Global Sleep Disturbance Research Articles

Identifying mechanistic links between sleep disturbance and binge eating: the role of depressed mood

ABSTRACT Global sleep disturbance is robustly linked with a subjective sense of loss-of-control over eating (LOC). Depressed mood has been proposed as a mechanism to explain the bi-directional relationship between sleep disturbance and LOC eating. The current study evaluated whether sleep disturbance indirectly affects LOC eating via depressed mood. Adults seeking treatment for a DSM-5 binge-spectrum eating disorder (e.g. bulimia nervosa, binge-eating disorder) were recruited (n = 79) and asked to complete self-report questionnaires assessing sleep disturbance and depression, and a semi-structured interview assessing LOC eating. Tests of indirect effects evaluated the effect of depressed mood on the association between global sleep disturbance and LOC frequency covarying for BMI and parent study. A significant indirect effect of depressed mood on the association between global sleep disturbance and frequency of LOC eating was identified (Est = 1.519, S.E. = 0.859, p = .033). The indirect effect of depressed mood on the association between sleep disturbance and LOC eating may indicate that depressed mood serves as a mechanistic link between sleep disturbance and LOC eating. The findings offer preliminary support for adjunctive treatments targeting both sleep disturbance and depressed mood for LOC eating. Future research should explore these pathways in a larger clinical sample.

Racial disparities in treatment engagement and outcomes in digital cognitive behavioral therapy for insomnia among pregnant women

ObjectivesIn the United States, Black women are disproportionately afflicted with prenatal insomnia. Although cognitive-behavioral therapy for insomnia (CBTI) may represent a strategy to reduce disparities in insomnia, racial minorities attend fewer healthcare appointments and have poorer outcomes from prenatal care and mental health treatment relative to white patients. The present study examined differences in treatment engagement and patient-reported outcomes in non-Hispanic Black and white pregnant women receiving digital CBTI. MethodsSecondary analysis of 39 pregnant women with clinical insomnia who received digital CBTI. Treatment engagement was operationalized as the number of sessions completed (≥4 considered an adequate dose). Treatment outcomes were assessed using the Insomnia Severity Index (ISI; insomnia) and Pittsburgh Sleep Quality Index (PSQI; global sleep disturbance). ResultsBlack women were 4 times more likely than white women to discontinue CBTI before receiving an adequate dose (8.3% vs. 33.3%). Regarding treatment outcomes, white women reported a mean reduction of 5.75 points on the ISI and a reduction of 3.33 points on the PSQI (Cohen's dz = 1.10-1.19). By comparison, Black women reported reductions of 2.13 points on the ISI and 1.53 points on the PSQI, which were statistically non-significant. Differences in treatment engagement did not account for the disparities in patient-reported outcomes. ConclusionsDuring pregnancy, Black women completed fewer CBTI sessions and experienced poorer treatment outcomes in response to digital CBTI relative to white women. Enhancements to insomnia therapy and its digital delivery may improve adherence and outcomes in Black pregnant women.

Sleep disturbances and sleep patterns in children with tic disorder: A case-control study.

Study objectivesTo characterize sleep disturbances and sleep patterns in children with Tic disorder (TD), and explore their association with TD severity and types.MethodsA case-control study was conducted in 271 children with TD recruited from a clinical setting and 271 non-TD children recruited from a primary school, matched by age (mean = 8.47 years, SD = 1.53 years) and gender (15.1% female). The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep patterns and sleep disturbances. The TD types and severity were assessed with the Yale Global Tic Severity Scale (YGTSS).ResultsThe TD children scored higher on CSHQ total score than non-TD group (t = 29.50, p < 0.001) and demonstrated severer global sleep disturbance. Compared to non-TD children, TD children presented with increased risks for global sleep disturbance (aOR: 1.95; 95% CI = 1.20–3.06), and most specific sleep disturbances, including bedtime resistance (aOR: 3.15; 95% CI = 1.96–5.06), sleep onset delay (aOR: 3.43; 95% CI = 1.58–7.46), sleep anxiety (aOR: 2.83; 95%CI = 1.83–4.38), parasomnias (aOR: 3.68; 95% CI = 2.02–6.62), night waking (aOR: 9.29; 95% CI = 2.64–32.65), sleep disordered breathing (aOR: 1.72; 95% CI = 1.03-2.90) and daytime sleepiness (aOR: 1.72; 95% CI = 1.09–2.74). Children with mild and moderate tics, Provisional Tic Disorder (PTD), Chronic Tic Disorder (CTD) and Tourette Syndrome (TS) presented with more global and more specific sleep disturbances. In addition, combined ADHD, etc.ConclusionChildren with TD are major risks for increased sleep disturbances, especially for those with severe and chronic symptoms. Furthermore, comorbid ADHD increases risk in certain areas of sleep. These findings highlight the importance to consider sleep outcomes in the assessment and treatment for children with TD.

Primary School Children's Sleep Habits: Association with Socioeconomic Factors and Physical Activity Habits.

Sleep disorders have significant health impacts and affect children’s performance and wellbeing. This study aims to characterise the sleep habits of Portuguese primary school children considering socioeconomic factors, daily lifestyle, presence of electronic devices in the bedrooms, and the practice of physical and sports activity (PSA) and to identify clinical factors that may be related to a child’s insufficient sleeping time. This study involved 1438 primary students. Sleep habits and problems were assessed using the short version of the Children’s Sleep Habits Questionnaire (CSHQ). The mean sleep duration was 9 h 37 min/ per night (SD = 44 min). The prevalence of global sleep disturbances was 25.8%. The main factors we identified to be positively associated with a child’s sleep deficit (i.e., <10 h) were: being older than 7 years, living further away from school, having electronic devices in the bedroom, going to bed and eating dinner later, less daily time of PSA, and having higher scores on the sleep duration subscales. Sleeping and eating habits, electronic devices in the bedroom, and a low level of engagement with PSA are associated with children’s sleep disturbance and shorter sleep duration.

Drug exposures in young children – The next frontier in occult injury testing

Child maltreatment (CM) can result in lifelong detrimental consequences, but its association with sleep disturbances in young children remains unclear.This study aimed to investigate the association of CM with sleep disturbances and short sleep duration among Chinese preschoolers.Data were from a representative sample of 17,023 children (6.17 ± 0.29 years old, 51.96% boys) at their graduation year of preschool in September 2019, as a subset of the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) study.Parents reported children's CM of different types and the Children's Sleep Habits Questionnaire (CSHQ). Logistic regression was used to evaluate the risk of sleep disturbances and short sleep duration linked to CM.Of the children, 12,583(73.92%) demonstrated sleep disturbances (CSHQ total score > 41) and 3017(17.72%) demonstrated short sleep duration (<9 h/night). After adjusting covariates, physical abuse (aOR = 1.16, 95%CI = 1.05–1.28) and emotional abuse (aOR = 1.50, 95% CI = 1.39–1.62) were associated with global sleep disturbances. Physical abuse (aOR = 1.16, 95% CI = 1.06–1.28), physical neglect (aOR = 1.29, 95%CI = 1.12–1.49), and emotional abuse (aOR = 1.19, 95% CI = 1.09–1.30) were associated with short sleep duration. Sexual abuse was not significantly associated with global sleep disturbances or short sleep duration. A cumulative association was noted that more CM types were associated with increased global sleep disturbances and short sleep duration.CM is associated with sleep disturbances and short sleep duration in young children. This highlights the efforts to prevent and reduce CM in favor of optimal sleep and whole health in young children.

The association between child maltreatment and sleep disturbances among preschoolers

BackgroundChild maltreatment (CM) can result in lifelong detrimental consequences, but its association with sleep disturbances in young children remains unclear. ObjectiveThis study aimed to investigate the association of CM with sleep disturbances and short sleep duration among Chinese preschoolers. Participants and settingData were from a representative sample of 17,023 children (6.17 ± 0.29 years old, 51.96% boys) at their graduation year of preschool in September 2019, as a subset of the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) study. MethodsParents reported children's CM of different types and the Children's Sleep Habits Questionnaire (CSHQ). Logistic regression was used to evaluate the risk of sleep disturbances and short sleep duration linked to CM. ResultsOf the children, 12,583(73.92%) demonstrated sleep disturbances (CSHQ total score > 41) and 3017(17.72%) demonstrated short sleep duration (<9 h/night). After adjusting covariates, physical abuse (aOR = 1.16, 95%CI = 1.05–1.28) and emotional abuse (aOR = 1.50, 95% CI = 1.39–1.62) were associated with global sleep disturbances. Physical abuse (aOR = 1.16, 95% CI = 1.06–1.28), physical neglect (aOR = 1.29, 95%CI = 1.12–1.49), and emotional abuse (aOR = 1.19, 95% CI = 1.09–1.30) were associated with short sleep duration. Sexual abuse was not significantly associated with global sleep disturbances or short sleep duration. A cumulative association was noted that more CM types were associated with increased global sleep disturbances and short sleep duration. ConclusionsCM is associated with sleep disturbances and short sleep duration in young children. This highlights the efforts to prevent and reduce CM in favor of optimal sleep and whole health in young children.

PTSD symptoms and suicide risk among firefighters: The moderating role of sleep disturbance.

The present study examined the moderating effect of global sleep disturbance and three disturbance facets (i.e., sleep efficiency, perceived sleep quality, and daily disturbances), on the association between PTSD symptom severity and suicide risk among firefighters. The sample was comprised of 802 trauma-exposed firefighters (93.5% male; Mage = 38.68; SD = 8.53), recruited from a large urban fire department in the southern U.S., who completed an online survey. Results indicated significant main and interactive effects of PTSD symptom severity and global sleep disturbance (and each disturbance facet) with regard to global suicide risk. Covariates included gender, years in the fire service, trauma load, and occupational stress. Models accounted for 24.1%-28.4% of variance in suicide risk. This study is the first to concurrently examine these variables among firefighters, and this line of inquiry has the potential to inform evidence-based policy as well as prevention and treatment programs for this vulnerable, understudied population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Acute and chronic fatigue in nurses providing direct patient care and in non-direct care roles: A cross-sectional analysis.

Nurses are at risk for work-related fatigue, which can impact their health, well-being, and job readiness. The purpose of this study was to examine the levels, types, and factors associated with fatigue in registered nurses (RNs) in direct patient care (DCRNs) and in non-direct patient care (non-DCRNs) roles. A cross-sectional survey was administered to 313 RNs. Measures included: Multidimensional Fatigue Symptom Inventory, Occupational Fatigue Exhaustion Recovery, Brief COPE, PROMIS® Global Sleep Disturbance, and Job Content Questionnaire. Acute fatigue levels in RNs were similar to those in diseased populations, and nearly 50% reported moderate/high levels of chronic fatigue. DCRNs reported higher levels of acute and chronic fatigue than non-DCRNs, but the differences were small and disappeared when accounting for other factors associated with fatigue including sleep disturbance, job strain, workplace support, maladaptive coping, and especially intershift recovery, which accounted for 20%-41% of fatigue variability. This study suggests that it may not be only nurses providing direct patient care who are at risk for acute and chronic fatigue. Intershift recovery may be particularly important in alleviating acute and chronic fatigue in nurses.

Grandparental care and sleep disturbances in preschool children: a population-based prospective cohort study

ObjectivesSleep disturbances are common in preschoolers, and profoundly affected by parenting. Grandparents are increasingly involved in childcare and have attracted worldwide attention for their potential impacts on child well-being. However, no studies have explored child sleep health within the context of grandparental care. We aimed to explore the association between grandparents as primary caregivers and children's sleep disturbances. MethodsParticipants included 20,324 preschoolers from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) in Shanghai, China. They were initially assessed in November 2016 and were reassessed in April 2018 and April 2019. Children's primary caregivers were collected at each survey. Sleep disturbances were assessed by the Children's Sleep Habits Questionnaire (CSHQ). ResultsAt baseline, 84.4% of children had global sleep disturbances (CSHQ total score >41). Compared with parents, random-effects model indicated that grandparents as primary caregivers increased the adjusted odds ratio (OR) for children's global sleep disturbances by 30% (OR [95%CI]: 1.30 [1.21, 1.40]). To the specific domains of CSHQ, two-way repeated-measures ANOVA showed significant “caregiver transition” group × wave interaction in the behavioral sleep disturbances, such as “Bedtime Resistance” (p < 0.001). At each survey, children with grandparents as primary caregivers demonstrated significant higher behavioral sleep disturbances than their counterparts with parental care. ConclusionsGrandparental care is associated with increased sleep disturbances, particularly behavioral sleep disturbances, in preschoolers. Future studies should explore the underlying mechanisms and whether sleep programs targeting grandparents can decrease children's sleep disturbances.

0955 Does Primary Caregiver Influence Sleep in Preschoolers? Evidence from a Large-Scale Longitudinal Study in China

Abstract Introduction The aim of the study is to characterize sleep disturbances and sleep patterns in preschoolers, and to examine the potential role of primary caregivers and particularly its transition on children’s sleep in a large-scale cohort study in China. Methods A representative sample of 20324 newly enrolled preschoolers(age 3-4 years) were recruited in Shanghai,China at 2016.11. Sleep disturbances were examined at 3 timepoints from age 3-4 years to 5-6 years by the Children’s Sleep Habits Questionnaire(CSHQ). Data on bedtime, onset time and offset time were included, along with primary caregivers derived from each follow-up. Prevalence and trend estimates of sleep disturbances and sleep patterns were presented. Multivariable logistic regression and propensity score-adjusted models for sleep disturbances at wave3 on different caregiving models were analysed adjusting for demographics, socioeconomic status, family characteristics, maternal mental health and CSHQ total score at baseline. Results Prevalence of global sleep disturbances (CSHQ total score&amp;gt;41) steadily fell from 84.2% to 73.8%. Specifically, behavioral sleep problem domains of “Bedtime besistance”and “Sleep anxiety” decreased from 66.4% to 47.3% and 53.4% to 37.8%, respectively. Meanwhile, Bedtime gradually delayed from 21:04(SD=0:37) to 21:20(SD=0:33) while offset time changed slightly from 7:13(SD=0:29) to 7:17(SD=0:27). Compared with counterparts in western countries, children slept for a shorter nocturnal sleep duration (NSD) with 9.51(SD=0.57) hours at wave1, 9.42(SD=0.57) hours at wave2 and 9.42(SD=0.52) hours at wave3. Different caregiving models were independently associated with sleep disturbances at wave3. Taking “Predominant parental care” as reference, “Predominant grandparental care” and “Transition from parental to grandparental care” were associated with higher odds of sleep disturbances (OR=1.32, 95% CI [1.17, 1.48], p&amp;lt;0.001 and OR=1.25, 95% CI [1.03, 1.52], p=0.020, respectively). While “Transition from grandparental to parental care” has no significant effect(OR=1.04, 95%CI [0.94, 1.15], p=0.436). Conclusion Grandparental care is associated with increased risk of sleep disturbances among preschoolers in China. Parenting and Grandparenting factors should be considered when assessing and treating sleep disturbances and optimizeing sleep health in preschoolers. Support Supported by the Chinese National Natural Science Foundation of China (81773443, 81728017, 81728017); Ministry of Science and Technology (2016YFC1305203); Shanghai Science and Technology Commission (17XD1402800, 18695840200, 2018SHZDZX05, 18JC1420305);

Insomnia, Short Sleep, And Snoring In Mid-To-Late Pregnancy: Disparities Related To Poverty, Race, And Obesity.

ObjectiveTo characterize sleep habits and parameters among women in mid-to-late pregnancy and to identify disparities associated with poverty, race, and obesity.DesignCross-sectional.SettingLarge multi-site health system in Metro Detroit.ParticipantsA total of 267 pregnant women (27.3% non-Hispanic black; gestational age: 27.99±1.20 weeks) completed online surveys on sleep quality, insomnia symptoms, sleep aid use, signs/symptoms of sleep-disordered breathing, and sociodemographics. Body mass index (BMI) and patient insurance were derived from medical records.ResultsAs high as 76.2% of the women reported global sleep disturbance, 30.6% endorsed snoring, 24.3% sleep <6 hrs/night, and over half screened positive for clinical insomnia. Yet, only 3.4% of the women reported an insomnia diagnosis and 3.0% reported a sleep apnea diagnosis. In unadjusted models, poverty, Medicaid coverage, self-identifying as black, and obesity before and during pregnancy (BMI ≥ 35) were associated with a wide range of sleep problems. However, adjusted models revealed specificity. Poverty was uniquely related to increased insomnia symptoms and trouble sleeping due to bad dreams. Obesity before pregnancy was related to poor sleep quality, snoring, sleep aids, and short sleep. Black women reported shorter sleep duration than white women but differed on no other sleep parameters.ConclusionClinical signs of insomnia and sleep-disordered breathing are common in mid-to-late pregnancy, but most cases go undetected. Problematic sleep disproportionately affects women in poverty, who self-identify as black, and who are obese before pregnancy. Poverty-related sleep issues are linked to insomnia, obesity-related disparities center on sleep-related breathing and medication use, and racial disparities relate to short sleep.

6.33 Prevalence and Correlates of Physical and/or Sexual Abuse Among Adolescents With Bipolar Disorder

Child maltreatment (CM) can result in lifelong detrimental consequences, but its association with sleep disturbances in young children remains unclear.This study aimed to investigate the association of CM with sleep disturbances and short sleep duration among Chinese preschoolers.Data were from a representative sample of 17,023 children (6.17 ± 0.29 years old, 51.96% boys) at their graduation year of preschool in September 2019, as a subset of the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) study.Parents reported children's CM of different types and the Children's Sleep Habits Questionnaire (CSHQ). Logistic regression was used to evaluate the risk of sleep disturbances and short sleep duration linked to CM.Of the children, 12,583(73.92%) demonstrated sleep disturbances (CSHQ total score > 41) and 3017(17.72%) demonstrated short sleep duration (<9 h/night). After adjusting covariates, physical abuse (aOR = 1.16, 95%CI = 1.05–1.28) and emotional abuse (aOR = 1.50, 95% CI = 1.39–1.62) were associated with global sleep disturbances. Physical abuse (aOR = 1.16, 95% CI = 1.06–1.28), physical neglect (aOR = 1.29, 95%CI = 1.12–1.49), and emotional abuse (aOR = 1.19, 95% CI = 1.09–1.30) were associated with short sleep duration. Sexual abuse was not significantly associated with global sleep disturbances or short sleep duration. A cumulative association was noted that more CM types were associated with increased global sleep disturbances and short sleep duration.CM is associated with sleep disturbances and short sleep duration in young children. This highlights the efforts to prevent and reduce CM in favor of optimal sleep and whole health in young children.

Diz-me como dormes: hábitos e problemas de sono em crianças portuguesas em idade pré-escolar e escolar

Background: Given the risk of significant organic and behavioral morbidity, it is crucial to evaluate sleep problems in clinical practice.Objectives: To evaluate sleep habits and problems in pre- scholar and scholar children and compare the results with other studies.Material and Methods: Children’s Sleep Habits Questionnaire Portuguese version (CSHQ-PT) was applied to parents of children (4-10 years old) attending daycare centers and elementary schools in Vila Nova de Famalicao county.Results: 107 pre-scholar and 122 scholar children were included (n=229), mean age 6,3 years. 54,1% were boys. 37,3% of children shared the bedroom with another relative . Mean bedtime was 21h:41m and mean wake-up time was 7h:20m. Mean sleep duration was 9.7hours, being longer in pre-scholars (p<0.001).The prevalence of global sleep disturbances was 75,7% and the mean CSHQ-PT total score was 47,05, being higher in pre-scholars (p=0,001). Pre-scholars also scored higher on bedtime resistance (p<0,001), sleep onset delay (p=0,046) and night wakening (p<0,001). Bedtime resistance and sleep anxiety scores were higher in only children (p=0.003). The prevalence of enuresis was 7,7%, restless sleep 52,7% and bruxism 22,2%.Conclusion: In this study, children tend to fall asleep later and sleep less than in other studies. A high prevalence of sleep problems was found, specially in pre-scholar children, which claims a different approach of this subject in pediatrician´s clinical practice.

Sleep Quality: A Pilot Study Comparing Patients With and Without Injection-Related Venous Ulcers.

The purposes of this study were to (a) compare sleep quality of persons with and without injection-related venous ulcers (VU) and (b) examine associations between global sleep quality with age, sex, comorbidities, pain, nutrition, physical health rating, fatigue, emotional problems, health-related quality of life, attitude toward physical activity, and number of ulcers. This study used a cross-sectional design. The participants included 31 patients with VU and 30 without VU (men [n = 35] and women; mean age = 54 years) who were attending an indigent clinic for wound care or general health. Participants were recruited from an urban clinic when they came for primary care or wound care. Questionnaires were administered at that time and included the Pittsburgh Sleep Quality Index (PSQI), Mini Nutrition Assessment, Patient Reported Outcomes Measurement Information System (PROMIS) questions about general physical health, fatigue, emotional problems, and quality of life, Brief Pain Inventory worst pain rating, Positive Attitude and Motivation for Physical Activity Scale, wound assessment, and demographic factors. The 2 groups did not differ on the PSQI in terms of time going to bed, minutes to fall asleep, time awakening, hours slept, and time in bed. Those with VU compared to without VU took more medications to help sleep (P≤ .03). There were no significant differences in PSQI correlations across groups. All study variables except age, gender, and quality of life were significantly related to Global sleep disturbance score. A higher number of comorbid conditions, worse pain, poorer nutrition, poor physical health rating, greater fatigue, more emotional problems, and poor attitude toward physical activity were related to greater sleep disturbances for all participants. Both groups had mean Global PSQI scores greater than 5 (with VU = 7.83 and without VU = 8.2), indicating sleep problems. Study findings suggest that sleep disturbances may be a concern in persons with VU and are related to many variables. Assessing sleep along with other aspects of wound care may provide a more comprehensive assessment of factors affecting a person with a VU.

Sleep Patterns, Sleep Disturbances, and Associated Factors Among Chinese Urban Kindergarten Children

This study aimed to characterize sleep patterns and disturbances among Chinese urban kindergarten children and examine potentially associated factors. Caregivers of 513 children (47.96% male) aged 3–6 years (mean age = 4.46, SD = 0.9) completed the Children’s Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). Almost 80% (78.8%) of the children scored above the original CSHQ cutoff point for global sleep disturbance. Regression analysis indicated that child’s age, and the presence of emotional problems, hyperactivity and peer problems, cosleeping, and interparental inconsistency of attitudes toward child rearing accounted for significant variance in the CSHQ total score (R2 = 22%). These findings indicate that there is an apparently high prevalence of sleep disturbances in Chinese urban kindergarten children; and sleep disturbances are associated with both child-related and parenting practice variables.

PS-349 Tell Me How You Sleep: Sleep Habits And Disturbances In Portuguese Pre-scholar And Scholar Children

Background and aims Given the risk of significant medical and behavioural morbidity, it is crucial to evaluate sleep disorders in clinical practice. We aimed to evaluate sleep habits and disturbances in pre-scholar and scholar children from a Northern region of Portugal and compare the results with other studies. Methods Children’s Sleep Habits Questionnaire Portuguese version (CSHQ-PT) was applied to parents of healthy children (4–10 years old) attending daycare centres and elementary schools in our city. Results 107 pre-scholar and 122 scholar children were included (n = 229), mean age 6,3 years. 54,1% were boys. Prevalence of co-sleeping was 37,3%. Mean bedtime was 9:41 pm and mean wake-up time was 7:20 am. Mean sleep duration was 9.7 h, being longer in pre-scholars (p < 0.001).75,7% of children suffered from global sleep disturbances and the mean CSHQ-PT total score was 47,05, being higher in pre-scholars (p = 0,001). Pre-scholars also scored higher on bedtime resistance (p < 0,001), sleep onset delay (p = 0,046) and night wakening (p < 0,001). Bedtime resistance and sleep anxiety scores were higher in only children (p = 0.003). The prevalence of enuresis was 7,7%, restless sleep 52,7% and bruxism 22,2%. Pre-scholars scored higher in night terrors (p = 0,04). It was hard to get the children out of bed in 56.7% and the children seemed tired during the day in 22.9%. Conclusion Included children tend to fall asleep later and sleep less than in other studies. A high prevalence of sleep disturbances was found, specially in pre-scholar children, which claims a different approach of this subject in our clinical practice.

Sleep disutbances and emotional/behavioral problems among Chinese school-aged children: prevalence and association

Introduction Sleep disturbances and emotional/behavioral problems are highly prevalent in childhood across all societies, and they frequently present with other co-morbidities. However, little is known about these issues among Chinese school-aged children. Therefore, the objectives were to investigate the prevalence of sleep disturbances and emotional/behavioral problems, and their associations. Materials and methods The sample comprises 886 children (6–12 years old) recruited from normal elementary schools in Shenzhen, China, with a cluster stratified sampling procedure. Their parents completed the Children Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and some socio-demographic questions to assess the domains involved. Results Based on clinical cut-offs, 69.5% of parents perceived their children had global sleep disturbances, the prevalence of specific sleep disturbances ranged from 5.2% (night waking) to 23.1% (bedtime resistance); 11.5% of parents perceive their children had global emotional/behavioral problems, the prevalence of specific emotional/behavioral problems ranged from 8.5% (emotional symptoms) to 26.6% (peer problems). The correlations between most sleep disturbances and emotional/behavioral problems domains were statistically significant (∣r∣ = 0.01 ∼ 0.39, p 0.05 or 0.01). After controlling the effects of age, gender, parental education level, housing income, and co- sleeping, emotional symptoms ( ∣ Â = 0.26, p 0.01), conduct problems ( ∣ Â = 0.09, p 0.05) and hyperactivity ( ∣ Â = 0.17, p 0.01) account for 16% variance in sleep disturbances. Conclusion As in other societies, both sleep disturbances and emotional/behavioral problems among school-aged children frequently occurred in China, and sleep disturbances are associated with emotional/behavioral problems, especially emotional symptoms, conduct problems and hyperactivity. Our study suggests a need to prevent, detect, and invent sleep disturbances and emotional/behavioral problems among Chinese children, and provides reference data to researchers and professionals. Acknowledgements The authors thank the lovely children and their parents and teachers. We acknowledge Rui Ma (Nanshan Xuefu Primary School) for her help with data collection. We also appreciate the efforts of Lin Lin and her three classmates (Shenzhen University, China) in data entry.

Sleep problems among Chinese preschool children: prevalence and associated factors

Introduction Sleep is a critical issue in child development and may be affected by a range of socio-demographic variables, parenting style and emotional/ behavior, etc. This study aimed to (1) characterize sleep patterns and sleep disturbances among Chinese preschool children, (2) determine the prevalence of sleep disturbances according to published norms, and (3) examine socio-demographic factors, parenting factors and emotional/behavioral problems that might be associated with sleep disturbances. Materials and methods A sample of 561 preschool children (53.2% male) aged 2–6 years was recruited from 10 kindergartens in Shijiazhuang city, China. Their parents completed the Children’s Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ) and self-made questionnaire including demographic characteristics, using of electronics as well as parenting styles. Results The mean bedtime was 21:23 (SD = 33 min), mean wake-up time was 7:02 am (SD = 21 min), mean sleep duration was 9 h 20 min (SD = 42 min). Overall, 49.4% of the children suffered from global sleep disturbances (CSHQ total score above 41). The prevalence of specific sleep disturbances ranged from 4.3% (falling asleep while watching TV) to 32.4% (needing parents in room to sleep). Correlations between most domains of sleep disturbances and emotional/behavioral problems were statistically significant, with Pearson’s correlation coefficients varying from 0.1 to 0.3 (p ∣ Â = −0.13, p ∣ Â = 0.17, p ∣ Â = 0.15, p ∣ Â = 0.18, p ∣ Â = 0.14, p ∣ Â = 0.14, p Conclusion Short sleep duration and sleep disturbances are prevalent among Chinese preschool children. Sleep disturbances are associated with age, co-sleeping, parenting attitude, emotional symptoms and hyperactivity.

Sleep patterns and problems among egyptian children with ADHD: The impact of symptoms severity and subtypes

Sleep problems are common among children with attention deficit hyperactivity disorder (ADHD). The present study was conducted to describe sleep patterns and problems in a sample of Egyptian children with ADHD and to examine the impact of symptoms severity and subtypes on their sleep. The parents of 100 ADHD children, aged 6–12 years, filled out the Children’s Sleep Habits Questionnaire (CSHQ) and Conners’ Parent Rating Scale-Revised: long version (CPRS-R:L) in Arabic. The parents of 100 normal control children filled out the CSHQ. The ADHD group had significantly higher scores on bedtime resistance, sleep duration, sleep anxiety, parasomnias, daytime sleepiness and global sleep disturbance (CSHQ total score) than in the control group. There were significant positive correlations between oppositional, hyperactivity, cognitive problems/inattention, and ADHD index subscales raw score and CSHQ scale scores. Children with Combined subtype had significantly higher scores than controls in bedtime resistance (p < 0.001), sleep anxiety (p < 0.001), parasomnias (p = 0.001), daytime sleepiness (p = 0.014), and total score (p<0.001). There were no significant difference between ADHD subtypes in regard to CSHQ scale scores (p > 0.05). Sleep problems are common among this sample of children with ADHD. This study suggests that sleep disturbances are related to symptoms severity and ADHD subtype. We would like to thank the parents and the children for participation in this study. Also, we would like to thank Janssen-Cilag pharmaceutical company that paid the cost of the CPRS-R:L questionnaire.

Sleep, symptom-ratings and serum ferritin levels in children with ADHD

The present study was conducted to describe sleep problems in a sample of Egyptian children with ADHD and to examine the effect of low serum ferritin levels on their sleep and symptom-ratings. The parents of 41 ADHD children, aged 6–12 years, filled out the Children’s Sleep Habits Questionnaire (CSHQ) and Conners’ Parent Rating Scale-Revised: long version (CPRS-R:L) in Arabic. Serum ferritin levels of the children were determined with the enzyme-linked immunosorbent assay method. The parents of 62 normal control children filled out the CSHQ. The ADHD group had significantly higher scores on bedtime resistance, sleep anxiety, parasomnias, sleep-disordered breathing, daytime sleepiness and global sleep disturbance (CSHQ total score) than in the control group. Children with serum ferritin levels <30 ng/mL had more disturbed sleep than children with serum ferritin levels ⩾30 ng/mL. There were significant negative correlations between sleep duration subscale, total score of CSHQ, and serum ferritin levels (p<0.05). There were no significant differences in ADHD symptoms in regard to ferritin levels (p > 0.05). Sleep problems are common among this sample of children with ADHD. This study suggests an association between low serum ferritin levels and sleep disturbances among Egyptian children with ADHD. We would like to thank the parents and the children for participation in this study. Also, we would like to thank Janssen-Cilag pharmaceutical company that paid the cost of the CPRS-R:L questionnaire.