Risk Factors For Sleep Problems Research Articles

Associations between sleep medication use and alcohol consumption over 36 years in Finnish twins

BackgroundSleep medication use is an indicator of underlying sleep problems that might be induced by various factors such as alcohol use. However, the longitudinal relationship between drinking and sleep problems remains poorly understood. We investigated associations between sleep medication and alcohol use throughout adulthood, and examined the role of familial and potential confounding factors contributing to these associations. MethodsWe used information of zygosity and self-report questionnaire data over a follow-up period of 36 years from the Older Finnish Twin Cohort (N=13,851). ResultsLogistic regression analyses suggested consistent associations between sleep medication use and heavy/binge drinking at all four time points (OR range =1.36-3.18, P <0.05), implying that increased drinking is associated with increased sleep medication use over time. Cross-lagged path analyses suggested that moderate/heavy and binge drinking predict sleep medication use at most time points (OR range = 1.15-1.94, P <0.05), whilst sleep medication use predicts subsequent abstaining from alcohol (OR range =2.26-2.47, P <0.05). Within-pair analyses implied that familial factors play a role, and quantitative genetic modelling estimated genetic factors to explain approximately 80% of the lifetime association of sleep medication use with moderate/heavy and binge drinking. ConclusionsDrinking is associated with sleep medication use throughout adulthood. Further, our results suggest that drinking is likely to predict sleep medication use, thereby potentially constituting a risk factor for sleep problems, and that genetic factors contribute to the association. These findings are important in terms of better understanding the development of sleep and alcohol use disorders.

The relationship between alexithymia, emotion regulation, and sleep problems in school-aged children: A multicentric study

ObjectivesAlexithymia, mood dysregulation, and sleep quality have complicated effects on children's development. The current study aimed to investigate the relationship between alexithymia, emotion regulation, psychiatric problems, and sleep problems among Egyptian school-aged children. MethodsA total of 564 Egyptian children, aged 6 to 14, were divided into two groups based on their total Children's Sleep Habits Questionnaire abbreviated score: group 1 (N = 300) with sleep problems and group 2 (N = 264) with non-sleep problems. Their parents completed the Strengths and Difficulties Questionnaire (SDQ) and subjectively assessed the children's emotions using the Children's Alexithymia Measure (CAM) and the Clinical Evaluation of Emotional Regulation-9 (CEER-9). ResultsMales were more proportional in the sleep problems group than others. The sleep problem group was significantly younger and had a longer daily sleep duration than the non-sleep problem group. Alexithymia and emotion dysregulation had the highest mean in the sleep problem group. Furthermore, alexithymia, emotion dysregulation, emotion difficulty, conduct, and prosocial problems were the most significant contributing factors and risk factors for sleep problems in children. ConclusionSleep problems in children were associated with younger male children with lengthy daily sleep duration and emotional, behavioural, and prosocial difficulties. Furthermore, alexithymia and emotion dysregulation are significant contributors and risk factors for sleep problems in school-aged children.

The relationship between stressful life events, sleep, emotional regulation, and depression in freshmen college students

AbstractIn recent years, adolescent sleep problems have received increasing attention. Stressful life events have been found to be a risk factor for sleep problems, but little is known about the components that may explain or influence this association. To investigate this, the present study tested whether depressive symptoms mediated the association between stressful life events and Chinese freshmen' sleep problems, as well as whether emotional regulation skills moderated this process. A sample of 513 Chinese freshmen (32.2% males, mean age = 19.04 years, SD = 1.21) completed anonymous questionnaires regarding stressful life events, depressive symptoms, emotional regulation and sleep problems (examined using Adolescent Self‐Rating Life Events Checklist, Epidemiologic Studies Depression Scale for Children, Pittsburgh Sleep Quality Index and Response to Stress Questionnaire). The study included covariates such as gender, age, and socioeconomic level. Depressive symptoms were shown to partially mediated the association between stressful life events and sleep problems in structural equation models. Emotional regulation moderated the relationship betweenn stressful life events and depressive symptoms. The results show that promoting emotional regulation could be beneficial in preventing and intervening sleep problems related to stressful life events.

Cross-sectional study on the sleep status and risk factors for sleep problems in infants and young children in Jilin Province

To explore the sleep status and risk factors for sleep problems in infants and young children in Jilin Province. A total of 1 080 healthy infants and young children aged 0-3 years from eight prefecture-level cities and one autonomous prefecture in Jilin Province were selected as subjects. A self-designed questionnaire was used to collect the general information of the subjects, and the Brief Infant Sleep Questionnaire was used to understand the sleep status of the subjects. Multivariate logistic regression analysis was used to analyze the risk factors for sleep problems. The total detection rate of sleep problems in the infants and young children was 38.24% (413/1 080). The total sleep time in the 4-11 month, 12-24 month, and 25-36 month age groups was higher than the recommended total sleep time (P<0.05). Multivariate logistic regression analysis showed that full-term birth, higher educational level of the main caregiver, and higher daytime activity intensity were protective factors for sleep problems in the infants and young children (P<0.05), while lower frequency of vitamin D supplementation, frequent night feeding, and maternal snoring were risk factors for sleep problems (P<0.05). The total sleep time of infants and young children over 4 months old in Jilin Province is higher than the recommended total sleep time, but the prevalence rate of sleep problems is higher. The occurrence of sleep problems is related to various factors. Strengthening follow-up on preterm infants, providing education on infant sleep knowledge to primary caregivers, and regularly supplementing with vitamin D can be beneficial in reducing sleep problems in infants and young children.

The prevalence, incidence, and risk factors of mental health problems and mental health service use before and 9 months after the COVID-19 outbreak among the general Dutch population. A 3-wave prospective study

Gain insight into the effects of the COVID-19 pandemic on the prevalence, incidence, and risk factors of mental health problems among the Dutch general population and different age groups in November-December 2020, compared with the prevalence, incidence, and risk factors in the same period in 2018 and 2019. More specifically, the prevalence, incidence, and risk factors of anxiety and depression symptoms, sleep problems, fatigue, impaired functioning due to health problems, and use of medicines for sleep problems, medicines for anxiety and depression, and mental health service. We extracted data from the Longitudinal Internet studies for the Social Sciences (LISS) panel that is based on a probability sample of the Dutch population of 16 years and older by Statistics Netherlands. We focused on three waves of the longitudinal Health module in November-December 2018 (T1), November-December 2019 (T2), and November-December 2020 (T3), and selected respondents who were 18 years and older at T1. In total, 4,064 respondents participated in all three surveys. Data were weighted using 16 demographics profiles of the Dutch adult population. The course of mental health problems was examined using generalized estimating equations (GEE) for longitudinal ordinal data and differences in incidence with logistic regression analyses. In both types of analyses, we controlled for sex, age, marital status, employment status, education level, and physical disease. Among the total study sample, no significant increase in the prevalence of anxiety and depression symptoms, sleep problems, fatigue, impaired functioning due to health problems, use of medicines for sleep problems, of medicines for anxiety and depression, and of mental health service in November-December 2020 was observed, compared with the prevalence in November-December 2018 and 2019 (T3 did not differ from T1 and T2). Among the four different age categories (18-34, 35-49, 50-64, and 65 years old and older respondents), 50-64 years respondents had a significantly lower prevalence of anxiety and depression symptoms at T3 than at T1 and T2, while the prevalence at T1 and T2 did not differ. A similar pattern among 65+ respondents was found for mental health service use. We found no indications that the incidence of examined health problems at T2 (no problems at T1, problems at T2) and T3 (no problems at T2, problems at T3) differed. Risk factors for mental health problems at T2 were mostly similar to risk factors at T3; sex and age were less/not a risk factor for sleep problems at T3 compared with at T2. The prevalence, incidence, and risk factors of the examined mental health problems examined nine months after the COVID-19 outbreak appear to be very stable across the end of 2018, 2019, and 2020 among the Dutch adult population and different age categories, suggesting that the Dutch adult population in general is rather resilient given all disruptions due to this pandemic.

Sleep Patterns and Development of Children With Atopic Dermatitis

To evaluate sleep patterns and the development of children with atopic dermatitis at an early age.In the study, the researchers included 80 children seen in a pediatric allergy clinic at the ages of 0 to 36 months who had atopic dermatitis, did not have any other chronic disease, and did not have a known developmental delay.This was a cross-sectional study in which the sociodemographic characteristics and clinical information of the patients were recorded. Severity of AD was evaluated according to the Scoring Atopic Dermatitis index. The sleep pattern and development of the patients were assessed by the Brief Infant Sleep Questionnaire and by the Guide for Monitoring Childhood Development, respectively. The primary outcome of the study was defining sleep patterns and the development of children with AD.The median age of the patients was 6 months; 63.7% of them were male and 50% of them had sleep problems. Male sex, having AD in the first 3 months after diagnosis, and moderate to severe AD were determined as risk factors for sleep problems. In all, 12.5% of the patients needed support for ≥1 developmental areas (gross motor skills, expressive language and communication, receptive language, fine motor skills, relationship, and play). Developmental delay was higher in patients with sleep problems. Multiple siblings and the presence of sleep problems were found to be risk factors for developmental delay.Boys with moderate to severe AD within the first 3 months of diagnosis were at increased risk for sleep problems. Children with AD who have multiple siblings and sleep problems should be evaluated for developmental delay and monitored closely.This is a unique study evaluating both sleep patterns and developmental problems together in children ages 0 to 36 months with AD. Frequent nighttime awakenings affected particularly the development of gross motor skills. Early detection of such problems may help prevent behavioral and cognitive dysfunction in later years. Further studies in this area are needed.

Understanding the Relationship Between Sleep Problems in Early Childhood and Borderline Personality Disorder: A Narrative Review.

ObjectiveRecent research indicates that sleep problems in childhood precede the development of borderline personality disorder (BPD) symptoms, but the mechanisms by which sleep problems associate with BPD are still unknown. This narrative review aims to provide some potential explanations for how early sleep problems might associate with BPD.MethodsWe used the biosocial developmental model of BPD as a framework to discuss how sleep problems may associate with BPD. Articles were identified via PubMed and Embase, and papers published between January 1991 and April 2021 were extracted. Authors made a series of literature searches using the following keywords: Sleep problems, Insomnia, Nightmares, Hypothalamic–Pituitary–Adrenal Axis (HPA), Prefrontal Cortex, Family Psychopathology, Disrupted Attachment, Child Maltreatment, Impulsivity, Emotion Regulation, Internalizing, Externalizing, Rumination, Childhood, Adolescence, Young people. The inclusion criteria were published in peer-reviewed journals; human studies or reviews; published in English. The exclusion criteria were commentaries; abstracts from conferences; studies with animal samples. A total of 96 articles were included for the purpose of this review.ResultsThe evidence from this review suggests that some biological factors and core features of BPD act as potential mechanisms mediating the associations between early sleep and subsequent BPD, while some family-related factors might constitute common risk factors for sleep problems and BPD.ConclusionThe biosocial developmental model of BPD provides a plausible characterization of how sleep disruption might lead to subsequent BPD. Further research on new developmental and early intervention approaches to understand how sleep in early stages associates with BPD could have significant clinical impact on these patients and could inform targeted therapeutic interventions.

An investigation of the link between prenatal alcohol exposure and sleep problems across childhood

ObjectiveTo investigate the association between dose and frequency of prenatal alcohol exposure (PAE) and sleep problems in children, after controlling for established risk factors for sleep problems. MethodsData from the birth cohort of the Longitudinal Study of Australian Children (LSAC) was used. Mothers of 3447 children provided information on alcohol consumption during pregnancy, children’s sleep problems from 2- to 9-years, and potential confounders associated with sleep problems. Children were classified into PAE groups based on distinct patterns of maternal drinking during pregnancy: abstinent, occasional, low, moderate, and heavy. The effect of PAE on the number and persistence of sleep problems across childhood (2−9 years) was examined. ResultsAfter controlling for multiple covariates that impact sleep, children with heavy PAE had 1.13 more sleep problems across childhood (2−9 years) relative to children whose mothers were abstainers, in particular 0.37 more at 2- to 3-years (0.504, 95 % CI 0.053, 0.956), and 0.34 more at 6- to 7-years (0.847, 95 % CI 0.299, 1.396). Compared to children of abstainers, heavy PAE increases the probability of having persistent sleep problems from 2- to 9-years by 22.57 %. No negative associations between moderate or low PAE and sleep were observed. Parenting, family, economic, and child health factors also significantly affected child sleep. ConclusionHeavy PAE was associated with significantly more sleep problems across childhood and a higher probability of reporting persistent sleep problems, relative to children with no PAE. Implications for the understanding and management of sleep in young children with PAE and FASD are discussed.

Sleep Problems and Posttraumatic Stress: Children Exposed to a Natural Disaster.

Sleep plays a critical role in children's growth and development. This study examined the frequency and persistence of children's sleep problems following a natural disaster, risk factors for children's sleep problems, and the bidirectional relationship between children's sleep problems and posttraumatic stress symptoms (PTSS) over time. This study assessed 269 children (53% female, M = 8.70 years, SD = 0.95) exposed to Hurricane Ike at 8 months (Time 1) and 15 months (Time 2) post-disaster. Children completed measures of hurricane exposure and related stressors, stressful life events, sleep problems, and PTSS. Children's sleep problems were significantly correlated from Time 1 to Time 2 (r = .28, p < .001). Risk factors for sleep problems at Time 2 were younger age, sleep problems at Time 1, and PTSS, not including sleep items, at Time 1. Examinations of the bidirectional relationship between sleep problems and PTSS indicated that PTSS significantly predicted later sleep problems, but sleep problems did not significantly predict later PTSS. Findings demonstrate that PTSS may contribute to the development and course of children's sleep problems post-disaster.

Sleep Patterns and Development of Children with Atopic Dermatitis

Introduction: Atopic dermatitis (AD) is a chronic inflammatory disease that begins in early childhood. Sleep problems have increased in children with AD. The aim of this study was to evaluate sleep patterns and the development of children with AD at an early age. Methods: This is a cross-sectional study consisting of a total of 80 children aged 0–36 months with AD. Patients were evaluated by the Brief Infant Sleep Questionnaire and International Guide for Monitoring Child Development. Results: The median age (IQR) of the patients was 6 (4.25–9) months, 63.7% of them were male and 50% of them had sleep problems. Male sex (OR: 3.78, p = 0.024, 95% CI, 0.083–0.837), patients with AD who were in the first 3 months after diagnosis (OR: 3.56; 95% CI, 1.220–10.43, p = 0.020), and moderate-severe AD (OR: 5.09; 95% CI, 1.649–15.748, p = 0.005) were determined as risk factors for sleep problems. In all, 12.5% of the patients needed support for one or more developmental areas (gross motor skills, expressive language and communication, receptive language, fine motor skills, relationship, and play). Developmental delay was higher in patients with sleep problems (p = 0.037). Multiple siblings (OR: 14.381; 95% CI, 1.557–132.871, p = 0.019) and the presence of sleep problems (OR: 8.011; 95% CI, 1.764–36.387, p = 0.024) were found to be risk factors for developmental delay. Conclusion: Boys with moderate-severe AD within the first 3 months of diagnosis were at increased risk for sleep problems. Children with AD who have multiple siblings and sleep problems should be evaluated for developmental delay and monitored closely.

Risk factors for sleep problems in infants

Background Sleep disorders in infants can cause developmental problems, suboptimal growth, behavioral disorders, fatigue, irritability, impulsiveness, and poor mother-infant bonding.&#x0D; Objective To evaluate possible risk factors for sleep disorders in infants.&#x0D; Methods This cross-sectional study was conducted in healthy infants aged 3-6 months. Subjects were selected using proportional random sampling from four different primary healthcare facilities in Manado, North Sulawesi. Their parents completed the Brief Infant Sleep Questionnaire. Sleep disorder was defined as the presence of one or more conditions including sleep duration less than 9 hours at night (from 19.00 until 07.00), waking up at night (from 22.00 until 06.00) more than 3 times, and more than 1 hour waking at night.&#x0D; Results Of 112 subjects, 58 (51.8%) were male. Subjects’ mean age was 4.21 (SD 0.829) months and 76 (67.86%) experienced sleep disorders. Sleep disorders had significant associations with low socioeconomic status (OR 17; 95%CI 3.8 to 75.8), middle school or lower maternal education (OR 44.5; 95%CI 9.8 to 202), non-supine sleeping position (OR 8.8; 95%CI 1.9 to 39.7), parental use of electronic devices (OR 156.2; 95%CI 35.1 to 692.9), and non-exclusive breastfeeding (OR 85.2; 95%CI 21.1 to 344.2). Correlative analyses also revealed that electronic media usage had the strongest association with sleep disorders, followed by breastfeeding pattern, maternal education, socioeconomic status, and sleeping position ( 0.839, 0.771, 0.624, 0.433, and 0.309, respectively). However, there were no significant correlations upon multivariate analysis.&#x0D; Conclusion Parental use of electronic media before sleeping is the strongest risk factor for sleep disorders among infants, followed by non-exclusive breastfeeding pattern, low maternal education, low socioeconomic status, and non-supine sleeping position. However, none of these correlations were significant upon multivariate analysis, this show that all these factors influence sleep together

Correlates of sleep quality and excessive daytime sleepiness in people with opioid use disorder receiving methadone treatment.

The aim of this study was to evaluate the prevalence and clinical correlates of impaired sleep quality and excessive daytime sleepiness among patients receiving methadone for opioid use disorder (OUD). Patients receiving methadone (n= 164) completed surveys assessing sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and related comorbidities. We used bivariate and multivariable linear regression models to evaluate correlates of sleep quality and daytime sleepiness. Ninety percent of patients had poor sleep quality (PSQI >5), and the mean PSQI was high (11.0 ±4). Forty-six percent reported excessive daytime sleepiness (ESS > 10). In multivariable analyses, higher PSQI (worse sleep quality) was significantly associated with pain interference (coefficient = 0.40; 95% CI = 0.18-0.62; β = 0.31), somatization (coefficient = 2.2; 95% CI = 0.75-3.6; β = 0.26), and negatively associated with employment (coefficient = - 2.6; 95% CI = - 4.9 to - 0.19; β = - 0.17). Greater sleepiness was significantly associated with body mass index (coefficient = 0.32; 95% CI = 0.18-0.46; β = 0.33), and there was a non-significant association between sleepiness and current chronic pain (coefficient = 1.6; 95% CI = 0.26-3.5; β = 0.13; p value = 0.09). Poor sleep quality and excessive daytime sleepiness are common in patients receiving methadone for OUD. Chronic pain, somatization, employment status, and obesity are potentially modifiable risk factors for sleep problems for individuals maintained on methadone. People with OUD receiving methadone should be routinely and promptly evaluated and treated for sleep disorders.

High occurrence of sleep problems in survivors of a childhood brain tumor with neurocognitive complaints: The association with psychosocial and behavioral executive functioning.

Survivors of childhood brain tumors are prone to sleep and neurocognitive problems. Effective interventions to improve neurocognitive functioning are largely lacking. In general, sleep problems are negatively related to neurocognitive functioning, but this relationship is unclear in survivors of childhood brain tumors. Therefore, the occurrence of sleep problems, potential risk factors, and the relation between sleep and executive functioning were evaluated. Baseline data of a randomized controlled trial on the effectiveness of neurofeedback were used. Childhood brain tumor survivors 8-18 years of age with parent-reported neurocognitive complaints ≥2 years after treatment were eligible. Parents completed the Sleep Disturbance Scale for Children. Executive functioning was assessed by parents and teachers (Behavior Rating Inventory of Executive Functioning). Multiple linear regression analyses were used to examine sociodemographic and medical characteristics and emotional difficulties and hyperactivity/inattention (Strength and Difficulties Questionnaire) as potential risk factors for sleep problems, and to assess the association between sleep and executive functioning. Forty-eight percent of survivors (n=82, 7.0±3.6 years post diagnosis, age 13.8±3.2years) had sleep problems and scored significantly worse than the norm on the subscales Initiating and Maintaining Sleep, Excessive Somnolence, and the total scale (effect sizes 0.58-0.92). Emotional problems and/or hyperactivity/inattention were independent potential risk factors. Sleep problems were associated with worse parent-reported executive functioning. Sleep problems occur among half of childhood brain tumor survivors with neurocognitive problems, and are associated with worse executive functioning. Future studies should focus on the development of sleep interventions for this population, to improve sleep as well as executive functioning.

Sleep problems in Korean children with Down syndrome and parental quality of life.

Sleep problems are common among children with Down syndrome (DS), and they can have a serious impact on children with DS as well as their parents and other family members. Specific aims of this study were to evaluate parent-reported sleep problems in children with DS and to examine the relationship between the sleep behaviour of children with DS and their parents' quality of life (QOL). A cross-sectional survey was conducted in September and October of 2017. Parents of children with DS were recruited from an online self-support community for parents of children with DS in South Korea. The mean age of the parents and children with DS was 40.40years (SD=5.09) and 7.89years (SD=3.03), respectively. Children's sleep problems and parents' QOL were assessed using the Children's Sleep Habits Questionnaire and the abbreviated version of the World Health Organization Quality of Life scale, respectively. Results revealed that 83% of the parents reported that their child with DS experienced sleep problems. Children with DS had significantly more bedtime resistance, night waking, parasomnias and sleep-disordered breathing than did typically developing children. In addition, their Children's Sleep Habits Questionnaire scores were higher than those of typically developing children. Moreover, being older, being male and having more severe developmental delays were significant risk factors for sleep problems among children with DS. Furthermore, sleep problems in children with DS negatively affected parents' QOL. Sleep problems negatively affect children with DS as well as their parents; therefore, health care providers should be aware of these issues and help parents manage sleep problems proactively.

Melatonin receptor agonist Piper betle L. ameliorates dexamethasone-induced early life stress in adult zebrafish.

Early life exposure to stress has been suggested to be a crucial factor for the development of the brain and its functions. It is well documented that childhood stress is a risk factor for sleep problems in adulthood. Piper betle L. leaf extract (PB) has been used in several traditional medicines to cure various ailments. Recently, PB has been proved to have antidepressant activity. The literature suggests that antidepressants affect the synthesis and release of melatonin through several mechanisms. Thus, this study investigated the potential role of PB for the treatment of sleep disruption after early life stress exposure. Firstly, dexamethasone (DEX) (2 and 20 mg/l for 24 h) was administered to zebrafish larvae on the 4th day post-fertilization (dpf) to induce early life stress. The effects of stress on behaviour during adulthood, melatonin level and stress-related gene expression (nfkb) in the brain were then studied. Next, the possible role of PB (10 and 30 mg/Kg) was studied by measuring its effect on behaviour and by quantifying the expression levels of several melatonin-related (MT1, MT2, aanat1, aanat2) and stress-related (nfkb) genes by qPCR. DEX-treated zebrafish exhibited anxious behaviour, along with a lower level of melatonin and a higher mRNA expression of nfkb. After treatment with PB, a similar effect on behaviour and gene expression levels as the melatonin treatment group (10 mg/kg; positive control) was seen in adult zebrafish. These molecular confirmations of the observed behavioural effects of the PB indicate a possible role in the treatment of early life stress-induced sleep disruption.

An epidemiologic study of self-reported sleep problems in a large sample of adolescent earthquake survivors: The effects of age, gender, exposure, and psychopathology

BackgroundThis study investigated the prevalence of sleep problems and their associated risk factors in child and adolescent survivors three years after the 2013 Ya'an earthquake. MethodsA total of 6132 adolescent survivors aged 9–18 years were invited to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Logistic analysis was used to identify possible relationships of sleep disturbance scores with earthquake exposures, mental health and demographic characteristics. ResultsMore than a quarter of the sample showed sleep problems of some kind, with 23.1% sleeping fewer than 7 h per night, 32.5% having difficulty falling asleep, 24.2% having difficulty remaining asleep, 25.3% having poor sleep quality, 17.4% having nightmares and 44.6% having difficulty functioning during daytime hours. Older participants were at a significantly higher risk of sleep issues than younger children (OR 2.89), and the subjects had significantly elevated risks of probable anxiety (OR 3.47), probable depression (OR 2.45), and probable posttraumatic stress disorder (OR 1.89). Other risk factors for sleep problems were earthquake exposure variables, including being injured (OR 1.42), having a parent injured (OR 1.27), witnessing death (OR 1.32) or feeling extremely scared (OR 1.22) in the Ya'an earthquake. ConclusionsSleep disturbances are common in adolescent earthquake survivors, and they are associated with age, gender, psychiatric symptoms and factors related to earthquake exposure. These results highlight the importance of development- and gender-specific interventions to prevent sleep disturbances after a major earthquake.

The effects of maternal risk factors during pregnancy on the onset of sleep difficulties in infants at 3months old.

Sleep problems in young children are among the most common concerns reported to paediatricians. Sleep is thought to have important regulatory functions, and sleep difficulties in early childhood are linked to several psychosocial and physiological problems. Moreover, several prenatal factors have been found to influence infants' sleep. Among them, most of the studies have been focused on maternal prenatal depression and/or anxiety as potential risk factors for sleep problems in childhood, whereas other relevant psychological factors during pregnancy have not received as much attention. Therefore, we aimed to examine the effect of several psychiatric maternal risk factors during pregnancy (i.e. symptoms of anxiety, depression, insomnia, alcohol use, seasonality, attention deficit and hyperactivity disorder and/or stressful life events) on the onset of some sleep problems related to sleep quality and sleep practices in 3-month-old infants. We examined 1,221 cases from a population-based birth cohort, with subjective measures during pregnancy in mothers, and at 3months after birth in the infants. The findings showed that all the maternal risk factors during pregnancy, except for symptoms of alcoholism and sleepiness, were related to sleep difficulties in infants. Interestingly, attention deficit and hyperactivity disorder symptomatology in mothers during pregnancy was the only variable that predicted more than two sleeping difficulties (i.e. long sleep-onset latency, co-sleeping with parents and irregular sleeping routines) at 3months old. Our results highlight the relevance of maternal risk factors during pregnancy, and not only prenatal depression and/or anxiety, as variables to be considered when examining sleep difficulties in infants.

Moderating Effect of Motor Proficiency on the Relationship Between ADHD Symptoms and Sleep Problems in Children With Attention Deficit Hyperactivity Disorder–Combined Type

ABSTRACTObjectives/Background: A high proportion of children with Attention Deficit Hyperactivity Disorder- Combined type (ADHD-CT) experience sleep and motor problems. This study investigated (a) whether motor proficiency moderated the relationship between ADHD symptoms and sleep problems in children with and without ADHD-CT and (b) whether this moderation differed as a function of ADHD diagnosis.Participants: A sample of 70 primary school male children between 8–15 years were recruited; children with ADHD-CT (n = 38; mean age 10 years, 2 months [SD = 1 year, 6 months]) and a typically developing (TD) (n = 32; mean age 9 years, 6 months [SD = 1 year, 5 months]) group.Methods: Motor proficiency was measured using the Movement Assessment Battery for Children-2nd Edition (MABC-2), ADHD symptoms were measured using the Conners’ Parent Rating Scale (CPRS) and parent reported sleep problems were measured using the Children’s Sleep Habits Questionnaire (CSHQ).Results: Children who reported higher ADHD symptoms and lower motor proficiency scores reported more sleep problems. The moderation effect only held in children with a diagnosis of ADHD-CT and not in the typically developing group.Conclusions: These findings indicate that children who experience greater severity of ADHD symptoms who also have lower motor proficiency may be at increased risk of experiencing sleep problems. These findings also illustrate the importance of considering motor proficiency when exploring risk factors for sleep problems in children with ADHD-CT as well as sleep interventions.

So Tired: Predictive Utility of Baseline Sleep Screening in a Longitudinal Observational Survey Cohort of First-Year Residents

Sleep impairment is highly prevalent among resident physicians and is associated with both adverse patient outcomes and poor resident mental and physical health. Risk factors for sleep problems during residency are less clear, and no screening model exists to identify residents at risk for sleep impairment. The objective of this study was to assess change in resident sleep during training and to evaluate utility of baseline sleep screening in predicting future sleep impairment. This is a prospective observational repeated-measures surveystudy. The participants comprised PGY-1 residents across multiple specialties at Partners HealthCare hospitals. Main measures used for this study were demographic queries and two validated scales: the Pittsburgh Sleep Quality Index (PSQI), measuring sleep quality, and the Epworth Sleepiness Scale (ESS), measuring excessive daytime sleepiness. Two hundred eighty-one PGY-1 residents completed surveys at residency orientation, and 153 (54%) completed matched surveys 9months later. Mean nightly sleep time decreased from 7.6 to 6.5hours (p < 0.001). Mean PSQI score increased from 3.6 to 5.2 (p < 0.001), and mean ESS score increased from 7.2 to 10.4 (p < 0.001). The proportion of residents exceeding the scales' clinical cutoffs increased over time from 15 to 40% on the PSQI (p < 0.001) and from 26 to 59% on the ESS (p < 0.001). Baseline normal sleep was not protective: 68% of residents with normal scores on both scales at baseline exceeded the clinical cutoff on at least one scale at follow-up. Greater age and fewer children increased follow-up PSQI score (p < 0.001) but not ESS score. During PGY-1 training, residents experience worsening sleep duration, quality of sleep, and daytime sleepiness. Residents with baseline impaired sleep tend to remain impaired. Moreover, many residents with baseline normal sleep experience sleep deterioration over time. Sleep screening at residency orientation may identify some, but not all, residents who will experience sleep impairment during training.

Can rheumatoid arthritis affect sleep in Egyptian patients?

Aim of the workTo investigate sleep problems in rheumatoid arthritis (RA) patients and to correlate sleep scores with disease characteristics and activity. Patients and methods100 RA patients and 40 matched controls were included. Disease activity score (DAS28), visual analogue scale (VAS) for pain, modified health assessment questionnaire (MHAQ) and medical outcomes study short form-36 (SF-36) were assessed and the van der Heijde-modified Sharp score (vdHSS) calculated. The Pittsburgh Sleep Quality Index (PSQI) was used to investigate the sleeping habits, sleep difficulty was assessed using the Athens Insomnia Scale (AIS) and daytime sleepiness was measured using the Epworth Sleepiness Scale (ESS). ResultsThe patients were 84 females and 16 males (F:M 5.25:1) with mean age of 48.1±12.4years, disease duration of 6.9±5.9years, DAS28 was 4.3±1.4, MHAQ was 0.95±0.6 and VAS was 45.2±21.1. The sleep scores PSQI, AIS and ESS were significantly increased in patients (6.98±2.8, 9.6±4.4 and 7.4±2.6) compared to control (2.6±1.9, 2.7±1.8 and 3.3±2.03 respectively; p=0.01 each). Sleep scores tended to be lower in females and were significantly higher in those with positive C-reactive protein. Rheumatoid factor positive patients and those not receiving methotrexate had significantly higher PSQI and AIS scores. Sleep scores significantly correlated with age, erythrocyte sedimentation rate, DAS28, VAS, MHAQ and vdHSS and negatively with SF-36 physical component score (PCS) (p=0.01 for all). Disease duration, DAS28, VAS and SF36 (PCS) were significant risk factors for sleep problems. ConclusionA high frequency of sleep disturbances in RA patients was observed. Interplay of pain, fatigue, activity and disability may lead to poor sleep quality.