Sleep Patterns In Children Research Articles

Sleep patterns and problems in infants and young children in Ireland.

There is an increasing recognition that sleep is an important aspect of health and well-being, and this is particularly the case in infancy and early childhood where sleep behaviours and patterns can result in substantial problems. This paper draws on Wave 1, 2, and 3 data from Growing Up in Ireland, the national longitudinal study of children in Ireland to provide an overview of sleep patterns in a population of children aged 9months (n=11,112), 3years (n=9,790), and 5years (n=8,996). The anonymised data made available through the Irish Social Science Data Archive were analysed using descriptive statistics. Findings from the analysis show that about two thirds of infants (66.9%; n=7,433) and just under 3 quarters of children aged 3years (72.8%; n=7,127) go to sleep between 7:00p.m. and 9:00p.m. and about 3 quarters (78.6%; n=7,070) of 5-year-old children are in bed by 9:00p.m. Just under half of infants (48.5%; n=5,000) wake up between 7:00a.m. and 8:00a.m. and 13.5% (n=1,500) wake up between 6:00a.m. and 7:00a.m. More than 80% (n=8,889) of mothers report their 9-month-old infant wakes up at least occasionally and 13.8% report it happens every night. Almost all infants nap during the daytime, with the majority (56.0%; n=6,222) doing so for between 1 and 2hours. About one third (65.4%; n=6,402) of 3-year-olds take daytime naps, but only 5.0% (n=449) of 5-year-olds do so. Substantial proportions of mothers report children's sleep patterns are at least a small problem for them (ranging from about 30% (n=3,333) in infancy to 22% (n=2,444) at 3years and 12% (n=1,079) at 5years). These findings highlight a substantial unmet need, and it is suggested that public health nurses and health visitors have a key role to play in supporting positive sleep patterns in early childhood.

Sleep patterns in children differ by ethnicity: cross-sectional and longitudinal analyses using actigraphy

ObjectivesTo determine whether sleep patterns (duration, timing, efficiency) differ by ethnicity. DesignLongitudinal study. SettingDunedin, New Zealand. ParticipantsA total of 939 children (48% male) aged 4-12 years (572 European, 181 Māori, 111 Pacific, 75 Asian). MeasurementsAll measurements were obtained at months 0, 12, and 24. Anthropometry was obtained using standard techniques, and parents completed questionnaires assessing demographics, dietary intake, and television habits of children. Sleep and physical activity were measured using Actigraph accelerometers over 1 week. Differences in sleep outcomes according to ethnicity were adjusted for demographics, weight status, and behavioral variables using mixed models. ResultsPacific children had greater body mass index and were more likely to live in deprived areas than children from other ethnic groups (all P<.001), but few differences were observed in behavioral variables. Pacific Island children slept 16 (95% confidence interval, 7-25) minutes less per night than New Zealand European children, predominantly as a result of later bedtimes (29; 20-38 minutes). By contrast, sleep efficiency did not differ by ethnicity or over time (all P≥.118). Māori children did not show the same relative deficits in sleep, displaying similar results to European children. Sleep duration decreased by 8 minutes (95% confidence interval, 6-10) a night each year over 2 years, and change over time did not differ by ethnicity (all P≥.165). ConclusionsFrom a young age, Pacific children had poorer sleep patterns than European children, and these patterns were maintained over 2 years.

Relationship Between Sensory Processing and Sleep in Typically Developing Children.

The relationship between sensory processing factors and the sleep habits and patterns of typically developing children ages 8-12 yr was investigated. Forty-five typically developing children and their parents or caregivers took part. Parents completed the Sensory Processing Measure-Home Form, Children's Sleep Hygiene Scale, and Children's Sleep Habits Questionnaire, and the children completed the Children's Report of Sleep Patterns. Spearman ρ correlation and linear regression analyses were completed with the children's sleep habits and patterns as the dependent variables and the sensory processing factors as the independent variables. Sensory processing factors were significantly associated with the children's sleep habits and patterns, as reported by parents and children. Predictive relationships were established between the children's sensory processing factors and sleep habits and patterns. Occupational therapy practitioners should consider sensory processing factors when working with children who present with suspected sleep problems.

Study of sleep pattern in children aged 1-12 years attending OPD at tertiary care hospital, Puducherry, India

Background: Children differ in their sleep pattern from adults and within their developmental age groups. Good sleep habits help them in better sleep outcomes. Inadequate sleep can contribute to various health issues. Hence, this study was carried out to find out sleep pattern in children and identify factors affecting it so that suitable measures can be taken to ensure good sleep hygiene in children.Methods: This was a cross-sectional observational study done in children aged 1-12 years. Every 5th child who attended OPD were included. Children who were very sick or had chronic illness or pain were excluded. Details pertaining to sleep was recorded after written parental consent.Results: The total sample size was 650. The mean age was 6.25±3.2 years. The mean bed time and wake up time was 9.18 pm±(1.02) and 6.41 am±(0.85) respectively. The mean night sleep duration was 9.38±1.05 hours. Co-sleeping was 97.5%. Sleep problem was seen in 51.1%. Screen time &gt;2 hours contributed to late bedtime and insomnia. Reduced physical activity/exercise was significantly associated with sleep problems.Conclusions: Sleep problems and poor sleep habits are common among children. Increased screen time and reduced physical activities in children contribute to poor sleep habits and sleep problem.

Evidence of Disturbed Sleep in Children With Eosinophilic Esophagitis and Persistent Epigastric Pain.

To determine whether the experience of persistent epigastric pain is associated with sleep disturbances in children with eosinophilic esophagitis (EoE). We hypothesized that children with EoE and persistent epigastric pain would (1) self-report greater current and worst pain severity, and (2) experience more disturbed sleep on objective and subjective measures in comparison with children with EoE but no persistent pain and healthy children. Fifty children with EoE were recruited for this cross-sectional study, of which 24 (48%) reported experiencing persistent epigastric pain. The remaining 26 (52%) children with EoE denied experiencing persistent pain. An additional 25 healthy children without EoE or persistent pain were included. All children provided severity ratings of current pain and worst pain experienced over the past week. Children then completed 12 consecutive nights of ambulatory sleep monitoring via actigraphy in the home. Caregivers provided information regarding their child's sleep patterns and internalizing symptoms. Children with EoE and persistent pain reported significantly greater severity of current pain (p < .001) and worst pain over the past week (p < .001) compared with EoE without persistent pain and healthy children. Compared with the other groups, children with EoE and persistent pain also demonstrated greater actigraphic sleep disturbances, lower sleep efficiency (p = .004) and greater wake after sleep onset (p = .034). This study provides novel evidence that a significant proportion of children with EoE experience persistent symptoms of epigastric pain. Persistent pain was associated with significant sleep disturbances in children with EoE.

Role of a behavioral therapy involving psychodrama for the treatment of sleep disorders in pediatric primary care

Sleep disorders are common in young children. Our objective was to describe a psychodrama using puppets and to assess the interest of this approach for the treatment of sleep disorders in ambulatory pediatric patients. This retrospective, observational, monocenter study was carried between 1st January 2014 and 31st December 2015. Children aged 12 months to 6 years with a sleep disorder confirmed according to the International Classification of Sleep Disorders-2 were recruited. The parents were questioned separately about their child's sleep rhythm and the family's quality of life (QoL). The child sitting on their parent's knee and, using puppets to represent the family members, the pediatrician reproduced the scenario that took place at home and demonstrated what should be changed. The parents were contacted by telephone 1-2 weeks after the therapy to determine whether the child's sleep patterns had improved. The primary endpoint was resolution of the sleep disorder. Thirty-eight children (mean age 27.2±14.0 months; mean duration of sleep disorder 12.7±9.5 months) were assessed. The most common sleep disorders were difficulties in falling asleep at evening bed-time (76.3%) and night-time wakening (76.3%). The main triggering factors were the birth of a sibling (30.8%) or an illness (30.8%). In the majority (52.2%) of families who were convinced that the psychodrama would work, an immediate and complete resolution of the sleep disorder was obtained within three days of the consultation. QoL improved in the majority of families after the consultation (QoL was average in 68.4% of families before the consultation vs. good in 84.2% after the consultation). Psychodrama was effective at bringing about an immediate and complete resolution of sleep disorders in children. This confirms the findings of other reports that show that behavioral therapy is effective in this context. This method could be adapted effectively by individual practitioners, enabling children to establish a good sleep pattern without the use of medications. A further large-scale, randomized, controlled trial is required to confirm these results.

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

ObjectiveSleep 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. MethodsA 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. ResultsMaternal 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. ConclusionsMothers' 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.

Later School Start Times: What Informs Parent Support or Opposition?

To investigate parental knowledge about adolescent sleep needs, and other beliefs that may inform their support for or objection to later school start times. In 2014, we conducted a cross-sectional, Internet-based survey of a nationally representative sample of parents as part of the C.S. Mott Children's Hospital National Poll on Children's Health. Parents with teens aged 13-17 years reported their children's sleep patterns and school schedules, and whether the parents supported later school start times (8:30 am or later). Responses associated with parental support of later school start times were examined with logistic regression analysis. Overall, 88% of parents reported school start times before 8:30 am, and served as the analysis sample (n = 554). In this group, 51% expressed support for later school start times. Support was associated with current school start times before 7:30 am (odds ratio [OR] = 3.1 [95% confidence interval (CI) 1.2, 8.4]); parental opinion that their teen's current school start time was "too early" (OR = 3.8 [1.8, 7.8]); and agreement with American Academy of Pediatrics recommendations about school start times (OR = 4.7 [2.2, 10.1]). Support also was associated with anticipation of improved school performance (OR = 3.0 [1.5, 5.9]) or increased sleep duration (OR = 4.0 [1.8, 8.9]) with later school start times. Conversely, parents who anticipated too little time for after-school activities (OR = 0.5 [0.3, 0.9]) and need for different transportation plans (OR = 0.5 [0.2, 0.9]) were often less supportive. Parental education about healthy sleep needs and anticipated health benefits may increase their support for later school start times. Educational efforts should also publicize the positive experiences of communities that have made this transition, with regard to limited adverse effect on after-school activity schedules and transportation.

Parental behaviors and sleep/wake patterns of infants and toddlers in Hong Kong, China.

To describe the sleep patterns of children below 36 months in Hong Kong, and evaluate the associations between parental behaviors and childhood sleep/wake patterns. Parents of 1049 infants and toddlers completed an internet-based expanded version of the Brief Infant Sleep Questionnaire. Total sleep duration (P<0.001), frequency (P<0.001) and duration (P<0.001) of nocturnal awakenings decreased with age, whereas the longest sleep duration (P<0.001) and nocturnal sleep duration (P<0.001) increased with age. Children who room- or bed-shared with parents had later bedtimes (P<0.001), but similar sleep duration compared with those who had a separate sleep location. Falling asleep independently was associated with longer nocturnal sleep duration (P<0.001) and less sleep awakenings (P<0.001). Full-time employment of parents was associated with shorter total sleep duration of children (P<0.001). Although breastfeeding was associated with more nocturnal awakenings (P<0.001), no association was detected between breastfeeding and shorter sleep duration in children. As infants and toddlers develop, their sleep consolidates. Falling asleep independently was associated with longer nocturnal sleep duration and fewer sleep awakenings, whereas sleep location was not. This is an important finding, especially for families with limited living space where parent/child room- or bed-sharing cannot be avoided.

Sleep behaviour relates to language skills in children with and without communication disorders

Background: Sleep problems are common in children with autism spectrum disorder (ASD). There is also emerging evidence that sleep quality influences language learning in typical development. However, there is a gap within the literature in regards to sleep and developmental language disorder in children (DLD).Objectives: The aims of this study were to: (i) compare sleep patterns of children with communication disorders to the sleep patterns of their typical peers, and (ii) ascertain whether sleep patterns related to language in this sample.Method: The relationship between sleep and language was investigated via parental questionnaires. There were 65 child participants in total aged between 3 and 18 years. Parents reported on 28 children with a developmental communication disorder (CD; ASD n = 8 or DLD n = 20) and 37 who were typical developing.Results: The children with a developmental communication disorder showed more sleep problems than their typical peers particularly in terms of getting to sleep and early waking. Furthermore, significant correlations were found between sleep behavior and language for children in both groups.Conclusion: Children with CD may have poorer sleep patterns than their typical peers which could compound developmental language difficulties.

The French Sleep Disturbance Scale for Children

ObjectiveThe psychometric properties of the Sleep Disturbance Scale for Children (SDSC) have been shown to be accurate, even when translated into several languages. The aim of the present study was to translate, adapt, and validate the SDSC for a French-speaking population. MethodsAfter forward- and back-translation, the tool was further translated and adapted into the French language. It was then pretested in terms of clarity on 33 French-speaking parents. Pretesting demonstrated that the questionnaire was well understood, indicating good clarity. During the validation phase, a total of 447 French-speaking parents of children aged between 4 and 16 years completed the SDSC. Among these, 66 children were diagnosed with sleep disorders by a pediatric specialist after a sleep consultation and polysomnographic recordings. ResultsThe factor analysis revealed five factors: difficulty in initiating and maintaining sleep (DIMS), sleep breathing disorders (SBD), disorders of excessive somnolence (DOES), parasomnias (PARA) and non-restorative sleep (NRS). This psychometric structure is reliable and logical in comparison with the experts' diagnoses. Convergent validity, divergent and internal reliability are very good. Inter-parental concordance in scoring the child's sleep problem does show differences in the ways in which parents report their children's sleep patterns. Cut-off was calculated for the total score (45). ConclusionThis study validated a 25-item French version of the questionnaire. The French SDSC could therefore be used to aid screening of sleep disorders in the general population.

Soft drinks consumption and child behaviour problems: the role of food insecurity and sleep patterns.

To examine whether the association between soft drinks consumption and child behaviour problems differs by food security status and sleep patterns in young children. Cross-sectional observational data from the Fragile Families and Child Wellbeing Study (FFCWS), which collected information on food insecurity, soft drinks consumption, sleep patterns and child behaviour problems. Bivariate and multivariate ordinary least-squares regression analyses predicting child behaviour problems and accounting for socio-economic factors and household characteristics were performed. Twenty urban cities in the USA with a population of 200 000 or more. Parental interviews of 2829 children who were about 5 years old. Soft drinks consumption was associated with aggressive behaviours, withdrawn and attention problems for children aged 5 years. However, the association differed by food security status. The association was mostly statistically insignificant among food-secure children after accounting for socio-economic and demographic characteristics. On the other hand, soft drinks consumption was associated with behaviour problems for food-insecure children even after accounting for these factors. However, after accounting for child sleep patterns, the association between soft drinks consumption and child behaviour problems became statistically insignificant for food-insecure children. The negative association between soft drinks consumption and child behaviour problems could be explained by sleep problems for food-insecure children. Since about 21 % of households with children are food insecure, targeted efforts to reduce food insecurity would help improve dietary (reduce soft drinks consumption) and health behaviours (improve sleep) and reduce child behaviour problems.

The Pediatric Sleep Clinical Global Impressions Scale-A New Tool to Measure Pediatric Insomnia in Autism Spectrum Disorders.

To pilot a clinician-based outcome measure that provides complementary information to objective measures and parent-based questionnaires for insomnia in children with autism spectrum disorders (ASD). The authors developed a Pediatric Sleep Clinical Global Impressions Scale (CGI). Questions included (1) the child's ability to fall asleep and remain sleeping independently (i.e., apart from parents); (2) bedtime resistance; (3) sleep onset delay; (4) night awakening; (5) parental satisfaction with their child's current sleep patterns; (6) family functioning as affected by their child's current sleep patterns; and (7) clinician's overall concern with the child's sleep. After refining the instrument through the evaluation of vignettes by ASD and sleep experts, the authors piloted the Pediatric Sleep CGI in a 12-week randomized trial of iron supplementation in children with ASD. Clinicians completed Pediatric Sleep CGIs and structured sleep histories, parents completed the Children's Sleep Habits Questionnaire (CSHQ), and children wore actigraphy watches. In repeated measures models, the Pediatric Sleep CGI and CSHQ were correlated for sleep onset delay (r = .66, p < .001), night wakings (r = .40, p < .001), and total score (r = .29, p < .001). The CGI-S sleep onset delay and actigraphy sleep onset delay scores (r = .75, p = .0095) were also correlated. The overall CGI-S showed improvement with therapy (p = .047). The Pediatric Sleep CGI shows promise in measuring clinician-rated outcomes in pediatric insomnia in children with ASD. Larger samples will be necessary to examine reliability, validity, and measure to change, as well as applicability to other populations with pediatric insomnia.

Macronutrient Intakes in Infancy Are Associated with Sleep Duration in Toddlerhood

Background: Dietary composition has been associated with sleep indexes. However, most of the evidence is based on cross-sectional data, and studies in young children are lacking.Objective: The aim of this study was to explore the longitudinal associations of macronutrient composition of the diet with sleep duration and consolidation (number of awakenings) in infancy and early childhood.Methods: The study was performed in 3465 children from the Generation R Study, a population-based cohort study in the Netherlands. Mothers reported their child's food intake at 13 mo of age by using a validated food-frequency questionnaire and their child's sleep patterns at 2 and 3 y of age. We used nutrient substitution models to assess the associations of relative macronutrient intakes with sleep indexes and adjusted the models for sociodemographic and lifestyle factors.Results: Isocaloric substitution of fat intake by protein or carbohydrate in infancy was associated with longer total sleep duration at 2 but not 3 y of age. For each 5% increase in energy intake of either protein or carbohydrate at the expense of fat, sleep duration at 2 y of age was longer by 6 min (95% CI: 0.4, 12 min) and 4 min (95% CI: 2, 6 min), respectively. Further exploration of macronutrient subtypes indicated no consistent differences between saturated or unsaturated fat and that intake of plant compared with animal protein or Trp did not explain the association of higher total protein intake with longer sleep duration at 2 y of age. Replacing unsaturated with saturated fat was associated with 7 min (95% CI: −13, −1 min) shorter total sleep duration at 3 y of age. Macronutrient intakes were not associated with sleep consolidation.Conclusions: Our results suggest that the macronutrient composition of the diet is associated with sleep duration in young children. Future research should further study the causality of this association and explore the underlying mechanisms.

A growth spurt in pediatric sleep research.

A growth spurt in pediatric sleep research.

Early Childhood Sleep Patterns and Cognitive Development at Age 6 Years: The Generation R Study.

To explore the association of sleep duration and awakening frequency with cognitive outcomes in young children. Mothers of 2,800 children from the Generation R cohort reported sleep duration and awakenings at children's age 24 months. At age 6 years, validated Dutch measures were used to assess children's nonverbal intelligence and language comprehension. We found a nonlinear association of total sleep time at 24 months with nonverbal intelligence ( p = 0.03) and language comprehension ( p = 0.04) at 6 years. Toddlers sleeping within the recommended 11-14 hr had more favorable cognitive development compared with both extremes. Frequent awakenings were negatively associated with nonverbal intelligence, but not with verbal comprehension. Sleep duration in toddlerhood has an inverted-U-shaped relation with childhood cognitive measures. Frequent awakenings are associated with lower nonverbal intelligence. Given the marked decline in sleep duration and awakenings in toddlerhood, developmental changes of sleep patterns might be important for cognitive development.

Obesity, Cardiorespiratory Fitness, and Self-Reported Sleep Patterns in Chilean School-Aged Children

The aims were to examine the association of sleep patterns with being overweight or obese and to analyze the association of cardiorespiratory fitness (CRF) with sleep patterns in children. The study involved 395 schoolchildren (12–13 years old). Sleep patterns were assessed with the Sleep Self-Report (SSR) questionnaire, grouped into four subscales: sleep quality, sleep-related anxiety, bedtime refusal, and sleep routines. CRF was predicted by the 20-m shuttle-run test. Logistic regression models showed that sleep-related anxiety problems predicted being overweight or obese in both sexes, and sleep quality problems predicted being overweight or obese in girls. Also, girls who had better CRF levels were less susceptible to sleep-related anxiety problems. Studies are required to determine if increasing CRF could be a possible strategy for improving sleep quality.

N analysis of sleep patterns in children with Autism spectrum disorder

n analysis of sleep patterns in children with Autism spectrum disorder

The influence of school time on sleep patterns of children and adolescents

ObjectiveThis epidemiological study evaluated the impact of school time on sleep parameters of children and adolescents. MethodsThis cross-sectional study involved 639 elementary and high school students (mean age 13.03 years, range 8–18, 58.5% female) from the south of Brazil. Participants answered the Morningness-Eveningness Questionnaire (MEQ), and were asked about their sleeping habits on weekdays and weekends. Sleep deficit was defined as the difference between sleep duration on weekdays and weekends. ResultsThe morning-school-time students presented significantly higher age, bedtime and wake up differences, sleep deficits, and social jetlag. The sleep deficit presented by girls was greater than that observed in boys of the same age. The difference between weekday and weekend waking times was also significantly greater in girls than in boys aged 13–18 years. Sleep deficit was significantly positively correlated with age and differences in wake up times, and significantly negatively correlated with MEQ scores, social jetlag, difference between weekday and weekend bedtimes, midpoint of sleep on weekends, and midpoint of sleep on weekends corrected for sleep deficit. A step-by-step multivariate logistic regression identified social jetlag, the difference between waking times on weekdays and weekends, and the midpoint of sleep on weekends as significant predictors of sleep deficit (Adjusted R2 = 0.95; F = 1606.87; p < 0.001). ConclusionThe results showed that school time influences the sleep parameters. The association of school schedules and physiological factors influence the sleep/wake cycle.

Parental Involvement in Infant Sleep Routines Predicts Differential Sleep Patterns in Children With and Without Anxiety Disorders.

This study compared parents' retrospective reports of their involvement in infant settling strategies and their relation to current sleep patterns among children (N=84, ages 7-11) with generalized anxiety disorder (GAD) and healthy controls. Parents of children with GAD were significantly more likely to report rocking their infants to sleep and putting infants down when they were already asleep than parents of healthy controls, even when accounting for infant health-related factors and parental anxiety. Greater involvement in infant sleep routines also predicted sleep patterns (measured via actigraphy) during childhood, though opposite relationships were observed in the two groups. Early involvement was related to poorer sleep in control children but better sleep for children with GAD even after controlling for current parenting practices. Findings suggest differential effects of early sleep-related parenting for children with and without later anxiety disorders with possible implications for early intervention.