Sleep Disturbances In Children Research Articles

Five-year follow-up of a clinic-based sleep intervention for paediatric epilepsy: A randomized clinical trial.

Sleep disturbances in children with epilepsy are prevalent, and are associated with substantial adverse medical and psychosocial consequences. This study is a 5-year follow-up of a clinic-based sleep intervention study that randomized 100 toddlers and preschool-age children with epilepsy to a usual care group or a sleep intervention group. The intervention group received standard paediatric neurology care plus three education sessions during the child's routine clinic visit. The outcomes measured were: (1) child sleep by actigraphy and parental report; and (2) maternal sleep and depression. We aimed to evaluate the long-term benefits of a clinic-based sleep intervention for paediatric epilepsy. In total, 42 families (42.0%) participated. The average child's age at follow-up was 9.55 years. Thirty-eight (90.5%) children were not obtaining sufficient sleep at baseline, and 40 (95.2%) at the 5-year follow-up. The numbers of children with clinically significant sleep disturbances were 40 (95.2%) at baseline and 36 (85.7%) at the 5-year follow-up. Fourteen mothers (33.3%) had poor sleep quality and high depressive symptoms at both assessment time points. There were no differences (P > 0.05) in the child and maternal outcomes between the two trial arms. Overall, there was no evidence that a clinic-based sleep intervention that effectively improved multiple aspects of sleep in toddlers and preschool-age children with epilepsy had long-lasting beneficial effects. Our findings suggest that sleep interventions for families of children with epilepsy require ongoing reinforcement and monitoring during routine paediatric neurology care to prevent sleep problems from persisting or recurring.

Sleep Disordered Breathing in Children with Autism Spectrum Disorder: An In-Depth Review of Correlations and Complexities.

Sleep-disordered breathing is a significant problem affecting the pediatric population. These conditions can affect sleep quality and children's overall health and well-being. Difficulties in social interaction, communication, and repetitive behavioral patterns characterize autism spectrum disorder. Sleep disturbances are common in children with ASD. This literature review aims to gather and analyze available studies on the relationship between SDB and children with autism spectrum disorder. We comprehensively searched the literature using major search engines (PubMed, Scopus, and Web of Science). After removing duplicates, we extracted a total of 96 records. We selected 19 studies for inclusion after a thorough title and abstract screening process. Seven articles were ultimately incorporated into this analysis. The research findings presented herein emphasize the substantial influence of sleep-disordered breathing on pediatric individuals diagnosed with autism spectrum disorder (ASD). These findings reveal a high incidence of SDB in children with ASD, emphasizing the importance of early diagnosis and specialized treatment. Obesity in this population further complicates matters, requiring focused weight management strategies. Surgical interventions, such as adenotonsillectomy, have shown promise in improving behavioral issues in children with ASD affected by OSA, regardless of their obesity status. However, more comprehensive studies are necessary to investigate the benefits of A&T treatment, specifically in children with ASD and OSA. The complex relationship between ASD, SDB, and other factors, such as joint hypermobility and muscle hypotonia, suggests a need for multidisciplinary treatment approaches. Physiotherapy can play a critical role in addressing these intricate health issues. Early sleep assessments and tailored weight management strategies are essential for timely diagnosis and intervention in children with ASD. Policy initiatives should support these efforts to enhance the overall well-being of this population. Further research is crucial to understand the complex causes of sleep disturbances in children with ASD and to develop effective interventions considering the multifaceted nature of these conditions.

Telehealth parent training for sleep disturbances in young children with autism spectrum disorder: A randomized controlled trial

Background and purposeYoung children with autism spectrum disorder (autism) have bedtime and sleep disturbances at much higher frequency and persistency than their neurotypical counterparts. Hence, access to early, effective treatment is critical in view of the importance of sleep in early childhood. Telehealth delivery could be a means to expand access to such early treatment if efficacious. The aim of this randomized control trial (RCT) was to compare a manualized, telehealth delivered, behaviorally based sleep parent training (SPT) intervention for parents of young children with autism and sleep disturbances to a control condition, a telehealth delivered parent education program with one sleep focused session (SPE). We hypothesized that the SPT group would show more improvements on child measures of sleep outcome measures, and daytime behaviors and parent measures of stress and sense of competence. We further aimed to explore the overall feasibility of telehealth delivery of SPT and SPE. Participants and methodsParents of 77 young children, ages 2–7 years, with autism and co-occurring sleep disturbances were enrolled in this study. Participants were randomized to either SPT or a comparison arm that included non-sleep related parent education except for one session. Each participant was individually administered a 5 session program delivered over 10 weeks. Outcome measures, including child sleep measures, child daytime behavior and parent stress and sense of competency were collected at weeks 5 and 10 after the baseline time point. Feasibility indicators (treatment fidelity, parent adherence, and parent attendance), and safety measures were also collected. ResultsOf 77 randomized participants, data were available for 36 participants randomized to SPT and 38 participants randomized to SPE. The mean age was 3 years, 8 months. Results support the efficacy of this manualized SPT intervention for bedtime and sleep disturbances. Sleep outcome measures were significantly improved in the SPT group compared to SPE on the Modified Simonds & Parraga Sleep Questionnaire-Composite Sleep Index (MSPSQ – CSI) (p < 0.001) with a large effect size of 0.83 at week 10. Positive response to treatment, as determined from the Clinical Global Impression-Improvement scale (CGI-I) at week 10 was observed in 56% of SPT participants compared to 32% in SPE (p = 0.037). There were no significant group differences in either the ABC-I as measure of daytime behaviors or in parental stress. There were group differences in favor of SPT over SPE on the PSOC, a measure of parent sense of competency. Feasibility and safety were further demonstrated with telehealth delivery. ConclusionsThis RCT demonstrated the efficacy of a telehealth delivered parent training intervention for bedtime and sleep disturbances in young autistic children compared to an active control condition. Further, parents in SPT reported more confidence in their parenting role than those in the SPE group, but SPT did not result in overall decreases in parental stress. Telehealth delivery allowed for a much broader reach with enrolled participants from 24 states. This study supports a telehealth approach to a manualized behavioral parent mediated intervention for sleep disturbance in young autistic children and offers an alternative to in-person delivered approaches. This telehealth delivery has the potential to improve access for families who have a young autistic child with sleep disturbances. Given the small sample size, determining predictors and moderators of treatment response was not possible and should be examined in a larger trial.

Pengaruh Akupresure Terhadap Kuantitas Tidur Balita

Background : Sleep disturbances in children are often complained of by parents, where sleep disturbances in children under five are 44.2%. A toddler's sleep quantity will greatly affect his growth, if a child has poor sleep quantity (&lt;11 hours/day) then this will also have a negative impact on the child's growth. Interventions that can be done to meet toddlers' sleep needs are by means of acupressure therapy. Acupressure is stimulation of acupuncture points with pressure that stimulates sensory nerve cells in the acupuncture point area thereby increasing local endorphins production and relieving pain in certain areas. Purpose: To analyze the effect of acupressure on the quantity of sleep for toddlers in the RW 12 Rejosari Karanggeneng Boyolali area. Method : This type of research is pre-experimental with one grub design (before and after) treatment. The sample obtained is from the calculation of the freeder formula plus 30% of the total sample calculation results, namely as many as 21 toddlers. Results: The results of the study with the Wilcoxon Signed Rank test obtained a P value = 0.000 where the P value is smaller ? (0.005) meaning that there is an effect of giving acupressure on the quantity of sleep for toddlers. Conclusion: There is an effect of acupressure on the quantity of sleep for toddlers in the RW 12 Rejosari Karanggeneng Boyolali area.

Sleep, internalizing symptoms, and health-related quality of life in children with neurodevelopmental disorders: a cross-sectional analysis of cohort data from three research programs in Canada

ObjectiveThe objectives of this study were to determine rates of sleep disturbances in children with neurodevelopmental disorders (NDDs) within and across disorders and compared to typically developing (TD) children and to describe differences above and below the clinical cut-off for sleep disturbances. In addition, we explored the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and health-related quality of life (HRQOL) in children with NDDs.MethodWe conducted cross-sectional data analyses of an existing database with community-dwelling children with NDDs (n = 1438) and TD children (n = 140) aged 4–12 years. Parent-reported measures on sleep disturbances using the Children's Sleep Habits Questionnaire (CSHQ), internalizing symptoms using the Revised Children's Anxiety and Depression Scale, and HRQOL using the KINDL-R were assessed. Hierarchical linear regression examined the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and HRQOL in children with NDDs.ResultsChildren with NDDs (8.5 ± 2.1 years, 69.9% M) had significantly greater total sleep disturbance index (TSDI) than TD children [(8.6 ± 2.3 years, 60.0% M) (mean difference = 6.88 [95% CI 5.37, 8.40]; p &amp;lt; 0.001) (n = 838 NDDs (58.3%); n = 120 TD (86.7%)]. Children with severe NDDs reported significantly greater TSDI above the clinical cut-off (i.e., ≥41; CSHQ) than those with less severe NDDs (p &amp;lt; 0.001). Internalizing symptoms (β = −0.082 [95% CI −0.144, −0.019]; p = 0.011) and TSDI (β = −0.226 [95% CI −0.380, −0.073]; p = 0.004) were significantly associated with HRQOL in children with NDDs.ConclusionSurveillance and management of sleep and internalizing symptoms are needed to improve HRQOL in children with NDDs. Commonalities in sleep disturbances for children with NDDs support transdiagnostic interventions to treat sleep.

Protocol for the safety and efficacy of fecal microbiota transplantation liquid in children with autism spectrum disorder: a randomized controlled study.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction, repetitive behavior and language impairment, and its worldwide prevalence has been found to be increasing annually in recent years. Till now, ASD is uncurable as its pathogenesis remains unknown. However, studies on both animals and humans have demonstrated that fecal microbiota transplantation (FMT) may ameliorate the symptoms of ASD, as well as gastrointestinal symptoms. Nonetheless, there is still no agreement regarding the optimal dosage or duration of FMT treatment for individuals with ASD. This clinical study is a double-blind, randomized, interventional trial conducted at a single center. The aim is to investigate the safety and efficacy of a pediatric formulation of FMT for ASD. A total of 42 children between the ages of 3-9 with ASD will be randomly assigned in a 2:1 ratio to either an FMT treatment group (n = 28) or a placebo group (n = 14), forming cohort 1. Additionally, 30 healthy children of similar age and gender will be recruited as the control group (cohort 2). Cohort 1 will be assessed using a variety of scales, including the Autism Behavior Checklist, Childhood Autism Rating Scale, Social Responsiveness Scale, Gastrointestinal Symptom Rating Scale, Children's Sleep Habits Questionnaire, and Psychoeducational Profile (Third Edition). These assessments will evaluate the effectiveness of FMT in reducing core symptoms and comorbidities (such as gastrointestinal symptoms and sleep disturbances) in children with ASD. The study will use metagenomic and metabolomic sequencing to assess changes in the composition and structure of the intestinal flora and its metabolites in blood, urine, and feces following treatment. Furthermore, the study will evaluate the acceptability of the FMT formulation by participants' legal guardians and investigate differences in the intestinal flora and metabolism in the FMT group before and after treatment compared to 30 healthy children. https://www.chictr.org.cn/, identifier ChiCTR2200058459.

Association between Maternal Personality Traits and Children's Sleep Disturbance: A Population-based Cohort Study in Republic of Korea.

Sleep affects the development and severity of psychiatric symptoms in children, and maternal personality traits may influence children's sleep. We aimed to confirm the longitudinal effect of maternal personality traits on children's sleep disturbance using cohort data from the Panel Study on Korean Children. Maternal personality traits were assessed using the Personality Assessment Inventory in 2009, and the sleep disturbance of children was assessed using parent survey data from 2010 to 2014 (2nd-6th waves). Among the 11 clinical scales of the Personality Assessment Inventory, the 5 scales that showed the most significant correlations were analyzed. Presence or absence of child sleep disturbance was evaluated with a chi-square test, and the effect of the Personality Assessment Inventory was assessed by a binary logistic regression analysis with child sleep disturbance as the dependent variable. Of the 171 mother-child dyads, 92 were classified into the sleep disturbance group and 79 were classified into the normal sleep group. Maternal somatic concerns showed a significant relationship with children's sleep disturbance at years 2 and 3. Maternal borderline features demonstrated a significant relationship with children's sleep disturbance from years 2 to 5. The binary logistic regression analysis revealed a significant association between high borderline features and children's sleep disturbance at years 2 and 3. High maternal borderline features evaluated at child age 1 were related to sleep disturbance in early childhood. In assessing a children's sleep problems, it may be important to examine mothers' dysfunctional personality traits.

Exercise and autism: exploring caregiver insights on exercise participation and sleep patterns in autistic children in Aotearoa New Zealand

IntroductionAutistic children experience sleep disturbances at a higher rate than do neurotypical children. It has been argued that sleep disturbances negatively impact behavior, exacerbate learning difficulties, and decrease the quality of life among autistic children. Increasing exercise has been proposed to address sleep disturbances, however, little is known about how exercise might best be promoted for autistic children in Aotearoa New Zealand. Here, we explored caregivers' lived experiences of their autistic child's sleep disturbances and participation in exercise.MethodsSemi-structured interviews were conducted with 15 mothers of autistic children aged between 5 and 10. Mothers also completed the Sleep Disturbances Scale for Children (SDSC).ResultsScores on the SDSC indicated that there was considerable variation in sleep disturbance severity. Eight themes were identified from the interviews: sleep disturbances, the impact of exercise on sleep, exercise activities, whānau involvement in exercise, barriers for participation in exercise, support for participation in exercise, sensory considerations for participation in exercise, and activities specifically for children with special needs.ConclusionsOur findings highlight how challenging sleep disturbances can be for autistic children and their families and how participation in exercise can be promoted to potentially minimize their negative impact.

Understanding the impacts of childhood adversity on sleep problems in children with fetal alcohol spectrum disorder: A comparison of cumulative and dimensional approaches.

The developmental impacts of prenatal alcohol exposure (PAE) and postnatal exposure to adversity are typically considered in isolation. However, both contribute independently to sleep problems. Children with fetal alcohol spectrum disorder (FASD) have PAE and significant sleep disturbances. What is not clear is the relative contribution to these disturbances of exposure to early life adversity. This study examined how exposure to such adversity impacts frequent insomnia symptoms and nightmares in children with FASD and "At Risk" designations. We compared two approaches to modeling adversity in children who had undergone a diagnostic assessment for FASD: a cumulative risk approach that sums adversities to create a total score and an approach that treats exposure to threat and deprivation as independent dimensions. Data on caregiver-reported exposure to adversity and sleep problems for 63 children (aged 3 years 4 months to 7 years 8 months) were extracted from clinical archives. Cumulative risk, threat exposure, and deprivation exposure scores were computed and were tested as predictors of insomnia symptoms and nightmares. All analyses controlled for age and gender. There were high rates of caregiver-reported sleep problems with 60.3% (n = 38) of children having nightmares and 44.4% (n = 28) having a frequent insomnia symptom. The cumulative risk analysis showed that for every additional exposure to adversity, the odds of having a caregiver-reported insomnia symptom increased by 38%. The dimensional analysis showed no relationship between deprivation and sleep problems. However, every additional exposure to threat increased the odds of nightmares by 93%. Exposure to postnatal adversity contributes to sleep disturbances in children with FASD, with unique roles for cumulative risk and the threat dimension of adversity. The implications of these findings for the etiology and treatment of sleep disturbances in children with FASD are discussed.

A Cross-Sectional Study of Sleep Disturbances in Children and Adolescents With Abdominal Pain-Associated Disorders of Gut-Brain Interaction.

The aims of the current study were to determine the frequencies of specific sleep disturbances in youth with abdominal pain-associated disorders of gut-brain interaction (AP-DGBIs) and to assess relationships with psychological dysfunction. This was a retrospective evaluation of 226 consecutive patients diagnosed with an AP-DGBI. All had undergone a systematic evaluation of gastrointestinal symptoms, the Sleep Disturbance Scale for Children, and the Behavior Assessment System for Children. Disorders of initiation and maintenance of sleep (DIMS; 40%) and disorders of excessive daytime somnolence (DOES; 14%) were each present in more than 10% of the patients. Both DIMS and DOES scores were more likely to be elevated in patients with anxiety and/or depression scores in the at-risk or elevated-risk ranges. Sleep disorders are common in youth with AP-DGBIs and are associated with anxiety and depression, even in those patients with anxiety and depression in the at-risk range.

Caregiver Perceived Stress and Child Sleep Health: An Item-Level Individual Participant Data Meta-Analysis.

Up to 50% of children and adolescents in the United States (U.S.) experience sleep problems. While existing research suggests that perceived stress in caregivers is associated with poorer sleep outcomes in children, research on this relationship is often limited to infant and early childhood populations; therefore, we investigated this association in school-age children and adolescents. We used cross-sectional caregiver-reported surveys and applied item response theory (IRT) followed by meta-analysis to assess the relationship between caregiver perceived stress and child sleep disturbance, and moderation of this relationship by child age and the presence of a child mental or physical health condition. We analyzed data from the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) Program, a collaboration of existing pediatric longitudinal cohort studies that collectively contribute a diverse and large sample size ideal for addressing questions related to children's health and consolidating results across population studies. Participants included caregivers of children ages 8 to 16 years from four ECHO cohorts. Caregiver perceived stress was measured using the Perceived Stress Scale (PSS), and child sleep disturbance was assessed using five sleep-related items from the School-Age version of the Child Behavior Checklist (CBCL). Increases in caregiver perceived stress and child mental or physical health condition were independently associated with greater sleep disturbance among children. The findings reinforce the importance of accounting for, and potentially intervening on, the broader family context and children's mental and physical health in the interest of improving sleep health.

Interventions for Disrupted Sleep Patterns and Insomnia in Pediatric and Adolescent Populations Diagnosed with ASD

The objective of this study is to develop a set of recommendations for effectively addressing sleep disturbance in adolescents and children with autism spectrum disorder (ASD). This will be achieved through a comprehensive evaluation of both pharmacological and non-pharmacological approaches utilised in the treatment of sleep disruptions in this specific population. Healthcare professionals who are providing care for adolescents and children with ASD and experiencing sleep disturbances should actively investigate potential underlying factors contributing to the disruption, such as medication usage or the presence of comorbid conditions. Subsequently, it is crucial for clinicians to address these identified causes in order to effectively manage the sleep disturbances. When managing sleep disturbance, it is advisable for clinicians to first suggest behavioural interventions, either independently or in combination with pharmacological or nutraceutical treatments, in order to facilitate improved sleep for children and their families. In cases where behavioural interventions prove ineffective and comorbid conditions and concurrent drug usage have been appropriately managed, healthcare professionals may contemplate the administration of melatonin, commencing with a conservative dosage. It is advisable to recommend melatonin of pharmaceutical grade if it is readily available for clinical use. It is incumbent upon healthcare professionals to engage in comprehensive discussions regarding the potential advantages and drawbacks associated with the utilisation of melatonin among paediatric patients, adolescents, and their guardians.

Symptoms mediate the relationship between childhood trauma and non-suicidal self-injury: A hospital-based study of adolescents with mood disorder.

Childhood trauma has a significant impact on the development of adolescents, which may lead to interpersonal and psychological problems. Determining the incidence and consequences of childhood trauma in psychiatric clinical practice is of great significance. A survey was conducted among adolescents with mood disorders. Childhood Trauma Questionnaire (CTQ), the Adolescent Non-Suicidal-Self-Injury Behavior Function Assessment Scale (ANBFAS) and a series of psychological scales were filled face to face. Path analysis was used to examine the causation structure of childhood trauma-related symptoms. A total of 117 participants (74.5%) had experienced at least one type of trauma. Interpersonal and psychological features of adolescent patients with childhood trauma were detailed in this study. The path analysis model showed that the relationships between childhood trauma and NSSI were mediated by depressive symptoms and thinking disorders, respectively, whereas depressive symptoms individually mediated the correlation between childhood trauma and sleep disturbances in adolescent patients with psychiatric disorders (χ2 /df = 1.23). For adolescent patients with childhood trauma, psychological counseling for interpersonal relationships should start with families and peers. It is important to treat their depressive symptoms and thinking disorders and alleviate NSSI behavior and sleep disorders.

Factors associated with melatonin use in child sleep disturbance: A survey of Australian parents

ObjectiveSleep disturbances are prevalent in Australian children and cause a significant amount of stress to both children and their parents. If sleep disturbances are left untreated, they can result in detrimental consequences to both child and parental wellbeing. While behavioural interventions are recognised as the gold standard treatment for paediatric insomnia, there is a growing use of melatonin from both prescription and non-prescription sources in paediatrics. However, empirical research on the efficacy and safety of melatonin for children is sparse, conflicting, and inconsistent. This first Australian study aimed to investigate correlates of melatonin use in a sample of children with sleep disturbance in Australia and assess whether melatonin is being administered to children contrary to Therapeutic Goods Administration Guidelines. MethodsAn exploratory online study was undertaken with 318 parents of Australian children with sleep disturbance (95.30% females). Logistic regression, mediation and descriptive analysis were conducted. ResultsAs hypothesised, higher parental stress, older child age, and a diagnosis of ADHD were significantly associated with melatonin use in this sleep disturbed sample. Other potential correlates such as financial stress, number of household dependents, child sleep disturbance, and autism were not significantly associated with melatonin use in adjusted analyses. ConclusionFindings show off-label melatonin use in children with sleep disturbance is prevalent. For the first time, this study showed an indirect path linking child sleep disturbances with melatonin use via parental stress. Overall, while the safety of melatonin use remains unknown, there is a clear need to mitigate parental stress to minimise potentially unmonitored and improper use of melatonin in children.

Effects of Child Life intervention on the symptom cluster of pain–anxiety–fatigue–sleep disturbance in children with acute leukemia undergoing chemotherapy

ObjectiveThis study aims to explore the application effect of Child Life intervention on pain, anxiety, fatigue, and sleep disturbance in children with acute leukemia. MethodsIn a single-blinded, parallel-group randomized controlled trial, 96 children with acute leukemia were randomized to either the intervention group, which received Child Life intervention twice a week for 8 weeks, or the control group, which received routine care. Outcomes were evaluated at baseline and day 3 postintervention. ResultsAll of the participants completed the study. Compared with the control group, the intervention group showed a significant reduction in pain, anxiety, fatigue, and sleep disturbance (P ​< ​0.001). However, no significant differences were observed in the disorders of excessive somnolence. ConclusionsChild Life intervention can effectively improve pain, anxiety, fatigue, and sleep disturbance in children with acute leukemia undergoing chemotherapy. The results suggest that symptom cluster management intervention based on Child Life provided a promising approach for simultaneously treating multiple symptoms within a cluster.

Exploration of sleep disturbances in children and adolescents with and without autism in a paediatric sample referred for polysomnography.

The purpose of the study was to increase the body of knowledge related to sleep in children with autism. The specific aims were to (i) identify the subgroup of children with autism, ages 3-17 years, referred for polysomnography and (ii) describe types and frequency of clinical encounters for sleep problems in a sample of children ages 3-17 with and without the diagnosis of autism. The authors performed a secondary data analysis of the de-identified Nationwide Children's Hospital Sleep DataBank, a collection of encounters with children referred for polysomnography. The data were filtered for ages 3-17 years at the time of the participant's first sleep study, and further filtered for the presence of an autism diagnosis. In the sample, there were 2838 unique participants (M = 10.5 years) with a total of 172 167 encounters between 2017 and 2019. Of these, 198 (7%) were diagnosed with Autism Spectrum Disorder, Asperger's Syndrome, or Pervasive Developmental Disorder. Among all participants, the most common sleep problems were apnea, snoring, non-specified sleep disorders (including restless sleeper), circadian rhythm disorder (CRD), and insomnia. The subgroup of patients diagnosed with autism was noted to have higher frequency of several types of sleep problems, especially restless sleep, CRD and insomnia, compared to those without an autism diagnosis. Findings elucidate the increased presence of sleep problems in paediatric patients with autism, and the need for purposeful sleep evaluation and research given the potential impact on daytime function for these individuals and their families.

Sleep-related items on the school-age CBCL and the PROMIS sleep disturbance 4-item short-form: A psychometric comparison from the Environmental Influences on Child Health Outcomes (ECHO) program.

The Child Behavior Checklist (CBCL) parent-report school-age form, a broad instrument widely used to evaluate youth's emotional and behavioral functioning, includes seven sleep-related items. These items are not an official subscale of the CBCL, but researchers have used them as a measure of general sleep problems. The primary objective of the present study was to evaluate the construct validity of the CBCL sleep items with a validated measure of sleep disturbance, the Patient-Reported Outcomes Measurement Information System Parent Proxy Short Form-Sleep Disturbance 4a (PSD4a). To do so, we used coadministered data on the two measures from 953 participants ages 5-18 years in the National Institutes of Health Environmental influences on Child Health Outcomes research program. Exploratory factor analysis (EFA) revealed two CBCL items were strictly jointly unidimensional with the PSD4a. To help prevent floor effects, we conducted further analyses that revealed three additional CBCL items could be included as an ad hoc measure of sleep disturbance. However, the PSD4a remains a psychometrically superior measure of child sleep disturbance. Researchers using these CBCL items to measure child sleep disturbance should account for these psychometric issues in their analysis and/or interpretation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Life-course adversity and sleep disturbance among low-income women with children

ObjectivesThis study explored whether patterns of lifetime adversity are associated with sleep disturbance and tested whether adult adversity mediates the relationship between childhood adversity and sleep. MethodsA sample of 1510 postpartum women in Wisconsin who received home visiting services completed assessments of childhood adversity, adult adversity, and sleep disturbance; 989 women completed another sleep assessment about one year later. Latent class analysis was used to identify classes of lifetime adversity, which were then used to predict later sleep ratings while controlling for earlier sleep ratings and demographic variables. A path analysis was conducted to explore whether adult adversity mediated the association between childhood adversity and sleep. ResultsAdverse childhood and adult experiences were highly prevalent, and greater life-course adversity was associated with sleep disturbance. The association between childhood adversity and sleep was significantly mediated by adult adversity. ConclusionsSleep quality appears to correspond with life-course adversity, pointing to ongoing opportunities for prevention and intervention.

Sleep Disturbances in Children and Adolescents with Autism Spectrum Disorder: An Overview for Clinicians

Background: Sleep disorders in autism spectrum disorders (ASD/SD) are distinct, broad, and highly variable clinical entities that ubiquitously affect core symptomatology, development of comorbid disorders, and overall quality of life for affected children and families. High genetic predisposition and the presence of co-occurring disorders present significant challenges in assessment and appropriate interventions. Objective: The study aimed to review the best available evidence and address the clinical gaps in the knowledge about sleep disorders in children and adolescents with autism spectrum disorders. Methods: The review provides a comprehensive literature search of 1622 articles and summarizes 110 selected for empirical evidence to methodically consider critical aspects of sleep disorders in ASD for informing clinicians of useful information. Results: Clinicians have insufficient guidance and support to effectively manage sleep disruptions in ASD youth in practice. Prevalence of sleep disruption in ASD, close to 80%, is characterized by unique subtypes, including but not limited to obstructive sleep apnea, circadian rhythm disorders, and sleep-related movement disorders. Greater awareness of sleep disruption, its neurodevelopmental basis, scope, and impact allows for improved treatment and prevention efforts of these conditions, and is critical for clinical practice and future research. The bidirectional nature of disruptive sleep and ASD is considered a major area requiring further clarification. Conclusion: Clinician-friendly screening tools are needed for everyday office practice to identify ASD/SD conditions and interventions, and mitigate harmful effects. Psychoeducational and cognitive-behavioral approaches for improving and supporting healthy sleep hygiene, considered the first line of treatment, are detailed. The weak database for the use of psychopharmacologic agents is summarized, and the strength of prescribing prolonged-release melatonin for optimal results is described. The promise of other medications is discussed.

The Sleep Disturbance Scale for Children: psychometric properties and prevalence of sleep disorders in Spanish children aged 6-16 years.

The present research aimed to investigate, for the first time, the validity and reliability of the Sleep Disturbance Scale for Children (SDSC) in a sample of 2733 Spanish children aged 6-16 years. We also described the prevalence and sociodemographic correlates of sleep disorder symptoms among young people, which had never been studied in Spain. Confirmatory factor analysis supported the original six-factor model and Cronbach's alpha for the total questionnaire was 0.82, which indicated good reliability. Moreover, all the SDSC subscales correlated positively and significantly with the total score (range=0.41-0.70), thus showing convergent validity. Considering T-scores >70 as pathological, we identified at least one sleep disorder in 116 participants (4.24%), including disorders of excessive somnolence (DOES; 5.82%), sleep-wake transition disorders (SWTD; 5.27%), and disorders of initiating and maintaining sleep (DIMS; 5.09%) among the most common problems. Students in secondary education and those from families with a low socioeconomic status were more likely to have DIMS, disorders of arousal, and DOES. Subjects with clinically elevated levels of sleep breathing disorders were more frequently of foreign origin and from disadvantaged families. Boys and primary school students were more prone to sleep hyperhidrosis, while SWTD were overrepresented among children with a low socioeconomic status. According to our results, the Spanish version of the SDSC seems to be a good instrument for assessing sleep disturbances in school-age children and adolescents, which is essential to prevent the significant implications of poor sleeping on the overall welfare of young people.