Sleep Problems In Youth Research Articles

Pain as a predictor of sleep problems in youth with autism spectrum disorders

Evidence suggests that pain interferes with sleep in youth with developmental disabilities. This study examined the relationship between pain and sleep problems in a sample of youth with parent-reported autism spectrum disorder (N = 62). Mothers reported on standardized measures of pain and sleep problems. Youth demonstrated atypically high levels of both observed pain and sleep problems. Pain predicted overall sleep disturbance and three specific sleep problems: sleep duration, parasomnias, and sleep-disordered breathing. These specific sleep problems were predicted by specific modalities of nonverbal pain communication (e.g. sleep duration problems were predicted by social communication of pain). Effects were consistent across probing of relevant moderators. These findings suggest that comprehensive assessment of both pain and sleep problems may provide important information for medical and behavioral treatment planning for youth with autism spectrum disorder.

Sleep Problems in Youth with ADHD: A Guide for Parents

Sleep Problems in Youth with ADHD: A Guide for Parents

Sleep Disorders in Children: A National Assessment of Primary Care Pediatrician Practices and Perceptions

To assess general pediatricians' screening practices for sleep-related issues and assess their knowledge on common sleep complaints in children, their perceived barriers to screening for sleep issues, and whether they have received training regarding sleep issues. A national random sample (n = 700) of general pediatricians who were members of the American Academy of Pediatrics were sent a valid and reliable questionnaire on sleep problems in youth. A total of 346 pediatricians (49%) responded. The vast majority (96%) indicated that they believed it was their job to counsel patients/guardians regarding sleep hygiene, yet few pediatricians (18%) had ever received formal training on sleep disorders. Those who did not screen for sleep problems spent significantly less time with each patient and perceived significantly more barriers to screening. Pediatricians who had received training about sleep disorders had significantly higher knowledge scores on sleep problems, perceived significantly fewer barriers to screening, and reported significantly higher confidence scores regarding counseling patients/guardians on sleep problems. These findings support the need for formal education on sleep disorders for all pediatricians.

A Parent General Behavior Inventory Subscale to Measure Sleep Disturbance in Pediatric Bipolar Disorder

Sleep disturbance is a reliable marker for differentiating children with bipolar spectrum disorders from those with attention-deficit/hyperactivity disorder. Sleep-related items were extracted from the Parent General Behavior Inventory (P-GBI) to determine whether these items, as a scale unto themselves, demonstrate adequate psychometrics to be useful as a possible endophenotypic marker for bipolar spectrum disorders. From July 2003 to July 2007, 625 youths and their parents completed semistructured Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version interviews. Parents also completed the 73-item P-GBI. Participants with bipolar spectrum disorders (DSM-IV criteria) scored significantly higher than all other participants on all 7 of the sleep variables (p < .005). On receiver operating characteristic (ROC) analysis, the sleep subscale did substantially as well at discriminating participants with bipolar spectrum disorders as did either of the 2 built-in GBI scales, depression and hypomanic/biphasic (area under the ROC curve = 0.74 vs. 0.75 and 0.77, respectively). The P-GBI sleep subscale, developed in this study, is a reliable measure of a wide range of mood-related sleep problems in youths diagnosed with bipolar spectrum disorders. Sleep disturbance appears to be a promising endophenotype for further clinical investigation, and the P-GBI sleep scale may provide an inexpensive way of quantifying this trait for research. Further research needs to evaluate how parent report compares to objective measures of sleep efficiency, such as actigraphy or polysomnography.

The nature of and behavioral treatment of sleep problems in youth with bipolar disorder.

Abstract Bipolar spectrum disorders (BP) occur in up to 1% of youth and are associated with significant impairment. Individuals with BP are often characterized by a decreased need for sleep or dysregulated sleep-wake schedules. For children, such sleep problems often relate to impairment in school and social functioning. Thus, sleep is an especially important target of intervention for youth with BP because of children's sensitivity to lack of sleep and dysregulated sleep routines. The present paper describes sleeprelated issues in individuals with BP while also discussing potential behavioral interventions to improve sleep in youth with BP. Two case examples are presented to illustrate potential interventions. Keywords: Bipolar spectrum disorders (BP), sleep-wake cycle. ********** Bipolar spectrum disorders (BP) affect about 1-4% of the population and are chronic mood disorders characterized by fluctuating states of depression and mania often resulting in significant impairment (Kessler, Chiu, Demler, & Walters, 2005). BP may also be present in childhood or adolescence and subsequently affect social and school functioning. Prevalence estimates range from 0% (Costello, Angold, Burns, Stangl et al., 1996) to 1.2% (Shaffer, Fisher, Greenwald, & Greenberg, 2002) for bipolar I in youths, .1% to .6% for bipolar II (Costello, Angold, Burns, Erkanli et al., 1996; Kessler, Avenevoli, & Merikangas, 2001; Lewinsohn, Klein, & Seeley, 1995; Shaffer et al., 2002; Wittchen, Nelson, & Lachner, 1998), and .3% for bipolar NOS (Lewinsohn et al., 1995). The nature of symptoms in youth with BP disorder may differ somewhat from those seen in adults. For example, youth with BP are more likely to exhibit rapid cycling and mixed states of mania and depression (National Institute of Mental Health, 2001). Symptoms may be similar to the hyperactivity that is characteristic of attention deficit and hyperactivity disorder, oppositionality seen with other behavior problems such as oppositional defiant disorder, or irritability characteristic of childhood depression. However, one symptom that is characteristic of BP that distinguishes it from these other disorders of childhood is a decreased need for sleep (Kowatch, Youngstrom, Danielyan, & Findling, 2005) and dysregulated sleep-wake schedules (Faedda, Baldessarini, Glovinsky, & Austin, 2004). In fact, sleep and related characteristics have long been known to play an important role in mood disorders, especially BP (Rao, 2003). Thus, the purpose of this paper is to describe the importance of sleep for youth in general, and youth with BP, in particular. The paper also describes potential behavioral interventions to improve sleep in youth with BP, and concludes with two case examples that illustrate these techniques. Relevance of Sleep for Child and Adolescent Functioning and Mood Sleep is important for regulating children's mood and behaviors and for maximizing attention and learning (Dahl, 1996; Mindell & Owens, 2003). In non-clinical samples, studies have shown that sleep problems are associated with behavioral and functional impairments. Indeed, one study with healthy children ages 7 to 12 found that quantity of sleep, especially low sleep time, was associated with teacher report of problem behaviors including attention and externalizing problems (Aronen, Paavonen, Fjallberg, Soininen, & Torronen, 2000). Irregularity in children's sleep-wake schedules are also related to poor teacher ratings of school functioning in fifth graders (Acebo & Carskadon, 1993). A large epidemiological study found that parent reports of their children's sleep problems were associated with their reports of internalizing and total problems, and with teacher reports of emotional, social, somatic, attention, and delinquent problems (Paavonen, Solantaus, Almqvist, & Aronen, 2003). Youth with sleep problems were almost three times more likely to have clinically significant emotional problems. …