddlers’ self-regulation. Healthy children (n=12; 4 males; 30–36 months (33.9±1.7) slept on a strict schedule (verified with actigraphy and sleep diaries) for 5 days before each of two afternoon assessments following a Nap and a No-Nap condition (~11-day protocol). Children were videotaped while attempting an unsolvable puzzle, and 10 mutually exclusive self-regulation strategies were later coded. On average, children lost ~90 min of sleep on the No-Nap versus the Nap day. Nap deprivation resulted in moderate-to-large effects on self-regulation strategies, with decreases in skepticism (d=0.77; 7% change), negative self-appraisal (d=0.92; 5% change), and increases in physical self-soothing (d=0.68; 10% change), focus on the puzzle piece that would not fit (perseveration; d=0.50; 9% change), and insistence on completing the unsolvable puzzle (d=0.91; 10% change). Results suggest sleep serves an important role in the way toddlers respond to challenging events in their daily lives. After losing daytime sleep, toddlers were less able to effectively engage in a difficult task and reverted to less mature self-regulation strategies, than when they were well-rested. Over time, chronically missed sleep may impair young children’s self-regulation abilities, resulting in risk for social-emotional, behavioral, and school problems. PMID:25394169

Motor-Behavioral Episodes in REM Sleep Behavior Disorder and Phasic Events During REM Sleep

PubMed Central

Manni, Raffaele; Terzaghi, Michele; Glorioso, Margaret

2009-01-01

Study Objectives: To investigate if sudden-onset motor-behavioral episodes in REM sleep behavior disorder (RBD) are associated with phasic events of REM sleep, and to explore the potential meaning of such an association. Design: Observational review analysis. Setting: Tertiary sleep center. Patients: Twelve individuals (11 males; mean age 67.6 ± 7.4 years) affected by idiopathic RBD, displaying a total of 978 motor-behavioral episodes during nocturnal in-laboratory video-PSG. Interventions: N/A Measurements and Results: The motor activity displayed was primitive in 69.1% and purposeful/semi-purposeful in 30.9% of the motor-behavioral episodes recorded. Sleeptalking was significantly more associated with purposeful/semi-purposeful motor activity than crying and/or incomprehensible muttering (71.0% versus 21.4%, P < 0.005). In 58.2% of the motor-behavioral episodes, phasic EEG-EOG events (rapid eye movements [REMs], α bursts, or sawtooth waves [STWs]) occurred simultaneously. Each variable (REMs, STWs, α bursts) was associated more with purposeful/semi-purposeful than with primitive movements (P < 0.05). Conclusions: Motor-behavioral episodes in RBD were significantly more likely to occur in association with phasic than with tonic periods of REM sleep. The presence of REMs, α bursts and STWs was found to be more frequent in more complex episodes. We hypothesize that motor-behavioral episodes in RBD are likely to occur when the brain, during REM sleep, is in a state of increased instability (presence of α bursts) and experiencing stronger stimulation of visual areas (REMs). Citation: Manni R; Terzaghi M; Glorioso M. Motor-behavioral episodes in REM sleep behavior disorder and phasic events during REM sleep. SLEEP 2009;32(2):241–245. PMID:19238811

Emotional distress and burden among caregivers of children with oncological/hematological disorders.

PubMed

Edmond, Sara N; Graves, Patricia E; Whiting, Sara E; Karlson, Cynthia W

2016-06-01

Caring for children with oncological and hematological disorders may lead to caregiver emotional distress and caregiver burden; however, little work has examined the relationship between children's symptoms and caregiver's distress and burden. This study used self-report survey data from caregivers (N = 96) and a cross-sectional design to examine correlates of caregiver emotional distress and burden. Data collected included caregiver and child demographic data, child symptoms (i.e., sleep problems, pain, and emotional/behavioral problems), caregiver emotional distress, and caregiver burden. Multiple linear regression found that parent reported financial difficulty (β = 0.29, t = 3.13, p = .003), greater child sleep problems (β = 0.29 t = 2.81, p = .007), greater child pain (β = 0.33 t = 3.48, p = .001), and greater child emotional/behavioral problems (β = 0.27, t = 2.71, p = .009) were all related to higher levels of caregiver emotional distress. Only financial difficulties (β = -0.35, t = -2.03, p = .04) and child pain (β = -0.30, t = -2.33, p = .02) were related to caregiver burden. Child symptoms may play an important role in the development of caregiver distress and caregiver burden; future research should utilize longitudinal designs to examine temporal and casual relationships. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Sleep and Learning

NASA Astrophysics Data System (ADS)

Margoliash, Daniel

2010-03-01

The neural basis of cognition represents a grand challenge problem involving multiple disciplines and approaches to the analysis of behavior. Song learning by juvenile songbirds such as zebra finches has proven to have considerable utility for exploring how behavior is represented at multiple levels of brain function. As classically described, young birds are exposed to a ``tutor'' (adult) song and commit that song to memory early in life, then engage in an extended period (weeks) of plastic singing as they slowly learn to match vocal output to the tutor song memory via auditory feedback. In recent years, the role of sleep in learning processes has been actively explored. Young birds isolated from adult songs, then suddenly given access to such songs at circa 40 days of age, show a sudden change in their singing behavior starting on the day following first exposure. Such birds sing songs that have less structure in the mornings than do the songs sung in the afternoons before or after that morning. This fluctuation is directly the result of sleep (not circadian rhythm), and the magnitude of fluctuation is positively correlated with the ultimate similarity to the tutor song. Examining spontaneous neuronal activity in certain brain structures during the night in sleeping adults shows ``replay'' of the patterns of activity the same neurons exhibit during daytime singing, and ``preplay'' of new patterns that will first be incorporated into daytime singing the following day. In experiments on juveniles, nighttime neuronal activity shows dramatic changes associated with song learning, even on the night after the first day of tutor song exposure (preceding changes in singing behavior). Offline processing, especially sleep, has been well documented to participate in memory consolidation in a very broad range of behaviors including in humans. Placing the bird song results in a theoretical framework thereby helps to inform a very broad range of phenomena.

Links between Sleep and Daytime Behaviour Problems in Children with Down Syndrome

ERIC Educational Resources Information Center

Esbensen, A. J.; Hoffman, E. K.; Beebe, D. W.; Byars, K. C.; Epstein, J.

2018-01-01

Background: In the general population, sleep problems have an impact on daytime performance. Despite sleep problems being common among children with Down syndrome, the impact of sleep problems on daytime behaviours in school-age children with Down syndrome is an understudied topic. Our study examined the relationship between parent-reported and…

Exploration of Differences in Types of Sleep Disturbance and Severity of Sleep Problems between Individuals with Cri du Chat Syndrome, Down's Syndrome, and Jacobsen Syndrome: A Case Control Study

ERIC Educational Resources Information Center

Maas, Anneke P. H. M.; Didden, Robert; Korzilius, Hubert; Curfs, Leopold M. G.

2012-01-01

The prevalence of sleep problems in individuals with intellectual disability (ID) seems to vary between genetic syndromes associated with ID. Different types of sleep disturbances may indicate underlying causes of sleep problems and these types of sleep disturbances may vary between different genetic syndromes. We examined and compared five types…

Characteristics Associated with Sleep Duration, Chronotype, and Social Jet Lag in Adolescents

ERIC Educational Resources Information Center

Malone, Susan Kohl; Zemel, Babette; Compher, Charlene; Souders, Margaret; Chittams, Jesse; Thompson, Aleda Leis; Lipman, Terri H.

2016-01-01

Sleep is a complex behavior with numerous health implications. Identifying sociodemographic and behavioral characteristics of sleep is important for determining those at greatest risk for sleep-related health disparities. In this cross-sectional study, general linear models were used to examine sociodemographic and behavioral characteristics…

Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus.

PubMed

Cai, Shirong; Tan, Sara; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang-Mei; Teoh, Oon Hoe; Chong, Yap-Seng; Meaney, Michael J; Kramer, Michael S; Gooley, Joshua J

2017-02-01

To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population. A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score). In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66). During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Sleep problems and suicide attempts among adolescents: a case-control study.

PubMed

Koyawala, Neel; Stevens, Jack; McBee-Strayer, Sandra M; Cannon, Elizabeth A; Bridge, Jeffrey A

2015-01-01

This study used a case-control design to compare sleep disturbances in 40 adolescents who attempted suicide with 40 never-suicidal adolescents. Using hierarchical logistic regression analyses, we found that self-reported nighttime awakenings were significantly associated with attempted suicide, after controlling for antidepressant use, antipsychotic use, affective problems, and being bullied. In a separate regression analysis, the parent-reported total sleep problems score also predicted suicide attempt status, controlling for key covariates. No associations were found between suicide attempts and other distinct sleep problems, including falling asleep at bedtime, sleeping a lot during the day, trouble waking up in the morning, sleep duration, and parent-reported nightmares. Clinicians should be aware of sleep problems as potential risk factors for suicide attempts for adolescents.

Genetic and neuronal mechanisms governing the sex-specific interaction between sleep and sexual behaviors in Drosophila.

PubMed

Chen, Dandan; Sitaraman, Divya; Chen, Nan; Jin, Xin; Han, Caihong; Chen, Jie; Sun, Mengshi; Baker, Bruce S; Nitabach, Michael N; Pan, Yufeng

2017-07-28

Animals execute one particular behavior among many others in a context-dependent manner, yet the mechanisms underlying such behavioral choice remain poorly understood. Here we studied how two fundamental behaviors, sex and sleep, interact at genetic and neuronal levels in Drosophila. We show that an increased need for sleep inhibits male sexual behavior by decreasing the activity of the male-specific P1 neurons that coexpress the sex determination genes fru M and dsx, but does not affect female sexual behavior. Further, we delineate a sex-specific neuronal circuit wherein the P1 neurons encoding increased courtship drive suppressed male sleep by forming mutually excitatory connections with the fru M -positive sleep-controlling DN1 neurons. In addition, we find that FRU M regulates male courtship and sleep through distinct neural substrates. These studies reveal the genetic and neuronal basis underlying the sex-specific interaction between sleep and sexual behaviors in Drosophila, and provide insights into how competing behaviors are co-regulated.Genes and circuits involved in sleep and sexual arousal have been extensively studied in Drosophila. Here the authors identify the sex determination genes fruitless and doublesex, and a sex-specific P1-DN1 neuronal feedback that governs the interaction between these competing behaviors.

Age and Sleep Disturbances Among American Men And Women: Data From the U.S. Behavioral Risk Factor Surveillance System

PubMed Central

Grandner, Michael A.; Martin, Jennifer L.; Patel, Nirav P.; Jackson, Nicholas J.; Gehrman, Philip R.; Pien, Grace; Perlis, Michael L.; Xie, Dawei; Sha, Daohang; Weaver, Terri; Gooneratne, Nalaka S.

2012-01-01

Study Objective: Explore the prevalence of sleep-related complaints across age groups, examining effects of sex, general health, and depressed mood. Design: Cross-sectional analysis of data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS). Setting: Epidemiologic. Participants: Complete-case analysis included 155,877 participants who responded to questions related to Self-Reported Sleep Disturbance (SLEEPDIST) and Self-Reported Tiredness/Lack of Energy (TIREDNESS). Interventions: None. Measurements and Results: Outcomes were self-reported complaints in response to survey questions assessing SLEEPDIST and TIREDNESS, dichotomized as reporting a complaint < 6 versus ≥ 6 nights or days, respectively, in a 2-wk period. Predictors were age, general health, and depressed mood. All analyses were adjusted for race/ethnicity, income, education, and time since last medical checkup. Across all age groups, women reported more SLEEPDIST and TIREDNESS. Poor general health, mild depressed mood, and moderate/severe depressed mood were associated with SLEEPDIST and TIREDNESS. Both SLEEPDIST and TIREDNESS generally declined across the life span, with fewest endorsements in respondents older than 80 yr. For SLEEPDIST, odds ratios (ORs, reference = 80+) declined from age 18-54 yr, rose slightly, and then declined again after age 59 yr in men. The pattern was similar for women, except a more marked rise was noted from age 40-59 yr. The pattern was similar for TIREDNESS. Conclusions: Advancing age was not associated with increased Self-Reported Sleep Disturbance or Self-Reported Tiredness/Lack of Energy. These results suggest that the often-reported increase in sleep problems with age is a nonlinear phenomenon, mediated by factors other than physiologic aging. Citation: Grandner MA; Martin JL; Patel NP; Jackson NJ; Gehrman PR; Pien G; Perlis ML; Xie D; Sha D; Weaver T; Gooneratne NS. Age and sleep disturbances among American men and women: data from the U.S. behavioral risk factor surveillance system. SLEEP 2012;35(3):395-406. PMID:22379246

Partial Sleep Deprivation Attenuates the Positive Affective System: Effects Across Multiple Measurement Modalities.

PubMed

Finan, Patrick H; Quartana, Phillip J; Remeniuk, Bethany; Garland, Eric L; Rhudy, Jamie L; Hand, Matthew; Irwin, Michael R; Smith, Michael T

2017-01-01

Ample behavioral and neurobiological evidence links sleep and affective functioning. Recent self-report evidence suggests that the affective problems associated with sleep loss may be stronger for positive versus negative affective state and that those effects may be mediated by changes in electroencepholographically measured slow wave sleep (SWS). In the present study, we extend those preliminary findings using multiple measures of affective functioning. In a within-subject randomized crossover experiment, we tested the effects of one night of sleep continuity disruption via forced awakenings (FA) compared to one night of uninterrupted sleep (US) on three measures of positive and negative affective functioning: self-reported affective state, affective pain modulation, and affect-biased attention. The study was set in an inpatient clinical research suite. Healthy, good sleeping adults (N = 45) were included. Results indicated that a single night of sleep continuity disruption attenuated positive affective state via FA-induced reductions in SWS. Additionally, sleep continuity disruption attenuated the inhibition of pain by positive affect as well as attention bias to positive affective stimuli. Negative affective state, negative affective pain facilitation, nor negative attention bias were altered by sleep continuity disruption. The present findings, observed across multiple measures of affective function, suggest that sleep continuity disruption has a stronger influence on the positive affective system relative to the negative affective affective system. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Chronic sleep loss and risk-taking behavior: Does the origin of sleep loss matter?

PubMed

Rusnac, Natalia; Spitzenstetter, Florence; Tassi, Patricia

2018-06-20

Many adolescents and young adults get insufficient sleep. A link between sleep loss and risk-taking behavior has been consistently found in the literature, but surprisingly, the role played by the origin of sleep loss in this link has never been investigated. Sleep loss can be voluntary (instead of sleeping, a significant amount of time is devoted to other activities) or involuntary (caused by a sleep disorder, for example, insomnia). The aim of this research was to investigate whether both types of sleep loss are associated to the same extent with risky behavior. Five hundred thirty-six university students between 19 and 25 years old participated in this study. Three groups were selected: participants with voluntary sleep loss, participants with insomnia, and normal sleepers. We assessed risk-taking behavior in virtual driving situations, as well as drinking habits in terms of quantity and frequency. To further explore the differences between the groups, we also measured sensation seeking, a personality trait related to risk-taking behavior. Compared to participants with insomnia and normal sleepers, participants with voluntary sleep loss take more risks in dangerous driving situations, drink more alcohol, and have higher disinhibition scores on the Sensation-Seeking Scale. On the other hand, no such differences were found between participants with insomnia and normal sleepers, suggesting that sleep loss is not always associated with risk taking. Whether sleep loss is associated with risk-taking behavior or not could depend on the origin of sleep loss and the underlying personality traits.

The Impact of a Cognitive Behavioral Pain Management Program on Sleep in Patients with Chronic Pain: Results of a Pilot Study.

PubMed

Blake, Catherine; Cunningham, Jennifer; Power, Camillus K; Horan, Sheila; Spencer, Orla; Fullen, Brona M

2016-02-01

To determine the impact of a cognitive behavioral pain management program on sleep in patients with chronic pain. Prospective nonrandomized controlled pilot study with evaluations at baseline and 12 weeks. Out-patient multidisciplinary cognitive behavioral pain management program in a university teaching hospital. Patients with chronic pain who fulfilled the criteria for participation in a cognitive behavioral pain management program. Patients assigned to the intervention group (n = 24) completed a 4 week cognitive behavioral pain management program, and were compared with a waiting list control group (n = 22). Assessments for both groups occurred at baseline and two months post cognitive behavioral pain management program. Outcome measures included self-report (Pittsburgh Sleep Quality Index) and objective (actigraphy) sleep measures, pain and quality of life measures. Both groups were comparable at baseline, and all had sleep disturbance. The Pittsburgh Sleep Quality Index correlated with only two of the seven objective sleep measures (fragmentation index r = 0.34, P = 0.02, and sleep efficiency percentage r = -0.31, P = 0.04). There was a large treatment effect for cognitive behavioral pain management program group in mean number of wake bouts (d = 0.76), where a significant group*time interaction was also found (P = 0.016), showing that the CBT-PMP group improved significantly more than controls in this sleep variable. Patients attending a cognitive behavioral pain management program have high prevalence of sleep disturbance, and actigraphy technology was well tolerated by the patients. Preliminary analysis of the impact of a cognitive behavioral pain management program on sleep is promising, and warrants further investigation.

Effectiveness of sleep education programs to improve sleep hygiene and/or sleep quality in college students: a systematic review.

PubMed

Dietrich, Shellene K; Francis-Jimenez, Coleen M; Knibbs, Melida Delcina; Umali, Ismael L; Truglio-Londrigan, Marie

2016-09-01

Sleep health is essential for overall health, quality of life and safety. Researchers have found a reduction in the average hours of sleep among college students. Poor sleep has been associated with deficits in attention, reduction in academic performance, impaired driving, risk-taking behaviors, depression, impaired social relationships and poorer health. College students may have limited knowledge about sleep hygiene and the behaviors that supports sleep health, which may lead to poor sleep hygiene behavior. To identify, appraise and synthesize the best available evidence on the effectiveness of sleep education programs in improving sleep hygiene knowledge, sleep hygiene behavior and/or sleep quality versus traditional strategies. All undergraduate or graduate college students, male or female, 18 years and older and of any culture or ethnicity. Formal sleep education programs that included a curriculum on sleep hygiene behavior. Educational delivery methods that took place throughout the participants' college experience and included a variety of delivery methods. Randomized controlled trials (RCTs) and quasi-experimental studies. Sleep hygiene knowledge, sleep hygiene behavior and/or sleep quality. Literature including published and unpublished studies in the English language from January 1, 1980 through August 17, 2015. A search of CINAHL, CENTRAL, EMBASE, Academic Search Complete, PsychINFO, Healthsource: Nursing/Academic edition, ProQuest Central, PubMed and ERIC were conducted using identified keywords and indexed terms. A gray literature search was also performed. Quantitative papers were assessed by two reviewers using critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Data were extracted using the JBI-MAStARI data extraction tool. Data extracted included interventions, populations, study methods and outcomes of significance to the review question and objectives. Meta-analysis was not possible due to limited studies and variability of design and interventions; therefore, results are presented in narrative form. This systematic review yielded three RCTs and one quasi-experimental study for inclusion. Two studies reported outcomes on sleep hygiene knowledge; one showing a statistically significant improvement (P = 0.025) and the other reported no difference (test of significance not provided). Two studies reported on sleep hygiene behavior; one showing no difference (P > 0.05) and the other reporting a statistically significant improvement (P = 0.0001). Four studies reported on sleep quality; three reporting no difference (P > 0.05) and the other reporting a statistically significant improvement (P = 0.017). This reviewed article identified insufficient evidence to determine the effectiveness of sleep education on sleep hygiene knowledge, sleep hygiene behavior or sleep quality in this population.

Deprivation and Recovery of Sleep in Succession Enhances Reflexive Motor Behavior.

PubMed

Sprenger, Andreas; Weber, Frederik D; Machner, Bjoern; Talamo, Silke; Scheffelmeier, Sabine; Bethke, Judith; Helmchen, Christoph; Gais, Steffen; Kimmig, Hubert; Born, Jan

2015-11-01

Sleep deprivation impairs inhibitory control over reflexive behavior, and this impairment is commonly assumed to dissipate after recovery sleep. Contrary to this belief, here we show that fast reflexive behaviors, when practiced during sleep deprivation, is consolidated across recovery sleep and, thereby, becomes preserved. As a model for the study of sleep effects on prefrontal cortex-mediated inhibitory control in humans, we examined reflexive saccadic eye movements (express saccades), as well as speeded 2-choice finger motor responses. Different groups of subjects were trained on a standard prosaccade gap paradigm before periods of nocturnal sleep and sleep deprivation. Saccade performance was retested in the next morning and again 24 h later. The rate of express saccades was not affected by sleep after training, but slightly increased after sleep deprivation. Surprisingly, this increase augmented even further after recovery sleep and was still present 4 weeks later. Additional experiments revealed that the short testing after sleep deprivation was sufficient to increase express saccades across recovery sleep. An increase in speeded responses across recovery sleep was likewise found for finger motor responses. Our findings indicate that recovery sleep can consolidate motor disinhibition for behaviors practiced during prior sleep deprivation, thereby persistently enhancing response automatization. © The Author 2015. Published by Oxford University Press.

Just a scary dream? A brief review of sleep terrors, nightmares, and rapid eye movement sleep behavior disorder.

PubMed

Haupt, Mark; Sheldon, Stephen H; Loghmanee, Darius

2013-10-01

The clinical spectrum of sleep disorders in children is broad, ranging from primary snoring and obstructive sleep apnea (OSA) syndrome to complex sleep-related behaviors and movement disorders. Although snoring and OSA typically receive significant attention and discussion, other biologically based sleep disorders are as common, if not more common, in children. A general pediatrician is frequently presented with the complaint of sleep talking, sleep walking, or abnormal movements during sleep. Even more alarming is the presentation of the child suddenly and explosively screaming during sleep. Such complaints fall under the category of parasomnias. Exclusive to sleep and wake-to-sleep transitions, these parasomnias include arousals with abnormal motor, behavioral, autonomic, or sensory symptoms. Parasomnias can be noticeably dissimilar in clinical manifestations, but most share biologic characteristics. Three parasomnias associated with loud vocalizations associated with sleep that can present to general practitioners include sleep terrors, nightmares, and rapid eye movement sleep behavior disorder (RBD). Although usually benign, these sleep disorders can be disruptive and even potentially dangerous to the patient and can often be threatening to quality of life. In this article, we describe the clinical features of some of these disorders and how to differentiate between their alarming presentations. Copyright 2013, SLACK Incorporated.

Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain.

PubMed

Cranford, James A; Arnedt, J Todd; Conroy, Deirdre A; Bohnert, Kipling M; Bourque, Carrie; Blow, Frederic C; Ilgen, Mark

2017-11-01

To examine the prevalence and correlates of sleep problems in a sample of medical cannabis patients. Adults ages 21 and older (N=801,M age=45.8) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, sleep, pain, and other related constructs. Over half of the sample (59%) met criteria for past 1-month sleep disturbance, defined as at least one sleep problem occurring on 15 or more nights in the past month. Most participants (86%) reported that sleep problems were due to their current pain. Approximately 80% of participants reported using cannabis in the past 6 months to improve sleep and, among these participants, cannabis was rated as helpful for improving sleep. Sleep-related cannabis side effects were rare (35%), but sleep-related cannabis withdrawal symptoms were relatively common (65%). Statistically significant correlates of past 1-month sleep disturbance included a) being female, b) being white, c) being on disability, d) not having a medical cannabis card, and e) frequency of using cannabis to help sleep. Sleep problems are highly prevalent and frequent in medical cannabis patients and are closely tied to pain. Sleep-related cannabis withdrawal symptoms are relatively common but their clinical relevance is unknown. The association between frequency of cannabis use to help sleep with higher odds of sleep problems will need to be clarified by longitudinal studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Neurobiological Mechanisms for the Regulation of Mammalian Sleep-Wake Behavior: Reinterpretation of Historical Evidence and Inclusion of Contemporary Cellular and Molecular Evidence

PubMed Central

Datta, Subimal; MacLean, Robert Ross

2007-01-01

At its most basic level, the function of mammalian sleep can be described as a restorative process of the brain and body; recently, however, progressive research has revealed a host of vital functions to which sleep is essential. Although many excellent reviews on sleep behavior have been published, none have incorporated contemporary studies examining the molecular mechanisms that govern the various stages of sleep. Utilizing a holistic approach, this review is focused on the basic mechanisms involved in the transition from wakefulness, initiation of sleep and the subsequent generation of slow-wave sleep and rapid eye movement (REM) sleep. Additionally, using recent molecular studies and experimental evidence that provides a direct link to sleep as a behavior, we have developed a new model, the Cellular-Molecular-Network model, explaining the mechanisms responsible for regulating REM sleep. By analyzing the fundamental neurobiological mechanisms responsible for the generation and maintenance of sleep-wake behavior in mammals, we intend to provide a broader understanding of our present knowledge in the field of sleep research. PMID:17445891

Sleep in Individuals with Cri du Chat Syndrome: A Comparative Study

ERIC Educational Resources Information Center

Maas, A. P. H. M.; Didden, R.; Korzilius, H.; Braam, W.; Smits, M. G.; Curfs, L. M. G.

2009-01-01

Background: Sleep problems are common in individuals with intellectual disability. Little is known about sleep in children and adults with Cri du Chat syndrome (CDC). Method: Sleep was investigated in 30 individuals with CDC using a sleep questionnaire. Sleep problems and sleep behaviours in individuals with CDC were compared with individuals with…

Sleep spindles may predict response to cognitive-behavioral therapy for chronic insomnia.

PubMed

Dang-Vu, Thien Thanh; Hatch, Benjamin; Salimi, Ali; Mograss, Melodee; Boucetta, Soufiane; O'Byrne, Jordan; Brandewinder, Marie; Berthomier, Christian; Gouin, Jean-Philippe

2017-11-01

While cognitive-behavioral therapy for insomnia constitutes the first-line treatment for chronic insomnia, only few reports have investigated how sleep architecture relates to response to this treatment. In this pilot study, we aimed to determine whether pre-treatment sleep spindle density predicts treatment response to cognitive-behavioral therapy for insomnia. Twenty-four participants with chronic primary insomnia participated in a 6-week cognitive-behavioral therapy for insomnia performed in groups of 4-6 participants. Treatment response was assessed using the Pittsburgh Sleep Quality Index and the Insomnia Severity Index measured at pre- and post-treatment, and at 3- and 12-months' follow-up assessments. Secondary outcome measures were extracted from sleep diaries over 7 days and overnight polysomnography, obtained at pre- and post-treatment. Spindle density during stage N2-N3 sleep was extracted from polysomnography at pre-treatment. Hierarchical linear modeling analysis assessed whether sleep spindle density predicted response to cognitive-behavioral therapy. After adjusting for age, sex, and education level, lower spindle density at pre-treatment predicted poorer response over the 12-month follow-up, as reflected by a smaller reduction in Pittsburgh Sleep Quality Index over time. Reduced spindle density also predicted lower improvements in sleep diary sleep efficiency and wake after sleep onset immediately after treatment. There were no significant associations between spindle density and changes in the Insomnia Severity Index or polysomnography variables over time. These preliminary results suggest that inter-individual differences in sleep spindle density in insomnia may represent an endogenous biomarker predicting responsiveness to cognitive-behavioral therapy. Insomnia with altered spindle activity might constitute an insomnia subtype characterized by a neurophysiological vulnerability to sleep disruption associated with impaired responsiveness to cognitive-behavioral therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

Sleep budgets in a globalizing world: biocultural interactions influence sleep sufficiency among Egyptian families

PubMed Central

Worthman, Carol M.; Brown, Ryan A.

2013-01-01

Declines in self-reported sleep quotas with globalizing lifestyle changes have focused attention on their possible role in rising global health problems such as obesity or depression. Cultural factors that act across the life course and support sleep sufficiency have received scant attention, nor have the potential interactions of cultural and biological factors in age-related changes in sleep behavior been systematically investigated. This study examines the effects of cultural norms for napping and sleeping arrangements along with sleep schedules, age, and gender on sleep budgets among Egyptian households. Data were collected in 2000 from 16 households with 78 members aged 3–56 years at two sites in Egypt (Cairo and an agrarian village). Each participant provided one week of continuous activity records and details of each sleep event. Records showed that nighttime sleep onsets were late and highly variable. Napping was common and, along with wake time flexibility, played a key role in maintaining sleep sufficiency throughout the life course into later middle age. Cosleeping was prevalent and exhibited contrasting associations with reduced duration and sufficiency of both nocturnal and total sleep, and with earlier, more regular, and less disrupted sleep. Daily sleep quotas met published guidelines and showed age-related changes similar to existing reports, but differed in how they were achieved. Cultural norms organizing sleep practices by age and gender appear to tap their intrinsic biological properties as well. Moreover, flexibility in how sleep was achieved contributed to sleep sufficiency. The findings suggest how biocultural dynamics can play key roles in sleep patterns that sustain favorable sleep quotas from infancy onwards in populations pursuing globalizing contemporary lifestyles. PMID:22651897

Self-Regulation in Newly Arrived International Adoptees

ERIC Educational Resources Information Center

Tirella, Linda Grey; Miller, Laurie C.

2011-01-01

Many newly arrived international adoptees (IA) have difficulties with eating, sleeping, and self-soothing/self-stimulating (SS) behaviors. However, to date the prevalence of these problems and associated risk factors have not been clearly identified. Therefore, we proposed to evaluate 387 IA for the presence of these self-regulation and behavioral…

Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population

PubMed Central

Seow, Lee Seng Esmond; Verma, Swapna Kamal; Mok, Yee Ming; Kumar, Sunita; Chang, Sherilyn; Satghare, Pratika; Hombali, Aditi; Vaingankar, Janhavi; Chong, Siow Ann; Subramaniam, Mythily

2018-01-01

Study Objectives: With the introduction of insomnia disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), greater emphasis has been placed on the diagnosis and treatment of sleep disorder even in the presence of a coexisting mental disorder. The current study seeks to explore the clinical picture of insomnia in the context of psychiatric disorders commonly associated with sleep complaints by assessing the prevalence and correlates of DSM-5 insomnia disorder, and examining the extent to which insomnia symptoms have been addressed in this population. Methods: Four hundred treatment-seeking outpatients suffering from depressive, bipolar affective, anxiety, and schizophrenia spectrum disorders were recruited. DSM-5 insomnia was established using the modified Brief Insomnia Questionnaire. Differences in sociodemographic factors, clinical status, impairment outcomes, and mental health services utilization were compared. Information on patients' help-seeking experiences for insomnia-related symptoms was collected to determine the treatment received and treatment effectiveness. Results: Almost one-third of our sample (31.8%) had DSM-5 insomnia disorder. Those with insomnia disorder had significantly higher impairment outcomes than their counterparts but no group difference was observed for mental health services utilization. Findings based on past treatment contact for sleep problems suggest that diagnosis and treatment of insomnia is lacking in this population. Conclusions: With the new calling from DSM-5, clinicians treating psychiatric patients should view insomnia less as a symptom of their mental illnesses and treat clinical insomnia as a primary disorder. Patients should also be educated on the importance of reporting and treating their sleep complaints. Nonmedical (cognitive and behavioral) interventions for insomnia need to be further explored given their proven clinical effectiveness. Citation: Seow LSE, Verma SK, Mok YM, Kumar S, Chang S, Satghare P, Hombali A, Vaingankar J, Chong SA, Subramaniam M. Evaluating DSM-5 insomnia disorder and the treatment of sleep problems in a psychiatric population. J Clin Sleep Med. 2018;14(2):237–244. PMID:29394962

Genetic Correlates of Individual Differences in Sleep Behavior of Free-Living Great Tits (Parus major)

PubMed Central

Stuber, Erica F.; Baumgartner, Christine; Dingemanse, Niels J.; Kempenaers, Bart; Mueller, Jakob C.

2016-01-01

Within populations, free-living birds display considerable variation in observable sleep behaviors, reflecting dynamic interactions between individuals and their environment. Genes are expected to contribute to repeatable between-individual differences in sleep behaviors, which may be associated with individual fitness. We identified and genotyped polymorphisms in nine candidate genes for sleep, and measured five repeatable sleep behaviors in free-living great tits (Parus major), partly replicating a previous study in blue tits (Cyanistes caeruleus). Microsatellites in the CLOCK and NPAS2 clock genes exhibited an association with sleep duration relative to night length, and morning latency to exit the nest box, respectively. Furthermore, microsatellites in the NPSR1 and PCSK2 genes associated with relative sleep duration and proportion of time spent awake at night, respectively. Given the detection rate of associations in the same models run with random markers instead of candidate genes, we expected two associations to arise by chance. The detection of four associations between candidate genes and sleep, however, suggests that clock genes, a clock-related gene, or a gene involved in the melanocortin system, could play key roles in maintaining phenotypic variation in sleep behavior in avian populations. Knowledge of the genetic architecture underlying sleep behavior in the wild is important because it will enable ecologists to assess the evolution of sleep in response to selection. PMID:26739645

RELATIONSHIPS BETWEEN BREAST-FEEDING, CO-SLEEPING, AND SOMATIC COMPLAINTS IN EARLY CHILDHOOD.

PubMed

Peters, Elisabeth Maria; Lusher, Joanne Marie; Banbury, Samantha; Chandler, Chris

2016-09-01

The central aim of this study was to expand a limited body of knowledge on the complex relationship between breast-feeding, co-sleeping, and somatic complaints in early childhood. An opportunity sample of 98 parents from the general population with children aged 18 to 60 months consented to participate in the study. Each parent completed a series of questionnaires measuring somatic complaints, sleep problems, co-sleeping, breast-feeding, and demographic factors. Findings indicated that co-sleeping was associated with increased somatic complaints and that breast-feeding associated with decreased somatic complaints. Co-sleeping also was found to be associated with an increase in sleep problems. Boys demonstrated significantly higher levels of sleep problems than did girls. These findings highlight the relationship between co-sleeping during early childhood, which could have implications for prevention, treatment, and intervention regarding somatic complaints and sleep problems in early childhood. © 2016 Michigan Association for Infant Mental Health.

Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report.

PubMed

Krakow, Barry; Ulibarri, Victor A

2013-03-01

Few studies have examined the co-morbidity between insomnia and sleep-disordered breathing in the clinical setting. This study evaluated treatment-seeking insomnia patients and their self-report of sleep breathing complaints. A retrospective chart review was conducted on 1,035 consecutive treatment-seeking, chronic insomnia patients who reported insomnia as their primary problem upon seeking care at a private, community-based sleep medical center. Measurements included the insomnia severity index, standard subjective sleep measures as well as rankings, attributions, and self-reports about sleep breathing disorders, problems, and symptoms. A total of 1,035 adult, treatment-seeking insomnia patients indicated insomnia interfered with daytime functioning, and their average insomnia severity was in the range of a clinically relevant problem: total sleep time (5.50 h, SD = 1.60), sleep efficiency (71.05 %, SD = 18.26), wake time after sleep onset (120.70 min, SD = 92.56), and an insomnia severity index (18.81, SD = 5.09). Of these 1,035 insomnia patients, 42 % also ranked a sleep breathing disorder among their list of reasons for seeking treatment, another 13 % revealed a concern about a sleep breathing problem, and another 26 % reported awareness of sleep breathing symptoms. Only 19 % of this clinical insomnia sample reported no awareness or concerns about sleep breathing disorders, problems, or symptoms. A greater proportion of men than women reported significantly more sleep breathing disorders, problems, or symptoms. Sleep breathing complaints were extremely common among a large sample of treatment-seeking, self-identified, adult chronic insomnia patients. Prospective prevalence research is needed to corroborate or revise these findings, and polysomnography should be considered in appropriate cohorts to determine the clinical relevance of treatment-seeking chronic insomnia patients' sleep breathing complaints.

Symptoms of insomnia among adolescents in the lower Rio Grande Valley of Texas.

PubMed

Roberts, Robert E; Lee, Eun Sul; Hemandez, Mike; Solari, Ana Cristina

2004-06-15

To estimate the prevalence of symptoms of insomnia among adolescents living along the United States-Mexico border and to examine whether ethnicity and birthplace affect risk for such symptoms. Cross-sectional school-based survey using a version of the 2001 Youth Risk Behavior Survey, modified to elicit data on sleep problems. A probability sample of 13 high schools selected from more than 40 high schools in the 4 southernmost counties in Texas-the Lower Rio Grande Valley-contiguous with Mexico. All ninth-grade students who agreed to participate (n = 5,118). The sleep module consisted of queries about trouble initiating asleep, trouble maintaining sleep, early morning waking, nonrestorative sleep, quality of sleep, and amount of sleep. Symptoms of insomnia were common, with 12.4% of respondents meeting symptom criteria for insomnia almost every day of the past month. Females were more likely to report insomnia, as were youths reporting lower socioeconomic status. Crude odds ratios suggested foreign-born and those who identified themselves as "Mexican" rather than "Mexican American" were at lower risk of insomnia. However, multivariate analyses eliminated these differences. More comparative research is needed to ascertain whether and how ethnic culture affects risk for disordered sleep.

Exploring sex and gender differences in sleep health: a Society for Women's Health Research Report.

PubMed

Mallampalli, Monica P; Carter, Christine L

2014-07-01

Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of well-established sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions.

Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report

PubMed Central

Mallampalli, Monica P.

2014-01-01

Abstract Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of well-established sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions. PMID:24956068

Sleep in adolescence: physiology, cognition and mental health

PubMed Central

Tarokh, Leila; Saletin, Jared M.; Carskadon, Mary A.

2016-01-01

Sleep is a core behavior of adolescents, consuming up to a third or more of each day. As part of this special issue on the adolescent brain, we review changes to sleep behaviors and sleep physiology during adolescence with a particular focus on the sleeping brain. We posit that brain activity during sleep may provide a unique window onto adolescent cortical maturation and compliment waking measures. In addition, we review how sleep actively supports waking cognitive functioning in adolescence. Though this review is focused on sleep in healthy adolescents, the striking comorbidity of sleep disruption with nearly all psychiatric and developmental disorders (for reviews see 1,2) further highlights the importance of understanding the determinants and consequences of adolescent sleep for the developing brain. Figure 1 illustrates the overarching themes of our review, linking brain development, sleep development, and behavioral outcomes. PMID:27531236

Links between sleep and daytime behaviour problems in children with Down syndrome.

PubMed

Esbensen, A J; Hoffman, E K; Beebe, D W; Byars, K C; Epstein, J

2018-02-01

In the general population, sleep problems have an impact on daytime performance. Despite sleep problems being common among children with Down syndrome, the impact of sleep problems on daytime behaviours in school-age children with Down syndrome is an understudied topic. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports of daytime behaviour problems among school-age children with Down syndrome. Thirty school-age children with Down syndrome wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Their parent and teacher completed a battery of measures to assess daytime behaviour. Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire, but not actigraph-measured sleep efficiency, was predictive of parent and teacher behavioural concerns on the Nisonger Child Behaviour Rating Form and the Vanderbilt ADHD Rating Scales. Actigraph-measured sleep period and parent-reported sleep duration on the Children's Sleep Habits Questionnaire was predictive of daytime parent-reported inattention. Actigraph-measured sleep period was predictive of parent-reported hyperactivity/impulsivity. The study findings suggest that sleep problems have complex relationships to both parent-reported and teacher-reported daytime behaviour concerns in children with Down syndrome. These findings have implications for understanding the factors impacting behavioural concerns and their treatment in school-age children with Down syndrome. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Maternal stress and psychological status and sleep in minority preschool children.

PubMed

Caldwell, Barbara A; Redeker, Nancy S

2015-01-01

Minority women living in inner city environments may be at more risk for psychological distress. Maternal stress, anxiety, depression, and psychological trauma can influence the preschool child's behavior and may have a negative impact on the preschool child's sleep patterns. The purpose of the study was to: (a) examine objective and subjective preschool children sleep patterns and (b) explore the relationship between objective and subjective sleep patterns in preschool children and maternal psychological status. A cross-sectional observational design was used. Descriptive analyses and correlations were conducted to examine the data. Twenty-one minority women were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children Program. Preschool children wore wrist actigraphs, and their sleep efficiency, time in bed, and sleep periods were analyzed. Mothers completed measures on depression, anxiety, stress, and psychological trauma. Mothers' self-report of their children's sleep habits indicated at risk scores for sleep problems. Life stress in the mothers was statistically significant and negatively related to preschool child's sleep duration. Mild to severe symptoms of depression and mild anxiety were reported and criteria for Post Traumatic Stress Disorder were found in 12 of the 21 mothers. The results of the study indicate that parent education on sleep and the minority preschool child should be part of community interventions and screening preschool parents for psychological distress should be considered with referrals for support services. © 2014 Wiley Periodicals, Inc.

A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation

PubMed Central

Williams, Jacob M.; McCrae, Christina S.; Rodrigue, James R.; Patton, Pamela R.

2016-01-01

Study Objectives: Sleep and fatigue difficulties appear to be highly prevalent among individuals with end-stage renal disease and individuals who have received a kidney transplant. While there is some evidence of biopsychosocial factors predicting sleep disturbance in these populations, previous studies have relied on single time point retrospective measurements. Methods: The study utilized a 2-week prospective measurement approach, including one night of polysomnographic measurement, nightly sleep diaries, and self-report measures of health, sleep, and mood. Results: The current study demonstrates that a number of psychological and behavioral factors, including negative mood, quality of life, napping, and caffeine consumption, are related to sleep disturbance among pre- and post-kidney transplant patients. This study also found that many of these factors have different relationships with sleep disturbance when comparing pre- and post-kidney transplant patients. Conclusions: These results suggest that such factors may be worthwhile areas for intervention in treating the symptoms of insomnia among pre- and post-transplant recipients. A nuanced approach to understanding sleep problems is likely warranted when conceptualizing insomnia and developing a treatment plan. Citation: Williams JM, McCrae CS, Rodrigue JR, Patton PR. A novel application of a biopsychosocial theory in the understanding of disturbed sleep before and after kidney transplantation. J Clin Sleep Med 2016;12(2):247–256. PMID:26350606

Sleep and Sleep Problems: From Birth to 3

ERIC Educational Resources Information Center

Du Mond, Courtney; Mindell, Jodi A.

2011-01-01

Sleep is an important aspect of a child's early development and is essential to family well-being. During their first 3 years, infants and toddlers spend more than 50% of their lives sleeping. However, concerns about sleep and sleep problems are among the most common issues brought to the attention of pediatricians. Although sleep is one of the…

Sleep Strategies of Night-Shift Nurses on Days Off: Which Ones are Most Adaptive?

PubMed Central

Petrov, Megan E.; Clark, C. Brendan; Molzof, Hylton E.; Johnson, Russell L.; Cropsey, Karen L.; Gamble, Karen L.

2014-01-01

Objectives: To determine the off-shift sleep strategies of bi-ethnic night-shift nurses, the relationship between these sleep strategies and adaptation to shift work, and identify the participant-level characteristics associated with a given sleep strategy. Methods: African-American and non-Hispanic White female, night-shift nurses from an academic hospital were recruited to complete a survey on sleep–wake patterns (n = 213). Participants completed the standard shiftwork index and the biological clocks questionnaire to determine sleep strategies and adaptation to night-shift work. In addition, chronotype was determined quantitatively with a modified version of the Munich ChronoType Questionnaire. Most participants worked ~3 consecutive 12-h night-shifts followed by several days off. Results: Five sleep strategies used on days off were identified: (a) night stay, (b) nap proxy, (c) switch sleeper, (d) no sleep, and (e) incomplete switcher. Nap proxy and no sleep types were associated with poorer adaptation to night-shift work. The switch sleeper and incomplete switcher types were identified as more adaptive strategies that were associated with less sleep disturbance, a later chronotype, and less cardiovascular problems. Conclusion: Behavioral sleep strategies are related to adaptation to a typical night-shift schedule among hospital nurses. Nurses are crucial to the safety and well-being of their patients. Therefore, adoption of more adaptive sleep strategies may reduce sleep/wake dysregulation in this population, and improve cardiovascular outcomes. PMID:25566182

How the design of a sleeping bag can support counter-measuring fatigue

NASA Astrophysics Data System (ADS)

Imhof, Barbara; Hoheneder, Waltraut; Vogel, Kaspar; Drudi, Laura

2013-10-01

The paper discusses six case studies of sleeping bag design, one used by astronauts onboard the Space Shuttle and another currently being used on the ISS, which was developed by a Russian company. Two inflatable designs, one by Wubbo Ockels for ESA and one by the University of Technology in Munich in cooperation with NASA are chosen as case studies as well. Two recent designs set a new paradigm and option of sleeping in zero-g. The cut of the sleeping bag of these two design case studies allows the person to relax and sleep in the neutral body position. They were developed by Toshiroh Ikegami from Kyoto City University of Arts and astronaut Chiaki Mukai for JAXA, and by the Vienna based team LIQUIFER Systems Group in cooperation with ESA-astronaut Gerhard Thiele. Currently there is an increased interest in astronauts' and cosmonauts' sleep quality and related comfort because analysis of their sleep quality showed that sleep during long exposure to microgravity does not always ensure good recovery of cognitive and functional capabilities. Present research in the area of sleep and performance preservation include studies by the Institute of Biomedical Problems (IBMP) in Moscow and the NASA-JSC study from the Behavioral Health and Performance Element Human Research Program about improving sleep quality on ISS. In the context of the paper the operational medical challenges of sleep quality will be described in order to establish the relevance of effective sleeping bag designs to support spaceflight crewmembers' well-being.

Childhood Abuse as a Risk Factor for Sleep Problems in Adulthood: Evidence from a U.S. National Study

PubMed Central

Lee, Chioun; Friedman, Elliot L.; Springer, Kristen W.

2011-01-01

Background Accumulating evidence indicates that stress impairs sleep quality. Few studies, however, have examined the extent to which early life stress can jeopardize sleep in adulthood. Purpose Guided by a life course epidemiological perspective on health, this study examined associations between childhood abuse and adult sleep problems. Methods We used data from 835 respondents in the National Survey of Midlife Development in the United States (MIDUS). Self-report measures assessed the frequency of physical, emotional, and sexual abuse in childhood, as well as global and component indicators of sleep problems in adulthood. Results Having experienced all three types of childhood abuse—even infrequently—was associated with global sleep pathology, as well as specific types of sleep problems. Reports of both frequent physical and frequent emotional abuse—even in the absence of sexual abuse—were also associated with poor sleep. Conclusions Childhood abuse is a risk factor for individuals’ long-term sleep problems. PMID:21656087

Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder.

PubMed

Murata, Emi; Mohri, Ikuko; Kato-Nishimura, Kumi; Iimura, Jiro; Ogawa, Makoto; Tachibana, Masaya; Ohno, Yuko; Taniike, Masako

2017-06-01

Obstructive sleep apnea (OSA) may affect daily cognitive functioning in children. The aims of our study were two-fold. The first aim was to detect, using the Child Behavior Checklist (CBCL), whether adenotonsillectomy (AT) for the treatment of OSA improved the behavior of children with autism spectrum disorder (ASD). The second aim was to identify characteristics for behavioral improvement following the treatment of OSA in these children with ASD. The behaviors of ASD children aged 5-14 years diagnosed as having OSA (n=30) were evaluated using CBCL before and after AT. CBCL evaluation of ASD children without OSA at two time points with the same interval served as a control (n=24). We statistically examined the two groups. In addition, we conducted a paired t-test to assess changes in CBCL Tscores between the improved group and unchanged/deteriorated group to identify characteristics that may affect behavioral changes following OSA treatment. After AT, T-scores of the CBCL scales were significantly improved in the OSA group, but no change was observed in the control. A paired t-test revealed that the improved group had significantly higher scores on the CBCL pre-AT than the unchanged/deteriorated group in ASD children with OSA after OSA treatment. Behavioral problems were significantly improved following AT in ASD children with OSA. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

[Preparation and effect of a behavioral science-based education program for sleep improvement among medical students].

PubMed

Ueda, Masumi; Adachi, Yoshiko; Hayama, Junko; Yamagami, Toshiko

2008-01-01

The present study aimed to investigate a simple education program that is effective for sleep improvement among medical students who will be medical doctors in the future. The education program applied in the present study was developed for sleep improvement based on behavioral science and changes in knowledge and sleeping habits were observed. Subjects were 6th-year medical students of 2002 and 2003. Students of 2002 attended a program including a 90-minute lecture and a 2-week practice learning session, and students of 2003 attended only the lecture. In the lecture, behavior therapy for chronic insomnia was explained using a booklet. In the practice learning session, students set a target behavior for improvement and conducted self-monitoring of their sleep and the targeted behavior. Changes in knowledge about sleep, attitude toward the therapy, sleep, and sleep-related habits were observed and compared between the 2 groups of subjects immediately and 2-weeks after the lecture. It was found that after both programs subjects had more knowledge about sleep than before. In the program including practice learning session, subjects' attitude for managing patients changed from before the lecture to after the lecture, and after the practice learning session. It was found that more than half of the students thought that they could provide sleep guidance based on the behavior therapy. Regarding the subjects' sleep, significant improvements were observed for "having nightmares upon falling asleep," "sleepiness during daytime," "sense of getting a sound sleep," and "mood upon waking up." Regarding sleep-related habits, significant improvements were observed for "taking a nap," "dozing off," and "eating breakfast." On the other hand, only the lecture subjects improved irregularity of bedtime and sleeping time. Although an increase in knowledge and improvement of sleep were observed among students who attended only the lecture, a further increase in knowledge and improvement of sleeping habits were observed among students who also attended the practice learning session. The results described herein suggest developing and providing a simple and convenient education program for sleep improvement was effective for increasing students' knowledge about sleep, developing improved coping methods regarding sleep, and improving sleep. It is also suggested that behavioral scientific instructive methods, including practice learning, are effective for medical education.

Insufficient sleep: Enhanced risk-seeking relates to low local sleep intensity.

PubMed

Maric, Angelina; Montvai, Eszter; Werth, Esther; Storz, Matthias; Leemann, Janina; Weissengruber, Sebastian; Ruff, Christian C; Huber, Reto; Poryazova, Rositsa; Baumann, Christian R

2017-09-01

Chronic sleep restriction is highly prevalent in modern society and is, in its clinical form, insufficient sleep syndrome, one of the most prevalent diagnoses in clinical sleep laboratories, with substantial negative impact on health and community burden. It reflects every-day sleep loss better than acute sleep deprivation, but its effects and particularly the underlying mechanisms remain largely unknown for a variety of critical cognitive domains, as, for example, risky decision making. We assessed financial risk-taking behavior after 7 consecutive nights of sleep restriction and after 1 night of acute sleep deprivation compared to a regular sleep condition in a within-subject design. We further investigated potential underlying mechanisms of sleep-loss-induced changes in behavior by high-density electroencephalography recordings during restricted sleep. We show that chronic sleep restriction increases risk-seeking, whereas this was not observed after acute sleep deprivation. This increase was subjectively not noticed and was related to locally lower values of slow-wave energy during preceding sleep, an electrophysiological marker of sleep intensity and restoration, in electrodes over the right prefrontal cortex. This study provides, for the first time, evidence that insufficient sleep restoration over circumscribed cortical areas leads to aberrant behavior. In chronically sleep restricted subjects, low slow-wave sleep intensity over the right prefrontal cortex-which has been shown to be linked to risk behavior-may lead to increased and subjectively unnoticed risk-seeking. Ann Neurol 2017;82:409-418. © 2017 American Neurological Association.

Using Multitheory Model of Health Behavior Change to Predict Adequate Sleep Behavior.

PubMed

Knowlden, Adam P; Sharma, Manoj; Nahar, Vinayak K

The purpose of this article was to use the multitheory model of health behavior change in predicting adequate sleep behavior in college students. A valid and reliable survey was administered in a cross-sectional design (n = 151). For initiation of adequate sleep behavior, the construct of behavioral confidence (P < .001) was found to be significant and accounted for 24.4% of the variance. For sustenance of adequate sleep behavior, changes in social environment (P < .02), emotional transformation (P < .001), and practice for change (P < .001) were significant and accounted for 34.2% of the variance.

A cohort study on self-reported role stressors at work and poor sleep: does sense of coherence moderate or mediate the associations?

PubMed

Hansen, Åse Marie; Grynderup, Matias Brødsgaard; Rugulies, Reiner; Conway, Paul Maurice; Garde, Anne Helene; Török, Eszter; Mikkelsen, Eva Gemzøe; Persson, Roger; Hogh, Annie

2018-05-01

The aim of the present study was to examine the bidirectional associations between subjective role ambiguity and role conflicts at work, respectively, and self-reported sleep 2 years later. In addition, we also examine whether sense of coherence (SOC) moderate or mediate the association between role stressors and poor sleep and between poor sleep and role stressors. We used questionnaire data collected in 2006 and 2008 from the Workplace Bullying and Harassment cohort. In 2006, 3363 responded to the questionnaire and in 2008 1671 responded. In total, 1569 participants responded in both 2006 and 2008 to the questions on role stressors (in terms of role ambiguity and role conflicts at work) and sleep problems in both 2006 and 2008. Sleep problems were assessed with the awakening index (AWI) and the disturbed sleep index (DSI). Moderation and mediation analyses of the association were estimated using structural equation modelling. We found a prospective association between role stressors and sleep problems [beta values were 0.07 (95% CI 0.03-0.11) and 0.05 (CI 0.01-0.10) for DSI and AWI, respectively] when adjusting for sleep problems at baseline, age, sex, and life style factors (i.e. alcohol, smoking, and leisure time physical activity). SOC moderated the association showing that participants with lower SOC scores who reported higher role ambiguity reported sleep problems to a higher extent than participants with high SOC scores. SOC also mediated the association between role stressors and sleep problems. We also found support for sleep problems at baseline and role stressors 2 years later [DSI 0.04 (CI 0.00-0.08) and 0.15 (CI 0.09-0.21)] for role ambiguity and role conflicts, respectively. Similar results were observed for AWI. Subjective role stressors were prospectively associated with sleep problems. Yet, sleep problems could also prospectively predict subjective role stressors (i.e. reverse causation). The analyses also showed that SOC may be regarded as both a mediating and a moderating factor of the association between subjective role conflicts and poor sleep. We found that SOC moderated the prospective association so participants with low SOC report more sleep problems with subjective role conflicts compared to participants with high SOC. Finally, we also found SOC mediated the prospective association between subjective role stressors and sleep problems and the reverse association.

Nigerian sleep study found that children slept less and had more problems than children in other countries.

PubMed

Senbanjo, Idowu O; Salisu, Mohammed A; Oshikoya, Kazeem A; Adediji, Uchechukwu O; Akinola, Ayodeji O

2018-03-12

We studied sleep patterns, sleep problems and associated socio-demographic factors among children aged one year to 12 years in Lagos, Nigeria. This prospective hospital-based study involved 432 children (55% males) who came for routine paediatric care at the Lagos State University Teaching Hospital. Information on socio-demographics, sleeping patterns and specific sleep disorders was obtained. The mean age of the subjects was 5.4 ± 3.3 years. Night sleep duration decreased significantly with age from 9.6 ± 1.3 hours at one to four years to 8.7 ± 1.0 hours at nine years to 12 years (p < 0.001). There was no significant gender difference in bedtimes (p = 0.057), rise times (p = 0.095) and night sleep duration (p = 0.191). Most (70%) napped during the day, and 26% of these did so on a regular basis. The most common sleep problems were enuresis (42%), afraid of sleeping alone (38%), snoring (28%) and sleep talking (24%). There was no significant association between sleep duration (p > 0.05), sleep problems (p > 0.05) and socio-demographic characteristics. Comparisons with other studies showed that the children had shorter sleep duration than peers in other countries and regions and a higher prevalence of sleep disorders. Children in Nigeria had shorter sleep duration and more sleep problems than children in other international studies. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

The Association Between Physical Activity, Sitting Time, Sleep Duration, and Sleep Quality as Correlates of Presenteeism

PubMed Central

Guertler, Diana; Vandelanotte, Corneel; Short, Camille; Alley, Stephanie; Schoeppe, Stephanie; Duncan, Mitch J.

2015-01-01

Objective: This study aims to examine the relationship of lifestyle behaviors (physical activity, work and non-work sitting time, sleep quality, and sleep duration) with presenteeism while controlling for sociodemographics, work- and health-related variables. Methods: Data were collected from 710 workers (aged 20 to 76 years; 47.9% women) from randomly selected Australian adults who completed an online survey. Linear regression was used to examine the relationship between lifestyle behaviors and presenteeism. Results: Poorer sleep quality (standardized regression coefficients [B] = 0.112; P < 0.05), suboptimal duration (B = 0.081; P < 0.05), and lower work sitting time (B = −0.086; P < 0.05) were significantly associated with higher presenteeism when controlling for all lifestyle behaviors. Engaging in three risky lifestyle behaviors was associated with higher presenteeism (B = 0.150; P < 0.01) compared with engaging in none or one. Conclusions: The results of this study highlight the importance of sleep behaviors for presenteeism and call for behavioral interventions that simultaneously address sleep in conjunction with other activity-related behaviors. PMID:25742538

Sleep Problems of Parents of Typically Developing Children and Parents of Children with Autism

ERIC Educational Resources Information Center

Lopez-Wagner, Muriel C.; Hoffman, Charles D.; Sweeney, Dwight P.; Hodge, Danelle; Gilliam, James E.

2008-01-01

Few researchers have investigated the relation of children's sleep problems to their parents' sleep problems. Children with autism have been reported to evidence greater sleep problems than do typically developing children (C. D. Hoffman, D. P. Sweeney, J. E. Gilliam, & M. C. Lopez-Wagner, 2006; P. G. William, L. L. Sears, & A. Allard, 2004). In…

Brief Report: Parental Descriptions of Sleep Problems in Children with Autism, Down Syndrome, and Prader-Willi Syndrome

ERIC Educational Resources Information Center

Cotton, Sue; Richdale, Amanda

2006-01-01

Children with an intellectual disability (ID) are at high risk of developing sleep problems. The extent to which the prevalence and nature of sleep problems in these children is dependent on the disorder underlying their intellectual impairments remains unclear. This study examined and compared parental descriptions of sleep problems in children…