Sleep Habits Questionnaire Research Articles

Sleep timing and the prevalence of hypertension in middle-aged and older populations: the sleep heart health study

ObjectivesSleep characteristics such as duration, continuity, and irregularity are associated with the risk of hypertension. This study aimed to investigate the association between sleep timing (including bedtime, wake-up time, and sleep midpoint) and the prevalence of hypertension.MethodsParticipants were selected from the Sleep Heart Health Study (n = 5504). Bedtime and wake-up times were assessed using sleep habit questionnaires. The sleep midpoint was calculated as the halfway point between the bedtime and wake-up time. Restricted cubic splines and logistic regression analyses were performed to explore the association between sleep timing and hypertension.ResultsA significant nonlinear association was observed between bedtime (Poverall<0.001; Pnonlinear<0.001), wake-up time (Poverall=0.024; Pnonlinear=0.076), sleep midpoint (Poverall=0.002; Pnonlinear=0.005), and the prevalence of hypertension after adjusting for potential confounders. Multivariable logistic regression showed that both late (> 12:00AM and 23:01PM to 12:00AM) and early (≤ 22:00PM) bedtimes were associated with an increased risk of hypertension compared to bedtimes between 22:01PM and 23:00PM. In addition, individuals with late (> 7:00AM) and early (≤ 5:00AM) wake-up times had a higher prevalence of hypertension than those with wake-up times ranging between 5:01AM and 6:00AM. Delaying the sleep midpoint (> 3:00AM) was also associated with an increased risk of hypertension. Furthermore, no significant interaction effect was found in the subgroup analyses stratified by age, sex, or apnea-hypopnea index.ConclusionsOur findings identified a nonlinear association between sleep timing and hypertension. Individuals with both early and late sleep timing had a high prevalence of hypertension.

Sleep Quality in School-Aged Children: The Role of Environmental Factors and Screen Time

Sleep plays a vital role in the optimal functioning of our body and is crucial for overall well-being. However, many parents are unaware of the negative consequences of sleep deprivation in children. This study examines factors affecting sleep in children and their correlation with screen time. The aim is to evaluate the relationship between screen time and environmental factors impacting sleep quality among school-aged children.A cross-sectional observational study was conducted on children aged 6 to 12 years. Sleep quality was assessed using a 22-item, pre-validated, parent-administered Children’s Sleep Habits Questionnaire (CSHQ). Contributing factors, including a screen time questionnaire, were gathered from parents. Children with pre-existing sleep disorders, neurobehavioral disorders, and chronic illnesses were excluded. A CSHQ score above 41 was considered abnormal, indicating a sleep problem. Data were analyzed using the Chi-square test with SPSS version 20.0.In this study, 40.3% of children experienced sleep disturbances. The total mean sleep score was 39.56 ± 14.84, with private school children showing greater disruptions (41.78 ± 12.96) compared to public school children (37.14 ± 16.33; p = 0.001). Significant correlations were found between sleep quality, screen time exposure, and environmental factors such as lower socio-economic status, bed sharing, and room sharing.This study highlights that both excessive screen time and adverse environmental conditions negatively impact children's sleep quality. Efforts to increase awareness among parents, educators, and healthcare providers are needed to reduce sleep disturbances.

A study of sleep disorders in Indian children: Tip of the iceberg

BackgroundInsufficient quality and quantity of sleep has dangerous neurodevelopmental outcomes in the form of poor concentration, poor scholastic performance, hyperactivity and obstructive sleep apnea. There is no structured data on prevalence of various sleep behaviours and sleep related disorders in children in India. We aim to study sleep behaviour of children to know the common paediatric sleep related disorders. MethodsWe enrolled 270 children between the age of 1 to 18 years visiting pediatric OPDs for minor ailments between June 2022 to June 2023 using Children Sleep habit questionnaire – (NICHD SECCYD, Wisconsin). Children having clinical features suggestive of obstructive sleep apnoea were further subjected to overnight level 1 Polysomnography study. ResultsMost children had bed time consistency with average sleep duration of Mean ± 2SD (8.58 ± 1.35 h, N=270), which was shorter than global average. Allergic disorders were significantly high with prevalence of allergic rhinitis up to 30 % and asthma between 8-10 % in our study. Prevalence of obstructive sleep apnea on Polysomnography study was 5.6%, parent reported snoring 10 %, restless leg movements 30% and open mouth breathing in 35% Indian children. In our study, Asthma had statistically significant association with sleep disordered breathing and obstructive sleep apnea with p value < 0.01. ConclusionsAsthma has statistically significant association with obstructive sleep apnoea in our study. Proper asthma treatment may reduce the burden of obstructive sleep apnoea in children. There is a growing need to screen children regularly for sleep related issues on routine visits.

Sleep problems of children with Down syndrome in northern China.

Limited research has looked at the present-day sleep problems among Chinese children with Down syndrome (DS). This study aimed to investigate the situation of the sleep problems of school-aged children with DS in northern China. Parents of children with DS were a convenience sample recruited through the special education schools of Shandong Province in China. The Chinese version of the Children's Sleep Habits Questionnaire was applied to assess the sleep problems of children with DS. Parents of 334 children with DS reported the average sleep duration was 9.7 (9.3-10.2) hours per night, and 62.0% of children with DS were reported sleeping less than 10h per night. Additionally, the total prevalence rate of sleep problems among children with DS was 69.8%. Sleep-disordered breathing (59.2%), sleep duration (33.8%) and bedtime resistance (32.0%) were the three most commonly reported sleeping problems. Younger children with DS (age 6-8years) had severe problems with bedtime resistance, sleep anxiety and parasomnias than older children with DS (age 9-12years) (all P<0.05). Sleep problems are prominent among children with DS in northern China and are worthy of attention. Caregivers and health professionals should raise awareness of sleep problems in this group of children and implement targeted interventions to improve their sleep quality as early as possible.

Association Between Sleep Hygiene Parameters and Sleep Habits in 5- to 10-Year-Old School-Age Children.

Insufficient sleep can lead to problems. We examined the sociodemographic characteristics, sleep habits, and association between sleep problems. Parents were requested to fill out a survey and Children's Sleep Habits Questionnaire (CSHQ). The mean age of 1226 students was 8.42 (5.0-10.0) years. A total of 50.7% were male students. In addition, 69.1% showed signs of sleep problems in the CSHQ. In multivariate logistic regression analysis, bed-sharing, owning cell phone, attending early education group, not using toilet before bedtime, television watching duration, being an only child, not doing physical activity, watching TV before bed on weekends, caffeinated beverage consumption, not reading a book before sleep, waking up at night, sleeping in lighted rooms, maternal education level, having 1 sibling, and not having tablet variables were statistically significant in causing sleep problems. Poor sleep habits and sleep hygiene problems are common in school-age children. Healthy sleep habits are essential to get adequate and quality sleep.

Clinical tics and quality of life in children and adolescents with tic disorders: The mediating role of sleep

BackgroundSleep conditions are important in children and adolescents with tic disorders. Psychiatric symptoms and tic symptoms themselves can detrimentally affect the quality of life (QOL) in individuals with tic disorders. However, there is currently a lack of explicit research evidence elucidating the relationship between sleep and the QOL in individuals with tic disorders. MethodsWe assessed 150 children/adolescents aged 4–14 years old diagnosed with tic disorders. Participants' tic symptoms were evaluated using the Yale Global Tic Severity Scale (YGTSS), while their sleep conditions were assessed using the Children's Sleep Habits Questionnaire (CSHQ), and quality of life was measured using the Gilles de la Tourette Syndrome-Quality of Life Scale (GTS-QOL), all utilizing standardized measurement instruments. Detailed statistical descriptions, correlation analyses, and mediation analyses of the data were performed. ResultsWe observed significant correlations among tic symptoms, sleep, and quality of life. Then, we confirmed the mediating role of sleep in the relationship between tic symptoms and quality of life (β = .591, 95%CI: .252–1.007). We also found that among different sleep variables, particularly bedtime resistance (β = .088, 95 % CI: .003–.260), played a significant mediating role. ConclusionsSleep was found to be a significantly mediator between tic symptoms and quality of life across various domains, especially bedtime resistance played an important mediating role. This indicates that assessment and management of sleep conditions in children/adolescents with tic disorders are important. These findings provide potentially valuable insights into the clinical evaluation of children and adolescents with tic disorders and the potential improvement of their quality of life in the future.

Effects of Ball Combination Exercise Combined with cTBS Intervention on Sleep Problems in Children with Autism.

Sleep problems significantly affect the quality of life of autism spectrum disorder (ASD) children. This study aimed to evaluate the effects of a 12-week ball combination exercise, continuous theta burst stimulation (cTBS) stimulation, and combined intervention on sleep problems in children with ASD. Forty-five ASD children were divided into three intervention groups (ball combination exercise(n = 12), cTBS stimulation(n = 10), combined (n = 12) and a control group (n = 11). The intervention groups underwent intervention, while the control group maintained daily activities. The effects were assessed using the Children's Sleep Habits Questionnaire (CSHQ) scale. The results revealed that after 12 weeks of intervention, three programs reduced sleep problems in children with ASD. The post-test scores of the cTBS group (p = 0.002) and the combined group (p < 0.001) were significantly lower than the baseline scores on the CSHQ scale. The exercise group (p = 0.002) and the combined group (p < 0.001) showed significant improvement in sleep anxiety, while there was no statistically significant difference in the effectiveness of the three interventions for sleep-onset delay. The combined group outperformed the single intervention groups in the CSHQ score and sleep anxiety sub-dimensions. The combined intervention group showed slightly superior performance in sleep onset latency, however, there was no significant difference. Three interventions alleviated sleep issues in ASD children, with the combined method proving more effective. This study validates non-pharmacologic and combined approaches for ASD sleep problems. Future research should delve deeper into the mechanisms of these interventions in ASD children's sleep improvement.

Sleep problems in preschool mediate the association between chronotype and socioemotional problems at school-age

ObjectivesEvening-chronotype is associated with increased socioemotional problems among school-aged children. Inadequate sleep and increased sleep problems are also prevalent among evening-chronotype children and may underlie the relationship between chronotype and socioemotional problems. However, it is unclear whether the association between chronotype and socioemotional problems at school-age may be mediated by poorer sleep during late preschool. MethodsOur study utilized cross-sectional data to examine the relations between chronotype, sleep duration, sleep problems and socioemotional problems in preschoolers. We subsequently performed longitudinal mediation analyses to examine how the association between chronotype at preschool-age and later socioemotional problems at school-age may be mediated by sleep problems and sleep duration during late preschool. 399 children from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study were included for analyses. Children's chronotype were identified with the Children's Chronotype Questionnaire at 4.5 years old. Sleep duration and problems were measured with the Children's Sleep Habits Questionnaire at 4.5 and 6 years old. Socioemotional problems were evaluated using the Child Behavioral Checklist at 4 and 7 years of age. All questionnaires were caregiver-reported. ResultsLinear regressions demonstrated that eveningness was associated with concurrent sleep problems and internalizing, externalizing and total behavioral problems at 4–4.5 years old, but not sleep duration. Mediation analyses supported that sleep problems (and not sleep duration) at 6 years old mediated the relationship between chronotype and socioemotional problems at 7 years old. ConclusionsOur findings suggest addressing sleep problems during early development may reduce socioemotional problems at school-age, especially among evening-chronotype children.

A pilot randomised controlled trial of a telehealth-delivered brief ‘Sleeping Sound Autism’ intervention for autistic children

BackgroundAccess to behavioural sleep intervention is beneficial for autistic children, yet many families face barriers to access associated with location and time. Preliminary evidence supports telehealth-delivered sleep intervention. However, no studies have evaluated brief telehealth sleep intervention. To address this, we evaluated telehealth delivery of the brief behavioural Sleeping Sound Autism intervention, using a two-armed, parallel-group, non-blinded, pilot randomised controlled trial (RCT) design (trial registration: ANZCTR12620001276943). MethodSixty-one families of autistic children without intellectual disability (5–12 years, 46% female) with caregiver-reported moderate–severe behavioural sleep problems participated Australia-wide, randomised to an intervention (n = 30) or treatment as usual control group (n = 31). Intervention group participants were invited to attend two video-conference telehealth sessions and one follow-up phone call with a trained clinician. Survey data was collected from caregivers at baseline and three- and six-months post-randomisation, to evaluate feasibility, acceptability, and efficacy. Ten intervention group caregivers participated in end-of-study semi-structured interviews to explore their experiences. ResultsForty-nine caregivers completed surveys. At baseline, 87% felt positive and 84% felt confident about participating via telehealth, and 75% believed the program would improve child sleep. At three-months, intervention group caregivers (n = 24) reported the usefulness (100%) of and preference for (71%) telehealth, and 95.8% would recommend this sleep program to other families. A significant group by time difference was observed in child sleep (Children's Sleep Habits Questionnaire) with large effect sizes (d = 0.87–1.05), emotion and behaviour (Developmental Behavior Checklist 2) with moderate effect sizes (d = 0.40–0.57), and caregiver mental health (Kessler 10) with small to moderate effect sizes (d = 0.60–0.28), favouring the intervention group (n = 23). There were no significant group differences in child (Child Health Utility instrument) or caregiver (Assessment of Quality of Life) quality of life. However, there were individual differences in the clinical significance of improved child sleep. Qualitative data showed that whilst telehealth was convenient for caregivers, without attenuating the benefits of most key intervention features, not all children were able to engage effectively with the clinician via telehealth. ConclusionsThis first pilot RCT of a brief telehealth behavioural sleep intervention for primary-school-aged autistic children suggests that telehealth delivery is acceptable, feasible and likely efficacious in improving sleep in the short-term. Providing families with ongoing choice of mode of delivery (telehealth/in-person) and examining the person-environment fit of telehealth for autistic children is important.

Within-child associations between sleep quality and emotional self-regulation over 6 months among preschool-aged (3- to 5-year-old) children

ObjectiveWe leveraged an observational, repeated-measures study to examine the within-child associations between sleep quality and emotional self-regulation, controlling for between-child effects.MethodsChildren aged 3–5 years and one parent each were recruited from the community in northern New England between 2019 and 2022. Parents completed online surveys at baseline and 2, 4, and 6 months post-baseline. Child sleep quality was measured with the validated Children's Sleep Habits Questionnaire modified for preschoolers; higher scores indicate worse sleep quality (range 32–96). Child emotional self-regulation was measured with the validated Child Social Behavior Questionnaire; higher scores indicate better emotional self-regulation (range 1–7). Adjusted mixed-effects linear regression was used to model the associations between nighttime sleep quality (exposure) and emotional self-regulation (outcome) measured at each of the four study time points while disaggregating the between- and within-child effects.ResultsChildren (n = 91) were largely white, non-Hispanic (88.7%), and from a higher social-economic status. Sleep quality scores averaged 38.9 (SD: 6.6) at baseline; 23.1% of children had scores &amp;gt;41, which is considered evidence of significant sleep problems. Emotional self-regulation scores averaged 4.2 (SD: 1.0). There was a significant within-child association between sleep quality and emotional self-regulation. Specifically, a decrease in sleep quality at any one time point, relative to each child's mean sleep quality, related to worse emotional self-regulation [standardized beta, βs = −0.31; 95% CI (0.53, −0.09)]; the between-child effect was not significant. Results were consistent when limited to children with complete data at all study visits (n = 78).ConclusionsThe findings support a causal, within-child association between sleep quality and emotional self-regulation in preschool-aged children, with effects evident over 6 months.

Pattern of sleep disorders among children with autism spectrum disorder

BackgroundSleep disorders (SDs) are among many co-morbid medical conditions that affect children with autism spectrum disorder (ASD). Raising awareness and improving the standard of care for children diagnosed with ASD may result from identifying SDs among them. This study aims to evaluate patterns of SDs among Sudanese children diagnosed with ASD.MethodUsing the Childhood Sleep Habit Questionnaire (CSHQ) to gather data on sleep disorders and SPSS version 26.0 for data analysis, a descriptive cross-sectional study was carried out in the five main autistic centres in Khartoum state covering all registered patients with ASD between April and June 2022. Ninety-two children diagnosed with ASD were enrolled in this study after the purpose of the research was explained and consent was obtained from their guardians. A p-value < 0.05 was considered to indicate statistical significance.ResultsThe mean age was 6.90 (± 2.6) years with a boys-to-girls ratio of 2.17:1. The prevalence of SDs (at least one sleep condition almost daily) was 95.65%. Sleep onset 71 (77.2%), limit setting 32 (32.6%), resistant onset to sleep 48 (52.2%), and combined 52 (56.5%) insomnia affected the majority of children. Additionally, there were significant associations between sex and Limit-setting insomnia, advanced sleep phase disorder, and narcolepsy type 2 (P values = 0.033, 0.009, and 0.037, respectively). Additionally, there was a significant association between age and sleep-related breathing disorders-snoring (p value = 0.031).ConclusionThe frequency of SDs is significant among children diagnosed with ASD from Sudan, and certain SDs are associated with age and sex. Subsequent studies are required to develop national guidelines for the prevalence, presentation, screening, and treatment of SDs in children diagnosed with ASD.

Sleep problems and duration in school-aged children at different levels of giftedness

ObjectivesOptimal sleep is crucial for developing and maintaining gifted children's cognitive abilities. However, only a few studies have explored the sleep profiles of gifted children and overlooked their internal variations. This study aimed to investigate subjective and object sleep profiles in school-aged gifted children with different levels of giftedness. MethodsThis study included 80 school-aged children (50 % male) aged 6–11 years. Giftedness was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). Subjective and objective sleep were evaluated using the Children's Sleep Habits Questionnaire (CSHQ) and Actiwatch 2. ResultsThe sample was divided into three groups based on their full scale intelligence quotient (IQ): 16 typically developing children (IQ < 130), 38 moderately gifted children (IQ: 130–145), and 26 highly gifted children (IQ > 145). The highly gifted children had the mildest sleep problems, particularly in sleep duration and daytime sleepiness. Moderately gifted children had the shortest subjective average sleep duration, while the three groups had no significant differences in Actiwatch-measured sleep variables. Furthermore, CSHQ total and daytime sleepiness subscale scores were negatively associated with the full scale IQ in gifted children after controlling for confounders including emotional and behavioral problems. ConclusionsChildren with higher levels of giftedness experience fewer subjective sleep problems but have similar objective sleep parameters. It is imperative to implement tailored sleep strategies for fostering intellectual development and nurturing young talents.

The Effect of Sleep Habits on Quality of Life in Pediatric Patients With Chronic Kidney Disease.

Sleep disturbance has been studied in adult patients with early and end-stage chronic kidney disease (CKD). However, there are limited publications on the pediatric patient population. This paper evaluated the association between sleep disturbances and quality of life (QoL) inpediatricpatients with CKD. The study included 22 patients and 22 healthy controls from the pediatric nephrology outpatient clinic.All participants completed the Turkish Generic Health-Related Quality of Life Questionnaire for Children and Adolescents (HRQoLQ) and the Child Sleep Habits Questionnaire(CSHQ). Patients diagnosed with CKD were compared in terms of HRQoLQ and CSHQ scores within themselves as kidney replacement therapy (KRT) recipients and non-recipients and with the control group. The mean HRQoLQ total score of the patients was 89.0 ± 12.4 and the mean CSHQ total score was 46.7 ± 5.6; there was no correlation between the total scores (p=0.599). CSHQ total and subgroup scores were similar in patients with and without KRT. The CSHQ total and subgroup median scores were not different in the patient and control groups. According to the HRQoL scale, the total QoL score and the physical and emotional well-being subscale scores were lower in patients receiving KRT than in those not receiving KRT. Sleep problems and HRQoL should not be underestimated in the pediatric CKD population, especially in patients receiving KRT. Large-scale studies with long-term outcomes are needed to understand better and improve QoL.

Telehealth-delivered behavioral sleep interventions for Autistic children: An evaluation of an enhanced stepped-care approach

BackgroundSleep problems are common among Autistic children and can have adverse effects on their development, well-being and quality of life. Telehealth offers a cost-effective and accessible model of delivering evidence-based sleep support. This study used a single-case design to evaluate the efficacy of telehealth-delivered behavioral sleep intervention (TDBSI), with intervention phases designed based according to a stepped-care approach. MethodFourteen Autistic children (3–17 years) and their parents participated in a 12-week program consisting of three sequential intervention phases: 1) self-directed online parent education supplemented with individualized intervention tip sheets, 2) group parent coaching via video conferencing, and 3) individualized parent coaching via video conferencing. The appropriateness of parent strategy selection and implementation fidelity was rated throughout. Sleep problem severity (SPS) scores are reported for each child as a measure of effect across intervention phases. The Children's Sleep Habits Questionnaire (CSHQ) and CSHQ-Autism are reported as measures of change from baseline to post-intervention. ResultsOnline parent education and tip sheets facilitated early success in parent strategy selection and implementation fidelity. SPS scores demonstrated large and statistically significant improvements in child sleep following the self-directed phase. Parent implementation fidelity and child sleep outcomes were further improved with group and individualized coaching. Post-intervention, the CSHQ and CSHQ-Autism revealed large and statistically significant improvements across subscales and participants compared to baseline. ConclusionsOnline parent education supplemented with individualized tip sheets demonstrates potential for addressing sleep problems in Autistic children. Therapist-led group and individualized parent coaching via videoconferencing show promise as higher intensity support for parents who do not achieve satisfactory results initially.

An investigation of sleep problems, gastrointestinal symptoms, comorbid psychopathology and challenging behavior in children and adolescents with Down Syndrome

BackgroundDown syndrome (DS) is one of the most common chromosomal abnormalities, and children with DS have increased risks of receiving diagnoses of specific comorbidities. AimsThis study aimed to assess the frequencies and relationships between sleep problems, gastrointestinal (GI) symptoms, comorbid psychopathology, and challenging behavior. Methods and proceduresThe Children’s Sleep Habits Questionnaire, Gastrointestinal Symptom Inventory, Autism Spectrum Disorder-Comorbid for Children, and Behavior Problems Inventory-Short Form were completed by 123 parents of children and adolescents with DS. Outcomes and resultsThe frequency of GI symptoms was 74.8 %, with high frequencies also found for: sleep problems (100 %), challenging behavior (100 %), and moderate to severe levels of comorbid psychopathology (tantrum=80 %; repetitive behavior=63 %; avoidant behavior=82 %; worry/depressed=61 %; conduct behavior=100 %; over-eating=100 %; under-eating=100 %). A significant moderate correlation was found between total GI symptoms and self-injurious behavior frequency. Children who presented with abdominal pain engaged in self-injurious behavior more frequently than those with no abdominal pain. Conclusions and implicationsFindings indicated a high frequency of sleep problems, comorbid psychopathology, GI symptoms, and challenging behavior and demonstrated a relationship between GI symptoms and self-injurious behavior in children and adolescents with DS. This research illustrated the importance of investigating comorbid conditions in individuals with DS. What this paper adds?Down Syndrome (DS) is a genetic condition characterized by trisomy 21 and is a leading cause of intellectual disability worldwide. The prevalence of DS is commonly associated with advanced maternal age and is associated with multiple comorbid conditions. The current study aimed to investigate the frequency of and relationship between sleep problems, gastrointestinal symptoms, comorbid psychopathology, and challenging behavior in children and adolescents with DS. High-frequency levels were found for sleep problems (100 %), challenging behavior (100 %), gastrointestinal symptoms (74.8 %), and moderate to severe levels of the different comorbid psychopathologies (tantrum=80 %; repetitive behavior=63 %; avoidant behavior=82 %; worry/depressed=61 %; conduct behavior=100 %; over-eating=100 %; under-eating=100 %). Results indicated a significant difference in self-injurious behavior frequency between individuals who presented with abdominal pain and those who did not. This study is the first to investigate the relationship of multiple comorbid conditions in a sample of children with DS. This paper adds to the literature by demonstrating the frequency of a number of comorbid conditions in children and adolescents with DS. The paper also adds novel findings to the literature by investigating the relationships between comorbid conditions in this population. The findings of this paper highlighted the frequency and comorbidities that exist between gastrointestinal symptoms, sleep problems, comorbid psychopathology, and challenging behavior. Analyses indicated that those who presented with abdominal pain, engaged in self-injurious behavior more frequently.Sleep problems, gastrointestinal symptoms, comorbid psychopathology, and challenging behavior in children and adolescents with Down Syndrome.

Sleep disturbance associations between parents and children with overweight and obesity.

This cross-sectional study examined sleep disturbance associations between parents and their school-age children with overweight and obesity. A 7-day wrist-worn actigraph recording was performed on 246 children aged 6-9 years with overweight and obesity recruited from 10 public elementary schools in Taipei, Taiwan. Children's sleep disturbance was assessed using the Children's Sleep Habits Questionnaire. Parental subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index, with parental depressive symptoms measured using the Epidemiologic Studies-Depression Scale. General linear models were used to examine sleep disturbance associations within parent-child dyads. The results showed that 208 (84.6%) children had a clinically significant sleep disturbance score, and 123 (50%) parents had poor sleep quality. Higher children's sleep disturbance scores significantly predicted poorer parental sleep quality (b = 0.11, p < 0.001). Poorer parental sleep quality was associated with more severe sleep disturbances in children (b = 0.46, p < 0.001). This association was independent of children's actigraphic sleep (all p > 0.05) and was not attenuated by adjustment for parental depressive symptoms (b = 0.14, p < 0.001). Findings from our study suggest that sleep disturbances occur in both parents and their school-age children with overweight and obesity, with a significant bidirectional association between the two. Nurses and healthcare professionals should proactively assess and screen for sleep disturbances in parent-child dyads of children with overweight and obesity. Future studies should develop family-based sleep interventions and evaluate their effects on the sleep, health, and well-being of children with overweight and obesity and their parents.

The sleep problems in individuals with Rett syndrome and their caregivers

Sleep problems are prevalent among individuals with Rett syndrome. We aimed to investigate sleep problems in individuals with Rett syndrome and their caregivers. A total of 29 participants diagnosed with Rett syndrome and their respective 29 caregivers were included. The Children Sleep Habits Questionnaire (CSHQ), the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the actigraphy data collected from Actiwatch 2 were used to investigate the change of sleep pattern. Based on the CSHQ questionnaire, 75.9% (22/29) of the patients reported sleep disturbances. The younger patients exhibited higher CSHQ scores. Actigraphy data revealed that both young and older patients had short total sleep duration, low sleep efficiency, long sleep-onset latency, long awaking duration, and fragmented sleep. The caregivers reported significantly higher PSQI scores, mildly declined sleep efficiency, and shorter total sleep duration in the actigraphy study. Associations were identified between smaller head circumference and shorter total sleep duration, more severe motor dysfunction and longer wake after sleep onset, worsen scoliosis and more awakenings per night. Sleep efficiency was inversely associated with epilepsy and positively associated with somatic growth. Sleep disturbances are common and should be investigated in individuals with Rett syndrome and their caregivers. Lay abstract Sleep problems are common and impactful among individuals with Rett syndrome (RTT) and their caregivers. We examined the sleep patterns of 29 RTT patients and their primary caregivers using various assessment tools. The study found that a majority of the patients experienced sleep disturbances, with younger patients showing more sleep difficulties. Caregivers also reported poor sleep quality. The findings emphasize the need to address sleep problems in RTT management, as improving sleep quality can positively impact the well-being of individuals with RTT and their caregivers.

Sleep disturbances are associated with greater healthcare utilization in children with autism spectrum disorder

BackgroundSleep disturbances are frequently reported in children with autism spectrum disorder (ASD) and are associated with the severity of co-occurring symptoms. This study’s aim was to examine the extent of healthcare utilization and clinical outcomes associated with sleep disturbances in children with ASD.Study designA retrospective, cross-sectional study of 541 children with ASD from the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) whose parents completed the Children’s Sleep Habits Questionnaire (CSHQ). Children with a total CSHQ score ≥ 48 were defined as having sleep disturbances. Sociodemographic characteristics, ASD diagnostic measures, chronic co-occurring conditions, medication usage, hospitalizations, visits to the emergency room (ER), and visits to specialists were compared in ASD children with and without sleep disturbances. Multivariate logistic regression models were then used to assess the independent association of sleep disturbances with clinical characteristics and healthcare utilization.ResultsOf the 541 children with ASD, 257 (47.5%) had sleep disturbances. Children with sleep disturbances exhibited higher rates of multiple (≥ 3) co-occurring conditions (19.1% vs. 12.7%; p = 0.0414) and prescribed medications (45.5% vs. 32.7%; p = 0.0031) than other children. Finally, ASD children with sleep disturbances were 1.72 and 2.71 times more likely to visit the ER and be hospitalized than their counterparts (aOR = 1.72; 99%CI = 1.01–2.95; and aOR = 2.71; 99%CI = 1.10–6.67, respectively).ConclusionsOur findings suggest that sleep disturbances are associated with greater healthcare utilization among children with ASD. Further studies could examine whether treating sleep disturbances in children with ASD yields additional clinical benefits beyond improvements in sleep.

The “supercompensation” effect of children’s lockdown during COVID-19: based on the analysis of changes in physical activity, sleep, and psychology

ObjectiveTo investigate the “supercompensation” effect of preschoolers during the coronavirus disease 2019 lockdown by comparing the changes in physical activity (PA), psychological, and sleep indicators before and after the lockdown.MethodsA total of 127 children (aged 3–6 years) were recruited. Before and after the lockdown, the children’s PA levels were measured using the ActiGraph GT3X+, and their psychological and sleep indicators were measured using the Strengths and Difficulties Questionnaire (SDQ) and Child Sleep Habit Questionnaire (CSHQ), respectively.ResultsRegarding PA, the children’s total physical activity, low-intensity physical activity, and medium-intensity physical activity (MVPA) were higher after the lockdown than before the lockdown, with significant differences in MVPA (p < 0.05). Regarding psychology, the children’s SDQ and multidimensional scores were better after the lockdown than before the lockdown, with a significant difference in SDQ scores (p < 0.05). Regarding sleep, the children’s CSHQ scores were better after the lockdown than before the lockdown, with a highly significant difference in CSHQ scores (p < 0.01).ConclusionAfter lockdown, children’s PA, psychological, and sleep effects were “supercompensated.” In particular, the PA of preschoolers before, during, and after the lockdown may show a “baseline-inhibition-supercompensation” process.

The Association Between Sleep Problems and Attentional Network Functions in Patients with Self-Limited Epilepsy with Centrotemporal Spikes.

To investigate sleep problems in children with self-limited epilepsy with central temporal spiking (SeLECTS) and to assess the relationship between sleep problems and attention network dysfunction. 107 children 6-14 years of age with SeLECTS and 90 age- and sex-matched healthy controls were recruited for this study. The sleep status of these participants was evaluated using the Children's Sleep Habits Questionnaire (CSHQ), while attentional network function was assessed with the attention network function test (ANT). Together, these analyses revealed that children with SeLECTS exhibited higher total CSHQ scores and sleep disorder incidence relative to healthy controls (P< 0.001). Children with SeLECTS had higher scores in delayed sleep onset, sleep duration, night awakenings, parasomnias, daytime sleepiness and sleep anxiety (P<0.01). Total CSHQ scores were negatively correlated with average ANT correct rates (ρ= -0.253, P<0.01), while they were positively correlated with total reaction time (ρ=0.367, P<0.01) and negatively correlated with the efficiency of the alerting and executive control networks (ρ=-0.344 P<0.01; ρ=-0.418 P<0.01). Children with SeLECTS face a higher risk of experiencing sleep disorders relative to age-matched healthy children, while also demonstrating that the magnitude of the impairment of attentional network function in these children is positively correlated with sleep disorder severity. Thus, the prognosis and quality of life of children with SeLECTS can be improved by interventions addressing sleep disorders.