Sleep In Children Research Articles

Common Childhood Sleep Problems and Disorders.

Sleep insufficiency and disturbances affect the physical, cognitive, and emotional well-being of children. To perform a narrative review on common sleep problems and disorders encountered in primary care for children and adolescents. A search of English literature in the Pubmed and Google Scholar databases published from 1 January 2000 till 31 October 2021 was conducted with the keywords "sleep problem" or "sleep disorder" and "child" or "adolescent". Findings in the relevant articles and cross-references were compiled. Sleep duration and habits of children vary widely across countries with different cultural backgrounds. There is robust evidence to support the promotion of positive bedtime routines and sleep hygiene as prevention and management of sleep problems. 15-70% of parents reported their children having sleep problems or disturbances. Common sleep complaints include difficulty in initiation or maintenance of sleep, abnormal behaviors or movements, snoring or abnormal breathing, and excessive daytime sleepiness. Comprehensive sleep history and a sleep diary are the first steps for evaluation. Home video and actigraphy may be used as preliminary tools to confirm the history. Referrals to a sleep specialist for polysomnography and other tests are needed, if suspecting specific sleep disorders, such as obstructive sleep apnea and narcolepsy, needs timely intervention. Common sleep disorders in different age groups encountered in primary care are reviewed with clinical features, indications for evaluation, and treatment options summarized. Screening for sleep problems shall be an integral part of each child's health care visit. It is important to evaluate the impact of common sleep problems and identify specific sleep disorders for early intervention to prevent long-term adverse outcomes.

Comparison of weekday-weekend differences in factors associated with school-age child sleep duration in the US and Singapore

Comparison of weekday-weekend differences in factors associated with school-age child sleep duration in the US and Singapore

Program to Support Child Sleep from the Occupational Therapy Perspective during the COVID-19 pandemic.

Introduction. Here we describe the interim results of the Program to Support Child Sleep from the Occupational Therapy Perspective (Programa de Acompañamiento al Sueño en la Infancia desde Terapia Ocupacional, PASITO) for children with neurodevelopmental disorders (NDDs) aged 3-10 years with insomnia, conducted between June 2020 and September 2021. Population and methods. Pre- and post-intervention quasi-experiment in an intervention group and a control group using the Sleep Habits Questionnaire (SHQ) and the Consensus Sleep Diary (CSD). Results. A total of 22 children with NDDs participated, 8 in the control group. The overall SHQ score for the intervention group improved (p < 0.001) from 54.9 (SD: 5.5) to 48.4 (SD: 4.5) and moved closer to the reference range of 42.6 (SD: 4.9). The CSD showed an increased sleep duration, earlier sleep onset, and fewer night wakings. Conclusion. These interim favorable results demonstrate that the PASITO may be a possible intervention to manage sleep problems in children with NDDs.

Primary School-Aged Children's Physical Activity Level, Eating Habit, and Sleeping Pattern Changes During the COVID-19 Pandemic in Indonesia.

Background and objective This study aims to explore the effect of physical distancing on physical activity, eating habits, and sleeping patterns among Indonesian primary schoolchildren during theCOVID-19pandemic. Methodology This cross-sectional study was conducted from October to December 2020, involving 489 primary schoolchildren. Parents/caregivers were queried about changes in their children's physical activity (utilizing the Physical Activity Questionnaire for Older Children - PAQ-C), eating habits (via a questionnaire modified from Southeast Asian Nutrition Surveys - SEANUTS), and sleeping patterns (assessed using the Children's Sleep Habits Questionnaire - CSHQ) both before and during the pandemic. Various sociodemographic characteristics and income status were also obtained. Paired univariate and multivariate analyses were conducted where applicable. Results In comparison to the period before the pandemic, both the PAQ-C score and active proportion significantly decreased during the pandemic (P= 0.000). Children consumed more snacks (322, 65.8%)but less canned and processed foods (180, 36.8%, and 128, 26.2%, respectively). Sleep duration and sufficiency increased significantly, with a CSHQ score mean of 48.62 ± 9.88 (P= 0.000, P= 0.004), and sleep disturbance was observed in 391 (79.96%)subjects. Conclusions Children were physically less active during the COVID-19 pandemic. They also experienced variable changes in eating habits based on parental employment, family income and expenses, and the presence of governmental support. While more children had longer sleep duration and more achieved the recommended sleep time, sleep disturbance happened in most subjects.

Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility.

The purpose of this study was to determine the sleep stage during which isolated snoring occurs in children and adults, and to analyze changes after treatment of obstructive sleep apnea (OSA). This retrospective study examined duration of snoring time and respiratory events during each sleep stage in adults and children who underwent polysomnography, had an apnea-hypopnea index (AHI) < 15/h and had snoring time ≥ 10% of total sleep time. Changes in duration of snoring time were also examined in adult patients after treatment with an oral appliance (OA). Snoring time was shown to be predominant during N3 and N2 sleep and less dominant during REM sleep in both children (n = 47) and adults (n = 93). These results were seen even in children with REM dependency. The percentage of snoring time during N3 sleep was more pronounced in women than in men among young adult patients aged < 40 years but was not significantly different between men and women overall. There were no significant differences in the percentage of snoring time in each sleep stage between young women with mild OSA and non-OSA. In children, there were no significant differences between boys and girls in the percentage of snoring time in any sleep stage. The percentage of snoring time during N3 was significantly higher sleep in the non-supine position than in the supine position in children, whereas no significant differences were noted between the supine and non-supine positions in any sleep stage in adults. OA treatment for adult patients (n = 20) significantly increased the percentage of snoring time during N3 sleep, although it significantly decreased AHI, total snoring time, and snoring time during N1 sleep and REM sleep. Snoring presented exclusively during the N3 sleep stage, especially in young women with mild OSA, and in children with OSA, especially in the non-supine position. Snoring time during N3 sleep increased during OA treatment for OSA.

Childhood maltreatment and sleep apnea: Findings from a cross-sectional general population study

ObjectiveCumulative evidence indicates that childhood maltreatment (CM) is associated with sleep disturbances possibly suggesting sleep apnea. However, the relation between CM and objective measures of sleep apnea as determined by polysomnography (PSG) has not yet been assessed. MethodsUsing a cross-sectional design and based on PSG measurements from N = 962 subjects from the SHIP-Trend general population study, we used linear regression models to investigate the relationship between apnea-hypopnea (AHI) and oxygen desaturation index (ODI) and Epworth sleepiness scale (ESS) metrics and the Childhood Trauma Questionnaire (CTQ). All significant models were additionally adjusted for obesity, depression, metabolic syndrome, risky health behaviors, and socioeconomic factors. ResultsWhile both AHI and ESS were positively associated with the CTQ sum score, ODI was not. Investigating the CTQ subscales, ESS was associated with emotional abuse and emotional neglect; AHI was associated with physical and sexual abuse as well as physical neglect. For both the sum score and the subscales of the CTQ, ESS effects were partially mediated by depressive symptoms, while AHI effects were mediated by obesity, risky health behaviors, and metabolic syndrome. ConclusionThe findings of this general population study suggest an association between CM, particularly physical neglect, and objective as well as subjective indicators of sleep apnea, which were partially mediated by depressive symptoms and obesity.

Medical clowns improve sleep and shorten hospitalization duration in hospitalized children

Intervention by medical clowns was proven to have a positive effect in reducing stress and anxiety, increasing cooperation and improving the child's experience prior to a medical procedure and during the various stages of hospitalization. Sleep has long been known to be essential for recovery from injury and sickness, improving immune functions, and there is an emerging understanding of the restorative role quality sleep has on health and diseases. Hospitalized children are more exposed to sleep disorders and sleep deprivation due to the hospitalized environment, anxiety, and illness. Different behavioral interventions to promote sleep were previously studied in hospitalized children, some showing potential benefits. In this study, we sought to examine the ability of medical clowns to positively impact the child's sleep during hospitalization. The study is an observational matching (case–control) interventional study which took place at the department of pediatrics in Carmel Medical Center. Forty-two hospitalized children ages 2–17 were included in two equal groups of intervention or control. Children in the control group were recruited based on a method of matching the chief complaint plus the medical diagnosis and age of the children in the intervention group in a 1:1 matching. The children's sleep parameters were objectively evaluated for two consecutive nights using an Actigraph device and subjectively by parent's questionnaire. Additional factors such as hospital length of stay and demographics were also monitored. The study group had an encounter with a medical clown (15–30 min) before bedtime on either the first or the second night, and the control group was not exposed to a medical clown at all. We then compared the data from both groups using unpaired t-tests. Hospitalized children exposed to a medical clown prior to bedtime (n = 21) and children not exposed to a medical clown (n = 21) were comparable in age and clinical characteristics. The study group had a significantly delayed wake-up time compared to the control group (06:59 ± 46 min vs. 07:26 ± 42 min, p < 0.05) (mean difference of 27 min). Night's duration (from bedtime to wake-up) was significantly longer in the study versus the control group (570 ± 76 vs. 500 ± 66.1 min, p < 0.05), a total mean increase of 70 min, and sleep efficiency were significantly increased (92.3 ± 4.6% vs. 87.9 ± 8.7%, p < 0.05). Within the clown group, when comparing nights with and without exposure to a medical clown, total sleep time was prolonged by a mean of 54 min on the night of the intervention (518 ± 74 min vs. 464 ± 59 min, p < 0.01), and the total wake time during the night were reduced (52 ± 27 min vs. 77 ± 61 min, P < 0.05), mean difference of 25 min), mainly by reduction of wake period after sleep onset (WASO) (42 ± 25 min vs. 66 ± 58 min, p < 0.05), mean difference of 24 min). Regarding general medical outcomes, hospital stay was significantly shorter in the clown group vs. control (104 ± 42 h vs. 128 ± 42 h, p < 0.05), a mean reduction of 23 h—nearly an entire day. An encounter with a medical clown before bedtime in hospitalized children positively affects sleep parameters, which may be of great importance for healing in general. The clown intervention was also shown to shorten the hospital stay. Larger scale studies are warranted to establish these findings.

Sleep health, nutrition, and cardiometabolic risk

Sleep deficiencies (e.g., insufficient sleep, irregular timing of sleep, poor quality of sleep) in childhood are highly prevalent and have consistently been shown to negatively impact both physical and mental health. Adverse outcomes of childhood sleep deficiencies include higher rates of obesity, depression, anxiety, and emotional dysregulation (Palmer et al., 2023). Importantly, research has shown that sleep difficulties often precede the development of these adverse health outcomes and represent a modifiable risk factor (McMakin &amp; Alfano, 2015). Given that sleep is a critical element of a child's life, good and sufficient sleep (quality and quantity) should be given extra attention by parents to help their children thrive, and to limit the chance that their child develops severe and less modifiable mental or physical health issues (Meltzer et al., 2021). Sleep is, therefore, a critical dimension of a child's health that should be given attention, especially for those at high risk for the development of obesity and related cardiometabolic sequelae.

Maternal Childhood Adversity and Infant Epigenetic Aging: Moderation by Restless Sleep During Pregnancy.

Maternal exposure to childhood adversity is associated with detrimental health outcomes throughout the lifespan and may have implications for offspring. Evidence links maternal adverse childhood experiences (ACEs) to detrimental birth outcomes, yet the impact on the infant's epigenome is unclear. Moreover, maternal sleep habits during pregnancy may influence this association. Here, we explore whether restless sleep during pregnancy moderates the association between exposure to maternal childhood adversity and infant epigenetic age acceleration in 332 mother-infant dyads (56% female; 39% Black; 25% Hispanic). During the 2nd trimester, mothers self-reported childhood adversity and past-week restless sleep; DNA methylation from umbilical vein endothelial cells was used to estimate five epigenetic clocks. Multivariable linear regression was used to test study hypotheses. Despite no evidence of main effects, there was evidence of an interaction between maternal ACEs and restless sleep in predicting infant epigenetic age acceleration using the EPIC Gestational Age clock. Only infants whose mothers reported exposure to both ACEs and restless sleep demonstrated accelerated epigenetic aging. Results provide preliminary evidence that maternal childhood adversity and sleep may influence the infant epigenome.

Sleep Health among Children Adopted from Foster Care: The Moderating Effect of Parent–Child Sleep Interactions

ABSTRACT Objectives Sleep disruption is prevalent among children placed in foster care, elevating risk for a range of deleterious outcomes. Theoretically, achieving permanency via adoption may have a positive influence on children’s sleep via the presence of various factors, but little is known about the sleep health of children adopted from foster care, including predictors and moderators of sleep health. Method The current study included 226 parents who adopted a child from foster care in the U.S. (aged 4–11 years) within the past two years and a propensity score matched sample of 379 caregivers of children currently in foster care. Both samples completed online questionnaires about their child’s sleep, physical, and mental health. Results Comparatively, children in foster care experienced more nightmares, night terrors, moving to someone else’s’ bed during the night, and worse overall sleep quality, whereas adopted children were reported to experience significantly more nighttime awakenings. In the adopted sample, a greater number of prior foster placements unexpectedly predicted lower total sleep disturbance scores, but this relationship was moderated by parent–child interactions around sleep. In general, greater parental involvement in children’s sleep was associated with lower levels of child sleep disturbance. Conclusions Findings suggest that while specific sleep problems might remit after children in foster care achieve permanence, nighttime sleep fragmentation often persists. Parent–child interactions surrounding sleep may be pivotal in improving sleep health in this population.

Association Between Home Renovation and Sleeping Problems Among Children Aged 6-18 Years: A Nationwide Survey in China.

Although the indoor environment has been proposed to be associated with childhood sleep health, to our knowledge no study has investigated the association between home renovation and childhood sleep problems. The study included 186,470 children aged 6-18 years from the National Chinese Children Health Study (2012-2018). We measured childhood sleeping problems via the Chinese version of the Sleep Disturbance Scale for Children (C-SDSC). Information on home renovation exposure within the recent 2 years was collected via parent report. We estimated associations between home renovation and various sleeping problems, defined using both continuous and categorized (binary) C-SDSC t-scores, using generalized mixed models. We fitted models with city as a random effect variable, and other covariates as fixed effects. Out of the overall participants, 89,732 (48%) were exposed to recent home renovations. Compared to the unexposed group, children exposed to home renovations had higher odds of total sleep disorder (odd ratios [OR] = 1.3; 95% confidence interval [CI] = 1.2, 1.4). Associations varied when we considered different types of home renovation materials. Children exposed to multiple types of home renovation had higher odds of sleeping problems. We observed similar findings when considering continuous C-SDSC t-scores. Additionally, sex and age of children modified the associations of home renovation exposure with some of the sleeping problem subtypes. We found that home renovation was associated with higher odds of having sleeping problems and that they varied when considering the type of renovation, cumulative exposure, sex, and age differences.

Effect of Foot Reflexology Massage on Sleep Habits in Children with Autistic Spectrum Disorder: A Randomized Clinical Trial

Background: Sleep plays a crucial role in children's motor, mental, and cognitive development. Due to the significant prevalence of sleep problems in children with autism and the side effects of pharmacological therapy, complementary interventions should be considered. Objectives: This study aimed to investigate the effect of foot reflexology massage on sleep habits in children with autistic spectrum disorder. Methods: This randomized clinical trial was conducted on 60 children with autistic spectrum disorder in Mashhad, Iran. The control group received routine care from the family. In the intervention group, in addition to the routine family care, a foot reflexology massage was performed for 15 min by parents for 30 nights before bedtime for children. The standard Children's Sleep Habits Questionnaire (CSHQ) was completed 3 times in both groups. In the control group, the questionnaire was completed at the beginning of the study, on the 15th day, and on the 30th day after entering the study. In the intervention group, the questionnaire was completed before the intervention, on the 15th day after the intervention, and on the 30th day after the intervention. Data were analyzed using SPSS version 16 by the independent t-test, Mann-Whitney test, and repeated measures analysis of variance (ANOVA). Results: Among the children included in the study, 78.3% were male, and their mean age was 8.56 ± 2.4 years. The mean total score of children's sleep habits before the intervention was not significantly different between the control and intervention groups (P = 0.71). After the intervention, the mean total score of children's sleep habits was significantly different between the control and intervention groups (P = 0.001). The foot reflexology massage, with a score reduction of 8.13 ± 3.95 points, had a significant impact on the score of sleep habits in the intervention group (P = 0.002). Conclusions: Foot reflexology massage improves the quality of sleep in children with autism and can be recommended as a safe intervention for parents of children with autism.

A comparison of perceived barriers to optimal child sleep among families with low and high income

ObjectiveFamilies with low-income experience suboptimal sleep compared to families with higher-income. Unique drivers likely contribute to these disparities, along with factors that universally impede sleep patterns, despite income level. To inform intervention tailoring, this mixed-methods study gathered parent’s perceptions about child sleep challenges to identify similarities/differences in families with lower-income and higher-income. MethodsParents who experienced difficulties with their child (ages 2-4years) sleep were categorized as lower income (n = 15; $30,000 ± 17,845/year) or higher income (n = 15; $142,400 ± 61,373/year). Parents completed a survey and semistructured interview to explore barriers and facilitators for child sleep. Two coders independently evaluated transcripts for lower-income and higher-income groups using inductive analyses. Constant-comparison methods generated themes and characterized similarities/differences by income group. ResultsGroups were similar in themes related to diverse bedtime routines, nighttime struggles with child sleep, parent strategies to reduce night wakings, parent effort to provide a sleep-promoting environment, and presence of electronic rules. Groups differed in themes related to factors influencing routine setting (eg, lower income: external factors influencing routines; higher income: personal attributes for structure), parent appraisal of child sleep (eg, higher income: ambivalence; lower income: mostly negative appraisal), nap timing and duration (eg, lower income: longer naps), and strategy utilization and pursuit of resources (eg, higher income: more parents tried various strategies and accessed online/print resources). ConclusionsParents experienced many similar barriers to child sleep, with a few distinct differences by income group. These findings can inform future intervention components for all families, as well as customized components to address the unique needs of families across income levels.

Time use and dimensions of healthy sleep: A cross-sectional study of Australian children and adults

BackgroundSleep is increasingly recognized as a multidimensional construct that occurs within the 24-hour day. Despite advances in our understanding, studies continue to consider the relationship between sleep, sedentary time and physical activity separately, and not as part of the 24-hour day. AimsTo determine the association between the 24-hour activity composition and dimensions of healthy sleep. MethodsThis study examined data on 1168 children (mean age 12years; 49% female) and 1360 adults (mean age 44years; 87% female) collected as part of the Child Health CheckPoint study. Participants were asked to wear a GENEActiv monitor (Activinsights, Cambs, UK) on their nondominant wrist for eight consecutive days to measure 24-hour time-use. Compositional data analysis was used to examine the association between time use (actigraphy-derived sleep duration, sedentary time, light physical activity and moderate-vigorous physical activity) and dimensions of healthy sleep. Healthy sleep was conceptualized in terms of continuity/efficiency, timing, alertness/sleepiness, satisfaction/quality, and regularity. Time allocations were also examined. ResultsThe 24-hour activity composition was significantly associated with all objectively measured and self-report dimensions of healthy sleep in both children and adults. Allocating more time to sleep was associated with earlier sleep onsets, later sleep offsets, less efficient and more consistent sleep patterns for both children and adults. ConclusionThis study highlights the integral relationship between daily activities and dimensions of sleep. Considering sleep within the 24-hour day activity composition framework may help inform lifestyle decisions to improve sleep health.

Shantala: The Touch to Improve the Quality of Life in Babies Attending a School in the Midwest of Santa Catarina

Introduction: Shantala is a technique that was created by an Indian mother, with the aim of massaging the baby. Your movements must be performed rhythmically and follow an order, becoming delicate and providing pleasure to the recipient. Many benefits are reported with Shantala, some of which include reducing intestinal colic, improving sleep quality and reducing stress and anxiety. Objective: To analyze the effectiveness of applying the Shantala massage technique to a group of babies enrolled in a school in the Midwest of Santa Catarina. Methods: This study is characterized as experimental research of an exploratory and descriptive nature. The sample consisted of 7 babies aged 4 to 12 months, of both sexes. The assessment was applied through a questionnaire on the perception of babies' behaviors, answered by their guardians, and sleep quality was assessed using the Brazilian version of the Children's Sleep Habits Questionnaire (CSHQ), both were applied pre and post -treatment. Afterwards, patients underwent 10 Shantala sessions. Participants only received care after consent from their guardians and approval from the ethics and research committee. Results: The results demonstrated that the babies' eating habits improved when compared pre- (28.6%) and post-treatment (57.9%), being classified as very good and 42.9% as excellent. In relation to social behavior, only 14.3% were classified as excellent before massage applications, increasing to 57.1% post-treatment. No child showed any symptoms of intestinal colic, anxiety or stress after the applications, which were present pre-application. The quality of sleep also improved post-treatment, showing an improvement in this habit in relation to the time of going to bed and waking up, including during the night. Conclusion: The research demonstrated that the Shantala technique promoted the reduction of stress levels, anxiety, reduced symptoms of intestinal colic and improved the quality of sleep, eating habits and social interaction, which consecutively generates a better quality of life in children.

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.

A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy.

Sleep quality is important during childhood and adolescence. Given the high prevalence of pain in children/youth with cerebral palsy, we aimed to measure the association between short-term pain trajectories and sleep disturbance in these individuals. We accrued the cohort between November 2019 and October 2020 and recruited children/youth who (1) were 8-18 years old; (2) had cerebral palsy with any Gross Motor Function Classification System level; and (3) could self-report pain and sleep disturbance. We collected self-reported baseline and weekly follow-up data using electronic questionnaires completed every week for 5 weeks. Sleep disturbance at 5 weeks was the primary outcome (pediatric Patient-Reported Outcomes Measurement Information System short form, v1.0-4a). We used general linear regression to assess the association between pain intensity trajectory group and sleep disturbance controlling for confounders. A total of 190 individuals were eligible; 102 were enrolled and 89 were included in our final analysis. Pain trajectory groups had estimated crude mean sleep disturbance scores at 5 weeks ranging from 56.0 (95% confidence interval, 51.8, 60.8) to 61.8 (55.7, 67.9). Compared to those with stable, no/very mild pain, those in the stable, high-pain group had the greatest sleep disturbance (adjusted β = 5.7; 95% confidence interval, 1.2, 10.2). Irrespective of pain trajectory, children and youth with cerebral palsy reported sleep disturbances. Those with a stable, high pain intensity in the previous 5 weeks reported the greatest sleep disturbance. The results highlight the importance of considering pain trajectories and their impact on sleep in children with cerebral palsy. Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. J Clin Sleep Med. 2024;20(5):719-726.

How staying in a gymnasium affects sleep and bed climate in children.

We investigated the relationship between sleep, ambient climate, and bed climate in school-aged children during a one-night stay in a simulated shelter in a gymnasium to demonstrate the effect of ambient climate, and bed climate on sleep. We obtained measurements during a one-night stay in a school gymnasium (C), days before C (BC), on the day after (A1), and on the second day after C (A2) in 13 healthy school-aged children during summer. Sleep was evaluated using an actigraph, and the temperature and humidity of the bedrooms in the participants' homes and in the gymnasium were monitored for 3 days before and after C. The bed climate of the chest and foot areas was measured for two nights before and after C. The participants were asked to report on their subjective sleep estimations and thermal sensations two nights before and after C. The ambient temperature in C was significantly higher than that in BC at the initial 180 min, while it significantly decreased compared to A1 and A2 in the last 100 min. The ambient humidity was significantly higher in both C and BC compared to A1 and A2. The sleep efficiency index decreased significantly in C (43±4.8%) compared to other conditions. Sleep time was significantly shorter in C than in other conditions during the initial 195 min. The increase in the bed climate temperature of the chest area in C was significantly delayed compared to that in the other conditions, around the initial 30 min after the lights were off. Subjective estimation revealed that in C, 85% of the participants were out of their sleeping bag at sleep onset, and their sleep was disturbed by heat (77%). Our study revealed that the disturbed sleep patterns observed with children in a simulated shelter may be related to a delayed increase in bed climate temperature in the chest area. This delayed increase could be related to the children not entering the sleeping bag and a delayed chest skin temperature increase during the sleep onset period.

Parent-Report Sleep Disturbances and Everyday Executive Functioning Difficulties in Children with Tourette Syndrome

ABSTRACT There is an increasing need to identify and treat sleep disturbances in Tourette syndrome (TS), a neurodevelopmental condition characterized by tics. This study explored sleep, tics, and executive functioning in children with TS (n=136) and neurotypical controls (n=101) through parent-report scales and open-ended questions. 85% of children with TS scored in the clinical range for a sleep disorder. Higher tic severity predicted increased sleep disturbances and executive difficulties. Qualitative insights indicated a bidirectional link between sleep and tics, which warrants consideration in clinical settings. Further research is needed to explore causal links.

The impact of the physical activity intervention on sleep in children and adolescents with neurodevelopmental disorders: a systematic review and meta-analysis.

The purpose of this review was to synthesize the current literature on the relationship between sleep and physical activity in children and adolescents with neurodevelopmental disorders. Articles were searched in PubMed, Web of Science, EBSCO, Cochrane, and Embase until April 2024. The meta-analysis was performed using Review Manager 5.3. Our results show that measuring sleep parameters by means of different measuring tools yields different results. Most studies have found no association between sleep and physical activity in children with neurodevelopmental disorders, especially when measured subjectively, such as parent reports and sleep logs. Physical activity interventions had a significant effect on sleep efficiency, wake after sleep onset, and sleep duration when measured objectively using instruments such as wrist actigraphy. Meta-analysis showed that children and adolescents with neurodevelopmental disorders who participated in mind-body activities (SMD = -3.01, 95%CI = -4.15~-1.87, p < 0.001, I2 = 99%) showed significant improvements in sleep, which were sessions lasting more than 12 weeks (SMD = -1.01, p < 0.01, I2 = 97%), performed at least 3 times per week (SMD = -0.81, 95%CI = -1.53~-0.10, p = 0.03, I2 = 95%), and lasted for more than 60 min per session (SMD = -1.55, 95%CI = -2.67~-0.43, p = 0.007, I2 = 97%). However, the results of these subgroup analyses must be interpreted with caution because of the small number of studies included. Our results show that measuring sleep parameters by means of different measuring tools yields different results. There was difficulty in interpreting many of the studies included in this meta-analysis, in view of the non-standardization of protocol, especially the ability range of the cohort, duration of the study, recommended exercises, whether the caregivers or researchers supervised the exercise regime/activity, and the practicality of continuing the exercise long-term by caregivers. Identifier, CRD42024541300.