Sleep Questionnaire Research Articles

The complex link between sleep-disordered breathing and asthma control in pediatric patients: A cross-sectional study

BackgroundIn children, asthma and sleep-disordered breathing (SDB) may affect quality of life (QoL), and SDB may complicate asthma management. ObjectiveTo evaluate the prevalence of SDB, its association with asthma control, and risk factors associated with SDB in a cohort of asthmatic children. The effects of asthma control and SDB on QoL were also investigated. MethodsWe consecutively recruited asthmatic children referred to our Pulmonology Service from December 1, 2022 to May 31, 2023. Data on anthropometrics, respiratory function, and allergies were collected. The prevalence of SDB was assessed by the Pediatric Sleep Questionnaire (PSQ). Asthma control status was assessed by the Childhood Asthma Control Test (C-ACT), while QoL was evaluated by the Pediatric Quality of Life Inventory (PedsQL) questionnaire. Factors associated with SDB were analyzed. ResultsA total of 78 asthmatic children aged 5–12 years were included. SDB was found in 37.2% of them, with a higher prevalence in children with uncontrolled versus well-controlled asthma (60.1% vs. 27.3%; p-value = 0.005). The C-ACT score was significantly lower in SDB-positive versus SDB-negative group, and uncontrolled asthma (C-ACT ≤19) was associated with a 4.15-fold increased risk of SDB. The PedsQL score was significantly lower in asthmatic children with than without SDB and was associated with lower SDB risk. SDB increased the risk of uncontrolled asthma in children, and asthmatic children with SDB had lower QoL. ConclusionIn asthmatic children, SDB affects both asthma control and QoL. Children with uncontrolled asthma should be referred for polysomnography to identify a possible underlying SDB.

Effectiveness of Earplugs and Eye Masks on Sleep Quality and Fatigue Among Nonventilated Patients in an Intensive Care Unit.

Sleep is a basic physiological need and is imperative for healing and rejuvenation. However, the environment of the intensive care unit (ICU), including loud sounds and bright lights, can undermine patients' sleep quality. This study was designed to determine the effectiveness of overnight use of earplugs and eye masks to improve sleep quality and potentially influence hemodynamic parameters and mitigate fatigue among nonventilated patients in an ICU. This experimental study was conducted among 84 nonventilated patients in an ICU. The patients were evenly divided between an intervention group (n=42) and a control group (n=42). The intervention group patients received earplugs and eye masks for three consecutive nights from 10:30 pm to 6:30 am, while the control group patients received routine care. Clinical data, responses to the Richards-Campbell sleep questionnaire, and rankings on a numerical fatigue scale were collected before (pretest) and after the intervention each night and the next morning (posttests 1, 2, and 3). The results revealed a significant reduction in fatigue. At pretest, fatigue scores in the study group were 4.19±1.64. The score was significantly reduced to 3.40±1.39 at posttest 1 and then to 2.21±1.00 at posttest 3 (p<0.0001). The sleep quality for the study group showed a significant improvement from the pretest score of 43.73±8.27 to 60.35±6.85 at posttest 3 (p<0.001), whereas the control group had slightly worse sleep quality, with 40.64±8.67 at pretest and 45.63±6.95 at posttest 3. Continuous patient monitoring is an essential nursing care activity in ICUs while ensuring good-quality sleep promotes healing and reduces fatigue. Sleep quality can be supported by devices such as earplugs and eye masks to limit undue disturbances in the ICU settings.

Sleep in Myasthenia Gravis: A Questionnaire-Based Study.

Disturbed sleep and its impact on quality of life (QoL) are underrecognized in myasthenia gravis (MG). To evaluate the quality of sleep in MG using standard sleep questionnaires and assess factors that determine sleep. Prospective, cross-sectional, hospital-based study. Fifty patients on stable drug therapy for at least 1 month and age- and gender-matched controls were assessed using standard sleep questionnaires [Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and NIMHANS Comprehensive Sleep Disorders Questionnaire (NCSDQ)]. Myasthenia Gravis Foundation of America (MGFA) grade was I, IIA, IIB, IIIA, IIIB, and IVA in 11, 19, 3, 10, 6, and 1 respectively. The mean PSQI and ESS scores were similar in patients and controls. Patients with abnormal ESS (>10) were older and had greater neck circumference (P = 0.018 and <0.001). Body mass index was greater in patients with PSQI > 5 (P < 0.05). Age, gender, and clinical severity did not affect PSQI. Compared with ESS and PSQI, NCSDQ showed higher frequency of disturbed sleep, snoring, early morning headache, difficulty in initiation, and maintenance of sleep in MG, although the differences between patients and controls were not significant. No correlation was found between QoL and ESS or PSQI. Patients of MG with stable clinical course with adequate treatment have sleep quality comparable with healthy controls. Longitudinal assessment of sleep quality at multiple time points throughout the disease course and correlating with cross-sectional disease severity may further delineate the impact of disease on sleep and QoL.

The diagnostic accuracy of the Arabic version of the Pediatric Sleep Questionnaire for screening for pediatric sleep-related breathing disorders in Saudi children.

Pediatric Sleep Questionnaire (PSQ) is a valid, reliable tool for screening for sleep-related breathing disorders (SRBDs) translated into several languages since 2000. The diagnostic accuracy of an Arabic version of the PSQ has never been tested. Our aim was to translate the original version of PSQ into Arabic (Arabic-PSQ), validate it as a reliable screening tool, and compare it to the gold standard diagnostic method for SRBDs. This was a prospective longitudinal study of 54 children (2-14 years) who were to undergo polysomnography (PSG). SRBD was assessed by administering the Arabic version of PSQ to the parents of these children. The validity and reliability of the Arabic-PSQ were assessed. Data were analyzed using Stata 16. Correlation between with polysomnographic indices and PSQ scores, as well as measurement of the diagnostic accuracy were determined. Receiver operating characteristic analysis between the mean PSQ scores and binary PSG results was done and the area under curve (AUC) value was calculated. Thirty-four (63%) children were diagnosed with obstructive sleep apnea by PSG (Apnea-Hypopnea Index [AHI] ≥1), 26 of whom were accurately identified with the Arabic-PSQ (76.5%). Arabic-PSQ showed comparable validity and reliability. Using a cutoff of 0.33, the score showed a significant correlation with AHI: Rs: 0.30 (P = 0.029). The sensitivity was 76.5%, the specificity was 50%, the positive predictive was 72.2%, the negative predictive value was 55.6%, the positive likelihood ratio was 1.63, and the negative likelihood ratio was 0.37. The Arabic-PSQ is a valid tool for the screening of Arabic-speaking populations for SRBD. It is valuable for directing the diagnostic approach in a timely and cost-effective manner.

Assessment of Changes in Behavior and Quality of Life after Monobloc Treatment in Children with Obstructive Sleep Apnea or Primary Snoring.

The aim of this study was to examine the quality of life and behavioral disorders in children with obstructive sleep apnea (OSA) or primary snoring, as well as how these problems changed after monobloc treatment. Fourteen children with primary snoring and 16 children with OSA who had skeletal class II malocclusion due to mandibular retrognathia were treated with monobloc appliances. To investigate the relationship between behavioral disorders and quality of life, parents were asked to complete four questionnaires: attention deficit and hyperactivity disorder (ADHD) scale, strength and difficulties questionnaire (SDQ), pediatric sleep questionnaire (PSQ), and Pittsburgh sleep quality scale (PSQS). Mann-Whitney U and Wilcoxon signed-rank tests were used to evaluate the data. According to the results of the PSQ and PSQS, an increase in sleep quality was observed after monobloc treatment. The decrease in the total ADHD score at the end of the treatment was found to be statistically significant in both the OSA (p<0.01) and snoring (p<0.01) groups. According to the SDQ scores, the increase in the social behavior score and the decrease in the peer bullying score in the snoring group were statistically significant (p<0.05). The use of a monobloc appliance in pediatric patients exhibiting primary snoring and OSA resulted in a notable reduction in sleep-breathing disorder symptoms and a notable enhancement in their overall quality of life. Based on the analyses of the questionnaires, it was concluded that the increase in sleep quality improved the pediatric patients' quality of life after orthodontic treatment with orthodontic monobloc appliances.

Prevalence of Somatic Symptom Disorder in Students of Tertiary Educational Institutes in Pakistan and Its Correlation With Academic Performance and Sleep Quality

Objective: Somatic symptom disorder (SSD) is a disorder characterized by several somatic symptoms without medical explanation. SSD has been a burden on healthcare for ages and its awareness is not widespread among the healthcare professionals or population. This study aims to find out the prevalence of SSD among university students in Pakistan and whether it is affecting their academic performance or sleep quality. Methods: It is an observational study conducted in Pakistan in June 2023. A sample size of 381 participants was used. Patient Health Questionnaire-15 was used as SSD diagnosis, Academic Performance Scale for measuring academic performance, and Functional Outcome of Sleep Questionnaire for rating sleep quality. SPSS software 27.0 was used as a statistical tool for analysis using descriptive statistic and tests like frequency, chi-square, and crosstabs. Results: The study found a 48.8% prevalence of SSD among Pakistani students, with higher rates in females (65.6%), and no age-related correlation (p=0.341). Furthermore, the relation between academic performance of students with SSD was significant (p&lt;0.001), whereas sleep quality was unaffected by SSD (p=0.281). Conclusion: The frequency of SSD is approximately 48.8% among the students in Pakistan. This high prevalence has been recorded to negatively affect the academic performance of the students and is more prevalent in females than males. However, it is not related to age and it does not cause any sleep disturbance. Future studies should focus on the risk factors of SSD and better treatment plans for effective control and awareness of this disorder.

Association between sleep microarchitecture and cognition in obstructive sleep apnea

Abstract Study Objectives Obstructive sleep apnea (OSA) increases the risk of cognitive impairment. Measures of sleep microarchitecture from EEG may help identify patients at risk of this complication. Methods Participants with suspected OSA (n = 1142) underwent in-laboratory polysomnography and completed sleep and medical history questionnaires, and tests of global cognition (Montreal Cognitive Assessment, MoCA), memory (Rey Auditory Verbal Learning Test, RAVLT) and information processing speed (Digit–Symbol Coding, DSC). Associations between cognitive scores and stage 2 non-rapid eye movement (NREM) sleep spindle density, power, frequency and %-fast (12–16Hz), odds-ratio product (ORP), normalized EEG power (EEGNP), and the delta:alpha ratio were assessed using multivariable linear regression (MLR) adjusted for age, sex, education, and total sleep time. Mediation analyses were performed to determine if sleep microarchitecture indices mediate the negative effect of OSA on cognition. Results All spindle characteristics were lower in participants with moderate and severe OSA (p ≤ .001, vs. no/mild OSA) and positively associated with MoCA, RAVLT, and DSC scores (false discovery rate corrected p-value, q ≤ 0.026), except spindle power which was not associated with RAVLT (q = 0.185). ORP during NREM sleep (ORPNREM) was highest in severe OSA participants (p ≤ .001) but neither ORPNREM (q ≥ 0.230) nor the delta:alpha ratio were associated with cognitive scores in MLR analyses (q ≥ 0.166). In mediation analyses, spindle density and EEGNP (p ≥ .048) mediated moderate-to-severe OSA’s negative effect on MoCA scores while ORPNREM, spindle power, and %-fast spindles mediated OSA’s negative effect on DSC scores (p ≤ .018). Conclusions Altered spindle activity, ORP and normalized EEG power may be important contributors to cognitive deficits in patients with OSA.

Silent struggles: Mapping the terrain of sleep, anxiety, and depression in the Era of pandemic for individuals with multiple sclerosis- a cross-sectional study

BackgroundThe pandemic's preventive measures adversely impacted physical and psychological well-being, leading to increased sleep issues and mental health problems. This study examines sleep health and mental well-being among individuals with multiple sclerosis (MS) during this period. It explores potential correlations between sleep problems and mental health in this population. MethodsA cross-sectional design utilized an anonymous SurveyMonkey survey distributed to three MS centers, collecting responses from 24 individuals with MS (21 females, 3 males). Sleep data were assessed using the Functional Outcome of Sleep Questionnaire (FSOQ)-10, and mental health status was assessed using the Depression Anxiety Stress Scale (DASS)-21. FOSQ scores ≥17.9 indicated normal sleep, while the DASS-21 comprised stress, anxiety, and depression subscales, each with 7 questions rated on a 0–3 scale, with higher scores indicating greater mental health issues. ResultsOf 24 participants, 18 MS individuals reported functional sleep issues during the pandemic. Analysis revealed significantly lower productivity, vigilance, and social outcomes in the sleep problems group (p < .01). Additionally, this group had elevated stress (p = .004) and depression scores (p = .002). Negative correlations were observed between sleep scores and both stress (ρ = -0.485, p = .016) and depression (ρ = -0.562, p = .004). Conclusions75 % of MS individuals experienced functional sleep disturbances during the pandemic, with 25 % affected by stress, 16.6 % by anxiety, and 37 % by depression. Sleep issues are correlated with increased stress and depression levels. Recognizing the impact on rehabilitative outcomes, specialists must consider sleep behavior and mental health when designing therapies for individuals with MS.

Exploring Determinants of Health-Related Quality of Life in Emerging Adults with Type 1 Diabetes Mellitus: A Cross-Sectional Analysis.

(1) Background: Emerging adulthood, from the age of 18 to 29 years, is a crucial phase for individuals with Type 1 Diabetes Mellitus, as it affects their Health-Related Quality of Life. (2) Methods: This cross-sectional study analyzes the influence of the Mediterranean diet, Diabetes duration, Hemoglobin A1c, and sleep disorders on Health-Relate Quality of Life in Type 1 Diabetes Mellitus. In this study, conducted in Andalusia, Spain, 362 emerging adults with Type 1 Diabetes Mellitus completed the Oviedo Sleep Questionnaire, the Adaptation of Mediterranean Diet Adherence Screener, and the Vida con Diabetes Tipo 1 (ViDa1) Health-Related Quality of Life questionnaire between October 2021 and July 2022. Pearson correlation coefficients and a multiple regression analysis were conducted for each Health-Related Quality of Life in Type 1 Diabetes Mellitus dimension (Interference with Life, Well-being, Self-care, and Concern about the Condition) for overall sample and separately for males and females. (3) Results: Different and significant correlations are found among factors such as Age, Body Mass Index, Currently being a student, Hemoglobin A1c, Sleep satisfaction, Insomnia, Hypersomnolence, and Adherence to Mediterranean diet. Notably, Insomnia is a main predictor for Interference with Life, Well-being, and Concern about the Condition, especially for females. (4) Conclusions: Insomnia is the main predictor of Health-Related Quality of Life in Type 1 Diabetes Mellitus among Andalusian emerging adults with this condition. Consequently, a regular assessment of sleep and Health-Related Quality of Life from a gender perspective in this age group is crucial.

Screening for orthosomnia: a reliability generalization meta-analysis of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ)

Screening for orthosomnia: a reliability generalization meta-analysis of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ)

An empirical comparison of sleep-specific versus generic quality of life instruments among Australians with sleep disorders

PurposeIn Australian adults diagnosed with a sleep disorder(s), this cross-sectional study compares the empirical relationships between two generic QoL instruments, the EuroQoL 5-dimension 5-level (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A), and three sleep-specific metrics, the Epworth Sleepiness Scale (ESS), 10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10), and Pittsburgh Sleep Quality Index (PSQI).MethodsConvergent and divergent validity between item/dimension scores was examined using Kendall’s Tau-B correlation, with correlations below 0.30 considered weak, between 0.30 and 0.50 moderate and those above 0.50 strong (indicating that instruments were measuring similar constructs). Exploratory factor analysis (EFA) was conducted to identify shared underlying constructs.ResultsA total of 1509 participants (aged 18–86 years) were included in the analysis. Convergent validity between dimensions/items of different instruments was weak to moderate. A 5-factor EFA solution, representing ‘daytime dysfunction’, ‘fatigue’, ‘wellbeing’, ‘physical health’, and ‘perceived sleep quality’, was simplest with close fit and fewest cross-loadings. Each instrument’s dimensions/items primarily loaded onto their own factor, except for the EQ-5D-5L and PSQI. Nearly two-thirds of salient loadings were of excellent magnitude (0.72 to 0.91).ConclusionModerate overlap between the constructs assessed by generic and sleep-specific instruments indicates that neither can fully capture the complexity of QoL alone in general disordered sleep populations. Therefore, both are required within economic evaluations. A combination of the EQ-5D-5L and, depending on context, ESS or PSQI offers the broadest measurement of QoL in evaluating sleep health interventions.

Prevalence of obstructive sleep apnea in obese patients candidates for bariatric surgery and predictive questionnaires

Introduction and objectivesObstructive sleep apnea (OSA) is a prevalent condition among electable to bariatric surgery obese patients, often remaining underdiagnosed, thereby increasing surgical risk. The main purpose was to determine prevalence of OSA among candidates for bariatric surgery and to assess the rate of underdiagnosis of this condition. Additionally, the study aimed to evaluate the specific performance of three sleep questionnaires and scales (Excessive Daytime Sleepiness Scale (EDSS), Epworth Sleepiness Scale (ESS), and STOP-Bang) in these patients. MethodsA longitudinal, prospective, single-cohort study, with consecutive sampling including patients aged 18–65 years with obesity grade II (body mass index (BMI) ≥ 35 kg/m2) and hypertension, type 2 diabetes, metabolic syndrome or OSA or obesity grade III or IV (BMI ≥ 40 kg/m2) elective for bariatric surgery. Patients were evaluated at the Otorhinolaryngology department with an anamnesis regarding OSA including the administration of three sleep questionnaires (EDSS, ESS, and STOP-Bang), followed by cardiorespiratory polygraphy (CRP) for sleep evaluation. Results124 patients were included in this study. While 74.2% of the sample exhibited OSA on CRP, only 28.2% had a prior diagnosis. The STOP-Bang questionnaire demonstrated the highest sensitivity (93.3%) for detecting moderate to severe OSA, although with low specificity (33.8%). EDSS and ESS did not show a significant association with the presence of OSA. ConclusionsOSA screening is crucial in candidates for bariatric surgery due to its high prevalence and low diagnosis rate. The STOP-Bang questionnaire may serve as a useful tool for identifying patients at risk of moderate to severe OSA and optimizing sleep assessments. However, further research is necessary to validate its utility in this specific population.

Analgesic Effect and Sleep Quality of Low-Dose Dexmedetomidine in Cardiac Surgical Patients After Ultrafast-Track Extubation: A Randomized Clinical Trial

To compare the analgesic and sleep quality effects of dexmedetomidine infusion versus placebo in patients undergoing cardiac surgery with ultra-fast track extubation. The randomized, double-blind clinical trial study. At a single academic center hospital. We included patients aged 25 to 65 scheduled for elective cardiac surgery under general anesthesia with cardiopulmonary bypass from October 2021 to December 2022. After immediate extubation in the operating room, the patients who were allocated at first after providing their consent to either the dexmedetomidine group (Dex) or the placebo group (Placebo) received continuous infusion of dexmedetomidine (0.2 μg/kg/h) or saline for 12 hours postoperatively. The groups' demographic and perioperative variables were not statistically significant. Total morphine consumption in milligrams at 12 and 24 hours after administered study drug, total sleep time in hours by BIS value ≤85, and sleep quality with the Richard-Campbell Sleep Questionnaire were compared. The analysis included 22 Dex and 23 Placebo patients. The consumption of morphine was not statistically different between the Dex and Placebo groups at 12 and 24 hours (p = 0.707 and p = 0.502, respectively). The Dex group had significantly longer sleep time (8.7 h [7.8, 9.5]) than the Placebo group (5.8 h [2.9, 8.5]; p = 0.007). The Dex group also exhibited better sleep quality (7.9 [6.7, 8.7] vs 6.6 [5.2, 8.0]; p = 0.038). Sedation with low-dose dexmedetomidine infusion for ultra-fast track extubation following cardiac surgery enhances sleep duration and quality.

Worse sleep architecture but not self-reported insomnia and sleepiness is associated with higher cortisol levels in menopausal women

ObjectiveWorsening of sleep quality during menopause is well recognized. However, the underlying hormonal regulation is insufficiently described. In this study, we evaluated associations between sleep and cortisol levels. Study designSeventeen perimenopausal and 18 postmenopausal women were enrolled in a three-night sleep study. Diurnal blood sampling was performed during the third night and the following day. Main outcome measuresSelf-reported insomnia and sleepiness were evaluated with the Basic Nordic Sleep Questionnaire and sleep architecture with all-night polysomnography. Diurnal cortisol samples were collected at 20-min intervals. Correlation analyses and generalized linear models adjusted by age, body mass index, vasomotor symptoms and depressive symptoms were conducted. ResultsIn correlation analyses, self-reported insomnia and sleepiness were not associated with cortisol levels. Lower sleep efficiency, slow-wave sleep and stage 1 percentages, number of slow-wave sleep and of rapid-eye-movement (REM) periods, longer slow-wave sleep latency and higher wake after sleep onset percentage were associated with higher cortisol levels (all p < 0.05). Further, lower slow-wave sleep percentage and longer slow-wave sleep latency correlated with steeper daytime cortisol slope (i.e. day cortisol decrease, both p < 0.05). In adjusted generalized linear models, lower sleep efficiency and number of rapid-eye-movement periods as well as higher wake after sleep onset percentage correlated with higher cortisol levels; lower slow-wave sleep percentage correlated with higher cortisol awakening response. ConclusionsWorse sleep architecture but not worse self-reported insomnia and sleepiness was associated with higher cortisol levels. This is important for understanding sleep in women, especially during the menopausal period.

Effects of ganaxolone on non-seizure outcomes in CDKL5 Deficiency Disorder: Double-blind placebo-controlled randomized trial

CDKL5 deficiency disorder (CDD) is a rare developmental and epileptic encephalopathy. Ganaxolone, a neuroactive steroid, reduces the frequency of major motor seizures in children with CDD. This analysis explored the effect of ganaxolone on non-seizure outcomes. Children (2–19 years) with genetically confirmed CDD and ≥ 16 major motor seizures per month were enrolled in a double-blind randomized placebo-controlled trial. Ganaxolone or placebo was administered three times daily for 17 weeks. Behaviour was measured with the Anxiety, Depression and Mood Scale (ADAMS), daytime sleepiness with the Child Health Sleep Questionnaire, and quality of life with the Quality of Life Inventory-Disability (QI-Disability) scale. Scores were compared using ANOVA, adjusted for age, sex, number of anti-seizure mediations, baseline 28-day major motor seizure frequency, baseline developmental skills, and behaviour, sleep or quality of life scores. 101 children with CDD (39 clinical sites, 8 countries) were randomized. Median (IQR) age was 6 (3–10) years, 79.2 % were female, and 50 received ganaxolone. After 17 weeks of treatment, Manic/Hyperactive scores (mean difference 1.27, 95%CI –2.38,-0.16) and Compulsive Behaviour scores (mean difference 0.58, 95%CI -1.14,-0.01) were lower (improved) in the ganaxolone group compared with the placebo group. Daytime sleepiness scores were similar between groups. The total change in QOL score for children in the ganaxolone group was 2.6 points (95%CI -1.74,7.02) higher (improved) than in the placebo group but without statistical significance. Along with better seizure control, children who received ganaxolone had improved behavioural scores in select domains compared to placebo.

Evaluation of Sleep Quality in Asthmatic Children with the Paediatric Sleep Questionnaire (PSQ).

Considering the high prevalence of sleep-related breathing disorders (SRBD) in asthmatic patients, we aimed to compare asthmatic children and healthy children in terms of SRBD according to Paediatric Sleep Questionnaire (PSQ) scores. A questionnaire covering sociodemographic characteristics of the patients and the PSQ, which evaluates sleep quality and consists of 22 questions, was administered. During the data collection process, 180 patients in the patient group and 170 patients in the control group were included. The patient group showed statistically significantly higher total scores and subscale scores for snoring, sleepiness, and inattention compared to the control group. Statistically significant correlations were found between the sleepiness subscale and body mass index z score in a negative direction and between age at presentation and duration of asthma in a positive direction. Our findings endorse employing the PSQ as a screening instrument in the outpatient environment to ensure timely referral of asthma patients to a sleep specialist for SRBD evaluation. Considering the widespread occurrence of snoring and asthma, this tool could aid in identifying patients with an elevated risk of SRBD and expedite the scheduling of nocturnal polysomnography for these children.

Combining developmental and sleep health measures for autism spectrum disorder screening: an ECHO study.

Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses. Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included. We performed logistic LASSO regression models with 10-fold cross-validation to identify whether a combination of items derived from the M-CHAT-R and BISQ are superior to the standard M-CHAT-R in predicting ASD diagnoses. The final sample comprised 1552 children. The standard M-CHAT-R had a sensitivity of 44% (95% CI: 34, 55), specificity of 92% (95% CI: 91, 94), and AUROC of 0.726 (95% CI: 0.663, 0.790). A higher proportion of children with ASD had difficulty falling asleep or resisted bedtime during infancy/toddlerhood. However, LASSO models revealed parental reports of sleep problems did not improve the accuracy of the M-CHAT-R in predicting ASD diagnosis. While children with ASD had higher rates of sleep problems during infancy/toddlerhood, there was no improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. Parental-reported sleep problems are common in autism spectrum disorder (ASD). We investigated whether the inclusion of parental-reports of infant/toddler sleep patterns enhanced the effectiveness of developmental screening for autism. We reported higher rates of difficulty falling asleep and resisting bedtime during infancy and toddlerhood among children later diagnosed with ASD; however, we did not find an improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. In our sample, the standard M-CHAT-R had a sensitivity of 39% among children of mothers with government insurance compared with a sensitivity of 53% among children of mothers with employer-based insurance.

Sleep patterns of children with Cri du Chat syndrome before and during the COVID-19 pandemic: An observational study

BackgroundSleep patterns in children with Cri du Chat syndrome (CDC) remain understudied. The pandemic and isolation disrupted routines, potentially affecting their sleep. MethodsWe compared the sleep characteristics of 53 children with CDC before and during the COVID-19-related social isolation periods with that of 106 children with autism spectrum disorder (ASD) and 160 without either condition (comparison group), using the adapted Brief Infant Sleep Questionnaire (BISQ). The variables wake after sleep onset (WASO), awakenings, environment, strategies, and sleep latency were dichotomized based on relevant outcomes. Binomial logistic models were used for binomial outcomes and the lowest Akaike Information Criteria determined total sleep time distribution. Generalized estimating equations examined pandemic effects and intergroup differences. Multinomial regressions assessed pandemic and disorder impact on child and caregiver sleep quality. ResultsChildren with CDC had higher WASO, awakenings, and poorer sleep compared with the ASD and comparison groups in the pre-pandemic assessment DiscussionThese findings emphasize the importance of addressing sleep impairment in children with CDC to improve their overall well-being, both during exceptional circumstances like the pandemic and in their daily routines. The study provides valuable insights into sleep patterns and highlights the impact of the pandemic on sleep quality in different neurodevelopmental populations.

Does caffeine improve team-based morning performances more than habituation?

Repeated sprint performance (≤6 s) has a 3-10% diurnal variation of an evening compared to a morning (17:00-19:00 vs. 06:00-10:00 h; Pullinger et al., 2019). Research distinguishing the effect of habit in comparison to other stimuli on morning performance is unestablished. Therefore, the present study investigates whether caffeine can improve team-based morning performance of 20 m repeated sprints, more than habituation. Eight team-based participants (age: 21 ± 1 years, body mass: 83 ± 9 kg, stature: 181 ± 5 cm) participated in this study. The participants retired at 22:30 h and raised at 06:30 h to be in the laboratory for 07:00 h throughout the study period. The participants completed with two familiarisations and were randomly allocated to two experimental conditions either 1) having taken caffeine on waking (300 mg at 06:30 h), then enter the laboratory at 07:00 h or, 2) The participant rose and retire as above but enter the laboratory at 07:00 h to sit on a cycle ergometer (60 mins) prior to the day of testing. They return the following day at 07:00 h. On entering the laboratory participants were seated, completed sleep questionnaires and mood was assessed using Perceived Onset Mood State (POMS) questionnaire. After 30-min Intra-aural temperature and fingertip blood glucose and lactate measured (as well as post warm-up and immediately after the RSP test). Thereafter, right- and left-hand grip strength (the best of 3 were recorded) and maximal repeated sprint performance measures were taken (RSP, 10 x 20m, 30s recovery period). Heart rate (HR), thermal comfort (TC), and rating of perceived exertion (RPE) were all recorded after each sprint. Data were analysed using a general-linear model.

Exploring the impact of sleep on emotional and physical well-being in professional cricketers: a cohort study over an in-season training period.

Professional athletes navigate a multitude of unique challenges associated to sport-specific factors (e.g., training, travel and competition) and non-sport factors (e.g., performance pressure, stress and anxiety) that can interfere with healthy sleep behaviors. Sleep plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. As poor sleep quality is known to impair proper brain function, this study aimed to investigate the effect of sleep quality on a professional athlete's ability to train, recover, and perform, as well as their overall emotional and physical well-being. A cohort study was performed in 40 professional male cricket athletes from the Dutch national cricket team (mean age 26.5 ± 5.1 years). The athletes were monitored across a 22 weeks in-season training period. Sleep quality and overall emotional and physical well-being were assessed using daily sleep diaries and questionnaires which scored the readiness to train, stress levels, fatigue, muscle soreness and flu symptoms respectively. Quality of sleep and subsequent association with the consecutive elements of the well-being questionnaire were assessed through statistical using the student t-test and clinical differences with the methodology of Osoba and colleagues: <5% "no change", 5%-10% "little change"; 10%-20% "moderate change"; and >20% "very much change". The results demonstrated that the professional athletes assessed their sleep quality as average with a mean score of 3.4 out of 5. Lower perceived quality of sleep (<75th percentile) was correlated with a decreased readiness to train (mean score 3.2 [IQR: 3.0-4.0] vs. 3.5 [IQR: 3.0-5.0]; P < 0.001) and increased extent of muscle soreness (2.7 [IQR: 2.0-3.0] vs. 2.3 [IQR: 2-3]; P < 0.001), stress level (mean score 2.3 [IQR: 2.0-3.0] vs. 1.9 [IQR: 1.0-2.0]; P < 0.001) and perceived fatigue (mean score 2.9 [IQR: 2.0-3.0] vs. 2.3 [IQR: 2.0-3.0]; P < 0.001). Likewise, in patients with lower perceived quality of sleep, the proportion of players presenting with flu symptoms increased over 4-fold (4.1% vs. 17%; P < 0.001). This study highlights that good sleep quality positively influences the overall emotional and physical well-being of professional athletes. Our results emphasize the importance of targeted sleep interventions to improve sleep quality and subsequently optimize psychological and physiological wellness.