Risk Of Sleep Problems Research Articles

Exposure to parental interpartner conflict in adolescence predicts sleep problems in emerging adulthood

ObjectivesParental interpartner conflict is a highly prevalent form of family risk that is stressful for adolescents with ramifications for their sleep. Multiple studies have demonstrated that adolescents from high-conflict homes are at risk for sleep problems. Building on this literature, we conducted novel analyses and investigated whether exposure to interpartner conflict in adolescence predicts sleep problems in the subsequent developmental period of emerging adulthood. MethodsWe used a rigorous four-wave design spanning 8years (collected between 2012-2020). At wave 1, participants were 245 adolescents from diverse backgrounds (M age=15.74years; 67% White/European American, 33% Black/African American; 52% girls). Individuals participated again in their adolescence at wave 2 (M age=16.77) and wave 3 (M age=17.69). Participants returned for wave 4 in emerging adulthood (M age=22.97). Adolescents reported on their parents’ interpartner conflict (intense and frequent conflict). Sleep duration (minutes) and quality (efficiency, long wake episodes) were measured using actigraphy. ResultsAfter controlling for autoregressive effects and several covariates, findings from a structural equation model revealed that greater exposure to parental interpartner conflict in adolescence predicted reduced sleep efficiency and more long wake episodes in emerging adulthood. ConclusionsResults build on the literature to consider sleep in the family context and are among the first to illustrate that exposure to parental interpartner conflict in adolescence predicts sleep problems in emerging adulthood. Continued investigations into the antecedents of sleep problems in emerging adulthood may benefit from considering past exposure to family risk.

Risk of Sleep Problems in Middle-Aged and Older Adults Experiencing Bodily Pains: Serial Multiple Mediation Estimates of Emotional Distress and Activity Limitations

Pain is increasingly becoming common among middle-aged and older adults. While research on the association between pain characteristics and sleep problems (SP) is limited in low- and middle-income countries, the underlying mechanisms of the association are poorly understood. This study examines the association of bodily pain intensity and pain interference with SP and investigates the mediating role of activity limitation and emotional distress in this association. We analyzed population-based data, including 1,201 individuals aged ≥50 (mean [SD] age 66.14 [11.85] years) from the 2016-2018 AgeHeaPsyWel-HeaSeeB study in Ghana. Multiple OLS regressions and serial multiple mediation modeling using bootstrapping analyses examined direct and indirect effects from pain to SP through activity limitation and emotional distress. Regressions demonstrated that pain intensity and interference were significantly associated with higher levels of activity limitation, emotional distress, and SP (range: β = 0.049-0.658). Bootstrapping analysis showed that activity limitation and emotional distress serially mediated the relationship between pain intensity and SP (total effect: β = 0.264, Bootstrap 95% confidence interval [CI] = 0.165-0.362; direct effect: (β = 0.107, Bootstrap 95% CI = 0.005-0.210; total indirect effect: β = 0.156, Bootstrap 95% CI = 0.005-0.210) accounting for ∼59%. Activity limitation and emotional distress mediated pain interference and SP association (total effect: β = 0.404, Bootstrap 95% CI = 0.318-0.490; direct effect: β = 0.292, Bootstrap 95% CI = 0.201-0.384; and total indirect effect: β = 0.112, Bootstrap 95% CI = 0.069-0.156) yielding ∼28%. Our data suggest that activity limitation and emotional distress may convey stress-related risks of pain on SP. Future research should evaluate if activity limitation and emotional distress could be effective targets to reduce the effect of pain on sleep in later-life.

ADHD Symptoms and Sleep Problems During Middle Childhood: The Indirect Effect of Peer Victimization.

The present cross-sectional study evaluated whether traditional and/or cyber peer victimization served as mechanisms linking ADHD symptoms to sleep disturbance and sleep impairment in a sample of 284 third- through fifth-grade students (51.9% boys; 50.4% Hispanic/Latine) from two elementary schools in the United States. ADHD symptoms were assessed using teacher ratings. Children provided reports of their traditional and cyber victimization as well as their sleep disturbance and impairment. Results from path analysis models revealed significant indirect effects of traditional victimization on the links from ADHD symptoms to sleep disturbance and impairment. There was also a significant indirect effect of cyber victimization on the link from ADHD symptoms to sleep impairment. These findings suggest that experiences of traditional and cyber peer victimization may need to be addressed among children exhibiting ADHD symptoms in order to mitigate their risk for sleep problems and downstream effects on other domains of psychosocial functioning.

Investigation of the relationship between disasters and sleep problems in adolescents

ABSTRACT This study was conducted to determine relationship between disasters and sleep problems in adolescents. In this descriptive and cross-sectional study, 407 adolescents aged 10–18 years were included. The data were collected with Descriptive Characteristics Form, Disaster Fear Form, and Bergen Insomnia Scale. 86.5% of the adolescents had experienced at least one disaster. It was found that 67.3% of adolescents experienced sleep problems after disasters. A positive correlation was found between the mean scores of Fear Disaster Form and Bergen Insomnia Scale. In addition, mean Bergen Insomnia Scale scores of adolescents who experienced earthquakes, pandemic disease, traffic accidents, and floods were statistically higher than those who did not (p < 0.05). By screening for sleep problems in adolescents who have experienced disasters and planning and implementing appropriate interventions, adolescents who are already at risk for sleep problems can develop healthy sleep habits and prevent physiological, mental, and cognitive problems due to sleep problems.

Sex difference in the association between pyrethroids exposure and sleep problems among adolescents: NHANES 2007–2014

BackgroundPyrethroids have been widely used in the United States and worldwide. Few studies examined the effect of pyrethroids exposure on sleep problems among adolescents.ObjectivesThis study investigated the associations between pyrethroids exposure and sleep problems in male and female adolescents.MethodsThe data were used from the National Health and Nutrition Examination Survey 2007–2014. In this study, 3-Phenoxybenzoic Acid (3-PBA) was used as a validated biomarker for pyrethroids exposure. The association between urinary 3-PBA and sleep problems was analyzed using logistic regression models.ResultsA total of 805 adolescents aged 16–20 years old were included in this study. The proportion of sleep problems was higher in females than in males (10.18% vs.7.35%, P = 0.154). A significant interaction was found between sex and 3-PBA (P interaction = 0.021) in the risk of sleep problems. A positive association of 3-PBA exposure with sleep problems was observed in male adolescents after adjusting for all the other covariates (OR = 4.04, 95% CI 1.31, 12.42). No statistically significant association was observed in female adolescents.ConclusionsA positive association was observed between pyrethroids exposure and sleep problems in male adolescents, but not in female adolescents. More studies are required to confirm our findings.

Sleep Disturbance in Chinese College Students with Mental Health Problems: A Moderated Mediation Model.

Sleep disturbance has an enormous impact on college students. Poor sleep is associated with low academic achievement, psychological distress and high health risk behaviors. College students with various mental health problems (e.g., anxiety and depression) are particularly at risk for sleep problems. The aim of the present study was to examine the impact of a wide range of internalizing/externalizing psychological problems on sleep disturbance. A total of 2134 Chinese college students (60.2% men) with mental health problems were selected as participants after completing the self-reported Chinese college student mental health screening scale. A web-based survey was used to assess a wide variety of internalizing/externalizing psychological problems and sleep disturbance. The results showed that hostility, somatic symptoms and obsessive-compulsive symptoms (OCS) were significantly associated with sleep disturbance. Somatic symptoms played a mediating role in the relationship between hostility and sleep disturbance. Moreover, the mediating effect was moderated by OCS, and a significant difference in the mediating effects was observed between low OCS and high OCS groups. Overall, our research findings indicate that a high level of OCS exacerbates the adverse effects of somatic symptoms on sleep disturbance, and suggests that assessment and improvement of hostility, somatic symptoms and OCS should be considered in facilitating better sleep among college students with mental health problems.

Parasympathetic functioning and sleep problems in children with autism spectrum disorder.

Respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system activity, has been linked with sleep quality among children with neurotypical development. The current study extended examination of these processes to children with autism spectrum disorder (ASD), a group at considerable risk for sleep problems. Participants included 54 children with ASD (aged 6-10 years, 43% Hispanic). RSA data were collected via a wired MindWare system during a 3-min baseline and a 3-min challenge task. Parents reported on their children's sleep problems and sleep duration using the Children's Sleep Habits Questionnaire, Abbreviated. Although no significant correlations emerged between RSA indices and parent-reported child sleep, baseline RSA and RSA reactivity interacted in the prediction of sleep problems. For children with higher RSA reactivity, higher baseline RSA was associated with fewer sleep problems, but for children with lower RSA reactivity, baseline RSA was not predictive. No main effects or interactions of RSA predicted sleep duration. Findings suggest resilience against sleep problems for children with ASD presenting with higher baseline RSA and higher RSA reactivity. Implications of these results center upon directly targeting psychophysiology (i.e., parasympathetic nervous system regulation) as a possible mechanism to improve sleep in children with ASD, and developing personalized interventions based on physiological markers of risk and resilience.

Sleep Problems Mediate the Relationship Between Psychosocial Stress and Pain Facilitation in Native Americans: A Structural Equation Modeling Analysis from the Oklahoma Study of Native American Pain Risk.

Native Americans (NAs) are more likely to experience chronic pain than non-Hispanic Whites (NHWs); however, the proximate causes predisposing NAs to chronic pain remain elusive. Likely due to centuries of adversity, discrimination, and marginalization, NAs report greater psychological stress than NHWs, which may place them at risk for sleep problems, a well-established risk factor for chronic pain onset. This study examined the effects of psychological stress and sleep problems on subjective and physiological measures of pain processing in NAs and NHWs. Structural equation modeling was used to determine whether ethnicity (NA or NHW) was associated with psychological stress or sleep problems and whether these variables were related to conditioned pain modulation of pain perception (CPM-pain) and the nociceptive flexion reflex (CPM-NFR), temporal summation of pain (TS-pain) and NFR (TS-NFR), and pain tolerance in a sample of 302 (153 NAs) pain-free participants. NAs experienced more psychological stress (Estimate = 0.027, p = .009) and sleep problems (Estimate = 1.375, p = .015) than NHWs. When controlling for age, sex, physical activity, BMI, and general health, NA ethnicity was no longer related to greater sleep problems. Psychological stress was also related to sleep problems (Estimate = 30.173, p = <.001) and psychological stress promoted sleep problems in NAs (indirect effect = 0.802, p = .014). In turn, sleep problems were associated with greater TS-pain (Estimate = 0.714, p = .004), but not other pain measures. Sleep problems may contribute to chronic pain risk by facilitating pain perception without affecting facilitation of spinal neurons or endogenous inhibition of nociceptive processes. Since psychological stress promoted pain facilitation via enhanced sleep problems, efforts to reduce psychological stress and sleep problems among NAs may improve health outcomes.

0497 Associations between Sleep Problems and ADHD Symptoms in Early Childhood: A Longitudinal, Primary-Care Based Study

Abstract Introduction Sleep problems are common, impairing correlates of ADHD. These associations may emerge as early as toddlerhood, suggesting sleep-focused interventions in early development may improve ADHD-related outcomes. However, previous research has been limited by cross-sectional methodology and small, clinically-referred samples. Thus, relationships between sleep and ADHD symptoms over time and in non-clinical samples remain unknown. The current study evaluated concurrent and longitudinal relationships between sleep problems and ADHD symptoms in early childhood in a large, non-clinical sample. Methods Children were recruited from primary care clinics at an academic medical center and assessed at two time points: T1 (n=1806, mean age: 20 months) and T2 (n=646, mean age: 37 months). Sleep problems and ADHD symptoms were evaluated via the caregiver-reported Child Behavior Checklist (CBCL) Sleep and DSM-Oriented ADHD scales, respectively. At T2, caregivers also completed the ADHD Rating Scale (ADHD-RS), which includes inattention and hyperactive/impulsive subscales. Associations between sleep and ADHD were examined using Pearson correlations at each time point. Stability of and longitudinal relationships between sleep and ADHD symptoms were also examined. Results Greater sleep problems were correlated with elevated CBCL ADHD at T1 (r=.40, p&amp;lt;.001) and T2 (r=.49, p&amp;lt;.001). At T2, greater sleep problems were also related to increased ADHD-RS scores (r=.44, p&amp;lt;.001), with similar relationships for inattention (r=.41) and hyperactivity/impulsivity (r=.43). Sleep problems (r=.51, p&amp;lt;.001) and CBCL ADHD (r=.52, p&amp;lt;.001) were moderately stable over time. Using the CBCL, partial correlations indicated that T1 sleep was associated with T2 ADHD after controlling for T1 ADHD (r=.11, p&amp;lt;.01); T1 ADHD was associated with T2 sleep problems after controlling for T1 sleep problems (r=.17, p&amp;lt;.001). Conclusion Sleep disturbances and ADHD symptoms were bi-directionally associated in a non-clinical sample of young children recruited in primary care. Results are consistent with conceptualization of ADHD as a 24-hour disorder and suggest that incorporating behavioral sleep techniques into empirically-based ADHD treatments may improve clinical outcomes for young children displaying ADHD symptoms. Future research may focus on 1) optimizing identification of toddlers and preschoolers at risk for sleep problems and ADHD and 2) developing interventions that can be delivered in primary care settings. Support (If Any) P50HD093074 , K23MH108704

Longitudinal Associations Between Cybervictimization and Adolescent Sleep Problems: The Role of Anxiety and Depressive Symptoms.

Adolescents who have experienced cybervictimization are at risk for sleep problems. However, there is a gap in knowledge about the mechanism that would explain this link. The study used a longitudinal design to test if cybervictimization predicted adolescents' sleep problems 6 and 12 months later, and whether these patterns could be explained in part by emotional distress in response to the victimization. Participants were 1987 Chinese adolescents (56.1% males) ages 10 to 14 (M = 12.32, SD = 0.53) at baseline. Data were collected over the course of 1year, in three waves 6months apart. The adolescents completed questionnaires regarding cybervictimization, sleep problems, depressive symptoms, and anxiety symptoms at all three time points. Autoregressive cross-lagged models showed that cybervictimization predicted later sleep problems after controlling for traditional peer victimization, and anxiety and depressive symptoms mediated this link. Multivariate latent growth models showed that the developmental trajectories of cybervictimization, sleep problems, anxiety symptoms, and depressive symptoms were related in complex ways over time. Measures of study variables were self-reported, and generalizability may be limited by a sample of adolescents from school in China. These results are important because of their implications for prevention and treatment of adolescents' sleep problems evoked by cybervictimization.

A Cross-Sectional Study on the Relationship Among Cytokines, 5-HT2A Receptor Polymorphisms, and Sleep Quality of Non-manual Workers in Xinjiang, China

BackgroundStudies have shown that cytokine activity changes during the sleep-wake process, suggesting that inflammatory factors may be involved in a mechanism affecting sleep quality. Furthermore, the serotonergic system is also one of the essential components of airway relaxation during sleep, especially the serotonin 2A receptor (5-HTR2A) type that plays an important role in the sleep-wake process. Therefore, this research aimed to investigate the effects of cytokines and 5-HTR2A polymorphisms on sleep quality in non-manual workers in Urumqi, Xinjiang in order to explore the relationship between the three.MethodsThis study used a cluster sampling method to randomly select non-manual workers who worked in Urumqi, Xinjiang for at least 1 year. From July 2016 and December 2017, this study recruited 1,500 non-manual workers for physical examination in the First Affiliated Hospital of Xinjiang Medical University. According to the inclusion and exclusion criteria, 1,329 non-manual workers were finally included in the questionnaire study. It used the Pittsburgh Sleep Quality Index questionnaire to assess sleep quality. Moreover, another 15% of respondents were randomly selected as the experimental study group. The polymerase chain reaction restriction fragment length polymorphism was used to detect 5-HTR2A gene genotypes. Simultaneously, the cytokine (IL-1β, IL-2, IL-6, and TNF-α) content was evaluated using an enzyme-linked immunoassay.ResultsThe results showed that among the 1,329 respondents, 870 had sleep quality problems, and the detection rate was 65.46%. The distribution of −1438G/A genotypes in the 5-HTR2A gene was significantly different among different sleep quality groups (p < 0.05), with no statistical significance present when comparing to T102C (p > 0.05). Logistic regression analysis showed that the AG [odds ratio (OR) = 2.771, 95% confidence interval (CI): 1.054–7.287] and GG (OR = 4.037, 95% CI: 1.244–13.105) genotypes at −1438G/A loci were both associated with poor sleep quality and were thus considered the susceptibility genotypes for sleep problems. Furthermore, IL-1β was shown to be a protective factor for sleep quality (OR = 0.949, 95% CI: 0.925–0.974). The interaction results showed that AG × IL-1β (OR = 0.952, 95% CI: 0.918–0.987) was associated with a lower risk of sleep problems than AA × IL-1β.ConclusionCytokines and 5-HTR2A polymorphisms not only have independent effects on sleep but also may have cumulative effects. Therefore, it is necessary to further explore the related mechanisms affecting sleep quality to improve the sleep quality of non-manual workers.

Are All Domains of Life Satisfaction Equal? Differential Associations With Health and Well-Being in Older Adults

Growing evidence documents strong associations between overall life satisfaction and favorable health and well-being outcomes. However, because most previous studies have assessed satisfaction with one’s life as a whole, we know little about whether specific domains of life satisfaction (e.g., satisfaction with income) might be driving better health and well-being outcomes. Data were from 13,752 participants in the Health and Retirement Study—a nationally representative cohort of US adults aged >or=50. We evaluated if positive changes in seven domains of life satisfaction (between t0;2008/2010 and t1;2012/2014) were associated with 35 indicators of physical, behavioral, and psychosocial health and well-being (at t2;2016/2018). Satisfaction with family life and non-work activities showed the largest associations with subsequent psychological factors, followed by satisfaction with financial situation and income. Effect estimates were double in magnitude for certain domains of life satisfaction (e.g., the association between satisfaction with family life and purpose in life (β=0.22, 95% CI:0.16,0.27) was more than twice as large as the association between satisfaction with housing and purpose in life (β=0.09, 95% CI:0.02,0.16). Further, some domains showed associations with physical health outcomes (e.g., participants with the highest satisfaction with health had a 21% decreased mortality risk (95% CI: 0.66,0.95)), health behaviors (e.g., higher satisfaction with income decreased risk of sleep problems by 11% (95% CI:0.80,0.99)), and social factors (e.g., loneliness (β: -0.16 to -0.42)). Individual domains of life satisfaction might be novel targets for interventions and policies seeking to enhance specific facets of health and well-being in our rapidly aging population.

Sleep problems, sleep environment and daily routines in Turkish preschoolers

ABSTRACT Aim: The aim of this study is to determine the sleep problems of preschoolers and the predictive power of children's sleep environment and daily routines on sleep problems. Method:The study, which is a cross-sectional survey study, was conducted on preschoolers in Turkey(n = 442). The data were collected based on the parents’ reports about the child's sleep environment, daily routines and sleep problems. The binary logistic regression model was used to determine the risk factors which are thought to be effective in the emergence of sleep problems. Results and Conclusion: The study revealed that although different for each sleep problem, the place where the child sleeps, the person with whom the child sleeps, whether the child has a regular bedtime and wake-up time, duration of daily play time, duration of daily outdoors play time, and the time spent daily on digital technologies are effective on the risk of sleep problems.

Perfectly Tired: Perfectionism and Sleep in Adolescents With Chronic Pain.

Conceptual links between perfectionism and chronic pain have been proposed yet minimal empirical data exists. Poor sleep is associated with high levels of perfectionism and is common among youth with chronic pain. This study explores associations between perfectionism and sleep quality in adolescents with chronic pain while considering levels of functional disability. Adolescents (ages 12-18) with chronic pain (N = 423) completed baseline measures of self-oriented perfectionism (SOP), socially prescribed perfectionism (SPP), sleep quality, and functional disability as part of routine clinical care at an outpatient chronic pain clinic and a pain rehabilitation day treatment program. Multivariate multiple regression assessed associations between perfectionism (SOP and SPP) and sleep (falling asleep/reinitiating sleep, returning to wakefulness, and going to bed). Two moderation models explored how relations between perfectionism (SOP and SPP) and sleep quality (total score) varied depending on level of functional disability. All analyses controlled for clinic setting. Results indicated SPP was associated with more difficulties across all sleep subdomains in adolescents with chronic pain, while SOP was unrelated to sleep quality. Associations between perfectionism and sleep quality were dependent on functional disability; perfectionism was most strongly associated with worse sleep quality for adolescents with less functional disability. This study highlights the relationship between perfectionism and sleep quality in adolescents with chronic pain and suggests that perfectionistic youth with less disability are at the greatest risk for sleep problems. Longitudinal research is needed to understand how perfectionism, sleep, and disability interact over time in youth with chronic pain.

Effect of Long-Term Diving Exposure on Sleep of Male Occupational Divers in Southern Taiwan: A Cross-Sectional Study.

Divers with a history of decompression sickness may be at high risk for sleep problems. However, limited studies have investigated the relationship between diving exposure and sleep problems of occupational divers. This study investigated the association between diving exposure and sleep quality and quantity among male occupational divers in southern Taiwan. This descriptive, cross-sectional study included 52 occupational divers and 121 non-divers recruited from southern Taiwan in 2018. Survey data were collected using the Taiwanese version of the Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and a self-report questionnaire that included demographic variables, diving exposure/protocols, and factors associated with sleep quality. Among all participants examined, occupational divers were significantly more likely to have both poor sleep quality (adjusted odds ratio [OR] = 3.00; 95% confidence interval [CI] = 1.48-6.06; P = 0.002) and excessive daytime sleepiness (adjusted OR = 4.49; 95% CI = 2.12-9.52; P < 0.001). The diving exposure time, depth, ascent rate, and decompression table use showed no significant associations between poor and good sleepers in the divers group. However, a history of decompression sickness was associated with poor sleep quality among divers (adjusted OR = 2.20; 95% CI = 1.07-4.54; P = 0.032). Our results showed that occupational divers had poor sleep quality and more excessive sleepiness than non-divers. Decompression sickness likely contributes to poor sleep quality. Prevention and early detection of decompression sickness-related sleep problems should be an occupational health priority.

Can sleep profiles predict autistic traits in siblings of children with autism spectrum disorder?

IntroductionAs the prevalence of ASD (autism spectrum disorder) continues to rise, so does the need to evaluate the impact of associated difficulties on both the diagnosed child and the immediate family.ObjectivesThe aim of the present study was to assess reports of sleep disturbance or abnormal sleep behaviours (sleep profiles) in the siblings of diagnosed autistic children (referred to throughout this study as high-risk siblings, or HR-sibs) and to determine if these sleep patterns correlated with evidence of disturbed sleep among their siblings who had full symptoms of autistic spectrum disorder.Material and MethodsThis case control cross-sectional study investigated 64 autistic children, 80 HR-sibs, and 80 typically developing children. Each study subject was assessed for sleep problems and autistic traits through the use of a sleep-wake diary, a school sleep habit survey, and a childhood autism spectrum test.ResultsChildren with autism spectrum disorders and their HR-sibs showed no significant differences regarding their sleep profiles. Typically, developing children had more middle insomnia than HR-sibs and had more wake latency.ConclusionIncreased risks for sleep problems in children with autism and their HR-sibs emphasized the importance of early screening for sleep problems in children with autism and their siblings.

On the role of moderators on children's sleep health in response to COVID-19.

Citation:Lionetti F, Fasolo M, Dellagiulia A. On the role of moderator on children’s sleep health in response to COVID-19. J Clin Sleep Med. 2021;17(2):353–354.

Stressors, Repetitive Negative Thinking, and Insomnia Symptoms in Adolescents Beginning High School.

Although the first year of high school may represent a particularly stressful time for adolescents, no research addresses how stressors are related to insomnia symptoms during this time. Thus, we examined how stress relates to concurrent and prospective insomnia symptoms in adolescents beginning high school (Aim 1). Additionally, we assessed repetitive negative thinking (RNT) as a mediator (Aim 2). We also evaluated whether the pattern of associations differed for boys and girls (Aim 3). Adolescents (N = 502; M age = 14.22 years; 58.2% girls; 91.2% Hispanic/Latinx) completed questionnaires about stressors related to beginning high school (e.g., school performance, peer pressure), family support, RNT, and insomnia symptoms at the beginning and end of their first year of high school. Multiple group structural equation models assessed relationships between these variables and evaluated differences between boys and girls. School/leisure conflict and low family support were directly associated with insomnia symptoms at both times, and RNT mediated these relationships in both boys and girls. In girls, peer pressure and low family support were indirectly associated with Time 1 and Time 2 insomnia symptoms via RNT. In boys, school performance was indirectly associated with Time 1 and Time 2 insomnia symptoms via RNT. Stressful experiences at the beginning of high school negatively affect sleep in adolescents both in the short and long term. Pediatric psychologists should educate adolescents and their parents about the risk of sleep problems during this time period and provide strategies for stress management and for proper sleep hygiene.

Sleep Disturbances in Survivors of Pediatric Acute Lymphoblastic Leukemia and Their Siblings.

Sleep disturbances have been identified by patients with cancer as common and distressing; however, conflicting evidence about the prevalence of these outcomes exists for survivors of childhood cancers. Additionally, little is known about how the experience of cancer might impact survivor siblings' sleep. The current study compared the sleep of survivors of acute lymphoblastic leukemia who were 2-7 years off therapy and their siblings to healthy control/sibling dyads. Participants (survivors, n = 45; survivor siblings, n = 27; controls, n = 45; control siblings, n = 41; 58% male) aged 8-18 (m = 11.64) completed a 7-day sleep diary and seven consecutive days of actigraphy. Parents (n = 90) completed the Children's Sleep Habits Questionnaire for each of their children. No between-group differences were found on measures of sleep diaries or actigraphy. Parents reported that survivor siblings had significantly poorer sleep habits than survivors or controls. For survivors, greater time off treatment and younger age at diagnosis were associated with less total sleep time, more wake after sleep onset, and decreased sleep efficiency via actigraphy. Sleep across all groups was consistent and below national guidelines. Although the survivor group did not have poorer sleep compared to their siblings or matched controls, within the survivor group, those who were diagnosed at an earlier age and those who were further off treatment had more disrupted sleep. Parent reports suggested that survivor siblings may be at risk for sleep problems.

0967 Clinical Characteristics of Children With Sleep Problems and Comorbid Psychiatric Disorders

Abstract Introduction Anxiety and Attention Deficit Hyperactive Disorder (ADHD) are common psychiatric comorbidities in children with sleep disorders. It is known that comorbid psychiatric disorders increase the risk of sleep problems. However, no study has compared the clinical characteristics of children presenting with sleep problems and various common psychiatric disorders. Methods Retrospective chart review of all children presenting to the sleep clinic for sleep problems between March 2016 to June 2017 was performed. Demographics, sleep intake patient questionnaires, polysomnograms and ICD-9/10 codes for comorbidities and sleep diagnoses were collected. In children with diagnoses of anxiety (ICD-9 300/ICD-10 F41) and ADHD (ICD-9 314/ICD-10 F90), demographics, presenting symptoms, Epworth sleepiness scores and prevalence of sleep comorbidities were compared. T-test (continuous) and Chi Square (categorical) were used. Unadjusted odds ratio was calculated for presenting symptoms and sleep comorbidities. P value of &amp;lt;0.05 was considered significant. Results 250 (F=145, 58%) children were evaluated. 71.2% children were diagnosed with anxiety and 28.8% diagnosed with ADHD. Mean age at presentation was 8.53 ± 4.2 years. Age, gender and race of children presenting with sleep problems and comorbid anxiety/ADHD were statistically similar. Children with anxiety spent less time in stage N3 sleep (25.2% ± 9.1 versus 28.6% ± 9.2) and had lower arousal indices (7.19 ± 3.8 versus 8.86 ± 5.5) compared to children with ADHD. Children with anxiety were more likely to present with chief complaint of “feeling tired or sleepy during the day” (OR:2.38, 1.32-4.37) and were more likely to have a diagnosis of hypersomnia (OR: 11.67, 3.19-42.75) versus children with ADHD. Conclusion Children with psychiatric comorbidities have distinct polysomnographic characteristics. Children with anxiety are more likely to present with daytime sleepiness and have a significantly higher prevalence of hypersomnia compared to children with ADHD. Support None