The Effect of Massage Stimulation on Sleep Quality among Stunted Children

To investigate the sleep quality in children with allergic conjunctivitis (AC) and their parents. Prospective, case-controlled study. Zhongshan Ophthalmic Center, a tertiary referral centre. Participants comprised 73 children aged 4-12 years with AC and their parents, and 81 healthy, age-matched children who served as controls and their parents. General information was recorded and ocular manifestations of children with AC were scored. Sleep quality of the children and parents were assessed using Children's Sleep Habits Questionnaire (CSHQ) and Pittsburgh Sleep Quality Index (PSQI). Children with AC and their parents had reduced sleep quality (Children's CSHQ: 48.3 ± 6.55 vs. 38.8 ± 4.63; Parental PSQI: 5.62 ± 2.12 vs. 3.40 ± 1.90, both p < 0.001) and significantly higher prevalence of poor sleep quality (CSHQ ≥ 41 in Children: 89.0% vs. 23.5%; PSQI > 7 in Parents: 18.5% vs. 1.23%, both p < 0.001). Children with AC scored worse on subcomponents of CSHQ including sleep onset delay, sleep duration, parasomnia, sleep-disordered breathing, and daytime sleepiness. Parents scored worse on subscores of PSQI including sleep duration, sleep disturbances, use of sleeping medication, and daytime sleepiness. Poor sleep quality in children with AC was associated with follicle formation (OR:3.95; 95% CI: 1.88-8.31, p < 0.001) and keratitis (OR:6.03; 95% CI: 1.29-28.3, p = 0.028). Parental poor sleep quality was associated with follicle formation (OR:7.14; 95% CI: 2.06-24.8, p = 0.002) and keratitis (OR:4.49; 95% CI: 1.27-15.9, p = 0.020) in children. AC has a negative association with sleep quality in children and their parents, especially in those children with severe follicle formation and keratitis. Chictr.org.cn, https://www.chictr.org.cn/showproj.aspx?proj=43511 , ChiCTR1900027486. Allergic conjunctivitis is a frequently encountered problem diagnosed and managed by ophthalmologists, paediatricians, allergists, and primary care physicians and has become a major public health issue. Sleep is crucial for learning and effective development in children. Our study discovered a strong association between these two conditions. This is the first study to evaluate the association of allergic conjunctivitis and sleep quality in children and their parents. This case-controlled study found that allergic conjunctivitis had a negative impact on sleep quality not only for children but also for their parents. The findings of this study suggest a multifaceted impact of AC with sleep quality; detailed assessment of sleep quality for improved care of paediatric patients with allergic conjunctivitis would be useful.

Children's sleep habits are profoundly affected by socio-economic, cultural, and environmental factors. We aim to describe the sleep habits of pediatric sub-populations from Cape Verde and Mozambique using the Children's Sleep Habits Questionnaire, and to ascertain the determinants of the questionnaire's score. We conducted cross-sectional surveys in surveillance appointments in Cape Verde and in a school in Maputo (Mozambique). The Cape Verde sample included 206 children (mean age: 6.5) and the Mozambique sample 454 children (mean age: 8). The Portuguese version of the Children's Sleep Habits Questionnaire was used to evaluate the children's sleep habits. The distributions of the questionnaire's scores across different levels of the demographic variables were compared using the Mann-Whitney and the Kruskal-Wallis tests. We used regression models to quantify the relationship between the demographic variables and the questionnaire's scores. Cape Verde sample: Questionnaire median score: 50 (range 36 - 81). Prevalence of sleep problems: 29.9% (cut-off = 56). Prevalence of parent-reported sleep problems: 22.8%. Co-sleeping: 63%. Bedtime television: 30%. Daytime nap: 63%. Questionnaire scores are associated with the mother's educational level, the children's age group, and with the frequency of daytime napping. Mozambique Sample: Median Questionnaire score: 48 (range 35 - 77). Prevalence of sleep problems: 28.4% (cut-off: 52). Percentage of parent-reported sleep problems: 6.9%. Co-sleeping: 29%. Bedtime television: 33%. Daytime nap: 23%. Questionnaire scores are associated with the mother's nationality, the father educational level, and with the frequency of bedtime television. Parents tend to overestimate the quality of their children's sleep. The prevalence of sleep disturbances and the cut-off values are higher than observed in previous studies, which may be due to the existence of different standards and cultural expectations across populations. Bedtime television, typically associated with more disturbed sleep, is frequent in both samples. Co-sleeping and daytime napping are frequent in the Cape Verde sample; wetting the bed is common and more prevalent than in previous studies. Bed-sharing increases the parents' awareness of their children's sleep quality, contributing to the high prevalence of parent-reported sleep problems. Parent-reported sleep problems underestimate the Children's Sleep Habits Questionnaire results. This is not necessarily indicative of more disturbed sleep and might reflect differences in sleep behavior, childcare practice, and cognitions and attitudes towards the concept of 'normal' sleep.

Sleep problems in children with fetal alcohol spectrum disorders (FASD) are reportedly common but not well characterized. Objectives were to: (1) assess sleep concerns in children with FASD using a caregiver-report survey, the Children's Sleep Habits Questionnaire (CSHQ); (2) compare CSHQ results with those of previously reported community sample; and (3) describe pilot polysomnography findings in children with FASD. Children with FASD were recruited from a behavioral intervention study, and participating caregivers completed the CSHQ. CSHQ results were compared with the original data from a previously published community sample of similar age. Participants with FASD and elevated CSHQ scores were offered overnight polysomnography. Thirty-three children with FASD (4.1-12.1 years) were enrolled; 85% of children with FASD scored above the clinical cutoff Total Score of 41, reflecting marked sleep disturbance. Elevated subdomain scores occurred primarily in areas concerning for pediatric insomnia. Those with comorbid ADHD had elevated CSHQ on additional subdomains with no difference in Total Scores. Compared with the community sample, children with FASD had higher Total Scores on the CSHQ (52 vs. 39, p < 0.001). Polysomnography, completed in 5 subjects, revealed mild sleep disordered breathing and fragmented sleep with elevated non-respiratory arousal indices. Clinically significant sleep problems are present in children with FASD on both subjective and objective measures. Further investigation is needed to better describe these sleep disturbances and their impact on overall health and daytime neurobehavioral problems in this clinical population.

ObjectivesThis study analyzes the effects of sleep quality along with sleep duration and bedtime on BMI in children aged 3–12 years and explores their role in the occurrence and development of obesity in children.MethodsThis study conducted a cross-section study on children in 18 cities and counties of Hainan Province. The Children's Sleep Habits Questionnaire (CSHQ), along with a parents-report children's features survey, was used to assess children's sleep quality and habits, among other factors.ResultsThe multivariable analysis results showed that bedtime was positively correlated with childhood overweight or obesity. However, the relationship between the outcome and sleep duration in children remains uncertain. The results of the additive interaction model indicated that sleep duration between 9 and 11 h or 11 h and above, combined with poor sleep quality or earlier bedtime (before 21:00), served as protective factors against children's overweight or obesity. Conversely, children with adequate sleep duration but later bedtime had a higher risk of being overweight or obese [OR (odds ratio): 1.214, 95% CI: 1.069–1.379]. Children with sleep duration less than 9 h, regardless of bedtime, had an increased risk of adverse outcomes (OR: 1.394, 95% CI: 1.022–1.901; OR: 1.268, 95% CI: 1.039–1.548).ConclusionShort sleep duration (<9 h) and late bedtime (>22:00) independently and synergistically increase obesity risk, while adherence to recommended sleep patterns (9–11 h, bedtime before 21:00) offers protection. Non-linear analyses confirm a heightened obesity risk below 9 h of sleep, with partial attenuation beyond 11 h. Poor sleep quality paradoxically associates with lower obesity risk.

This cross-sectional study examined sleep disturbance associations between parents and their school-age children with overweight and obesity. A 7-day wrist-worn actigraph recording was performed on 246 children aged 6-9 years with overweight and obesity recruited from 10 public elementary schools in Taipei, Taiwan. Children's sleep disturbance was assessed using the Children's Sleep Habits Questionnaire. Parental subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index, with parental depressive symptoms measured using the Epidemiologic Studies-Depression Scale. General linear models were used to examine sleep disturbance associations within parent-child dyads. The results showed that 208 (84.6%) children had a clinically significant sleep disturbance score, and 123 (50%) parents had poor sleep quality. Higher children's sleep disturbance scores significantly predicted poorer parental sleep quality (b = 0.11, p < 0.001). Poorer parental sleep quality was associated with more severe sleep disturbances in children (b = 0.46, p < 0.001). This association was independent of children's actigraphic sleep (all p > 0.05) and was not attenuated by adjustment for parental depressive symptoms (b = 0.14, p < 0.001). Findings from our study suggest that sleep disturbances occur in both parents and their school-age children with overweight and obesity, with a significant bidirectional association between the two. Nurses and healthcare professionals should proactively assess and screen for sleep disturbances in parent-child dyads of children with overweight and obesity. Future studies should develop family-based sleep interventions and evaluate their effects on the sleep, health, and well-being of children with overweight and obesity and their parents.

This study investigates dietary patterns and sleep quality in children and adolescents on the autism spectrum, compared to non-autistic peers. It explores the relationship between dietary habits and sleep quality, aiming to identify modifiable factors that could enhance well-being in ASD individuals. A cross-sectional case-control study was conducted with 158 participants on the autism spectrum and 77 non-autistic individuals aged 6-17years in Spain. Dietary patterns were assessed using a validated food frequency questionnaire, while sleep quality was measured with the Children's Sleep Habits Questionnaire (CSHQ-SP) and Pittsburgh Sleep Quality Index (PSQI). Statistical analyses, including non-parametric tests and Spearman's correlation, were performed to examine differences and associations. Children on the autism spectrum displayed higher sugar intake and lower consumption of fruits and vegetables compared to non-autistic peers. ASD adolescents consumed more sugary beverages, with less pronounced differences in other food categories. Sleep quality was significantly poorer in the ASD group across all age cohorts, characterized by increased sleep latency, parasomnias, and daytime dysfunction. Positive associations were found between fruit and vegetable intake and improved sleep quality in ASD children. Unexpectedly, adolescents on the autism spectrum showed a complex relationship between sugar consumption and sleep quality, indicating potential short-term benefits but long-term risks. This study highlights the interplay between diet and sleep quality in ASD populations. Interventions promoting healthier eating habits, such as increased fruit and vegetable intake and reduced sugar consumption, could improve sleep outcomes and overall well-being in this vulnerable population.

Sleep is one of the important measurements of the quality of life for children especially suffering from a chronic illness such as cancer. Our aim was to determine the changes in sleep quality and to investigate the effect of virtual reality-based exercise (VRBE) approaches on sleep in patients with acute lymphoblastic leukemia (ALL) off treatment. The participants (ALL and healthy siblings) were evaluated for sleep quality with polysomnography and "Children's Sleep Habit Questionnaire" before and after 12 weeks. The study randomized into two groups: an exercise group who received VRBE in two days in a week, 45 min of each session for 12 weeks and an control group who were managed with supportive measures. The VRBE comprised of aerobic exercise in four different games by Nintendo Wii Fit Plus®. This randomized controlled trial was carried out on 38 participants. Before intervention, ALL patients (n = 24) and healthy siblings (n = 14) had similar sleep quality in terms of polysomnography and Children's Sleep Habit Questionnaire findings. After intervention, total time asleep (p = 0.023), respiratory disturbance index of hypopnea (p = 0.005), apnea/hypopnea index (p = 0.008), and number of apnea (p = 0.028) statistically significant improved. Patients with ALL off treatment had similar values of sleep quality with healthy siblings. Novel types of exercises like VRBE have positive effects on sleep disorders in children with ALL and also healthy siblings. Future studies are needed comparing the different types of interventions.

Child perception and parent's perception about child sleep quality.

BackgroundThe atopic dermatitis (AD) can limit a patient's physical and psychosocial development as well as lower their overall quality of life (QOL), including sleep quality.ObjectiveThe purpose of this study was to evaluate the relationships between clinical disease severity, QOL and sleep quality in children and adults with AD.MethodsThe SCORing atopic dermatitis (SCORAD) was examined to evaluate the severity of AD in fifty adult AD patients and 50 children AD patients. A questionnaire based on the children's sleep habits questionnaire (CSHQ) and the children's dermatology life quality index (CDLQI) were used to evaluate QOL and sleep disturbance in children AD patients. The Pittsburgh sleep quality index (PSQI) and dermatology life quality index (DLQI) were used in adult AD patients.ResultsThe SCORAD and CSHQ score, the SCORAD and CDLQI score and the CSHQ and CDLQI score demonstrated significant correlations. The SCORAD and PSQI score showed no significant correlation. However, there were significant correlations between the SCORAD and DLQI score and the PSQI and DLQI score.ConclusionIncreasing severity of AD affects sleep quality in child AD patients. In adults, even though the total score of the sleep questionnaire is not associated with the severity of AD, two components of sleep questionnaire are associated with the severity of AD. There is a significant correlation between sleep quality and QOL in both children and adults. Therefore, we suggest that evaluating the sleep quality as well as clinical severity of the disease is necessary in the management of AD patients.

Sleep quality and depression in mothers of children with epilepsy and its relation to their children’s sleep

The aim of this clinical trial was to determine the effects of melatonin administration on disease severity and sleep quality in children diagnosed with atopic dermatitis (AD). This randomized, double-blinded, placebo-controlled trial was conducted by recruiting 70 patients, aged 6-12years, who had been diagnosed with AD. Study participants were randomly allocated into two intervention groups to receive either 6mg/d melatonin supplements or placebo (n=35 each group) for 6weeks. Severity of disease was assessed using the scoring atopic dermatitis (SCORAD) and objective SCORAD indices. Sleep quality was evaluated by completing the Children's Sleep Habits Questionnaire (CSHQ). Following 6weeks of intervention, melatonin supplementation significantly improved SCORAD index (β -3.55; 95% CI, -6.11, -0.98; P=0.007), objective SCORAD index (β -3.23; 95% CI, -5.08, -1.38; P=0.001), serum total IgE levels (β -153.94ku/L; 95% CI, -260.39, -47.49; P=0.005), and CSHQ scores (β -2.55; 95% CI, -4.34, -0.75; P=0.006). However, melatonin had no significant impact on pruritus scores, high-sensitivity C-reactive protein (hs-CRP), sleep-onset latency, total sleep time, weight, and BMI compared with placebo. Overall, melatonin supplementation had beneficial effects on disease severity, serum total IgE levels, and CSHQ among children diagnosed with AD.

Background: Children with autism often experience sleep disturbances with normal development. Physical activity is known as one of the recommended non-pharmacological interventions to improve sleep quality. Objectives: This study aims to determine the effect of physical activity on sleep quality in children with Autism Spectrum Disorder (ASD). Methods: Quantitative study of quasi-experimental model with non-random pretest-posttest with control group design. The sample of this study was 30 ASD children aged 4-17 years and had sleep disturbances through measurement with The Children's Sleep Habits Questionnaire (CSHQ) instrument. The intervention group received a home jogging/walking program for 3 weeks with a duration of 30 minutes each day. The control group did daily physical activities as usual. Results: The results of data analysis using paired t-test in the intervention group obtained a p-value of 0.00 (&lt;0.05) so that it was known that there was a difference in the average pretest-posttest score of sleep quality. The results of data analysis using paired t-test in the control group obtained a p-value of 0.057 (&gt; 0.05) so that it is known that there is no difference in the average score of pretest-posttest sleep quality. The results of data analysis using independent t-test obtained a p-value of 0.00 (&lt;0.05). Conclusion: This shows that there is a significant difference between the intervention group and the control group and the provision of physical activity in the form of a home jogging/walking program has an effect on sleep quality in children with ASD Keywords : Keywords: Sleep quality, Physical activity, Autism Spectrum Disorder (ASD)

China has undergone massive socioeconomic change during the past several years, and its impact on children's sleep is still unrecognized. Shanghai, as one of typical economically fast-developing cities, was chosen as observational city in this study, which was designed to explore trends in sleep quality in Shanghai school-aged children and related high risk factors on sleep quality. Totally 884 fifth grade school-aged students were sampled by stratified cluster random sampling method from 10 primary schools of Shanghai in 2005, then four years later in 2009, 2161 same grade students were sampled from the same schools. Chinese version of Children's Sleep Habits Questionnaire (CSHQ) was used to evaluate 8 sleep quality parameters among those children, and high risk factors on school-aged children's sleep quality were investigated as well. The prevalence of poor sleep quality decreased from 29.2% in 2005 to 27.9% in 2009, and among 8 sleep quality parameters, bedtime resistance decreased from 33.1% to 28.7%, sleep anxiety from 50.6% to 39.8%, night waking from 25.2% to 21.5%, and parasomnia from 51.2% to 45.8%. The factors, such as heavier homework burden, longer daily computer use, bright light during sleep, cosleeping, existence of chronic disease and irregular sleep habits of parents, were associated with poor sleep quality of school-aged children after adjusting for children's age, gender, and family social-economic status. Part of sleep quality parameters improved during the past 4 years, but current situation is still tough with more than 1/4 poor sleep quality children. Helping children to develop good sleep hygiene as well as educating parents how to shape children's regular sleep habits might be effective methods to improve children's sleep quality.

Introduction Sleep is crucial for parents of young children, especially given its influence on parental sensitivity. Yet, parents’ sleep has been shown to be influenced by child sleep disturbances, which remain common during toddlerhood and the preschool years. Furthermore, child sleep disturbances have been linked to parenting stress, which is in turn associated with parental sleep. Therefore, this study aimed to investigate the potential mediating effect of parenting stress on the association between child sleep disturbances and parental sleep quality. Methods Participants included 68 parents (91.2% mothers, age M = 34.07, SD = 5.37) of children aged between 29 and 72 months. Child sleep quality, parental sleep quality and parenting stress were measured using the Children’s Sleep Habits Questionnaire, the Pittsburgh Sleep Quality Index and the short form of the Parenting Stress Index respectively. For all measures, higher scores represent more difficulties in the corresponding component (i.e., worse sleep and more stress). A multiple regression analysis was conducted to assess the mediating effect of parenting stress on the relationship between child and parent sleep quality, while controlling for parent age, education and ethnicity. Results The model with all predictors was significant F(5, 62)=7.76, p &amp;lt;.001 and explained 38.50% of the variance in parental sleep quality. Results suggest a significant indirect pathway from child sleep quality to parenting stress to parental sleep quality (b =.05, 95% CI [.005,.103]). Conclusion These results suggests that the relationship between child and parent sleep quality are partially explained by its effect on parenting stress. While child sleep quality remains the strongest predictor of parental sleep quality, parenting stress can partly explain how child sleep disturbances contribute to parental sleep quality by accentuating its influence. Therefore, parenting stress should be considered when adressing parent and child sleep. Support (if any)

ObjectiveWe leveraged an observational, repeated-measures study to examine the within-child associations between sleep quality and emotional self-regulation, controlling for between-child effects.MethodsChildren aged 3–5 years and one parent each were recruited from the community in northern New England between 2019 and 2022. Parents completed online surveys at baseline and 2, 4, and 6 months post-baseline. Child sleep quality was measured with the validated Children's Sleep Habits Questionnaire modified for preschoolers; higher scores indicate worse sleep quality (range 32–96). Child emotional self-regulation was measured with the validated Child Social Behavior Questionnaire; higher scores indicate better emotional self-regulation (range 1–7). Adjusted mixed-effects linear regression was used to model the associations between nighttime sleep quality (exposure) and emotional self-regulation (outcome) measured at each of the four study time points while disaggregating the between- and within-child effects.ResultsChildren (n = 91) were largely white, non-Hispanic (88.7%), and from a higher social-economic status. Sleep quality scores averaged 38.9 (SD: 6.6) at baseline; 23.1% of children had scores &amp;gt;41, which is considered evidence of significant sleep problems. Emotional self-regulation scores averaged 4.2 (SD: 1.0). There was a significant within-child association between sleep quality and emotional self-regulation. Specifically, a decrease in sleep quality at any one time point, relative to each child's mean sleep quality, related to worse emotional self-regulation [standardized beta, βs = −0.31; 95% CI (0.53, −0.09)]; the between-child effect was not significant. Results were consistent when limited to children with complete data at all study visits (n = 78).ConclusionsThe findings support a causal, within-child association between sleep quality and emotional self-regulation in preschool-aged children, with effects evident over 6 months.