Sleep Difficulties In Children Research Articles

Behavioral Sleep Interventions for Children with Rare Genetic Neurodevelopmental Conditions: A Retrospective Analysis of Overall Outcomes for 26 Cases

Abstract Objectives Sleep difficulties are highly prevalent among children with rare genetic neurodevelopmental conditions (RGNC) such as Angelman and Smith-Magenis syndromes. Behavioral interventions are commonly used in the treatment of sleep difficulties in children; however, research is limited in children with RGNC. This study evaluated the overall effectiveness and acceptability of function-based behavioral sleep interventions for children with RGNC. Methods Data was collated from a series of experimental single-case research studies with 26 children (18 months to 19 years of age) with a range of RGNC, who received a behavioral sleep intervention. Intervention strategies included circadian (e.g., sleep/wake rescheduling), antecedent (e.g., sleep hygiene), and/or consequence (e.g., positive reinforcement of sleep-conducive behavior and modified extinction) modifications implemented by parents. Clinicians provided support for parents mostly via telehealth methods. Overall outcomes were examined using modified Brinley plots and effect size estimates. The effect of age, gender, and a range of psychological variables on intervention response was also examined. Results Improvements in sleep problem severity were observed for 24/26 participants, and gains were maintained at long-term follow-up for 13/16. Interestingly, 50% of the children achieved clinically significant change with less restrictive strategies (e.g., circadian, antecedent and positive reinforcement strategies), suggesting extinction procedures may be used as the last option in a sequence of interventions. Parents generally perceived interventions to be acceptable. There was minimal evidence of any differential response to intervention as a function of age, gender, or psychological variables. Conclusions Results suggest function-based behavioral interventions offer an effective and socially valid method for treating sleep disturbance in children with RGNC.

The potential of repetitive transcranial magnetic stimulation for addressing sleep difficulties in children with autism – A brief communication

Sleep difficulties can co-occur with autistic traits and have been frequently reported in children diagnosed with autism. Thus, sleep difficulties may impact neural development, cognition, and behavioural functioning in children with autism. Interventions, such as repetitive transcranial magnetic stimulation (rTMS), that target aberrant neural structures underpinning autistic traits and sleep difficulties in children could have beneficial effects. The rTMS effects on the pathophysiological pathways hypothesised to underpin autism and sleep difficulties are well-established in the literature; however, clinical evidence of its potential to improve sleep difficulties in children with autism is limited. While the preliminary data is promising, further robust rTMS studies are warranted to encourage its use in clinical practices.

Methylphenidate and Sleep Difficulties in Children and Adolescents With ADHD: Results From the 2-Year Naturalistic Pharmacovigilance ADDUCE Study

Objective: Short-term RCTs have demonstrated that MPH-treatment significantly reduces ADHD-symptoms, but is also associated with adverse events, including sleep problems. However, data on long-term effects of MPH on sleep remain limited. Methods: We performed a 2-year naturalistic prospective pharmacovigilance multicentre study. Participants were recruited into three groups: ADHD patients intending to start MPH-treatment (MPH-group), those not intending to use ADHD-medication (no-MPH-group), and a non-ADHD control-group. Sleep problems were assessed with the Children’s-Sleep-Habits-Questionnaire (CSHQ). Results: 1,410 participants were enrolled. Baseline mean CSHQ-total-sleep-scores could be considered clinically significant for the MPH-group and the no-MPH-group, but not for controls. The only group to show a significant increase in any aspect of sleep from baseline to 24-months was the control-group. Comparing the MPH- to the no-MPH-group no differences in total-sleep-score changes were found. Conclusion: Our findings support that sleep-problems are common in ADHD, but don’t suggest significant negative long-term effects of MPH on sleep.

The Lighter Touch: Less-Restriction in Sequentially Implemented Behavioral Sleep Interventions for Children with Rare Genetic Neurodevelopmental Conditions.

The prevalence of sleep difficulties among children with rare genetic neurodevelopmental conditions (RGNC) is high. Behavioral interventions are commonly used in the treatment of sleep difficulties in children with neurodevelopmental conditions such as autism, however, research is scarce in children with RGNC. The range of co-occurring complexities within this population, means there is a need for research to not only determine the effectiveness of behavioral sleep interventions, but also which components might be the least restrictive (i.e., intensive/aversive) and minimally sufficient. This study used a single-case multiple baseline design to investigate the effectiveness and acceptability of behavioral sleep interventions, indicated within a Functional Behavior formulation in eight children with RGNC (M = 7.3years). Intervention components were sequentially administered across up to three phases, based on the principle of less restriction (from least to relatively more intensive) to determine what might be minimally sufficient. Results showed an improvement in sleep onset latency, night wakings, early morning waking and unwanted bed-sharing for 7/7, 6/7, 3/3 and 3/3 children respectively. Improvement was observed for most participants following the less restrictive phases of intervention (circadian modifications, antecedent modifications and positive reinforcement), however, more restrictive, albeit modified, extinction procedures were still implemented for five participants. Improvements were maintained at follow-up and interventions were deemed acceptable to parents. Less restrictive function-based behavioral strategies are an effective, and in some cases sufficient, contribution to a sequence of interventions for a range of sleep difficulties. They should be implemented first, before more restrictive strategies.

Multiple factors to consider in understanding sleep difficulties in children with fetal alcohol spectrum disorders.

Multiple factors to consider in understanding sleep difficulties in children with fetal alcohol spectrum disorders.

Eating habits matter for sleep difficulties in children and adolescents: A cross-sectional study.

Sleep difficulties are a common sleep-related problem among children and adolescents. However, the association between eating habits and sleep difficulties has not been extensively studied. Therefore, this study aimed to investigate the relationship between eating habits and sleep difficulties in children and adolescents. This study utilized cross-sectional data from the 2013/2014 Health Behaviour in School-aged Children survey. A total of 213,879 young adolescents provided self-reported information on their weekday and weekend breakfast consumption, fruit and vegetable intake, sweet and soft drink consumption, and sleep difficulties. Covariates such as sex, age, family affluence, physical activity, and body mass index were also assessed. Multilevel generalized linear modelling was used to analyse the association between independent and dependent. Results were reported as odds ratios (OR) with 95% confidence intervals. Of all study participants, approximately 50% were girls. Regression models indicated that more frequent breakfast consumption was associated with fewer sleep difficulties (e.g., consuming breakfast on weekdays for 5 days: OR = 1.49, 95% CI: 1.45-1.54). Fruit and vegetable consumption once a week or more was also linked to fewer sleep difficulties (all OR > 1.08, ≥ 1.07). In addition, consuming fewer sweets and soft drinks was generally associated with fewer sleep difficulties. This study provides evidence supporting the association between healthier eating habits and reduced sleep difficulties in children and adolescents. Future research using longitudinal or experimental designs is encouraged to confirm or negate these findings. Additionally, this study offers practical guidance for nutritional counselling professionals and sleep health promotion practitioners.

The impact of sleep difficulties in children with attention deficit hyperactivity disorder on the family: a thematic analysis.

Attention deficit hyperactivity disorder is a complex but common neurodevelopmental condition characterized by symptoms of inattention, hyperactivity, and impulsivity associated with a significant level of academic, social, and functional impairment. Problems around sleep frequently co-occur with attention deficit hyperactivity disorder and are thought to affect 50% to 80% of children and adults with the condition. Sleep issues typically include trouble falling asleep, bedtime resistance, night-time waking, and early rising. The impact of these problems on families and parents is profound but poorly researched. Semistructured interviews took place with 12 mothers of children with attention deficit hyperactivity disorder who struggle with sleep. Participants were asked about sleeping patterns and issues, methods used to improve sleep, the impact on parents' sleep and wider family life, and involvement with clinical services and support groups. Data were analyzed using thematic analysis. Three themes were identified in the data: a constant battleground; the cumulative effect of lack of sleep: impact on functioning and the wider family; a mixed bag of strategies: the tried, tested, and needed. Long-term sleep issues and challenging behavior at bedtime had substantial negative effects on families. Parents experiencing sleep deprivation experienced functional impairments to daily life and well-being and strain on relationships with children and spouses. Findings revealed parents were consistently and profoundly impacted by their children's sleep problems. Parents sought strategies and support in many different ways but were often unsuccessful. French B, Quain E, Kilgariff J, Lockwood J, Daley D. The impact of sleep difficulties in children with attention deficit hyperactivity disorder on the family: a thematic analysis. J Clin Sleep Med. 2023;19(10):1735-1741.

Роль родительских представлений о своем сне и сне ребенка в регуляции сна и бодрствования у детей 5—13 лет: культурно-исторический подход в психосоматике

<p>From perspective of cultural-historical approach in psychosomatics, the psychological regulation of a child's sleep and wakefulness is developed in children in interaction with significant adults. The aim was to reveal the relationship between dysfunctional beliefs of parents about their own sleep and its vulnerability as well as their violations of sleep hygiene and parental beliefs about the sleep of their children aged 5-13, the beliefs of the children about their sleep and their quality of sleep and wakefulness. 147 pairs of "parent-child 5-13 years old without diagnosed sleep disorders" participated (47 pairs with a child 5-6 years old, 49 pairs with a child 7-9 years old, 51 pairs with a child 10-13 years old). Parents answered questions about their child's sleep pattern, filled children's sleep habits questionnaire, dysfunctional beliefs about sleep and sleep vulnerability scales about their own and their child's sleep, insomnia severity index, and a scale of behavioral factors of sleep disturbances about their own sleep. Children answered the questions of children's self-report about their sleep, dysfunctional beliefs about and vulnerability of their sleep scales, pediatric sleepiness scale. According to the analysis of mediation, dysfunctional perceptions of parents about their own sleep are indirectly associated with sleepiness and sleep difficulties in children, since they increase the likelihood of the same perceptions of parents about their children's sleep. Sleepiness, according to the children appraisals, is additionally indirectly related to the dysfunctional beliefs of parents about their sleep through the mediation of the child's beliefs about their sleep. Parents' beliefs about their sleep vulnerability are associated with children's poorer sleep and sleepiness, as they increase the likelihood of the child's sleep vulnerability beliefs, which, in turn, increase the likelihood of the child's own perceptions of the vulnerability of his sleep. The data are consistent with the perspective of the psychology of physicality about the development of the psychological regulation of sleep and wakefulness of the child in interaction with significant adults.</p>

An exploratory study of sleep quality and quantity in children with causal variants in SYNGAP1, an autism risk gene

Study objectivesSleep disturbances are reported in 62% of children with SYNGAP1-Intellectual Disability (SYNGAP1-ID), a rare neurodevelopmental disorder characterized by intellectual disability, epilepsy, autism spectrum disorder (ASD), sensory and behavioral challenges. Although Children’s Sleep Habits Questionnaire (CSHQ) scores are elevated in children with SYNGAP1-ID factors that predict sleep disturbance are not well understood. The goal of this study is to identify predictors of sleep problems. MethodsParents of 21 children with SYNGAP1-ID completed questionnaires, and 6 children wore the Actiwatch2 for 14 continuous days. Non-parametric analysis of psychometric scales and actigraphy data were performed. Actigraphy derived sleep parameters were compared to controls and rest activity rhythms were assessed using arctools an open-source R package. ResultsCSHQ total sleep scores in children with SYNGAP1-ID and ASD were not different from children with SYNGAP1 without ASD (p = 0.61). Sleep anxiety (β 1.646, 95% CI 0.9566 to 2.336) and parasomnias (β 0.6294, 95% CI 0.06423 to 1.195) were strong predictors of bedtime resistance (R2 = 0.767, p < 0.001). The sedentary to active transition probability during the 12–18 h epoch (β = 0.004, p = 0.008, R2 = 0.85) and the duration of the active bout during the 18–24 h epoch (β = 0.166, p = 0.029, R2 = 0.74) were strong predictors of total sleep disturbance. ConclusionThe CSHQ may be a reliable measure of sleep difficulties in children with SYNGAP1-ID. Sleep anxiety, parasomnias and difficulty winding-down are significant contributors to sleep disturbances.

Жалобы на нарушения сна у детей 5—13 лет: распространенность и содержание. Часть 1

&lt;p&gt;Sleep-related complaints are common in children and affect their daytime sleepiness, success and quality of life. However, often parents are unaware of or do not consider them as a problem demanding treatment. &lt;strong&gt;Aim.&lt;/strong&gt; To identify the parental appraisals of the patterns and difficulties with sleep in children aged 5&amp;mdash;13 years and parental subjective qualification of them as a problem. &lt;strong&gt;Methods.&lt;/strong&gt; In 147 pairs of &amp;laquo;parent-child 5&amp;mdash;13 years old without diagnosed sleep disorders&amp;raquo; (47 pairs with a child 5&amp;mdash;6 years old, 49 with a child 7&amp;mdash;9 years old, 51 with a child 10&amp;mdash;13 years old), parents answered questions about the pattern children&amp;rsquo;s sleep habits and completed the Children&amp;rsquo;s Sleep Habits Questionnaire. Children replied to Sleep Self-Report. &lt;strong&gt;Results.&lt;/strong&gt; Difficulties with sleeping are common in children 5&amp;mdash;13 years of age: irregular bedtimes, prolonged time falling asleep, falling asleep in someone else&amp;rsquo;s bed, night terrors, insufficient sleep time, frequent nocturnal awakenings, sleep-talking, early morning awakenings, long time to get up in the morning, fatigue in the afternoon 3 times a week or more are typical for every third child, while protests against going to bed, the impossibility of waking up on their own in the morning, difficulties in getting up in the morning &amp;mdash; for every second child. For children 10&amp;mdash;13 years old, lack of sleep was also wide-spread. Parents frequently do not consider sleep difficulties in children as a problem. The pattern of going to bed, sleeping, and waking up didn&amp;rsquo;t not differ between boys and girls, but girls rated their sleepiness higher, and rated sleep quality lower. With age, daytime and nighttime sleep was reduced, bedtime became later, while breathing problems during sleep, parasomnia symptoms and night terrors became rarer. &lt;strong&gt;Conclusion.&lt;/strong&gt; Given the prevalence of complaints about various difficulties associated with sleep in children aged 5&amp;mdash;13 years, the acute question is why parents do not qualify these difficulties as problems and do not seek help is relevant.&lt;/p&gt;

Effects of a Sleep Health Education Program for Children and Parents on Child Sleep Duration and Difficulties

Preschool-aged children often lack sufficient sleep and experience sleep difficulties. A consistent bedtime routine, falling asleep alone, and other sleep practices reduce difficulties and increase sleep duration. To evaluate the effects of a preschool-based sleep health literacy program on children's sleep duration and difficulties and on parent sleep knowledge, attitudes, self-efficacy, and beliefs 9 and 12 months after the program. This stepped-wedge cluster randomized clinical trial was implemented across the 2018-2019 school year. Head Start preschool personnel delivered interventions and collected outcomes data at baseline and 4 follow-ups. Seven Head Start agencies across New York State were randomized to implement interventions in either fall 2018 or winter and spring 2019. Outcomes were ascertained at 9- and 12-month follow-up. From March 19 through September 28, 2018, Head Start staff recruited (a) English- or Spanish-speaking parents (b) of children 3 years of age on or about September 2018 (c) who planned to remain at the site through the school year. Altogether, 519 parent-child (aged 3 years) dyads completed baseline and (any) follow-up data. A 2-week classroom curriculum for children, a 1-hour parent workshop, and 1-on-1 parent discussions at home or school. Outcomes were the pre- vs postintervention differences measured at baseline and 9-month follow-up for parent-reported child school-night sleep duration per sleep logs, mild or moderate sleep difficulties per a validated questionnaire, and the total and domain scores for parent sleep knowledge, attitudes, self-efficacy, and beliefs. A modified intention-to-treat analysis excluding participants with only baseline data was used. The mean (SD) age at enrollment of 519 children was 2.7 (0.1) years, 264 (50.9%) were girls, 196 (37.8%) lived in Spanish-speaking households, and 5 (0.9%) identified as Alaskan Native or American Indian, 17 (3.2%) as Asian American or Pacific Islander, 57 (10.8%) as Black, 199 (37.8%) as White, and 63 (12.0%) as other. Mean sleep durations increased nonsignificantly from baseline by 5.6 minutes (95% CI, -2.3 to 13.6 minutes; P = .17) at 9-month follow-up and by 6.8 minutes (95% CI, 0.2-13.7 minutes; P = .06) at 12-month follow-up. There was a slight improvement in parental knowledge (1.13 unit increase from baseline; 95% CI, 0.13-2.12 units), but no significant outcomes for parent sleep attitudes (0.16 unit increase from baseline; 95% CI, -0.46 to 0.77 units), self-efficacy (-0.13 unit decrease from baseline; 95% CI, -1.02 to 0.76 units) and beliefs (-0.20 unit decrease from baseline; 95% CI, -0.56 to 0.16 units). Intervention effects for child sleep difficulties were not significant (odds ratio, 1.13; 95% CI, 0.62-2.09). Fewer than 1 in 4 parents accurately perceived their child's sleep difficulty at 12 months. The findings of this large pragmatic, stepped-wedge cluster randomized clinical trial, albeit largely negative, may have implications for the sustained impact, focus, and potential population-level effects of sleep education programs. Future research should evaluate the effects of more recurrent programming that emphasizes recognition of sleep problems and whether small increments of sleep across months and years in early childhood have meaningful effects. ClinicalTrials.gov Identifier: NCT03556462.

Anxiety disorders across middle childhood and early adolescence in a UK population-based cohort.

Patterns of development and underlying factors explaining anxiety disorders in children and adolescents are under-researched, despite their high prevalence, impact and associations with other mental disorders. We aimed to a] understand the pattern and persistence of specific anxiety disorders; b] examine differing trajectories of symptoms of specific anxiety disorders and; c] examine socio-demographic and health-related predictors of persistent anxiety disorder-specific symptoms, across middle childhood to early adolescence. The current study used data from 8122 participants in the Avon Longitudinal Study of Parents and Children birth cohort. The Development and Wellbeing Assessment questionnaire was administered to parents to capture child and adolescent anxiety total scores and DAWBA-derived diagnoses. Separation anxiety, specific phobia, social anxiety, acute stress reaction, and generalized anxiety at 8, 10 and 13years were selected. Further, we included the following socio-demographic and health-related predictors: sex, birth weight, sleep difficulties at 3.5years, ethnicity, family adversity, maternal age at birth, maternal postnatal anxiety, maternal postnatal depression, maternal bonding, maternal socio-economic status and maternal education. Different anxiety disorders presented different prevalence and patterns of development over time. Further, latent class growth analyses yielded a trajectory characterized by individuals with persistent high levels of anxiety across childhood and adolescence; for specific phobia (high=5.8%; moderate=20.5%; low=73.6%), social anxiety (high=3.4%; moderate=12.1%; low=84.5%), acute stress reaction (high=1.9%; low=98.1%) and generalized anxiety (high=5.4%; moderate=21.7%; low=72.9%). Finally, the risk factors associated with each of the persistent high levels of anxiety disorders were child sleeping difficulties and postnatal maternal depression and anxiety. Our findings show that a small group of children and young adolescents continue to suffer from frequent and severe anxiety. When considering treatment strategies for anxiety disorders in this group, children's sleep difficulties and postnatal maternal depression and anxiety need to be assessed as these may predict a more prolonged and severe course of illness.

Evidence-Based Behavioral Strategies in Smartphone Apps for Children's Sleep: Content Analysis.

BackgroundEmpirically supported treatments for pediatric sleep problems exist, but many families turn to other sources for help with their children’s sleep, such as smartphone apps. Sleep apps are easy for families to access, but little evidence exists regarding the validity of the services and information provided in the developer descriptions of the apps.ObjectiveThe goal of this study was to examine the features and claims of developer descriptions of sleep apps for children.MethodsA search of the Apple iTunes store and Google Play was conducted using the terms “kids sleep,” “child sleep,” and “baby sleep.” Data on the type of app, price, user rating, and number of users were collected. Apps were analyzed in comparison with evidence-based behavioral strategies and were thematically coded on the basis of claims provided in developer descriptions.ResultsA total of 83 app descriptions were examined, of which only 2 (2.4%) offered sleep improvement strategies. The majority were sound and light apps (78%) and 19% were bedtime games or stories. Only 18 of 83 (21.6%) apps were identified as containing empirically supported behavioral sleep strategies. Despite this, many apps asserted claims that they will help children “fall asleep instantly,” “cry less and sleep better,” or improve child development.ConclusionsA large variety of sleep apps exist for use among children, but few include evidence-based behavioral strategies according to the developer descriptions of the apps. Addressing sleep difficulties in children is important to promote physical, cognitive, and emotional development. Collaboration between sleep researchers and technology developers may be beneficial for creating evidence-supported apps to help with children’s sleep in the future.

The relationship between sleep and depression and bipolar disorder in children and young people.

Sleep difficulties are often reported in practice, and are part of the diagnostic criteria for depression and bipolar disorder. To inform the understanding of the relationship between sleep and both depression and bipolar disorder. We conducted a narrative literature review of affective disorders and sleep difficulties in children and young people. Specific sleep disorders, such as parasomnias, narcolepsy and sleep-related movement disorders, are associated with depression, whereas insomnia, obstructive sleep apnoea and circadian rhythm disorders are associated with both depression and bipolar disorder in children and young people. Conversely, children and young people with depression can present with a number of sleep difficulties, and these are associated with higher depression severity and greater fatigue, suicidal ideation, physical complaints, pain and decreased concentration. Sleep disturbances among adolescents with bipolar disorder can affect the severity of depressive and manic symptoms, are a poor prognostic indicator and have been associated with social and academic impairment. Antidepressants and antipsychotics can directly affect sleep architecture, which clinicians need to be aware of. Non-pharmacological interventions for sleep problems could prevent and/or minimise the risk of relapse in affective disorders. Sleep difficulties can occur before, during and after an episode of depression or bipolar disorder, and have a higher prevalence in affective disorders compared with the general population. A multi-modal approach would include the treatment of both the affective and specific sleep disorder. Further research is needed in this field to understand the impact of combined interventions on clinical outcomes.

O017 Parents’ experiences of having a child with Down Syndrome and sleep difficulties

Abstract Introduction This qualitative study that investigates parents’ experiences of having a child with Down Syndrome (DS) and sleep difficulties is a part of a broader mixed-method study entitled Sleep Difficulties in Children with Down Syndrome: An Evaluation of Parent/Carer and Family Quality of Life. Methods We conducted semi-structured interviews with 26 parents (fathers n = 4 and mothers n = 22), and reflexive Thematic Analysis (TA) was operationalised for data analysis. The interviews covered the following key topics: DS diagnosis; timeline of their child’s sleep patterns and difficulties; implications for parental sleep, day-time function, and well-being; family dynamics; and access to supports. Results Most participants described negative experiences at time of diagnosis, including not feeling listened to, and receiving inconsistent, insensitive and inadequate information and/or treatment. Most strikingly, no parents recall receiving sleep specific information. Most participants described their child’s sleep difficulties affecting their own sleep, day-time function and family dynamics, yet they commonly normalised these experiences. Such normalisation was a recurring theme across their experiences of having a child with DS and is contextualised by their accounts of resisting prejudiced attitudes towards their child since diagnosis. Discussion This is the first qualitative study to investigate parents’ experiences of having a child with DS and sleep difficulties. Implications include professional development for health care workers focusing on sleep as a significant comorbidity for these children, and awareness of families’ tendencies to normalise their experiences when delivering care.

Young children's sleep difficulties: Are mainstream research findings supported by more recent evidence?

A substantial body of evidence about how to support parents with their child's sleep difficulties has been published and this can inform the practice of health visitors and others who work with the families concerned. However, does more recently published research in this field support or question the findings of mainstream studies? This article will examine how some recent studies do support and develop earlier evidence, while others open new fields of research, or challenge official guidance in new ways.

Pediatric Sleep Difficulties: How OTs Address Sleep as an Occupation

Abstract Date Presented 04/13/21 This study examines the current practices of OTs in the treatment of sleep difficulties in children. The study used a survey design to explore assessment methods, interventions, and preparedness of pediatric OTs in addressing sleep. The study lays the foundation for the need for future research in effectiveness of sleep interventions in the pediatric population. Primary Author and Speaker: Aimee Piller Additional Authors and Speakers: Kimberly Lieberman, Abraham Kim, Erin Thrasher, and Theresa Guzaldo

Sleep-Related Breathing Problem Trajectories Across Early Childhood and Academic Achievement-Related Performance at Age Eight.

Background: Childhood sleep disordered breathing (SDB) has been linked to poorer academic performance; however, research has not investigated the extent improvement in SDB may alter outcomes across key academic skills. This study aimed to investigate if children's early SDB status could predict later academic outcomes, and if an improvement in SDB status across the early childhood years would coincide with better, later performance in key academic skills related to reading, numeracy, and listening comprehension.Methods: Eighty five case children with an SDB symptom score >25 (maximum 77) were matched to 85 control children (score <12) at recruitment (age 3). SDB severity (symptom history and clinical assessment) was evaluated at ages 3, 4, 6, and 8 years and performance on individually-administered academic skills assessed at age 8 (91% retention from age 3). Case children were categorized into “improved” or “not-improved” groups based on SDB trajectories over the 5 years. Contributions of SDB status and trajectory group to academic performance were determined using regression analysis adjusted for demographic variables.Results: History of SDB from age 3 predicted significantly poorer performance on some key academic skills (oral reading and listening skills) at age 8. Children whose SDB improved (45%) performed better in oral reading fluency than those whose SDB did not improve, but difficulties with specific tasks involving oral language (listening retell) remained when compared to controls.Conclusion: Findings support links between early SDB and worse academic outcomes and suggest key academic areas of concern around oral language. Findings highlight the need for child mental health professionals to be aware of children's sleep problems, particularly SDB (past and present), when assessing potential barriers to children's achievement, to assist with appropriate and timely referrals for evaluation of children's sleep difficulties and collaborative evaluation of response to intervention for sleep difficulties.

Association between sensory modulation and sleep difficulties in children with Attention Deficit Hyperactivity Disorder (ADHD)

BackgroundSleep difficulties have been reported in up to 85% of children with Attention Deficit hyperactivity disorder (ADHD). Children with ADHD exhibit commonly sensory modulation difficulties (SMD) and experience more significant functional difficulties. Sleep difficulties have also been associated with SMD. The aim of this study was to evaluate whether SMD are associated with sleep difficulties in children with ADHD. MethodsWe assessed sleep difficulties using the Children's Sleep Habits Questionnaire, and SMD using the Short Sensory Profile (SSP) questionnaire. A total of 25 children with ADHD and atypical sensory profiles, 13 children with ADHD and typical sensory profiles and 38 children used as controls (all children aged 8–11 years) were included. ResultsSleep difficulties were detected in 86.4% of children with ADHD and atypical SSPs, as compared to 30.8% of children with ADHD and typical SSPs, and 16.7% of controls. A multivariate logistic regression revealed that children with ADHD and atypical SSPs had significantly increased odds for sleep difficulties as compared to controls (OR = 32.4; 95% CI 4.0–260.1, p = 0.001), while children with ADHD and typical SSPs were indistinguishable from controls. Suspected confounders (gender, age, mother's education, and stimulant therapy) did not contribute to sleep difficulties. ConclusionIn this pilot study, SMD were associated with sleep difficulties in children with ADHD.

Pediatric Sleep Difficulties: How OTs Address Sleep as an Occupation

Abstract Date Presented 03/28/20 This study examines the current practices of OTs in the treatment of sleep difficulties in children. The study used a survey design to explore assessment methods, interventions, and preparedness of pediatric OTs in addressing sleep. The study lays the foundation for the need for future research in effectiveness of sleep interventions in the pediatric population. Primary Author and Speaker: Aimee Piller Additional Authors and Speakers: Elizabeth Torrez, Katie Hawk, Mekenzie Keenportz, Kelly Maki, Tara Rudkoski