Sleep Onset Problems Research Articles

In vitro Modified Release Studies on Melatoninergic Fluorinated Phenylalkylamides: Circumventing their Lipophilicity for Oral Administration.

In an attempt to circumvent the lipophilicity burden for the oral administration of new potent synthetic melatoninergic fluorine-substituted methoxyphenylalkyl amides, we conducted in vitro modified release studies using carefully selected matrix tablets' biopolymeric materials in different ratios. In particular, we sought to attain release profiles of these analogues similar to that of the parent compound, the chronobiotic hormone Melatonin (MLT), and also of the commercially available drug, Circadin®. It was found that some of these systems, albeit being more lipophilic than MLT, mimic the in vitro release patterns of melatonin and Circadin®. Moreover, a number of these derivatives were proven suitable for dealing with sleep onset problems, whilst others for dealing with combined sleep onset/sleep maintenance dysfunctions.

Sleep patterns among preschool offspring of parents with and without psychopathology: Association with the development of psychopathology in childhood.

Disturbed sleep during early childhood predicts social-emotional problems. However, it is not known how various early childhood sleep phenotypes are associated with the development of childhood psychopathology, nor whether these relationships vary as a function of parental psychopathology. We identified sleep phenotypes among preschool youth; examined whether these phenotypes were associated with child and parent factors; and determined if early sleep phenotypes predicted later childhood psychopathology. Using data from the Pittsburgh Bipolar Offspring study, parents with bipolar disorder (BD), non-BD psychopathology, and healthy controls reported about themselves and their offspring (n = 218) when their children were ages 2-5. Offspring and parents were interviewed directly approximately every 2 years from ages 6-18. Latent class analysis (LCA) identified latent sleep classes; we compared these classes on offspring demographics, parental sleep variables, and parental diagnoses. Kaplan-Meier survival models estimated hazard of developing any new-onset Axis-I disorders, as well as BD specifically, for each class. The optimal LCA solution featured four sleep classes, which we characterized as (1) good sleep, (2) wake after sleep onset problems, (3) bedtime problems (e.g., trouble falling asleep, resists going to bed), and (4) poor sleep generally. Good sleepers tended to have significantly less parental psychopathology than the other three classes. Risk of developing new-onset Axis-I disorders was highest among the poor sleep class and lowest among the good sleep class. Preschool sleep phenotypes are an important predictor of the development of psychopathology. Future work is needed to understand the biopsychosocial processes underlying these trajectories.

0778 Functional thalamo-cortical connectivity relates to sleep-onset problems in early infancy

Abstract Introduction Healthy sleep patterns are crucial for proper brain development in infancy. However, little is known about the relationship between early sleep disturbances and functional brain connectivity. The thalamus plays a critical role in the regulation of sleep and wakefulness, and undergoes rapid growth in the first year. Therefore, we examined how early thalamic connectivity relates to sleep-onset problems during the first 6 months of life. Methods All data were collected as part of the Baby Connectome Project (1U01MH110274). Forty-six infants (between 3-5 months old) underwent resting-state fMRI scans during natural sleep. The fMRI data were preprocessed and analyzed using FSL, and the bilateral thalamus was used in seed-based analyses. The Infant Behavior Questionnaire (IBQ) was used to create a measure of sleep initiation. Five IBQ items (21-25) were reverse-scored and averaged to generate the Infant Sleep-Onset Problems (ISOP) score, with higher scores indicating longer sleep latencies. ISOP scores across 3-6 months were used as regressors in whole-brain analyses. Results Preliminary results suggest a positive correlation between ISOP scores and connectivity between the thalamus and precuneus, such that greater sleep-onset problems were associated with stronger connectivity between the thalamus and precuneus. In contrast, there was a negative correlation between ISOP scores and connectivity between the thalamus and anterior cingulate cortex, such that fewer sleep-onset problems were associated with stronger connectivity between the thalamus and anterior cingulate cortex. Conclusion Our findings suggest that stronger thalamic connectivity with the precuneus, a region involved in the perception and integration of information, is related to greater sleep initiation difficulties. In contrast, stronger connectivity between the thalamus and anterior cingulate cortex, a region involved in attention allocation and emotional regulation, is associated with less sleep initiation problems. While these results are preliminary, they indicate that early sleep problems are associated with altered development of functional thalamo-cortical networks. Support (if any)

Potent Lipophilic Melatoninergic x-fluoro-y-methoxy Substituted Phenylalkylamides: Molecular Dynamics Calculations and in vitro Modified Release in Aqueous Media from Tablet Formulations.

We report herein on the design and development of matrix tablets containing potent synthetic melatonin (MLT) receptor analogues, the x-fluoro-y-methoxy substitiuted phenylalkylamides (compounds I-IV), the preparation and melatoninergic potency of which was recently communicated. > Methods: The presence of the fluorine atom in compounds I-IV, besides not affecting their binding affinity, compared to the pineal hormone melatonin, it also slows down their metabolism, which is a major drawback of MLT. However, as fluorine increases the lipophilicity, solid pharmaceutical formulations of I-IV, involving the appropriate biopolymers for their modified release in aqueous media, were developed in the context of the present work. > Results: The release profile of analogues I-IV was found to be similar to that of MLT and also of the commercially available drug, Circadin®. Some of these systems are suitable for dealing with sleep onset problems, whilst others for dealing with combined sleep onset/sleep maintenance problems. > Conclusion: Apart from the nature and relevant content of the formulants used, this bimodal release profile of the new analogues depends, to a large extent, on the diverse structural arrangement of their side chains in space, as nicely demonstrated by the molecular dynamics calculations, conducted in the context of this study. >.

Infant sleep predicts trajectories of social attention and later autism traits.

Children with neurodevelopmental disorders including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often experience sleep disturbances, but little is known about when these sleep differences emerge and how they relate to later development. We used a prospective longitudinal design in infants with a family history of ASD and/or ADHD to examine infant sleep and its relation to trajectories of attention and later neurodevelopmental disorders. We formed factors of Day and Night Sleep from parent-reported measures (including day/night sleep duration, number of naps in the day, frequency of night awakenings and sleep onset problems). We examined sleep in 164 infants at 5-, 10- and 14-months with/without a first-degree relative with ASD and/or ADHD who underwent a consensus clinical assessment for ASD at age 3. By 14-months, infants with a first-degree relative with ASD (but not ADHD) showed lower Night Sleep scores than infants with no family history of ASD; lower Night Sleep scores in infancy were also associated with a later ASD diagnosis, decreased cognitive ability, increased ASD symptomatology at 3-years, and developing social attention (e.g., looking to faces). We found no such effects with Day Sleep. Sleep disturbances may be apparent at night from 14-months in infants with a family history of ASD and also those with later ASD, but were not associated with a family history of ADHD. Infant sleep disturbances were also linked to later dimensional variation in cognitive and social skills across the cohort. Night Sleep and Social Attention were interrelated over the first 2 years of life, suggesting that this may be one mechanism through which sleep quality influences neurodevelopment. Interventions targeted towards supporting families with their infant's sleep problems may be useful in this population.

Association between Sleep Onset Problem and Subjective Cognitive Complaints among Japanese Older Adults during the Coronavirus Disease 2019 Pandemic.

Older adults are more likely to have age-related sleep problems, which may result in the reduction of cognitive functions. This study was designed to examine the relationship between sleep onset problem and subjective cognitive complaints (SCC) among community-dwelling older adults during the coronavirus disease 2019 pandemic. In this study, 186 older adults aged 65 and above were enrolled and were instructed to respond to an online survey. This survey comprised questions regarding sleep quality (four items such as sleep duration, use of sleep medication), SCC (six domains), and sociodemographic information (eight items such as age, gender, stress condition). We classified the participants into two groups according to the presence or absence of sleep onset problem and examined the relationship between each SCC domain. The sleep onset problem (+) (n = 70) group had significantly higher frequency of scheduled memory decline, misplacement, disorientation in time, word recall decline, and forgetfulness. Furthermore, the sleep onset problem affected the participants' scheduled memory after adjusted for potential covariates (OR, 2.28; 95%CI, 1.13-4.73; p = 0.02). Older adults with sleep onset problem may need to be evaluated for SCC and supported in term of both sleep status and SCC.

Prevalence of Sleep Hygiene Awareness, Practices and Quality among Elementary School Students in Canada

Enough sleep is crucial for physical and emotional growth of kids and students. It has been noted that there is a progressive decline in bedtime as kids turn into teens, despite the fact that the need for sleep among students does not decrease. Teenagers need for sleep has been estimated as much as 9.2 h per day. Poor sleep has actually been noted to lead to poor diet regimen, excessive weight, stunted growth, psychological health concerns, as well as chemical abuse. Much as the need for sleep is an individual particular, approximately at least 8.3 hrs. of rest per evening is recommended for teens, to avoid excessive daytime drowsiness. High quality sleep is necessary for young professional athletes for making sure much better performance in psychomotor as well as cognitive activities, and for minimizing the chances of creating challenging factors for musculoskeletal discomfort. Detection of sleep disorders in adolescent complaining of sleeplessness is a day-to-day challenge for doctors and clients alike. The purpose of the research study was to assess the prevalence of sleep hygiene awareness, practices and quality among elementary schools students in Canada. The study was a literature based. The research discovered that a boost in the occurrence of difficulty in getting sleep and in too much screen time exposure and marginal increase in physical activity levels. In addition, teens exceeding 2-h everyday display time had 20% higher probabilities of reporting sleep-onset problems, while no association was discovered for physical activity. The study also discovered that a regular every night routine aids the body recognize that it is going to bed; this could consist of taking warm shower or bathroom, checking out a publication, or light stretches. Whenever feasible it is essential for the students to try to avoid emotionally distressing conversations and activities before attempting to sleep considering that maintaining a routine sleep timetable also on weekends keeps the timing of the body's body clock and also can aid you fall asleep and wake up much more quickly. Based on the finding, the research study concluded that the daily substances that students take, the medicines one takes, how long they sleep in a day and exactly how they choose to invest their nights can considerably influence their quality of sleep. Also a couple of mild adjustments can, in many cases indicate the difference between sound rest as well as a restless evening. Finishing a two-week rest diary can help one understand how their routines impact their sleep. The study suggested that teenagers must reserve no more than eight hrs. For sleep given that the suggested quantity of sleep for a healthy grownup goes to least 7 hrs. Keywords: Sleep Hygiene, Awareness, Sleep Quality, Sleep Disorder, Students

Relationship of overweight and obesity to insomnia severity, sleep quality, and insomnia improvement in a clinically referred pediatric sample.

Children with overweight or obesity are more likely to experience sleep disorders, although the role of weight in pediatric insomnia treatment has not been examined. The current study examined the relationships of high body mass with pretreatment insomnia severity and global sleep problems and the potential moderating impact of weight on changes in insomnia severity following insomnia treatment. Participants included 1,133 youth ages 2-18 years clinically referred for insomnia treatment. The Pediatric Insomnia Severity Index was collected at the initial assessment and throughout treatment as part of routine clinical care. Treatment status was coded as no treatment, early termination, and completed treatment. Secondary measures of global sleep problems at the initial assessment included the Adolescent Sleep Wake Scale, Adolescent Sleep Hygiene Scale, and Children's Sleep Habits Questionnaire. Medical chart review of visits within ± 3 months of baseline was used to obtain age-adjusted and sex-adjusted body mass index Z-score. Among adolescents, regression analyses found that higher body mass index Z-score modestly predicted baseline insomnia severity (P = .021) and worse sleep hygiene (P < .001). For children, higher body mass index Z-score was modestly associated with baseline total sleep problems (P = .006) but not insomnia severity (P = .792). Across ages, body mass index Z-score predicted neither treatment status nor insomnia improvement (P > .05). Findings were similar in categorical analyses comparing patients with overweight/obesity to healthy weight. Although there is evidence that children of higher body mass present for insomnia treatment with greater sleep concerns, body mass does not predict treatment completion or insomnia improvement. Data suggest insomnia treatment is effective irrespective of weight status. Duraccio KM, Simmons DM, Beebe DW, Byars KC. Relationship of overweight and obesity to insomnia severity, sleep quality, and insomnia improvement in a clinically referred pediatric sample. J Clin Sleep Med. 2022;18(4):1083-1091.

Sleep and daytime problems during the COVID-19 pandemic and effects of coronavirus infection, confinement and financial suffering: a multinational survey using a harmonised questionnaire

ObjectivesSleep is important for human health and well-being. No previous study has assessed whether the COVID-19 pandemic impacts sleep and daytime function across the globe.MethodsThis large-scale international survey used a...

Prognostic and predictive analysis of effectiveness of pharmacological and non-pharmaceutical treatment approaches for chronic insomnia

Background. Limited access to cognitive behavioral therapy for insomnia (CBT-I) which is the most effective and safe treatment approach for chronic insomnia leads to the elaboration of shortened and interned delivered CBT-I methods. Investigation of effectiveness predictors of the new methods is important for their better result.&#x0D; Aim. Investigation of effectiveness predictors for pharmacotherapy and CBT-I based brief behavioral therapy for insomnia (BBT-I).&#x0D; Materials and methods. The data for the analysis were acquired from a randomized study of 42 participants with chronic insomnia who received either zopiclone 7.5 mg or BBT-I for 2 weeks. The difference of the insomnia severity index from pre- to post-treatment was the main outcome measure. Potential predictors included demographic and medical history data, objective sleep characteristics, baseline scores of Beck depression inventory (BDI), Spielberger anxiety scale, Toronto alexithymia scale, sleep hygiene index, dysfunctional beliefs and attitudes about sleep scale, Epworth sleepiness scale. Univariate linear regression analysis was used for prognostic analysis. To identify predictors of treatment outcome after the treatment course and after the 2 weeks follow-up we used multiple linear regression models with interaction.&#x0D; Results. In the prognostic analysis higher amount of awakenings during the night and a higher proportion of the 1 stage NREM sleep measured objectively correlated with better outcome E=0.2202 (p=0.05) and E=0.55 (p=0.039) respectively. Older age and higher baseline BDI score significantly worsened the outcome: E=0.233 (p=0.047) and E=0.2 (р=1.55e-06) respectively. Clinical predictors of the BBT-I effectiveness were an absence of the sleep onset problems and absence of GABA hypnotics use in medical history and the higher baseline daytime sleepiness.&#x0D; Conclusion. Neurophysiological (frequency of awakenings, percentage of the sleep stage N1) and clinical (severity of depression, age, daytime sleepiness) predictors of the effectiveness of BBT-I were revealed. This findings will help to select the patients who should undergo a shortened course of CBT-I.

How do children and adolescents of separated parents sleep? An investigation of custody arrangements, sleep habits, sleep problems, and sleep duration in Sweden

ObjectivesAn increasing number of children and adolescents divide their time between their separated parents’ homes. Although marital conflict is disadvantageous for children's sleep, little is known about how children of separated parents sleep. The objective was to investigate the association between children's custody arrangements and sleep habits and sleep initiation difficulties. DesignCross sectional nationally representative samples of adolescents from the WHO study Health Behaviour in School-aged Children (HBSC) (n = 11,802). SettingSweden in 2013/2014 and 2017/2018. ParticipantsAdolescents in grades 5, 7, and 9 from Swedish compulsory comprehensive school. MeasurementsThe survey included questions on sleep behaviors including bedtime, wake-up time and frequency of sleep onset problems. The analysis methods used were ordinary least squares and logistic regression. ResultsThe results show differences by custody arrangement, but they are not uniform across the dependent variables. Children and adolescents in sole maternal custody were less likely to sleep as much as recommended (P < .001), more likely to have late bedtimes (P < .001), report sleep initiation difficulties (P < .01) and to report social jetlag between school mornings and weekends (P < .05) compared to those in 2-parent families. Shared physical custody was associated with a higher likelihood of late bedtimes (P < .05) and sleep initiation difficulties (P < .05) compared to those in 2-parent families, but not of sleeping less than recommended or reporting social jetlag. Less-than-equal sharing was generally associated with worse sleep than in 2-parent families. ConclusionsAs custody arrangements seem to be associated with sleep, it is important to understand the mechanisms behind the findings.

Sleep and its relation to health-related quality of life in 3\u201310-year-old children

BackgroundConsidering the reports of increasing sleep problems in children, affecting health and well-being in young children and their families, we found it important to gain more knowledge about sleep and its correlation to health-related quality of life (HRQoL) in young, healthy children. The aims with this study were to describe sleep quality, sleep duration, and HRQoL in healthy 3–10-year-old children and to test associations between children’s sleep and HRQoL.MethodsParents of 160 children (average age: 6.9 years, SD ±2.2) participated in the study. Sleep onset problems (SOP), sleep maintenance problems (SMP), and sleep duration were measured by the Pediatric Insomnia Severity Index (PISI). KIDSCREEN-27 was used to measure HRQoL in five dimensions: physical well-being, psychological well-being, autonomy and parent relation, social support and peers, and school environment.ResultsThe average score was 2.2 for SOP (SD +/− 2.2) and 1.3 for SMP (SD +/− 1.6). Few children (2%) were reported to sleep less than 8 h per night. Younger children had statistically significant higher SOP and SMP than older children. Correlations were found between SOP and poor psychological well-being (p < 0.05, ρ = − 0.16), and between SMP and poor physical wellbeing (p < 0.05, ρ = − 0.16), psychological well-being (p < 0.05, ρ = − 0.21), poor school environment (p < 0.01, ρ = − 0.29), autonomy and parent relation (p < 0.05, ρ = − 0.16), and poor social support and peers (p < 0.05, ρ = − 0.19).ConclusionChildren’s sleep associates with health-related quality of life and needs to be acknowledged in child health care settings and schools.

654 Potential Longitudinal Association Between COVID-19 Infection Outcomes and Insomnia Symptoms

IntroductionThe COVID-19 pandemic has had an unequivocal negative impact worldwide, including increases in stress related to social isolation, unemployment, grief, and fear of contracting the virus. This increased stress has likely led to a greater prevalence of sleep continuity disturbance (i.e., insomnia) in the general population. The goal of the present study was to assess the prevalence of sleep continuity disturbance (i.e., insomnia) in the United States during the initial months of the pandemic. In addition, longitudinal assessment is currently ongoing in order to further assess participant experiences with COVID-19. Specifically, these follow-up data will be used to assess whether, among those that contracted COVID-19, insomnia at baseline (Time 1) predicts worse outcomes (e.g., symptoms of greater frequency, duration, or severity) upon follow-up (Time 2).MethodsA national survey was conducted from April-June 2020. Participants answered questions regarding social distancing practices, mood, sleep, physical activity, and COVID-19 symptoms. Insomnia symptom prevalence and severity were estimated with a retrospective sleep diary and the Insomnia Severity Index (ISI). A follow-up assessment is currently ongoing and will be completed in March 2021. The follow-up survey consists of similar questions and additional items regarding COVID-19 testing, symptoms [frequency, duration, and severity], and outcomes [outpatient treatment, incidence and duration of hospitalization, and incidence and type of respiratory assistance].Results4,133 adults (Mage = 45.8 years; range = 18 - 86 years; 78.7% female) completed the baseline survey. The prevalence of clinically significant sleep continuity disturbance (≥ 30 minutes) was 44.6% for sleep latency problems and 36.2% for wake after sleep onset problems. Nearly 34% of subjects reported average total sleep times of less than 7 hours. Over 17% of subjects (n = 719) reported total ISI scores in the clinical range (ISI total score ≥ 15).ConclusionThe present study suggests the prevalence of clinically significant insomnia symptoms during COVID-19 remain high in the general population (17–45% depending on definition of insomnia). Similarly, the prevalence of short sleep is elevated. Whether these incident data are associated with COVID-19 outcomes remains to be determined and will be the subject of follow-up analyses in January/February 2021.Support (if any)Vargas: K23HL141581; Perlis: K24AG055602

Circadian Clock Gene Polymorphisms and Sleep-Onset Problems in a Population-Based Cohort Study: The Yamagata Study.

A number of genome-wide association studies have investigated sleep phenotypes and disorders in humans. However, the contribution of genetic variation to sleep problems in Japanese populations has remained unclear. Sleep-onset problems are the most common symptom of insomnia. Here, we examined the relationship between single nucleotide polymorphisms (SNPs) of BMAL1 (ARNTL1), CLOCK, CRY1, CRY2, and PER2, which are genes involved in the clock mechanism, and sleep-onset problems in a Japanese general population. This study included 1,397 subjects aged ≥ 40 years who participated in an annual health check-up in Yamagata Prefecture. A total of 80 SNPs of 5 circadian clock genes were analyzed. Multivariate logistic regression analyses identified variant rs11113179 in CRY1 and variants rs1026071 and rs1562438 in BMAL1 as genetic risk factors for sleep induction disorder. These findings suggest that CRY1 and BMAL1 polymorphisms are related to sleep-onset problems in a Japanese general population. However, none of the SNPs remained significant at a stringent level of multiple correction.

Insomnia Symptoms and Their Association with Anxiety and Poor Sleep Hygiene Practices Among Ethiopian University Students.

ObjectiveThere is a paucity of research evidence available regarding the impact of anxiety and sleep hygiene on insomnia and related sleep complaints among collegiate students in lower-income countries. The purpose of this study was to investigate if insomnia and insomnia-related sleep complaints are associated with anxiety, age, and sleep hygiene practices among a sample of university students in Ethiopia.Design, Measures, Setting, and ParticipantsThe participants were young adults (n=525; mean age 21.5 ± 3.0 years; mean BMI of 20.7 ± 2.7kg/m2). Young collegiate adults at Mizan-Tepi University in southwestern Ethiopia were randomly selected to participate in this cross-sectional study. The measures included the Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), the Generalized Anxiety Disorder–7 Scale (GAD-7), and the Sleep Hygiene Index (SHI). Descriptive statistics, binary logistic regression, and multiple linear regressions were used.ResultsInsomnia was associated with young age group (≤25 years) (odds ratio (OR) = 2.20, 95% confidence interval (CI) 1.04–4.66), higher GAD-7 (anxiety) (OR = 1.05, 95% CI 1.0–1.10) and SHI (poor sleep hygiene) (OR = 1.15, 95% CI 1.05–1.26) scores. All four insomnia-related sleep complaints were associated with increasing GAD-7 scores, as well as higher SHI scores (p<0.001).ConclusionInsomnia was associated with younger age group (≤25 years), higher anxiety level, and poor sleep hygiene. Four major sleep complaints in insomnia, ie, sleep onset problems, poor sleep quality, awakening problems, and daytime disturbances, were all associated with higher anxiety levels and poor sleep hygiene.

1109 Broadly Assessing Sleep Complaints In A Sample Of Patients With ADHD

Abstract Introduction It is commonly observed in clinical settings that patients with ADHD regularly present with comorbid “sleep disturbances”. In the absence of broad based sleep disorders assessments, it is thought that this represents Delayed Sleep Phase Disorder (DSPD). Recently, a surveillance study was undertaken in a university-based, outpatient specialty clinic for adults with ADHD, by adding a comprehensive sleep disorders screener (SDS-CL-25) to the clinical intake procedures. These data were used to ascertain which sleep disorders symptoms are common in this clinical cohort. Methods SDS-CL-25 data were collected in 150 subjects (93/57 male/female, mean age 32.8, age range 18-79). The SDS-CL-25 is a 25 item instrument developed to screen for 13 sleep disorders at one time (Sleep Dx symptoms are endorsed on Likert-scales; 0 [never] 4 [&amp;gt;5x/week]). For the purposes of this study, the percentage of subjects endorsing frequent symptomatology (sum of the percent of endorsements for columns 3 &amp; 4)was calculated per symptom. Sums of &amp;gt;20% were considered, a priori, to be of clinical significance. Results Patients endorsed: increased fatigue (59%); SL or WASO or EMA’s &amp;gt;30 minutes (40%; 26%; 21%, respectively); late preferred time to bed (31%); work &amp; school limits sleep opportunity (30%); variable time to and out of bed (27%); and snoring (21%). The average percent endorsement was 15% (range 0-59%). Conclusion These results suggest that, consistent with clinical observations, adult patients diagnosed with ADHD frequently endorse late preferred time to bed, variable sleep wake schedules, work/school limitations on sleep opportunity, and sleep onset problems that are accompanied by daytime fatigue. This constellation of symptoms is consistent with the notion that patients with ADHD tend to have comorbid DSPD. The high prevalence of middle and late insomnia was unexpected and suggests that Insomnia Disorder (proper) may also be a feature of ADHD. Support No support was provided for this abstract.

Swedish translation and validation of the Pediatric Insomnia Severity Index

BackgroundTo increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aims of the study were to (1) present a Swedish translation of the PISI, (2) examine the factor structure of the Swedish version of PISI, and test the reliability and validity of the PISI factor structure in a sample of healthy children in Sweden.MethodsThe English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed.ResultsIn total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors were related to all KIDSCREEN-27 dimensions.ConclusionsThe Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep.

Sleep Onset Problems and Subcortical Development in Infants Later Diagnosed With Autism Spectrum Disorder.

Sleep patterns in children with autism spectrum disorder (ASD) appear to diverge from typical development in the second or third year of life. Little is known, however, about the occurrence of sleep problems in infants who later develop ASD and possible effects on early brain development. In a longitudinal neuroimaging study of infants at familial high or low risk for ASD, parent-reported sleep onset problems were examined in relation to subcortical brain volumes in the first 2 years of life. A total of 432 infants were included across three study groups: infants at high risk who developed ASD (N=71), infants at high risk who did not develop ASD (N=234), and infants at low risk (N=127). Sleep onset problem scores (derived from an infant temperament measure) were evaluated in relation to longitudinal high-resolution T1 and T2 structural imaging data acquired at 6, 12, and 24 months of age. Sleep onset problems were more common at 6-12 months among infants who later developed ASD. Infant sleep onset problems were related to hippocampal volume trajectories from 6 to 24 months only for infants at high risk who developed ASD. Brain-sleep relationships were specific to the hippocampus; no significant relationships were found with volume trajectories of other subcortical structures examined (the amygdala, caudate, globus pallidus, putamen, and thalamus). These findings provide initial evidence that sleep onset problems in the first year of life precede ASD diagnosis and are associated with altered neurodevelopmental trajectories in infants at high familial risk who go on to develop ASD. If replicated, these findings could provide new insights into a potential role of sleep difficulties in the development of ASD.

The roles of repetitive negative thinking and perfectionism in explaining the relationship between sleep onset difficulties and depressed mood in adolescents

ObjectiveThe present study investigated the relationship between difficulty initiating sleep and depressed mood and whether it is mediated by repetitive negative thinking. A moderating role of perfectionism was also examined. MethodsWe surveyed 393 adolescents aged 14 to 20 years (M = 17.32, SD = 1.90) via an online questionnaire that assessed difficulty initiating sleep, repetitive negative thinking, perfectionism, and depressed mood. ResultsResults indicated that repetitive negative thinking fully mediated the relationship between difficulty initiating sleep and depressed mood. In addition, this relationship was moderated by perfectionism, specifically, the relationship between repetitive negative thinking and depressed mood was stronger among more perfectionistic adolescents. ConclusionsThese findings highlight that repetitive negative thinking is significantly associated with both difficulty initiating sleep and depressed mood, supporting the conceptualization of repetitive negative thinking as a transdiagnostic process. Further, individual differences in perfectionism may amplify the relationship between repetitive negative thinking and mood. The role of repetitive negative thinking and perfectionism in explaining the link between sleep onset problems and depressed mood has important clinical implications through providing possible treatment targets.

Sleep onset problems and subcortical development in infants later diagnosed with autism spectrum disorder

Sleep onset problems and subcortical development in infants later diagnosed with autism spectrum disorder