Sleep In Children Research Articles

Turkish adaptation of the maternal cognition about infant sleep questionnaire

BackgroundExploring early childhood sleep problems requires a detailed understanding of parental beliefs and cognitions related to infant sleep. There is a need for validated measures to investigate the cognitions of Turkish mothers about infant sleep however no scale measuring parental perceptions related to infant sleep behaviors in Turkish is available. We aimed to culturally adapt the Maternal Cognitions about Infant Sleep Questionnaire (MCISQ) in Turkish. MethodsSubjects were recruited from an internet sample through social media. Internal consistency was evaluated by Cronbach's alpha, and test-retest reliability was determined by Pearson's correlation test and paired t-test. For factorial validity, the principal component factor analysis was performed for the components of MCISQ. ResultsA total of 417 mothers, most aged between 25 and 29 years (47.8 %), participated in the study. Infants' age ranged between 6 and 18 months, with a mean of 10.5 ± 3.9 months. Factor analysis revealed four factors after removal of item 11: Anger, doubt, safety, limit setting. Cronbach's alpha was 0.85. A subgroup of 32 mothers completed MCISQ three weeks after the initial administration. Total mean scores showed a significantly strong correlation (p:<0.01, r:0.82). Higher scores were noted in both total and subscale scores in infants with maternally reported sleep problems (p:<0.01). ConclusionFindings suggest a four-factor solution for MCISQ in Turkish mothers with infants aged 6–18 months. The adapted Turkish version is composed of 19 items with good reliability. Factor structure and items included in the subscales differed from the original study, highlighting the cultural factors related to maternal perceptions about infant sleep.

Association between Maternal Depression and Sleep Disorders in Toddlers: A Case Report

Poor sleep quality in childhood can lead to socio-emotional and academic problems. In early childhood, sleep is mostly influenced by environmental factors, such as the mother’s mental health. The aim of this case report is to expand the body of knowledge surrounding the association between sleep disturbances in toddlers and maternal depression. An 18-month-old child was referred to a Child Psychiatry consultation due to multiple nocturnal awakening almost every night since he was 3 months old. The mother reports depressive symptoms. It was concluded that the child met criteria for night awakening disorder. The treatment plan included sessions to promote parenting skills and the use of prolonged-release melatonin. The literature shows that maternal depressive symptoms are related to difficulties in initiating and maintaining sleep in young children, and it is important to diagnose and treat this symptomatology to mitigate its impact on these children’s sleep.

Sleep Duration Is Associated with Household Food Insecurity and Sugar-Sweetened Beverage Intake Among Women, Infants and Children Participating Children Ages 0-5.

To determine associations between child and household characteristics and sleep duration among low-income children in Los Angeles County. Cross-sectional study. Survey data collected in 2017 and 2020 in Los Angeles County, California. Special Supplemental Nutrition Program for Women, Infants and Children (WIC) households with children ages 4-60months. Sleep duration for children 4-60months old (less than recommended (LTR), recommended range, more than recommended (MTR)), household food insecurity (HFI), sociodemographics, and daily servings of sugar-sweetened beverages (SSB). Multinomial logistic regression, stratified by child age, was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for associations between household/child characteristics and LTR or MTR sleep compared to recommended duration among WIC participating children 4-60months old. The final sample included 3512 children ages 4-23months and 6035 children ages 24-60months. In the study population, 32% (3-5years old) to 44% (4-11months) of children under 5 did not meet the recommended hours of sleep per night. HFI was associated with higher odds of LTR (OR 1.27, CI 1.12-1.45) and MTR (OR 1.46, CI 1.15-1.87) sleep among 24-60month-old children. Each additional daily SSB serving was associated with higher odds of LTR sleep (4-23months: OR 1.10, CI 1.02-1.19; 24-59months: OR 1.12, CI 1.08-1.17). HFI and SSB intake are associated with not getting the recommended amount of sleep among low-income WIC participating children. Nutrition assistance program participants may benefit from receiving information about recommended sleep duration for young children and how to establish sleep routines to optimize sleep duration.

Findings on Sleep of Children with Cerebral Palsy and Their Mothers' Sleep and Emotional Intelligence

Objective: This study was aimed to (i) sleep characteristics of children with cerebral palsy (CP), and sleep and emotional intelligence results of their mothers, and (ii) explore the relationship these parameters both with each other and with demographic characteristics of children and their mothers. Methods: Thirty-three children with CP and their mothers were included this study. Functional level of children was evaluated with Gross Motor Function Classification Scale (GMFCS) while sleep parameters with Child Sleep Habits Questionnaire-Abbreviated Form (CSHQ-AF). Sleep quality and emotional intelligence of mothers was evaluated by The Pittsburg Sleep Quality Index (PSQI) and Revised Schutte Emotional Intelligence Scale (RSEI), successively. Results: The highest percentage of children with CP participating in the study was at level 3 (GMFCS) with 24.24%. Mean sleep score of children with CP according to CSHQ-AF was 50.33 (SD: 9.38) points. Twenty-nine (87.9%) of children with CP had pediatric sleep problem while 51.5% of mothers had poor sleep quality. RSEI total score of mothers was 149.54 (SD: 16.94). No relationship was found between sleep and emotional intelligence of mothers with sleep of children with CP (p&gt;0.05). Conclusion: The rate of sleep problems was found to be higher in children with CP compared to their mothers as expected. The lack of relationship between sleep and emotional intelligence can be explained by the reality that both parameters can be affected by many factors.

Glymphatic dysfunction coincides with lower GABA levels and sleep disturbances in succinic semialdehyde dehydrogenase deficiency.

Succinic semialdehyde dehydrogenase deficiency (SSADHD) is an inherited metabolic disorder of γ-aminobutyrate (GABA) catabolism. Cerebral waste clearance along glymphatic perivascular spaces depends on aquaporin 4 (AQP4) water channels, the function of which was shown to be influenced by GABA. Sleep disturbances are associated independently with SSADHD and glymphatic dysfunction. This study aimed to determine whether indices of the hyperGABAergic state characteristic of SSADHD coincide with glymphatic dysfunction and sleep disturbances and to explicate the modulatory effect that GABA may have on the glymphatic system. The study included 42 individuals (21 with SSADHD; 21 healthy controls) who underwent brain MRIs and magnetic resonance spectroscopy (MRS) for assessment of glymphatic dysfunction and cortical GABA, plasma GABA measurements, and circadian clock gene expression. The SSADHD subjects responded to an additional Children's Sleep Habits Questionnaire (CSHQ). Compared with the control group, SSADHD subjects did not differ in sex and age but had a higher severity of enlarged perivascular spaces in the centrum semiovale (p < 0.001), basal ganglia (p = 0.01), and midbrain (p = 0.001), as well as a higher MRS-derived GABA/NAA peak (p < 0.001). Within the SSADHD group, the severity of glymphatic dysfunction was specific for a lower MRS-derived GABA/NAA (p = 0.04) and lower plasma GABA (p = 0.004). Additionally, the degree of their glymphatic dysfunction correlated with the CSHQ-estimated sleep disturbances scores (R = 5.18, p = 0.03). In the control group, EPVS burden did not correlate with age or cerebral and plasma GABA values. The modulatory effect that GABA may exert on the glymphatic system has therapeutic implications for sleep-related disorders and neurodegenerative conditions associated with glymphatic dysfunction.

Epidemiology of sleep patterns and circadian typology in uruguayan children: The contribution of school shifts

Healthy sleep is defined by the combination of adequate duration, good quality, and regular timing. In children, sleep thus depends on the interplay of individual, parental, organizational, community, and social variables, but only a few studies have addressed this issue in a comprehensive way nationwide. Using the Uruguayan nationally representative survey (Nutrition, Child Development, and Health Survey, Encuesta de Nutrición, Desarrollo Infantil y Salud, ENDIS), we present the first epidemiological characterization of chronobiological and sleep parameters in Latin American children. On average, Uruguayan urban children (n = 2437; 5−10-years old) showed quite late chronotypes (MSFsc = 03:53 ± 1:07), moderate misalignment (SJL = 1.0 ± 0.9 h), and adequate sleep duration (SDweek = 9.9 ± 1.0 h). Further, we show the substantial influence of school shift schedules on children's circadian typology and sleep patterns. Our results show that children attending the morning school shift have a higher risk of sleep problems than afternoon-school shift ones. The chronotype and sleep were earlier in morning-school shift children than in children attending the afternoon school shift. However, morning-school shift children had stronger misalignment, shorter sleep on school days, and a higher risk of chronic sleep deficit and non-healthy circadian misalignment (even worse in late chronotypes) than afternoon-shift children. This evidence points to the need of evaluating policies to reorganize school start times to prevent the negative effects that early schooling seems to have on children's sleep health, which has been neglected so far.

Factors contributing to U.S. parents’ decisions to administer melatonin to children

ObjectivePediatric melatonin use is increasingly prevalent in the U.S. despite limited research on its efficacy and long-term safety. The current study investigated factors contributing to parents’ decisions whether to give children melatonin. MethodsParents of children 1.0–13.9 years completed an online questionnaire on children's health, sleep, and melatonin use. Parents who reported giving melatonin to their child were asked open-ended follow-up questions on why their child takes melatonin and why they stopped (if applicable). Responses were assigned to categories through thematic coding. ResultsData were analyzed on 212 children who either consumed melatonin in the past 30 days (n = 131) or took melatonin previously (n = 81). Among children who recently took melatonin, 51.1 % exhibited bedtime resistance and 46.2 % had trouble falling asleep. Parents most commonly gave children melatonin to: help them fall asleep (49.3 %), wind down before bedtime (22.7 %), facilitate changes in their sleep routine (17.5 %), and/or change their circadian rhythm (11.4 %). Parents stopped giving melatonin because their child did not need it anymore (32.0 %), experienced negative side effects (9.3 %), and/or concerns about health and safety (13.3 %). Finally, parents initiated melatonin use on their own (50.0 %), were encouraged by a friend or family member (27.4 %), and/or followed the recommendation of a health provider (48.1 %). ConclusionsParents administered melatonin to children for a number of reasons and discontinued melatonin based on their own observations of a variety of effects. Parents frequently initiated use without the recommendation of a medical professional. Further research on indications and efficacy of melatonin and wider dissemination of guidelines are needed to help parents make informed decisions regarding children's sleep health.

Development, psychometric evaluation, and factor analysis of an instrument measuring quality of life in autistic preschoolers.

Early interventions for autistic children should target their quality of life (QoL) but require adapted measures. The association of a child's temperament and parental characteristics with the QoL of autistic children remains unknown. We constructed an autism module based on a thematic analysis, a Delphi survey with experts, and a pre-test with parents to be completed alongside the proxy version of the PedsQL 4.0. We explored compliance, responsiveness, internal consistency, convergent validity, and factor structure with 157 parents of autistic preschool children. We examined the association between child and parental characteristics with the QoL of autistic children using correlation analysis, principal component analysis, hierarchical ascending classification, and linear regression. Sociodemographic information was collected via multiple choice questions, autism severity via Autism Diagnostic Observation Schedule (ADOS)scores, and parental acceptance and child's temperament via the Acceptance and Action Questionnaire and the Emotionality, Activity, and Sociability. An autism module comprised of 27 items emerged. Psychometric evaluation resulted in a 24-item autism module with good internal consistency and significant convergent validity. ADOS total score was not significantly related to QoL, contrary to children's sleep issues, children's emotionality, and parental acceptance. The autism module is a reliable QoL proxy measure for autistic preschool children. Results suggest parental interventions targeting children's QoL.

Sleep and memory consolidation in healthy, neurotypical children, and adults: a summary of systematic reviews and meta-analyses.

This review systematically assesses the impact of sleep on memory and cognition in healthy individuals across different life stages. It specifically examines how sleep affects memory processes in children, adults, and older adults. The methodology involved a comprehensive literature search, starting with 46 known papers. Keywords and Mesh terms related to sleep and memory consolidation were derived using the Word Frequency Analysis tool in SR Accelerator and Mesh on Demand. A detailed search on PubMed yielded a large set of records. Classifier training on 4854 decisions, these were narrowed down to 1437 papers for full-text screening, culminating in 19 systematic reviews and meta-analyses. Sleep enhances memory consolidation, especially for complex declarative information. While the role of sleep in procedural memory consolidation in children remains less robust compared to declarative memory, findings suggest potential but inconsistent benefits. Sleep improves prospective memory consolidation and aids in complex associative memory tasks. Memory reactivation during sleep, specifically slow-wave sleep, and spindles are implicated in memory consolidation. Meta-analytic evidence suggests that while sleep benefits both emotional and neutral memory consolidation, there is no strong preferential effect of sleep on emotional memory in comparison to neutral memory. In older adults, there is a noticeable reduction in sleep-dependent memory consolidation, particularly for declarative memory, likely linked to a decline in slow-wave sleep. This suggests a decrease in the benefits of sleep for memory consolidation with aging. Overall, the review underscores the importance of sleep in memory processes across all ages, highlighting variations in its impact on different types of memory and across age groups. It points to future research directions for enhancing understanding and practical applications in clinical and educational settings.

War exposure prior to conception: Longitudinal associations between maternal emotional distress and child sleep 10 years later

Exposure to war is known to impact children’s physical and mental health. Recent research reveals that war exposure might even affect the developmental outcomes of children who are yet to be conceived. In this study, we sought to extend such prior work by investigating longitudinal associations between pre-conception war exposure and the accompanying maternal emotional distress on child sleep. Israeli mothers, who conceived within a year after the Lebanon war in 2006 (N = 68), were followed until their children reached 10 years of age. At that age, child sleep problems were measured through mother and child reports. Results from analyses of covariances (ANCOVAs) showed that war exposure prior to conception itself did not predict child sleep. However, hierarchical regression analyses showed that higher levels of maternal emotional distress, as a result of pre-conception war exposure, predicted more sleep problems in girls. Further exploratory analyses revealed that these associations showed themselves in both maternal and child reports on various sleep domains. In boys, no evidence was found for associations between maternal emotional distress during wartime and sleep 10 years later. These results indicate that war-related pre-conception stress might have long-term, sex-specific effects on child sleep, though replication with larger samples is needed to corroborate the findings.

Parental Accuracy of Reporting Child Sleep Duration: Examining Sleep and Childhood Obesity in Midwestern Latinx Youth

This study examined the relationship between the accuracy of parental reporting of children’s sleep duration compared to objectively measured child sleep and tested whether any discrepancies were related to childhood obesity prevalence in a sample of Latinx families ( N = 119). A paired sample t-test revealed that parents significantly overestimated their child’s sleep duration by 1.33 hours, t(86) = 6.69, p &lt; .001. Using a one-way ANOVA, no significant differences were found in children’s BMI percentile when grouped by the parent’s accuracy of their child’s sleep duration F(3, 83) = .76, p = .52. A potential, although non-significant, trend regarding parent accuracy and child BMI may merit further examination. Future research should seek to determine if the discrepancy in parent reported child sleep duration is indeed linked with increased child BMI and if this knowledge could be used in targeted intervention efforts to reduce childhood obesity.

The association of tonsillar microbiota with biochemical indices based on obesity and tonsillar hypertrophy in children

The correlation between tonsil microbiome and tonsillar hypertrophy has not been well established. Given that oral dysbiosis is related to several metabolic diseases and that tonsillar hypertrophy leads to disordered breathing during sleep and obesity in children, it is necessary to investigate the relationship between the oral microbiome and tonsillar hypertrophy. After 16S rRNA amplicon sequencing of tonsillectomy samples, we evaluated the correlation between the tonsil microbiome and biochemical blood indices in pediatric patients who underwent tonsillectomy. Groups are classified into two categories: based on BMI, and grades 2, 3, and 4 based on tonsil size. Children with obesity and tonsillar hypertrophy have similar microbiome compositions and induce comparable changes in microbiome abundance and composition, confirming the association from a metagenomic perspective. In addition, obesity and tonsillar hypertrophy demonstrated a strong correlation with the Proteobacteria to Firmicutes (P/F) ratio, and among various biochemical indicators, alanine aminotransferase (ALT) levels increase with obesity and tonsillar hypertrophy, indicating a possible association of tonsil microbiome and liver metabolism. These novel findings demonstrate the significance of the tonsil microbiome and suggest the need for tonsil regulation, particularly during childhood.

Prevalence of toddlers meeting 24-hour movement guidelines and associations with parental perceptions and practices

ObjectivesWhether toddlers (1-2 years) meet 24-hour Movement Guidelines and how parental practices and perceptions are related to compliance are uncertain. This study: a) estimated the proportion of toddlers meeting individual and combined movement guidelines; and b) examined associations between parental perceptions/practices and toddlers’ compliance with movement guidelines. DesignCross-sectional study. MethodsAustralian parents self-reported their parenting practices/perceptions (routines, co-participation, restrictions, concerns, knowledge) and toddlers’ movement behaviours in the baseline assessment of Let’s Grow (n=1145), a randomised controlled trial. The World Health Organization’s Guidelines on Physical Activity, Sedentary Behaviour, and Sleep for children under 5 years were used to estimate the prevalence of compliance with individual and combined movement guidelines. Logistic models assessed cross-sectional associations. ResultsThe prevalence of meeting guidelines was 30.9% for screen time, 82.3% for sleep, 81.6% for physical activity, 20.1% for combined, and 2.1% meeting none. Parents’ knowledge of the guidelines, fewer concerns and more favourable restrictions concerning movement behaviours were associated with greater compliance with individual and combined movement guidelines. Routines for screen time and for combined behaviours were associated with adherence to their respective guidelines. Less co-participation in screen time and more co-participation in physical activity were associated with greater compliance with the relevant guidelines. ConclusionsGiven only 20% of toddlers met all guidelines, strategies early in life to establish healthy movement behaviours, especially screen time, are needed. Future studies could target the parental practices/perceptions identified in this study to support toddlers with optimal sleep and physical activity and reduced screen time.

Early nap cessation in young children as a correlate of language and psychosocial outcomes: Evidence from a large Canadian sample

ObjectivesMost children stop napping between 2 and 5years old. We tested the association of early nap cessation (ie, children who stopped before their third birthday) and language, cognition functioning and psychosocial outcomes. MethodsData were from a national, longitudinal sample of Canadian children, with three timepoints. Children were 0-to-1 year old at T1, 2-to-3 years old at T2, and 4-to-5 years old at T3. Early nap cessation was tested as a correlate of children’s psychosocial functioning (cross-sectionally and longitudinally), cognitive function (longitudinally), and language skills (longitudinally). There were 4923 children (50.9% male; 90.0% White) and their parents in this study who were included in the main analyses. Parents reported on demographics, perinatal and developmental variables, child functioning, and child sleep. Children completed direct assessments of receptive language and cognitive ability. Nap cessation, demographic, and developmental-control variables were tested as correlates of cross-sectional and longitudinal outcomes using linear regression (with a model-building approach). ResultsEarly nap cessation correlated with higher receptive language ability (β = 0.059 ± 0.028) and lower anxiety (β = −0.039 ± 0.028) at T3, after controlling for known correlates of nap cessation, nighttime sleep, and other sociodemographic correlates of the outcomes. Cognitive ability, hyperactivity-inattention, and aggression were not correlated with nap cessation. ConclusionsEarly nap cessation is related to specific benefits (ie, better receptive language and lower anxiety symptoms). These findings align with previous research. Future research should investigate differences associated with late nap cessation and in nap-encouraging cultures, and by ethnicity.

Sleep and its association with dental caries or myopia in first graders.

First grade is a transition from pre-school to school-age. The change in lifestyle behaviours such as sleep may have a physiological response, which contributes to the presence or absence of two highly incident diseases: dental caries or myopia. The aim of the study was to examine the association between sleep and myopia as well as sleep and dental caries in first graders. It is a cross-sectional study. This was a recruitment phase of an interventional study. A total of 338 children whose caregivers completed a Children's Sleep Habits Questionnaire. Caregivers also provided information regarding myopia and caries status of children and their parents. Binary logistic regression was applied to analyse the potential risk factors. Dental caries and myopia rates were 45.9% and 9.5%, respectively. After adjusting for children's gender, children's age, fathers with caries and mothers with caries, the odds ratio for dental caries in children who slept less than 9 h when compared to those who slept for nine and more hours was 1.94. Mothers with caries were 3.37 times more likely to have children with caries than mothers without caries. However, sleep was not associated with myopia in first graders. Sleeping less than 9 h and maternal caries were risk factors of children developing dental caries. Future sleep and myopia studies can be conducted on higher graders who may present prolonged exposure and accumulations of myopic risk factors. Screening of children with insufficient sleep is needed for nurses to enable the early identification of high-risk groups for dental caries in school settings. Family nurses are encouraged to work with family members to implement tailored sleep interventions, in order to facilitate better sleep and oral health practices in both school and home settings. This study protocol was registered on ClinicalTrials.gov (Registration number: Redacted).

Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children

Sleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified. To examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs). This cohort study used data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023. Sleep disturbances were assessed using the Children's Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire. Occurrence of incident and resolved EBDs at the 2-year follow-up. The cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P < .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P < .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P < .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P < .001) were higher than among the group with no sleep disturbances. In this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.

Associations between maternal stressful life events and child health outcomes in indigenous and non-indigenous groups in New Zealand

ABSTRACT Exposure to stressful life events (SLE) around the time of pregnancy is associated with adverse health outcomes for mothers and children. Previous New Zealand research found Indigenous Māori women are more likely to be exposed to SLE than non-Māori, and are exposed to a higher number of SLE. The consequences of this for ethnic inequities in child health outcomes are unknown. This paper examines the relationship between patterns of maternal SLE exposure with child health and development outcomes at age 3 years, for Indigenous and non-Indigenous children. We found most children had a stressful early life environment at least sometimes, but more than a quarter of Māori children had a mother experiencing multiple SLE on all occasions measured. We found a clear association between maternal experiences of SLE and disordered child sleep and development concerns. While not able to fully assess the contribution of maternal SLE to ethnic inequities in child health outcomes, we did clearly demonstrate that more Māori children have mothers exposed to multiple SLE, and that these maternal SLE are associated with poorer child outcomes. The impacts of chronic SLE exposure need to be better understood, especially given the large ethnic disparity in chronic SLE exposure.

Changes in Sleep in Children and Adults with Cystic Fibrosis and Primary Ciliary Dyskinesia over Time and after CFTR Modulator Therapy.

Cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) are associated with sleep disturbances affecting quality of life (QOL) in both children and adults. However, little is known about the progression of these complaints over time, and the effect of CFTR modulator (CFTRm) therapies. Participants completed sleep quality (SDSC, PSQI) and quality of life questionnaires (PedQL, QOL-BE) as well as the Epworth sleepiness scale (ESS) at baseline and after 4 years. Medical records were reviewed for clinical data and correlations were sought between sleep, QOL, and clinical parameters. A total of 67 patients (33 pediatric), 37 pancreatic insufficient CF (CF-PI), 15 pancreatic sufficient CF (CF-PS), and 15 PCD patients, completed the study. In adults, global sleep quality decreased from 85.8% (76.2-90.5) to 80.9% (71.4-85.7); (p = 0.009). Analysis by disease cohort showed a significant deterioration only in the CF-PS group. In adults off CFTRm, sleep quality decreased from 85.7% (78.6-88.2) to 80.9% (71.4-87.3); (p = 0.021) and from 85.8% (76.2-92.9) to 76.2% (71.4-85.8); (p = 0.078) in people on CFTRm. Changes in sleep quality and changes in QOL over time were strongly associated with each other. In conclusion sleep quality deteriorates over time, correlates with QOL, and is driven primarily by adults and CF-PS patients. CFTRm has a possible effect on sleep initiation; however, results are mixed, and further long-term studies are required.

Sleep disturbances in children and adolescents after kidney transplantation.

Disturbances of sleep are prevalent among children with chronic kidney disease. However, the aetiology of sleep disorders in children particularly after kidney transplantation is not clear. We sought to ascertain the prevalence and type of sleep disturbances in paediatric kidney transplant recipients and to identify predictors of sleep disturbances in this population. Caregivers of kidney transplant recipients completed online questionnaires about their child's sleep. The questionnaires utilised were the Sleep Disturbance Scale for Children (SDSC), the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), questions about sleep hygiene, and questions about restless leg syndrome. Demographic and clinical details were collected from medical records. Thirty-five children were included in the study, with a median (IQR) age of 14.1years (9.5-16.1) and median years (IQR) since transplant of 3.7 (0.7-8.7) years, and 72.0% were identified to have at least one category of sleep disturbance according to scores on the SDSC. The most common sleep disturbances reported were disorders of initiating and maintaining sleep (DIMS) (40.0%) and disorders of excessive somnolence (DOES) (31.4%). Statistically significant predictors of sleep disturbances include low estimated glomerular filtration rate and increased age. Among children who screened positive for DIMS and DOES, the majority indicated use of electronic devices in 1h before bed. A high prevalence of sleep disturbances has been identified in children after kidney transplants, and some risk factors may be modifiable. Further studies are required to understand whether there are other readily modifiable predictors of sleep disturbances.

Application of biophilic natural lighting to reduce blue spectrum exposure in dark rooms on children’s sleep quality

Technology plays an essential role in people's lives, and gadgets have become a prevalent trend for information and communication. However, excessive gadget use among children can have negative side effects. Children often spend extended periods of time engaged with gadgets, disregarding screen brightness and maintaining a close distance to the screen. Some parents resort to gadgets as a quick way to pacify their children during tantrums. To address the challenges posed by advanced technology, this study aims to observe and interview parents with children aged 5 to 12. According to UC Davis Health in California, blue light, which is emitted by electronic devices, has the shortest wavelength and the highest energy. It can disrupt the production of melatonin, the hormone that regulates sleep. Exposure to blue light in a dark room, such as when children use electronic devices at night, further disrupts their sleep patterns. To mitigate this, the study will explore the implementation of biophilic natural lighting, which mimics the lighting found in nature. The goal is to create a harmonious and healthier environment that connects children with the natural world, promoting their well-being. By conducting a case study involving workers in biophilic and non-biophilic environments and a dark room is not an ideal choice for playing with gadgets, the study aims to investigate how biophilic natural lighting can reduce the exposure to blue spectrum in dark rooms, particularly for children. The ultimate objective is to determine the impact of biophilic natural lighting on children's sleep quality and propose effective lighting strategies to improve their overall sleep quality. The results of this study will demonstrate the significant improvement in children's sleep quality with the implementation of biophilic natural lighting, providing valuable design guidelines for creating healthier environments for children.