Sleep Disturbances In Children Research Articles

The management of sleep disturbances in children with attention-deficit/hyperactivity disorder (ADHD): an update of the literature.

Sleep disorders represent an important comorbidity in individuals with ADHD. While the links between ADHD and sleep disturbances have been extensively investigated, research on the management of sleep disorders in individuals with ADHD is relatively limited, albeit expanding. The authors searched PubMed, Medline, PsycInfo, Embase+Embase Classic, Web of Sciences databases, and clinicaltrials.gov up to 4 January 2024, for randomized controlled trials (RCTs) of any intervention for sleep disorders associated with ADHD. They retained 16 RCTs (eight on pharmacological and eight on non-pharmacological interventions), supporting behavioral intervention and melatonin, and nine ongoing RCTs registered on clinicaltrials.gov. The pool of RCTs testing interventions for sleep disorders in individuals with ADHD is expanding. However, to inform clinical guidelines, there is a need for additional research in several areas, including 1) RCTs based on a precise phenotyping of sleep disorders; 2) pragmatic RCTs recruiting neurodevelopmental populations representative of those seen in clinical services; 3) trials testing alternative interventions (e.g. suvorexant or light therapy) or ways to deliver them (e.g. online); 4) sequential and longer-term RCTs; 5) studies testing the impact of sleep interventions on outcomes other than sleep; 6) and implementation of advanced evidence synthesis and precision medicine approaches.

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.

Bedtime Regularity and Sleep Sufficiency in Children with Tourette Syndrome

ObjectiveDespite research demonstrating sleep disturbance in children with Tourette Syndrome (TS), few studies have examined bedtime regularity and sleep sufficiency, two important sleep health dimensions. Therefore, this study examined bedtime regularity and sleep sufficiency in children with TS relative to matched healthy controls, and its associated demographic, clinical, and behavioral factors. MethodParticipants were 384 parents or caregivers of children aged 3 to 17 years, including 192 with current TS and 192 matched healthy controls drawn from the 2020-2021 cycle of the National Survey of Children’s Health. Parents completed questions assessing demographics (i.e., age, race, sex), clinical (i.e., ADHD, ASD, anxiety, depression, tic severity, behavioral or conduct problems, ADHD medication, health-condition related impairment), and behavioral (i.e., screen time) characteristics. Mann-Whitney U test and chi-square test of independence were performed to compare groups on bedtime regularity and sleep sufficiency, respectively. Ordinal regression and binary logistic regression without and with backward elimination were performed to evaluate indicators of bedtime regularity and sleep sufficiency, respectively, in children with TS. ResultsChildren with current TS had significantly poorer bedtime regularity, but not sleep sufficiency, relative to matched healthy controls. In children with TS, anxiety and two or more hours of daily screen time were associated with higher likelihood of poor bedtime regularity. Autism was associated with lower likelihood of insufficient sleep, and depression was associated with increased likelihood of insufficient sleep. ConclusionsFindings put forth screen time, anxiety, and depression as intervention targets to optimize sleep health in children with TS.

Follow-up of telehealth parent training for sleep disturbances in young children with autism spectrum disorder

Objective/BackgroundBedtime and sleep disturbances are ubiquitous in children with autism. The telehealth delivery of a behavior analytic parent training program was earlier reported to be efficacious in improving child sleep and parent sense of competency. Our aim in this brief report was to determine the durability of the telehealth delivered sleep parent training program (SPT) compared to the control condition in this randomized controlled trial. Telehealth delivery could be a means to expand access to such early treatment if efficacious. Participants/MethodsParents of young children, ages 2–7 years, with autism and co-occurring sleep disturbances were enrolled in this study. Participants were randomized to either SPT or a comparison arm that included non-sleep related parent education except for one session Sleep Parent Education; SPE). Each participant was individually administered a 5 session program delivered over 10 weeks. Outcome measures were collected at weeks 5 and 10 and at post-treatment follow-up at 16 weeks. ResultsFollow-up week 16 data were available for 30 participants randomized to SPT and 24 participants randomized to SPE. Demographics for this follow-up cohort were similar to the full sample. At week 16 follow-up, there was a significant group difference between SPT and SPE the Modified Simonds & Parraga Sleep Questionnaire-Composite Sleep Index (MSPSQ – CSI) (p = 0.011) with an effect size of 0.68. Further, 8 of the 10 children in SPT who were negative responders at the week 10 endpoint were rated as positive responders at week 16 by the treatment masked IE compared to 2 out of 12 in the SPE group (p = 0.008). ConclusionsPost-treatment follow-up data suggests SPT is durable over time compared to SPE, the active control group. Further, for some participants in SPT, a positive responsive emerged after the treatment endpoint. This brief report adds to the efficacy of SPT as a time-limited intervention for insomnia in young autistic children.

Adverse Childhood Experiences and Sleep Disturbances Among Puerto Rican Young Adults

Sleep quality is a known marker of overall health. Studies suggest that adverse childhood experiences (ACEs) are associated with sleep disturbances among children and adults. To examine the association of retrospective and prospective ACEs with sleep quality among a cohort of Puerto Rican young adults from 2 sociocultural contexts. This prospective cohort study used data from the Boricua Youth Study (BYS), a population-based study representing Puerto Rican children from the South Bronx, New York, and Puerto Rico conducted from August 2000 to August 2003. Participants who were 5 to 9 years of age at enrollment in the BYS and who participated in wave 4 of the BYS took part in the Health Assessment (HA) when they were 18 to 29 years of age, from April 2013 to August 2017. Of the eligible 982 participants, 813 (82.8%) participated in the HA. Statistical analysis was conducted from January 2023 to January 2024. Prospective ACEs measured from parent and youth responses and retrospective ACEs measured among young adults using questions from the validated ACE questionnaire from the original ACEs study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention and published in 1998. Analysis included 8 overlapping items from both questionnaires. Sleep quality was assessed in the HA with the Pittsburgh Sleep Quality Index. The summary score included 7 components of the Pittsburgh Sleep Quality Index. The hypothesis was formulated after data collection. Sleep quality information was gathered at the same time as retrospective ACEs in the HA. Of the 813 participants, 438 (53.9%) lived in Puerto Rico as children, 411 (50.6%) identified as female, and the mean (SE) age of participants was 22.9 (0.07) years. After adjusting for sociodemographic factors, retrospective ACEs had a significant association with worse sleep outcomes (β [SE] = 0.29 [0.07]; 95% CI, 0.15-0.44; P < .001). Prospective ACEs did not have a significant association with sleep quality, after adjusting for sociodemographic factors (β [SE] = 0.05 [0.10]; 95% CI, -0.14 to 0.24; P = .59). This study suggests that there is a significant association between retrospective ACEs and sleep quality among Puerto Rican young adults, after adjusting for sociodemographic factors. Prospective ACEs were not significantly associated with sleep disturbances, after adjusting for sociodemographic factors. Addressing ACEs reported in young adulthood may help reduce sleep disorders.

Factors associated with sleep disturbances in children and adolescents with Angelman Syndrome

BackgroundAngelman Syndrome (AS) is a rare genetic disorder characterised by hyperactivity, overexcitability, developmental delays, and lack of speech. MethodsThis study used secondary data analysis to investigate sleep disturbances in children and adolescents (n = 212) who are enrolled in the Global Angelman Syndrome Registry. Participants were divided into two groups based on the presence or absence of sleep disturbance. The cut-off score of 40 on the Sleep Disturbance Scale for Children was used to indicate the presence or absence of sleep disturbances. Sleep disturbances and their association with co-occurring conditions were examined regarding challenging behaviour, language and communication, infancy history, gastrointestinal symptoms, and epilepsy. Multiple regression was then conducted to investigate possible predictors for sleep disturbances. ResultsChildren and adolescents with AS, with and without sleep disturbances, differed considerably regarding anxiety. Sleep disturbances were significantly associated with an ability to use spoken words and computerised communication devices, and anxiety was a predictor of sleep disturbances. ConclusionFuture research is necessary to replicate this novel research, and to advance the clinical treatment of sleep disturbances in children and adolescents with AS.

Effect of sleep disordered breathing severity in children with Down syndrome on parental wellbeing and social support

IntroductionSleep disorders, particularly sleep disordered breathing (SDB), are common in children with Down syndrome (DS). We investigated the relationship between SDB severity and parental psychological wellbeing and their perception of social support. Methods44 children with DS (3–19 years) underwent overnight polysomnography and were categorised into three groups: primary snoring, Mild and Moderate/Severe obstructive sleep apnoea (OSA). Parents completed questionnaires about their child's behaviour (Child Behavior Checklist), sleep symptoms (Pediatric Sleep Survey Instrument) and SDB-related quality of life (OSA-18), together with the DUKE-UNC Functional Social Support (DUKE) and Psychological General Well-Being Index (PGWBI) questionnaires for themselves. 34 children completed a follow-up study after 2 years. ResultsThere were no significant differences between SDB severity groups for parental perceived social support or psychological wellbeing. Total scores on the DUKE were below average and PGWBI scores were indicative of moderate psychological distress in all three groups. Reduced perceived levels of social support were significantly correlated with externalising child behaviour and sleep disturbance. Diminished parental psychological wellbeing was also significantly correlated with increased sleep disturbances and reduced quality of life in children. At follow-up there were no significant changes in any questionnaire outcome, however parents of children with improved SDB severity had improved PGWBI vitality scores. ConclusionThe degree of parent-reported sleep disturbance in children with DS was linked to suboptimal perceived parental social support and poor psychological wellbeing. Our results emphasise the need for enhanced awareness of the detrimental effects of sleep problems in children with DS on parental wellbeing.

Improvement in quality of life with continuous positive airway pressure outweighs the treatment burden in children with obstructive sleep apnea.

Continuous positive airway pressure (CPAP) for treatment of obstructive sleep apnea (OSA) may pose a significant burden on families. We assessed the impact of CPAP for children on quality of life (QOL) and caregiver treatment burden. Prospective cohort study of children commencing outpatient CPAP in a specialist sleep centre 2020-2022. Questionnaires regarding sleep-related symptoms (PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment), QOL (OSA-18, QI-Disability), caregiver burden (Caregiver Strain Questionnaire) and overall health impact (Glasgow Children's Benefit Inventory) were completed by caregivers at CPAP commencement and 6 weeks later. Twenty-sixpatients completed follow-up (7 female; median age 11.4 year, baseline obstructive apnea hypopnea index 10.3/h; 77% overweight or obese, 73% comorbidity other than obesity). OSA-related QOL (OSA-18) significantly improved at follow-up (p < 0.01), as did child general QOL (p < 0.001), sleep disturbance (p < 0.01) and sleep-related impairment (p < 0.001). Caregivers mostly rated CPAP as beneficial to their child's health but 19% rated CPAP as harmful or having no effect. Caregiver strain reduced at follow-up (p < 0.001) and benefit outweighed inconvenience (p < 0.0001) in 81%. CPAP adherence was correlated with overall health impact (r = 0.67, p < 0.01) but not with caregiver rating of inconvenience. CPAP resulted in improvements in QOL and sleep-related symptoms, and reduced caregiver strain. Perceived benefits outweighed the burden of treatment for most but not all families. CPAP adherence was moderately correlated with family-reported measures of benefit but not related to perceived inconvenience. This study provides reassuring evidence regarding the benefits and impacts of CPAP for children, many of whom already have complex health care needs.

Phenotyping sleep disturbances in children and adolescents with Autism Spectrum Disorder based on clinical assessment and SDSC scoring

Phenotyping sleep disturbances in children and adolescents with Autism Spectrum Disorder based on clinical assessment and SDSC scoring

Sleep disturbances in children and adolescents with type 1 diabetes mellitus: Prevalence, and relationship with diabetes management

ObjectiveA decline in sleep quality and regularity has been reported in patients with type 1 diabetes mellitus (T1D) in many studies. However, research on medical-based sleep disorders in patients with T1D is limited. Diagnosing sleep disorders is crucial, as it negatively impacts academic performance, cardiovascular health, and cognitive functions among children as well as essential skills for effective diabetes management. Our objective was to assess sleep disturbances in patients diagnosed with T1D and explore whether these patients experience significantly more sleep disturbances compared to their healthy peers. MethodsThis study, designed as a cross-sectional case-control investigation, involved a cohort of 250 participants (144 T1D, 106 control cases) aged 6–15 years. The Sleep Disturbance Scale for Children (SDCS) scores of the T1D group were compared with those of the control group. Furthermore, the study explored the correlation between clinical/biochemical parameters and SDCS scores within the T1D group. ResultsThe mean age of individuals in the T1D group was 10.27 ± 3.25 years, while the control group had a comparable mean age of 10.48 ± 3.5 years (P = 0.303). Within the T1D group, the median duration of diabetes was 5 (1-15) years, and the median glycosylated hemoglobin A1c (HbA1c) level for the past one year was 8.4 %. Although there was no significant difference in total SDSC scores between the T1D and control groups, both groups exhibited average scores that remained close to the threshold indicative of sleep disturbances (>39). Notably, individuals with total SDSC scores surpassing 39 were identified at rates of 48.6 % in the T1D group and 47.6 % in the control group, respectively. Furthermore, disorders of arousal nightmares (DA) were more prevalent in T1D patients compared to their healthy peers (P = 0.049). Additionally, HbA1c showed a positive correlation with scores for disorders of excessive somnolence (DOES) and total scores (P < 0.001, R = 0.368; P = 0.003, R = 0.243). ConclusionOur study found that the prevalence of sleep disturbances among children and adolescents with T1D was not significantly higher than that observed in their healthy peers. Nevertheless, it is crucial to note that a notable portion, 48.6 % of T1D cases and 47.6 % of healthy cases, displayed sleep disturbances based on SDSC scores. To optimize diabetes management and proactively address potential challenges, incorporating routine screening for sleep disturbances in the monitoring of T1D patients can yield valuable benefits.

Phenotyping sleep disturbances in children and adolescents with ADHD based on clinical assessment and SDSC scoring

Phenotyping sleep disturbances in children and adolescents with ADHD based on clinical assessment and SDSC scoring

Sleep Health among Children Adopted from Foster Care: The Moderating Effect of Parent–Child Sleep Interactions

ABSTRACT Objectives Sleep disruption is prevalent among children placed in foster care, elevating risk for a range of deleterious outcomes. Theoretically, achieving permanency via adoption may have a positive influence on children’s sleep via the presence of various factors, but little is known about the sleep health of children adopted from foster care, including predictors and moderators of sleep health. Method The current study included 226 parents who adopted a child from foster care in the U.S. (aged 4–11 years) within the past two years and a propensity score matched sample of 379 caregivers of children currently in foster care. Both samples completed online questionnaires about their child’s sleep, physical, and mental health. Results Comparatively, children in foster care experienced more nightmares, night terrors, moving to someone else’s’ bed during the night, and worse overall sleep quality, whereas adopted children were reported to experience significantly more nighttime awakenings. In the adopted sample, a greater number of prior foster placements unexpectedly predicted lower total sleep disturbance scores, but this relationship was moderated by parent–child interactions around sleep. In general, greater parental involvement in children’s sleep was associated with lower levels of child sleep disturbance. Conclusions Findings suggest that while specific sleep problems might remit after children in foster care achieve permanence, nighttime sleep fragmentation often persists. Parent–child interactions surrounding sleep may be pivotal in improving sleep health in this population.

Interventions for Disrupted Sleep Patterns and Insomnia in Pediatric and Adolescent Populations Diagnosed with ASD

The objective of this study is to develop a set of recommendations for effectively addressing sleep disturbance in adolescents and children with autism spectrum disorder (ASD). This will be achieved through a comprehensive evaluation of both pharmacological and non-pharmacological approaches utilised in the treatment of sleep disruptions in this specific population. Healthcare professionals who are providing care for adolescents and children with ASD and experiencing sleep disturbances should actively investigate potential underlying factors contributing to the disruption, such as medication usage or the presence of comorbid conditions. Subsequently, it is crucial for clinicians to address these identified causes in order to effectively manage the sleep disturbances. When managing sleep disturbance, it is advisable for clinicians to first suggest behavioural interventions, either independently or in combination with pharmacological or nutraceutical treatments, in order to facilitate improved sleep for children and their families. In cases where behavioural interventions prove ineffective and comorbid conditions and concurrent drug usage have been appropriately managed, healthcare professionals may contemplate the administration of melatonin, commencing with a conservative dosage. It is advisable to recommend melatonin of pharmaceutical grade if it is readily available for clinical use. It is incumbent upon healthcare professionals to engage in comprehensive discussions regarding the potential advantages and drawbacks associated with the utilisation of melatonin among paediatric patients, adolescents, and their guardians.

A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy.

Sleep quality is important during childhood and adolescence. Given the high prevalence of pain in children/youth with cerebral palsy (CP), we aimed to measure the association between short-term pain trajectories and sleep disturbance in these individuals. We accrued the cohort between November 2019 and October 2020 and recruited children/youth who: 1) were 8-18 years old; 2) had CP with any gross motor function classification system (GMFCS) level; and 3) could self-report pain and sleep disturbance. We collected self-report baseline and weekly follow-up data using electronic questionnaires completed every week for five weeks. Sleep disturbance at five weeks was the primary outcome (paediatric Patient-Reported Outcomes Measurement Information System [PROMIS] short form (v1.0-4a)). We used general linear regression to assess the association between pain intensity trajectory group and sleep disturbance controlling for confounders. 190 individuals were eligible, 102 were enrolled and 89 were included in our final analysis. Pain trajectory groups had estimated crude mean sleep disturbance scores at 5 weeks ranging from 56.0 (95% CI 51.8, 60.8) to 61.8 (55.7, 67.9). Compared to those with stable no/very mild pain, those in the stable high pain group had the greatest sleep disturbance (adjusted β=5.7; 95% CI 1.2, 10.2). Irrespective of pain trajectory, children and youth with CP reported sleep disturbances. Those with a stable, high pain intensity in the previous five weeks reported the greatest sleep disturbance. The results highlight the importance of considering pain trajectories and their impact on sleep in children with CP.

Quality of melatonin use in children and adolescents: findings from a UK clinical audit

BackgroundMelatonin is commonly used to treat sleep disturbance in children and adolescents, although uncertainties about its optimal use remain.ObjectiveTo determine to what extent prescribing of melatonin complies with evidence-based clinical...

Treatment of Sleep Disorders in Children with Atopic Dermatitis: What's New?

Atopic dermatitis (AD), also known as atopic eczema, is a chronic and inflammatory disease caused by an interaction of genetic, immunological, and environmental factors. It is characterized by skin lesions and itching and progresses with periods of improvement and worsening. Patients with AD often experience sleep disorders, which leads to a worsening of the quality of life of patients and their families and may be associated with poorer school performance, behavioral and mood dysfunction, risk of short stature, metabolic syndrome, mental illness, neurocognitive dysfunction, psychiatric comorbidities such as anxiety, stress, depression, attention deficit hyperactivity disorder (ADHD). Furthermore, sleep disturbances in children with AD have been associated with pruritus and greater severity of dermatitis. To this day, we do not have a curative treatment for this disease, but there is treatment, and it is possible to keep the disease under control. In these patients, controlling the condition is very important to improve the quality of sleep, at the same time, with better sleep there is greater control of AD. Despite being very common in AD, we currently have few studies on sleep disorders and their treatment in this disease, and there is no consensus on the therapeutic approach. We carried out a descriptive study with a narrative review of the literature. The research was based on studies published in English and Portuguese between January 2013 and October 2023, electronically in several databases, such as PubMed, Scientific Electronic Library Online, and Latin American and Caribbean Literature in Health Sciences. The objective of this review is to describe possible treatments for sleep disorders in AD, in order to contribute to a better understanding and clinical management of these cases, seeking to minimize the impact on the lives of these patients.

Sleep disturbances in children and adolescents after kidney transplantation.

Disturbances of sleep are prevalent among children with chronic kidney disease. However, the aetiology of sleep disorders in children particularly after kidney transplantation is not clear. We sought to ascertain the prevalence and type of sleep disturbances in paediatric kidney transplant recipients and to identify predictors of sleep disturbances in this population. Caregivers of kidney transplant recipients completed online questionnaires about their child's sleep. The questionnaires utilised were the Sleep Disturbance Scale for Children (SDSC), the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), questions about sleep hygiene, and questions about restless leg syndrome. Demographic and clinical details were collected from medical records. Thirty-five children were included in the study, with a median (IQR) age of 14.1years (9.5-16.1) and median years (IQR) since transplant of 3.7 (0.7-8.7) years, and 72.0% were identified to have at least one category of sleep disturbance according to scores on the SDSC. The most common sleep disturbances reported were disorders of initiating and maintaining sleep (DIMS) (40.0%) and disorders of excessive somnolence (DOES) (31.4%). Statistically significant predictors of sleep disturbances include low estimated glomerular filtration rate and increased age. Among children who screened positive for DIMS and DOES, the majority indicated use of electronic devices in 1h before bed. A high prevalence of sleep disturbances has been identified in children after kidney transplants, and some risk factors may be modifiable. Further studies are required to understand whether there are other readily modifiable predictors of sleep disturbances.

Sleep quality and depression in mothers of children with epilepsy and its relation to their children’s sleep

ObjectiveThis study aimed to evaluate the relationship between sleep disturbances in children with epilepsy (CWE) and maternal sleep quality and depression severity. MethodsA Cross-sectional study was conducted in pediatric sleep disturbances using questionnaires on mother-reported sleep of CWE [Children's Sleep Habits Questionnaire (CSHQ)], maternal sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and maternal depression status [Self-Rating Depression Scale (SDS)]. 114 dyads consisting of CWE and their mothers were included in this study. ResultsOver three-quarters (78.9 %) of mothers reported poor sleep quality (total PSQI score ≥ 5), and nearly a third (29.8 %) met clinical criteria for moderate or severe depression levels. The mothers' total PSQI scores were between 5.93 ± 2.44 (range: 2–16 points). The most affected PSQI subcomponents were sleep latency (AUC = 0.826p < 0.001) and daytime dysfunction (AUC = 0.800p < 0.001). The majority of children (88.6 %) were stated by their mothers to have sleep-related problems. The total CSHQ scores of the children were between 49.06 ± 9.20 (range: 33–86 points). The most affected CSHQ subcomponents were detected sleep anxiety (AUC = 0.856, p < 0.001), bedtime resistance (AUC = 0.818, p < 0.001) and daytime sleepiness (AUC = 0.807, p < 0.001). There was a statistically significant positive correlation between maternal sleep quality and depression severity (rho = 0.842; p < 0.001). A statistically significant positive moderate correlation was detected between sleep problems in CWE and maternal sleep quality and depression severity (rho = 0.406; p < 0.001, rho = 0.399; p < 0.001, respectively). As a result of multiple stepwise logistic regression analysis, the presence of seizures during sleep and generalized epileptiform discharges on electroencephalography were associated risk factors with poor maternal sleep quality (OR:6.6, p = 0.014; OR:11.5, p = 0.018, respectively). A borderline insignificant relationship was observed between a less than 50 % decrease in seizure frequency and the poor maternal sleep quality (OR:20.59p = 0.059). Seizures during sleep was associated risk factor with children's sleep disturbances (OR:7.2, p = 0.02). ConclusionsSleep problems in CWE may lead to negative consequences such as sleep quality and/or depression in mothers. Interventions planned to correct sleep disturbances in mothers suggest that children's sleep problems should be optimally managed.

Sleep problems and impact of obstructive hydrocephalus in newly diagnosed pediatric brain tumor patients

BackgroundPediatric brain tumor patients are at risk of developing sleep problems. Previous studies were conducted in longer-term survivors or without comprehensive sleep evaluations, therefore it remains unclear whether and when problems arise. Insights can facilitate timely interventions. The aim is to examine sleep problems and contributing factors shortly after diagnosis. MethodsChildren 6–16 years with a primary brain tumor (diagnosed ≤3 months) were recruited for a prospective study. Sleep was measured at home using wrist-worn actigraphy and questionnaires (PROMIS Sleep Disturbance and Sleep Related Impairment, self- and parent-reports). Mean PROMIS scores, prevalence of sleep problems (established by cut-off scores) and actigraphic outcomes were compared to norms (t-test, chi-square, linear regression). Risk factors were explored with multivariable linear regression models. ResultsSixty-nine children (68% male, mean age 11.6 ± 2.8 years, 53 ± 28 days after diagnosis) participated. Parents reported more child sleep disturbances (mean T = 53.7, P < .01) compared to norms. Rates of self- and parent-reported severe sleep disturbances were elevated (11% versus 5% in norms, P < .04). Parents also reported higher rates of moderate child sleep disturbance (31%) and sleep related impairment (42%) than norms (25%, P < .03). Actigraphy was comparable to healthy controls. Obstructive hydrocephalus was associated with longer sleep times (B=41.04, 95%CI 11.41;70.68) and shorter time since diagnosis with self-reported sleep disturbances (B=−.11, 95%CI −0.19;−0.03). ConclusionSleep problems are more frequently reported shortly after pediatric brain tumor diagnosis, compared to healthy controls. Attention for sleep around brain tumor diagnosis and impact of obstructive hydrocephalus is important, as sleep is vital for recovery and health-related quality of life.

Food Intake and Sleep Disorders in Children and Adolescents with Obesity.

Over the last few decades, numerous scientific studies have investigated the possible association between sleep duration and adiposity during childhood, since it has been reported that sleep deprivation causes a related increase in caloric intake. Even though the underlying pathogenetic mechanisms are still under study and not completely known, the effect of dietetic habits and nutrient intake on sleep quality and patterns has been reported. The aim of this study is to explore the intricate interplay between food intake/diet patterns and pediatric sleep disturbances in children and adolescents with obesity, emphasizing the importance of not underestimating this aspect in the prevention and treatment of this complex disease. Recent evidence supports a high correlation between specific diet patterns and foods with sleep disturbances in children at all ages. Diets rich in fiber, fruit, vegetables, and anti-inflammatory nutrients and low in saturated fats seem to promote better sleep quality. Sleep disturbances are, in turn, risk factors for the development of obesity. Therefore, food strategies should be applied to counteract this harmful process. Unraveling the complex links between dietary habits, sleep patterns, and obesity is essential for developing effective strategies to combat this critical public health issue.