Determinants Of Sleep Problems Research Articles

The Experiences and Determinants of Sleep Problems of Immigrant and Canadian-Born Older Adults-Analysis of Canadian Longitudinal Study on Aging Baseline Data.

Although prevalent, limited knowledge is available on the experience of sleep problems (i.e., disturbance in sleep latency and in sleep maintenance) and their determinants in immigrant older adults. To compare immigrant and Canadian-born older adults' experiences of: 1) sleep problems, 2) determinants of sleep problems, categorized into precipitating and perpetuating factors, and 3) determinants most significantly contributing to each sleep problem. Baseline data obtained by the comprehensive cohort of the Canadian Longitudinal Study on Aging were analyzed. Participants 55+ years of age and with complete data on their country of birth comprised the sample, with 18,245 Canadian-born and 4,257 immigrant older adults. Single or multiple items were used to assess the precipitating (chronic condition, sleep disorders, pain, depressive symptoms, psychological distress, education, marital and socio-economic status) and perpetuating (smoking, alcohol consumption, physical activity) factors. Chi-square test and independent sample t-test were used in the comparison and multiple regression was applied to determine the most significant determinant of each sleep problem in each group of older adults. Despite differences in a few determinants of sleep problems, the set of factors contributing to disturbance in sleep latency and maintenance was comparable for Canadian-born and immigrant older adults, and included: having a sleep disorder and high level of depressive symptoms and psychological distress. The findings highlight the importance of public health campaigns to increase older adults' awareness of sleep problems, the factors that may contribute to disturbance in sleep, and strategies to prevent and/or manage sleep problems.

Determinants of sleep problems in children with intellectual disability.

Children with intellectual disabilities are more likely to experience sleep disorders of insomnia, excessive daytime sleepiness and sleep breathing disorders than typically developing children. The present study examined risk factors for these sleep disorders in 447 children (aged 5-18years), diagnosed with an intellectual disability and comorbid autism spectrum disorder, cerebral palsy, Down syndrome or Rett syndrome. Primary caregivers reported on their child's sleep using the Sleep Disturbance Scale for Children (SDSC), as well as medical comorbidities and functional abilities. Multivariate linear and logistic regressions were used to examine the effects of these factors on SDSC t scores and a binary indicator, respectively for the relevant subscales. Receiving operating characteristic curves were generated for each logistic regression model to determine their ability to discriminate between poor and good sleep. Comorbidities rather than functional abilities were associated with poorer sleep. In particular, recurrent pain, frequent seizures, frequent coughing, constipation and prescription of sleep medications were associated with abnormal sleep across the entire sample, but predictors differed between diagnostic groups. The present study suggests that comorbidities are more strongly associated with quality of sleep than functional impairments. The present study provides new information on potential associations between frequent coughing, prescription sleep medications and sleep quality that should be further investigated.

Sleep disturbances among children with autism spectrum disorders, attention deficit/hyperactivity disorders, and their gender, age group-matched siblings

Background: Sleep disturbances are commonly associated with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The strength of this association with comparison to matched general population published in the previous studies was inconclusive. Objectives: The objectives of this study were to examine sleep disturbances among ASD and ADHD children in comparison to their matched control of typically developed siblings. Materials and Methods: Children, aged 3–17 years, attending Al-Wafa and Al-Rashad Centers, were recruited using convenience sampling. Each registered case with ASD diagnoses had a typically developed siblings matched for sex and age group of ± 5 years differences (75 cases and 75 siblings). ADHD group included children with similar age group, diagnosed as ADHD, who attended school health clinics (50 cases and 50 siblings); same inclusion criteria were applied to both ASD and ADHD cases. Sibling groups were brothers and sisters of ASD or ADHD cases matched for gender and age group of ± 5 years. The mothers were interviewed and completed a fact and data sheet prepared for the study. The data sheet included items from the sleep disorders scale for children (SDSC). Results: There were no significant differences between children with ASD and their siblings. Children with ADHD had significant difference with siblings in sleep variables such as movement during sleep (P = 0.04), reading prior to sleep (P = 0.002), and the need to take medicine (P = 0.01). Children with ASD showed more disturbances in sleep variables compared to children with ADHD but did not reach significant level with the exception of suffocation during sleep which was more among children with ADHD. Conclusion: The differences between the groups were unremarkable. Parental attitude and sleep hygiene practice were the major determinants of sleep problems which need further elucidation.

Determinants of sleep disturbances in Rett syndrome: Novel findings in relation to genotype.

Rett syndrome is a rare but severe neurological disorder associated with a mutation in the methyl CpG binding protein 2 (MECP2) gene. Sleep problems and epilepsy are two of many comorbidities associated with this disorder. This study investigated the prevalence and determinants of sleep problems in Rett syndrome using an international sample. Families with a child with a confirmed Rett syndrome diagnosis and a MECP2 mutation registered in the International Rett Syndrome Phenotype Database (InterRett) were invited to participate. Questionnaires were returned by 364/461 (78.9%) either in web-based or paper format. Families completed the Sleep Disturbance Scale for Children and provided information on the presence, nature, and frequency of their child's sleep problems. Multivariate multinomial regression was used to investigate the relationships between selected sleep problems, age group, and genotype and linear regression for the relationships between sleep disturbance scales and a range of covariates. Night waking was the most prevalent sleep problem affecting over 80% with nearly half (48.3%) currently waking often at night. Initiating and maintaining sleep was most disturbed for younger children and those with a p.Arg294* mutation. Severe seizure activity was associated with poor sleep after adjusting for age group, mutation type, and mobility. We were surprised to find associations between the p.Arg294* mutation and some sleep disturbances given that other aspects of its phenotype are milder. These findings highlight the complexities of aberrant MECP2 function in Rett syndrome and explain some of the variation in manifestation of sleep disturbances. © 2016 Wiley Periodicals, Inc.

Determinants of sleep problems in patients with spondyloarthropathy

To characterize sleep complaints and identify biopsychosocial factors associated with sleep problems in patients with spondyloarthropathy (SpA). The sample comprised 125 patients with SpA. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants completed standardized questionnaires assessing depressed mood, perceived stress, leisure time physical activity, functional disability and disease activity. A series of hierarchical multiple regressions were computed to examine the determinants of the following sleep parameters: quality, latency, duration and efficiency. The mean global PSQI score was 8.7 (SD = 5.0), with 69% of the sample classified as poor sleepers (PSQI global score >5). Worse functional status was associated with poorer sleep quality (p = 0.006), longer sleep latency (p = 0.004), shorter sleep duration (p = 0.001) and poorer sleep efficiency (p = 0.004). Higher depressed mood scores emerged in the multivariate analyses as a significant determinant of poorer sleep quality (p = 0.010), shorter sleep duration (p = 0.007) and poorer sleep efficiency (p = 0.006). Higher perceived stress was an independent contributor of poorer sleep quality (p = 0.033). The relationships between worse functional status and poorer sleep quality and shorter sleep duration were more pronounced for participants who completed the questionnaires in the English language. Sleep problems are prevalent among patients with SpA. Our findings suggest that multiple factors are associated with sleep complaints in persons with SpA with functional status, depressed mood and stress differentially contributing to specific sleep parameters. Multimodal interventions, which include non-pharmacological methods targeting these biopsychosocial factors, require evaluation to optimize the management of sleep disruptions in SpA.