Sleep Disorders In Children Research Articles

Research progress on melatonin, 5-HT, and orexin in sleep disorders of children with autism spectrum disorder.

Sleep disorders are among the common comorbidities of autism spectrum disorder (ASD), which not only affect the daily life and learning ability of children but may also exacerbate other symptoms of ASD, seriously impacting the quality of life of children and their families. Given this, understanding the neurobiological mechanisms of sleep disorders in children with ASD has significant research value for developing effective intervention strategies. Melatonin, 5-HT, and orexin are key neurotransmitters that regulate the sleep-wake cycle. Through in-depth analysis of the biological functions and regulatory pathways of these neurotransmitters, new perspectives may be provided for personalized treatment of sleep disorders in children with ASD. This article reviews the research progress on melatonin, 5-HT, and orexin in sleep disorders among children with autism spectrum disorder, focusing on exploring the mechanisms of these key neurotransmitters in sleep disorders of children with ASD and how they affect the sleep-wake cycle, providing a theoretical basis for improving the sleep quality of children with ASD.

Erratum to “Association of food intake with sleep disorders in children and adolescents with obesity” [Sleep Med: X 4 (2022) 100053

Erratum to “Association of food intake with sleep disorders in children and adolescents with obesity” [Sleep Med: X 4 (2022) 100053

Risk factors of obstructive sleep apnea syndrome in the developmental age

Background: Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent respiratory sleep disorder in children, associated with severe health consequences, including hypertension, cardiac dysfunction, and neurocognitive impairment. Despite extensive research on OSAS in adults, the risk factors for pediatric OSAS remain underexplored. Objective: This literature review aims to identify and present the key risk factors associated with pediatric OSAS based on contemporary studies. Methods: A systematic search of the PubMed and Scopus databases was conducted for literature published between 2016 and 2024. Search terms included “obstructive sleep apnea,” “children,” and “risk factors.” A total of 93 relevant studies were reviewed after excluding non-pediatric and irrelevant papers from an initial pool of 283. Results: The most commonly identified risk factors for pediatric OSAS include adenoid and tonsillar hypertrophy, obesity, craniofacial abnormalities, and asthma. Additional risk factors such as allergic rhinitis, recurrent upper respiratory infections, nasal stenosis, congenital diseases, low vitamin D levels, and preterm birth were also noted. Conclusion: Pediatric OSAS is influenced by multiple factors, including anatomical, physiological, and genetic components. Further research is required to explore emerging risk factors, such as role of vitamin D deficiency and microbiota, and to clarify the impact of variables like ethnicity and breastfeeding.

Impact of asthma and allergic rhinitis control on sleep disordered breathing in pediatrics

AimThe aim of our study is to assess the quality of sleep in children with asthma and/or allergic rhinitis, as well as the impact of the control of allergic respiratory diseases on sleep disturbances. Materials and methodsIt is an observational cross-sectional study on children attending pediatric allergy appointments at a portuguese tertiary hospital (G1), and compared to a control population (G2). The asthma and rhinitis control was determined using the Control of Allergic Rhinitis and Asthma Test (CARAT/CARATKids) questionnaires. Sleep was evaluated using the Pediatric Sleep Questionnaire (PSQ). G1 included 61 patients and G2 included 100 children. ResultsAbout a third of the children in the study group had sleep-related breathing disorders (SDB), compared to 9 % on the control group (p-value <0.05). There was a significant positive correlation between uncontrolled asthma and allergic rhinitis, and SDB (p-value <0.05). ConclusionSDB is more prevalent among children with asthma and/or allergic rhinitis. The absence of control of the allergic respiratory diseases has a negative impact on sleep. We recommend large cross-sectional studies to better comprehend the exact relationship between the two conditions, as well as the use of objective diagnostic tools. We believe it is essential to implement early screening for sleep disorders in children with allergic respiratory diseases, through validated questionnaires.

Characteristics of gut flora in children who go to bed early versus late

Investigating the characteristics of the gut flora in children who go to bed early versus late. The study sample consisted of 88 healthy children aged 2–14 years, with an equal number of boys and girls. The researchers collected faecal samples from all participants and sequenced the genome of their gut flora. Findings indicate that beta diversity was statistically significant at the genus level for both the early and late sleeper groups (P = 0.045). Furthermore, alpha diversity indicators, including Simpson’s index (P = 0.0011) and Shannon’s index (P = 0.0013), exhibited higher values at the genus level. The differences observed in terms of species diversity, abundance, and metabolic pathways offer potential avenues for implementing pharmacological interventions aimed at addressing sleep disorders in children.

Sleep disorders in early childhood with chronic somatic conditions and atypical development - with particular reference to Down syndrome

A szakirodalmi adatok és szülők beszámolói alapján a krónikus betegséggel élő, illetve fogyatékosságban érintett – és különösen az idegrendszer fejlődési zavarával diagnosztizált – kisgyermekek körében jelentősen nagyobb az alvásproblémák előfordulásának gyakorisága, hasonló korú, tipikus fejlődésmenetű gyermekcsoportokkal összehasonlítva. A tünetek az esetek többségében multifaktoriális etiológia talaján bontakoznak ki, megjelenésüket a gyermek szomatikus állapota, a társuló neurológiai és pszichiátriai zavarok, valamint a kapcsolati jellemzők és a környezeti körülmények együttesen befolyásolják. Krónikus betegséggel küzdő, atipikus fejlődésmenetű, sajátos idegrendszeri működéssel és viselkedési fenotípussal jellemezhető gyermekcsoportokban az alvászavar aluldiagnosztizált jelenség, mivel a komplex tüneti képben nehezen különíthető el a gyermek állapotának, valamint az alvástünetek jellegzetességeinek és következményeinek megjelenése. A krónikus betegséggel élő vagy fogyatékosságban érintett gyermeket nevelő családok esetében a fokozott kihívást jelentő élethelyzetekhez való alkalmazkodást tovább nehezítheti az alvászavarok megjelenése, melyek jelentős hatást gyakorolhatnak a családtagok jóllétére és életminőségére. A Down-szindrómában érintett gyermekek a tanulmányunk fókuszában álló speciális szükségletű gyermekcsoportok kihívásaival egyszerre találkoznak, esetükben az egyes szindrómaspecifikus jellemzők, a krónikus szomatikus állapotok, valamint az idegrendszer strukturális és funkcionális elváltozásai komplex módon járulnak hozzá az alvással összefüggő problémák gyakoribb előfordulásához. A gyakorlatban alkalmazott prevenciós és intervenciós szemléletű kezdeményezések az alvásproblémák korai azonosítása mellett számos rövid és hosszú távú negatív fejlődési, illetve viselkedési következmény megelőzését és kezelését, enyhítését teszik lehetővé, hozzájárulva az érintett gyermekek és családtagjaik kapcsolati jellemzőinek és életminőségének javításához. Orv Hetil. 2024; 165(36): 1411–1422.

Factors Associated with Sleep Disorders in Children with Cerebral Palsy

Factors Associated with Sleep Disorders in Children with Cerebral Palsy

Evaluation of Sleep Disorders in Allergic Diseases in Childhood

Objective: Sleep is a vital component of human life that serves many critical roles in physical and mental health, and well-being. There were few studies on children, diagnosed with allergic diseases, especially preschool children. The aim of our study mas to evaluate sleep disorders in children with allergic diseases. Material and Methods: This retrospective study was conducted in Dr. Burhan Nalbantoğlu Hospital Child Immunology and Allergy outpatient clinic between January 1 and March 20, 2024, patients included who were diagnosed with allergic rhinitis, asthma and/or atopic dermatitis.The ‘Sleep Disturbance Scale for children (SDSC) was applied to the parents by the researcher during the outpatient clinic visit. Results: In this study, 145 patients were involved. Five (3.4%) patients had clinically significant SDSC score. There was a statistically significant difference in the Children’s Sleep Disturbance Scale mean score between having and not having symptoms of allergic diseases. Patients diagnosed wheezy child tended to have higher mean score of SHY. Among patients having symptoms of allergic diseases, there was statistically significant difference in the SDSC mean score between having nose congestion, cough, and activity limitation and not having these symptoms. Patients using oral antihistaminic treatment tended to have higher total mean scores of SDSC. Conclusion: In this study, out of 145 patients, 5 (3.4%) patients had clinically significant SDSC score. Patients having symptom of allergic diseases tended to have higher total mean score of childrens’ sleep disturbance scale. Patients diagnosed wheezy child tended to have higher mean score of SHY. Patients having nose congestion, cough, and activity limitation tended to have higher total mean score of SDSC.

Modern approach to pharmacotherapy of chronic insomnia in childhood

Insomnia is a widespread problem in the pediatric population. The prevalence of insomnia in childhood varies from 5% to 50%. The lack of adequate therapy can lead to chronicity, impairment of cognitive and motor functions, and eventually development of cardiovascular and metabolic diseases, diabetes, and gastrointestinal and mental disorders. Thus, timely identification and treatment of childhood insomnia is important. This study aimed to summarize and systematize current information about the modern approach to pharmacotherapy of chronic insomnia in childhood. Modern and foreign randomized controlled trials over the past 10 years were analyzed. Treatment of chronic insomnia includes non-pharmacological and pharmacological approaches. Behavioral strategies are recommended as first-line treatment for childhood insomnia. The availability of different pharmacological drug groups allows for a personalized approach to treatment. However, the use of off-label drugs requires a justified prescription. The lack of large-scale clinical studies on the effectiveness, tolerability, dosing, and safety profile of drugs implies the need for further research to better understand the risks (negative side effects) and benefits of using such drugs for treating sleep disorders in children.

Long-term exposure to ozone and sleep disorders in children: A multicity study in China

Evidence regarding the link between long-term ambient ozone (O3) exposure and childhood sleep disorders is little. This study aims to examine the associations between long-term exposure to O3 and sleep disorders in children. We conducted a population-based cross-sectional survey, including 185,428 children aged 6–18 years in 173 schools across 14 Chinese cities during 2012 and 2018. Parents or guardians completed a checklist using Sleep Disturbance Scale for Children, and O3 exposure at residential and school addresses was estimated using a satellite-based spatiotemporal model. We used generalized linear mixed models to test the associations with adjustment for factors including socio-demographic variables, lifestyle, meteorology and multiple pollutants. Mean concentrations of O3, particulate matter with diameters ≤2.5 mm (PM2.5) and nitrogen dioxide (NO2) were 89.0 μg/m3, 42.5 μg/m3 and 34.4 μg/m3, respectively. O3 and NO2 concentrations were similar among provinces, while PM2.5 concentration varied significantly among provinces. Overall, 19.4% of children had at least one sleep disorder. Long-term exposure to O3 was positively associated with odds of sleep disorders for all subtypes. For example, each interquartile increment in home-school O3 concentrations was associated with a higher odds ratio for global sleep disorder, at 1.22 (95% confidence interval: 1.18, 1.26). Similar associations were observed for sleep disorder subtypes. The associations remained similar after adjustment for PM2.5 and NO2. Moreover, these associations were heterogeneous regionally, with more prominent associations among children residing in southeast region than in northeast and northwest regions in China. We concluded that long-term exposure to O3 is positively associated with risks of childhood sleep disorders. These associations varied by geographical region of China.

Review of respiratory sleep disorders in children with genetic and metabolic diseases

Sleep is an important physiological process for the optimal functioning of the human body. Respiratory sleep disorders in children can be found in any age group with a prevalence of 2-5%. Genetic and metabolic syndromes in children associate a higher prevalence of sleep pathology. Polysomnography represents the gold standard investigation for evaluation and monitoring of breathing disorders associated with sleep. Early detection of sleep pathology in children and periodic monitoring plays an important role in improving quality of life of these patients.

Eating Behavior, Sleep Disorders and Digital Game Addiction in Children and Determination of Associated Factors by CHAID Analysis

Background: Healthy nutrition and good quality sleep are one of the most important factors for growth and development in a child. Digital game addiction may cause some problematic behaviors and affect children's nutrition and sleep. We aimed to investigate the relationship between digital game addiction, eating behavior, and sleep disorders in children. Methods: The study was conducted with 252 mothers with children between the ages of 4-7 years, selected by convenient sampling methods. The Digital Game Addiction Scale, Children's Eating Behavior Questionnaire and The Sleep Disturbance Scale for Children (SDSC) were used to collect data. The correlation coefficient and the decision tree CHAID algorithm were used in the data analysis. Results: Digital game addiction negatively affects children's eating behavior and sleep patterns. It was found that there was a mostly positive but weakly significant relationship between digital game addiction and children's eating behaviors (P&lt;.01; P&lt;.05) and a highly significant relationship was found between the sleep disorder scale sleep hyperhidrosis sub-dimension (P&lt;.05). While digital game addiction is affected by gender, the mother's education level, and eating behavior are affected by the mother's age, the parent's education level, and the child's gender (P&lt;.05). The child's age is the variable that affects the children's sleep disorder (P&lt;.05). Conclusion: Intervention programs for children and families can be created for the causes of digital game addiction, its effects on child development and the correct use of the digital world.

Exposures to particulate matters and childhood sleep disorders—A large study in three provinces in China

ObjectivesEvidence on the link between long-term ambient particulate matter (PM) exposures and childhood sleep disorders were scarce. We examined the associations between long-term exposures to PM2.5 and PM1 (PM with an aerodynamic equivalent diameter <2.5 μm and <1 μm, respectively) with sleep disorders in children. MethodsWe performed a population-based cross-sectional survey in 177,263 children aged 6 to 18 years in 14 Chinese cities during 2012–2018. A satellite-based spatiotemporal model was employed to estimate four-year annual average PM2.5 and PM1 exposures at residential and school addresses. Parents or guardians completed a checklist using the Sleep Disturbance Scale for Children. We estimated the associations using generalized linear mixed models with adjustment for characteristics of children, parents, and indoor environments. ResultsLong-term PM2.5 and PM1 exposures were positively associated with odds of sleep disorders for almost all domains. For example, increments in PM2.5 and PM1 per 10 μg/m3 were associated with odds ratios of global sleep disorder of 1.24 (95 % confidence interval [CI]: 1.14, 1.35) and 1.31 (95 %CI: 1.18, 1.46), respectively. Similar results were observed for subtypes of sleep disorder. These associations were heterogeneous regionally, with stronger associations among children residing in southeast region than in northeast and northwest regions. Moreover, larger estimates of PM1 were found than that of PM2.5 in southeast region. ConclusionLong-term PM2.5 and PM1 exposures are independently associated with higher risks of childhood sleep disorders, and these associations vary by geographical region.

Prevalence and Characteristics of Sleep Disorders in Children Aged 7-17: Insights from Parental Observations at the Dental Office.

Sleep disorders (SD) in children is a topic of great relevance due to their impact on a child's general health. This has led us to study their prevalence and the factors that disturb them in the developing population. Using a validated Likert-type questionnaire, different behaviors observed by the parents during the different phases of their children's sleep were evaluated during the last 6 months. A total of 206 children between the ages of 7 and 17 who attended a dental office participated in the study. The prevalence of SD was 47.6%. There were no significant differences regarding the SD in relation to sex (p = 0.796). The mean total score for children aged 7 to 11 years old was 42.3 (±14.25) compared to 45.44 (±15.51) for the group consisting of children aged 12 to 17 years old, reporting a statistically significant difference among both age groups (p = 0.01). The most frequent disorder was related to initiating and maintaining sleep (64.9%) while the least prevalent were the respiratory sleep disorders (27.2%). Given the high prevalence of these disorders, it is necessary to intercept them during childhood and establish educational guidelines in this regard throughout primary care.

Background factors of childhood sleep disorders: interparental conflicts, parent-child attachment, parenting style and the quality of parent-child relationship

A szakirodalmi adatok szerint az egészségesen fejlődő gyermekek 20–30%-a megtapasztal valamilyen alvásproblémát gyermekkorban. Csecsemőknél és kisebb gyermekeknél az alváshiány és a fiziológiás alvási ritmus felborulása a nappali nyűgösség mellett hosszú távon hatással van a fejlődés minden területére (a mozgás-, a kognitív, a nyelvi készségekre és az emocionális fejlődésre is). Nagyobb gyermekeknél és serdülőknél ez rövid távon nappali fáradtsághoz és figyelemzavarhoz vezet, idővel azonban súlyosabb hatások is lehetnek, a szellemi és a fizikai teljesítmény csökkenésén át a hangulatingadozásig, sőt depressziós és szorongásos tünetek megjelenéséig. Ezért különösen nagy jelentősége van minden olyan környezeti tényező ismeretének, amelyet összefüggésbe hozhatunk a gyermekkorban megjelenő alvásproblémák kialakulásával. A jelen szakirodalmi összefoglaló célja átfogó képet adni azokról a kutatásokról, amelyek a gyermekek alvászavarait családi kontextusban vizsgálják, hiszen gyermekkorban a család funkcionalitása meghatározó tényező a gyermekek alvásának minőségét illetően. Az alvásproblémák megjelenésében a szülők közötti kapcsolat minősége, a szülők konfliktusmegoldó stratégiái, a szülői szerepükben való funkcionalitás, a szülők mentális egészsége, a gyermekkel kialakult kötődés minősége, a szülők nevelési stílusa, az esti, elalvási rituálék mind fontos szerepet játszanak. Figyelembe véve az alvásproblémák hosszú távú negatív következményeit, érdemes számba venni a hatékony intervenciós lehetőségeket. Elmondható, hogy amennyiben a szülő a gyermeke alvásproblémájával keresi fel orvosát, úgy érdemes nagyító alá venni a család funkcionalitását, a szülők párkapcsolati minőségét, a szülő-gyermek kapcsolat minőségét is. Ha ezeken a területeken derül fény problémára, akkor a szakorvosi kezelés mellett érdemes javasolni számukra a szülő-csecsemő/kisgyermek konzultációt, szülőkonzultációt, esetleg párterápiás, családterápiás lehetőségeket, a probléma teljes körű és hosszú távú megoldása érdekében. Orv Hetil. 2024; 165(17): 652–663.

Melatonin in infants—physiology, pathophysiology and intervention options

AbstractThe effectiveness of melatonin in nonorganic sleep disorders in children and adolescents has been examined in 33 randomised controlled studies [1]. This review presents the current state of knowledge on the physiology, pharmacokinetics, pathophysiology and toxicity of melatonin in infancy based on well-documented studies. Up to the third month of life, premature and full-term babies cannot produce their own melatonin, so they are dependent on exogenous supply via their own mother’s breast milk, non-pooled breast milk or non-pooled formula. Non-pooled means that a distinction should be made between melatonin-rich night milk and melatonin-poor day milk. A number of intervention studies indicate that administration of melatonin to infants may have analgesic and antioxidant effects related to ophthalmological examinations, prevention of bronchopulmonary dysplasia, and the treatment of hypoxic ischaemic encephalopathies. Since melatonin concentrations in the mother’s blood, in breast milk and, e.g., also in cow’s milk show regular day–night fluctuations, and since breastfed infants have a more stable melatonin supply and fewer sleep disorders, infants who cannot be breastfed by their own mother should preferably have chrononutrition made from non-pooled human or cow’s milk. There has recently been evidence that infantile colic is a disorder with delayed development of chronobiological rhythms.

1136 Sleep Disorders in Children and Adolescents with Long COVID

1136 Sleep Disorders in Children and Adolescents with Long COVID

Melatonin versus placebo in the treatment of sleep disorders in children and adolescents with autism: Systematic review and meta-analysis

Objective: To systematically review the evidence on the use of melatonin in the treatment of sleep disorders in children and adolescents with autism spectrum disorder (ASD). Method: Systematic review of randomized controlled clinical trials on the use of melatonin and included children and adolescents with ASD and sleep disorders, searching MEDLINE, SCOPUS, Web of science, Cochrane Central Register Controlled Trials, in the period between September and October 2023. The selection of studies were carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Changes in Total Sleep Time (TST) and Sleep Latency (SL) measurements were statistically significant. The 95% CI of 1.66 [1.10, 2.23] and 2.55 [1.02, 4.08] showed an increase in TST with the use of the intervention. (p &lt; 0.00001) [18, 19]. Garstang showed a statistical difference with the use of melatonin, with the result of 95% CI of -5.96 [-8.77, -3.16], as well as Cortesi with a 95% CI of -1.23 [-1.75, - 0.70] and Gringras with -1.35 [-1.79, -0.91], with reduced latency to start sleep (p = 0.0002). Conclusions: Larger samples are needed to evaluate the effectiveness of melatonin on other sleep patterns, such as nighttime awakenings and sleep quality.

Therapy program assisted with therapy dogs for children with Autism Spectrum Disorder (ASD)

IntroductionAutism spectrum disorders (ASD) is a neurodevelopmental disorder with an estimated lifetime prevalence of at least 1%. Some studies suggest that approximately 60% of children with ASD show emotional dysregulation and 44-86% sleeping disorders.Studies suggest that cognitive behavioral therapy and animal-assisted therapy AAT can be an intervention strategy to promote emotional and behavioral dysregulation and sleep disturbances.ObjectivesThe purpose of this study was to investigate the effect of a therapy program assisted with dogs (AAT) together with cognitive behavioral therapy (CBT) on behavioral and emotional regulation and sleep disorders in children diagnosed with ASD.MethodsThe sample was composed of 24 children between 7 and 10 years old diagnosed with ASD randomized into two groups (CGT group (control group) and AAT + CBT group (experimental group). Inclusion criteria: communication level of simple sentences, mild-moderate difficulties in behavioral and emotional regulation and sleep disturbances. Exclusion criteria: intellectual disability, children with specific dogs phobia. Assessment included ADOS-2, WISC-V, CGAS. dysregulation profile of Achenbach scale and Sleep Disturbance Scale for Children-Bruni. A program of 12 sessions (weekly one-hour sessions) focusing emotional and behavioral regulation and sleep disturbance was designed (Behavior Emotional Sleep Treatment Program. A pre-post evaluation was performed.ResultsParticipants were 20 boys and 2 girls (2 participants dropped out), with a mean age of 9. Regarding the socio-demographic and clinical characteristics, no significant differences has been observed between both groups in the global functioning measured with the Children’s Global Assessment scale (CGAS) (p=0.832), nor in the cognitive capacity (QI ) neither in reference to the associated comorbidities (p=0.103) nor in the variable prescription pharmacological treatment (p= 0.142). In emotional self-regulation, a significant improvement in emotional regulation difficulties was observed after treatment in both groups (experimental group: p=0.014; control group: p=0.012). However, the comparison between the pre-post intervention results between groups, regarding the emotional regulation variable, a greater improvement is observed in the experimental group (p=0.013). Significant improvements were also observed in sleep disorders (Bruni scale total score and in the sleep conciliation and maintenance difficulties scale) in both groups.ConclusionsTo conclude, although this is a pilot study with a small sample size and further research is needed, results suggest that a therapy program assisted with therapy dogs and CBT have positive effects on emotional dysregulation and sleep disturbances in children with ASD and offers a possible intervention strategy.Disclosure of InterestNone Declared

Exploring the Effects of Repetitive Transcranial Magnetic Stimulation on Comorbid Sleep Disorders in Preschool Children with Attention-Deficit Hyperactivity Disorder.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurological developmental disorders in children, and sleep disorders (SDs) are a common comorbidity in children with ADHD. There are currently no pharmacological treatment options for SD in children with ADHD of preschool age (4-6 years). Repetitive transcranial magnetic stimulation (rTMS) is a novel, non-invasive neuromodulation technique. This study explores the effectiveness of rTMS for comorbid SDs in preschool-aged children with ADHD. Thirty-five children of preschool age with ADHD and comorbid SDs were recruited for this study. The children were divided into a parent behavior management training (PBMT) group (n = 19) and a repetitive transcranial magnetic stimulation combined with parent behavior management training group (n = 16). Both groups underwent 8 weeks of treatment. The children's SD scores were assessed using the Chinese Children's Sleep Habits Questionnaire, were measured before the start, at the end, and 4 weeks after the end of the intervention, and were used to measure the effects. Within-group differences were compared using a repeated-measures analysis of variance, and between-group differences were compared using an independent samples t-test and Mann-Whitney U-test. Both the PBMT group and the rTMS combined with the PBMT group significantly improved the SDs of preschool-aged children with ADHD (P < .001), but the effect of the intervention was more pronounced in the rTMS combined with the PBMT group (P < .001) and lasted longer than the PBMT group (P = .004). Repetitive transcranial magnetic stimulation is a promising non-pharmacological therapy to improve SD in preschool-aged children with ADHD.