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Biomedical subjects

A Sadeh

Publications and source records attributed to A Sadeh.

At least 19 recordsLinked to original sources
PubMed2001

Sleep patterns and sleep disruptions in kindergarten children.

Assessed sleep patterns and sleep disruptions in kindergarten children and investigated the relation between sleep measures derived from objective and subjective evaluation methods. The sleep patterns of 59 normal kindergarten children (mean age = 5.5 years) were monitored for 4 to 5 consecutive nights by means of activity monitors (actigraph) and by means of parental daily sleep logs. The correlation between the actigraphic measures and the daily parental logs indicated that parents were accurate reporters of sleep schedule measures. However, parents were less accurate in assessing sleep quality measures, significantly underestimating the number of night-wakings and overestimating the quality of their children's sleep. Fragmented sleep was found, by means of activity monitoring, in 41% of the children.

Child↗
PubMed2000

Attention deficit/hyperactivity disorder children with a 7-repeat allele of the dopamine receptor D4 gene have extreme behavior but normal performance on critical neuropsychological tests of attention.

An association of the dopamine receptor D4 (DRD4) gene located on chromosome 11p15.5 and attention deficit/hyperactivity disorder (ADHD) has been demonstrated and replicated by multiple investigators. A specific allele [the 7-repeat of a 48-bp variable number of tandem repeats (VNTR) in exon 3] has been proposed as an etiological factor in attentional deficits manifested in some children diagnosed with this disorder. In the current study, we evaluated ADHD subgroups defined by the presence or absence of the 7-repeat allele of the DRD4 gene, using neuropsychological tests with reaction time measures designed to probe attentional networks with neuroanatomical foci in D4-rich brain regions. Despite the same severity of symptoms on parent and teacher ratings for the ADHD subgroups, the average reaction times of the 7-present subgroup showed normal speed and variability of response whereas the average reaction times of the 7-absent subgroup showed the expected abnormalities (slow and variable responses). This was opposite the primary prediction of the study. The 7-present subgroup seemed to be free of some of the neuropsychological abnormalities thought to characterize ADHD.

Alleles↗
PubMed2000

Sleep patterns and sleep disruptions in school-age children.

This study assessed the sleep patterns, sleep disruptions, and sleepiness of school-age children. Sleep patterns of 140 children (72 boys and 68 girls; 2nd-, 4th-, and 6th-grade students) were evaluated with activity monitors (actigraphs). In addition, the children and their parents completed complementary sleep questionnaires and daily reports. The findings reflected significant age differences, indicating that older children have more delayed sleep onset times and increased reported daytime sleepiness. Girls were found to spend more time in sleep and to have an increased percentage of motionless sleep. Fragmented sleep was found in 18% of the children. No age differences were found in any of the sleep quality measures. Scores on objective sleep measures were associated with subjective reports of sleepiness. Family stress, parental age, and parental education were related to the child's sleep-wake measures.

Age Factors↗
PubMed2000

Instability of sleep patterns in children with attention-deficit/hyperactivity disorder.

OBJECTIVE: To compare the stability of the sleep-wake system of children with attention-deficit/hyperactivity disorder (ADHD) and controls by objective and subjective measures. METHOD: Thirty-eight school-age boys with diagnosed ADHD and 64 control school-age boys were examined using actigraphic monitoring and sleep diaries, over 5 consecutive nights. RESULTS: Increased instability in sleep onset, sleep duration, and true sleep were found in the ADHD group compared with the control group. Discriminant analysis revealed that children's classification (ADHD versus control) could be significantly predicted on the basis of their sleep measures. CONCLUSIONS: The findings support the hypothesis that instability of the sleep-wake system is a characteristic of children with ADHD. Given the potential negative effects of disturbed or unstable sleep on daytime functioning, it is recommended that a thorough sleep assessment be conducted when a sleep disturbance is suspected or when symptoms associated with daytime sleepiness or decreased arousal level are present.

Adolescent↗
PubMed1999

Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures?

STUDY OBJECTIVES: This study provides estimates of reliability for aggregated values from 1 to 7 recording nights for five commonly used actigraphic measures of sleep patterns, reliability as a function of night type (weeknight or weekend night), and stability of measures over several months. DESIGN AND SETTING: Data are from three studies that obtained 7 nights of actigraph data (using Mini Motionlogger actigraphs and associated validated algorithms [ASA]) on children and adolescents living at home on self-selected sleep-wake schedules. PARTICIPANTS: Participants were 169 children aged 12-60 months, and 55 adolescents aged 11-16 years. MEASUREMENTS AND RESULTS: Up to 28% of weekly recordings may be unacceptable for analysis in young participants because of illness, technical problems, and participant noncompliance; studies aiming to collect 5 nights of actigraph data should record for at least 1 full week. Reliability estimates for values aggregated over any 5 nights were adequate (> or = .70) for sleep start time, wake minutes, and sleep efficiency. Measures of sleep minutes and sleep period were less reliable and may require 7 or more nights for estimates of stable individual differences. Reliability for 1- or 2-night aggregates were poor for all measures. We found significant and high correlations between summer and fall session measures for all five variables when weekend nights were included. CONCLUSIONS: Five or more nights of usable recordings are required to obtain reliable actigraph measures of sleep for children and adolescents.

Adolescent↗
PubMed1998

Sleep and pulmonary function in children with well-controlled, stable asthma.

The aim of this study was to assess sleep and pulmonary function in asthmatic and control children. Forty children with well-controlled, stable asthma, and 34 controls (age range: 8.2 to 15.4 years) were monitored with wrist actigraphs and peak-flow meters for 3 consecutive days. In addition, asthma severity was assessed by subjective parental and self-rating scale and symptom checklist. Asthmatic children had poorer sleep quality in comparison to their controls, as manifested in lower percentages of quiet sleep (p < .05) and increased activity level during sleep (p < .05). As expected, asthmatic children had reduced morning peak expiratory flow measures (p < .01) and a higher evening-to-morning drop in peak expiratory flow (p < .005). Peak-flow measures were significantly correlated with subjective and objective sleep measures. In the asthmatic group, sleep measures were also correlated with subjective asthma severity indices and symptom checklists. We conclude that poorer sleep is associated with reduced pulmonary function. The reduced sleep quality, coupled with subjective reports of increased fatigue and reduced alertness found in asthmatic children, suggest that these children are at risk for developing neurobehavioral deficits associated with chronic sleep loss.

Adolescent↗
PubMed1997

Sleep quality in children with attention deficit hyperactivity disorder: an actigraphic study.

The aim of the present study was to compare the sleep of 12 children with attention deficit hyperactivity disorder (ADHD) with that of 12 normal controls. The children were examined in their natural environment, using continuous actigraphic monitoring over several consecutive nights, as well as undergoing subjective parental reports. It was hypothesized that children diagnosed with ADHD would suffer from reduced sleep quality than children without ADHD. This hypothesis was supported by the actigraphic measures, but not supported by the subjective parental reports. It was also found that the sleep quality of the two groups differed over the course of the night, which suggests a difference in sleep architecture. Various possible explanations for these findings, their implications regarding the relationship between sleep and ADHD, and the resulting treatment ramifications are discussed, and suggestions for further research are provided.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

Sleep and melatonin in infants: a preliminary study.

Sleep-wake patterns of 20 normal, healthy infants (16 girls and four boys; age range: 26-37 weeks) were recorded for a period of 1 week with a miniature activity monitor. Urine samples were extracted from the infants' disposable diapers that were collected during a 60-hour period to determine the levels of 6-sulphatoxymelatonin (aMT6s, a melatonin metabolite) using a radioimmunoassay test. Infants with "mature" secretion patterns (i.e. with an adult-like circadian rhythm) had a significantly delayed sleep-wake cycle in comparison to those with "immature" patterns. The onset of their nocturnal-sleep episode was delayed by almost 1 hour (22.1 vs. 21.2 hours; p < 0.05). Higher secretion rates of aMT6s during the evening hours (6:00-10:00 p.m.) were associated with earlier onset of nocturnal sleep (r = 0.51; p < 0.05). A delayed peak of melatonin was associated with more fragmented sleep during the night (e.g. r = 0.49; p < 0.05; for lower sleep percent). These findings suggest that melatonin plays an important role in the evolution of the sleep-wake system.

Child Development↗
PubMed1996

Newborns' sleep-wake patterns: the role of maternal, delivery and infant factors.

OBJECTIVE: The purpose of this study was to assess the sleep-wake patterns of fullterm (> or = 37 weeks) newborns and to evaluate the effects of specific factors including maternal gestational diabetes, infant size and anthropometric measures, gender, gestational age and delivery variables. METHODS: Two-hundred twenty newborns were studied in the hospital nursery for a continuous 24-h period with miniature activity monitors attached to the infants' ankles. The sample consisted of 102 infants of gestational diabetic mothers (IGDM) and 118 controls. Anthropometric measurements were obtained and maternal and infant characteristics were recorded. RESULTS: The newborns had a discernible diurnal sleep pattern and slept twice as much during the nighttime as daytime hours (P < 0.001). Higher skinfold measurements correlated significantly with increased quiet and motionless sleep (P < 0.05) for the IGDM but not for controls. Sleep of infants born at later gestational ages was characterized by increased percent of quiet and motionless sleep (P < 0.0001). No direct gender effects were identified. CONCLUSIONS: Multiple factors were associated with the sleep-wake patterns of the newborns on our study cohort including maternal glucose values during pregnancy, increased measures of adiposity in IGDM, increased gestational age, mode of delivery and delivery Sequence. Investigation of the sleep-wake characteristics of neonates using activity monitors is a noninvasive method for gaining new understanding of the relationships between sleep wake activity patterns and infant characteristics.

Adult↗
PubMed1996

Evaluating night wakings in sleep-disturbed infants: a methodological study of parental reports and actigraphy.

The aim of this study was to investigate the use of objective and subjective sleep measures in diagnostic assessment of night-waking problems during infancy. Infant sleep-wake measures obtained from parental daily logs were compared with objective sleep measures derived from activity monitoring during a week-long period in 66 referred infants. Reported sleep measures were significantly correlated with objective sleep measures and showed a significant level of day-to-day stability. Parents were accurate reporters of sleep-schedule measures (e.g. sleep onset, r = 0.88; sleep duration, r = 0.74; p < 0.0001). However, parents were less accurate in assessing sleep quality measures, significantly overestimating the time that their infants spent in actual sleep and underestimating the number of their night-wakings (r = 0.41 and r = 0.60, respectively; P < 0.001). It is suggested that subjective and objective measures should play a complementary role in the clinical assessment of night-waking problems in early childhood.

Child, Preschool↗
PubMed1995

The effect of nasolacrimal occlusion on drug-induced mydriasis.

BACKGROUND: Nasolacrimal occlusion has been shown to improve the efficacy of some topically applied ocular drugs. The aim of this study was to investigate the effect of nasolacrimal occlusion on tropicamide-induced mydriasis. METHODS: We compared pupillary dilatation by 0.125% tropicamide with and without nasolacrimal occlusion in 40 healthy volunteers. RESULTS: Analysis of variance with repeated measures failed to show any advantage due to nasolacrimal occlusion in drug-induced mydriasis. CONCLUSION: Nasolacrimal occlusion did not increase the mydriasis obtained with 0.125% tropicamide.

Adult↗
PubMed1995

The role of actigraphy in the evaluation of sleep disorders.

This paper, which has been reviewed and approved by the Board of Directors of the American Sleep Disorders Association, provides the background for the Standards of Practice Committee's parameters for the practice of sleep medicine in North America. The growing use of activity-based monitoring (actigraphy) in sleep medicine and sleep research has enriched and challenged traditional sleep-monitoring techniques. This review summarizes the empirical data on the validity of actigraphy in assessing sleep-wake patterns and assessing clinical and control groups ranging in age from infancy to elderly. An overview of sleep-related actigraphic studies is also included. Actigraphy provides useful measures of sleep-wake schedule and sleep quality. The data also suggest that actigraphy, despite its limitations, may be a useful, cost-effective method for assessing specific sleep disorders, such as insomnia and schedule disorders, and for monitoring their treatment process. Methodological issues such as the proper use of actigraphy and possible artifacts have not been systematically addressed in clinical research and practice.

Circadian Rhythm↗
PubMed1995

Sleep and psychological characteristics of children on a psychiatric inpatient unit.

OBJECTIVE: To assess the association of objective measures of sleep-wake patterns and psychological status and abuse history of children hospitalized in a psychiatric inpatient unit. METHOD: Thirty-nine inpatient children participated in the study. They were monitored for one to three consecutive nights with miniature wrist activity monitors for objective assessment of sleep-wake patterns. In addition, a thorough psychiatric and psychosocial assessment was completed with each child and the parents. RESULTS: Children's self-ratings of depression, hopelessness, and low self-esteem were significantly correlated with objective sleep measures indicating poorer sleep quality. No significant correlations between intelligence scores and sleep measures were found. Nonabused and sexually abused children had better sleep quality than physically abused children. CONCLUSIONS: Sleep quality during hospitalization is strongly associated with self experiences of depression, hopelessness, and low self-esteem in children with severe behavior disorders.

Adolescent↗
PubMed1995

Case study: sleep and aggressive behavior in a blind, retarded adolescent. A concomitant schedule disorder?

Blind people are prone to suffer from sleep-wake schedule disorders. This report describes 2 months of monitoring of sleep patterns and aggressive behaviors in a totally blind, severely retarded adolescent boy, hospitalized in a psychiatric hospital. The documented sleep-wake patterns seem to portray a sleep-wake schedule disorder with a monthly periodicity. Aggressive behaviors seem to echo the same periodicity, suggesting that a common or linked biobehavioral timing mechanism may underlie both sleep and episodic aggressive outbursts. The need to consider sleep schedule disorders as a primary process underlying some psychopathological disorders, and the related risks of misdiagnosis and mistreatment, are highlighted.

Adolescent↗
PubMed1994

Somatic, cognitive and emotional characteristics of abused children in a psychiatric hospital.

A systematic review of medical records of one hundred consecutive admissions to a children's psychiatric inpatient unit was conducted to assess specific somatic, cognitive and emotional characteristics that distinguish sexually abused children from other hospitalized children. Sexually abused children were characterized by: a lower performance IQ, higher incidence of parasomnia prior to admission, longer length of hospital stay, and comparatively small physical stature.

Adolescent↗
PubMed1994

Assessment of intervention for infant night waking: parental reports and activity-based home monitoring.

Sleep patterns of 50 infants (aged 9-24 months) with sleep disturbances were studied by using an activity monitor (actigraph) and parental reports during the baseline and intervention periods. Two behavioral intervention methods were used to treat the multiple or prolonged night-waking problems. Infant sleep significantly improved during the period of intervention as measured by both actigraphic and parental monitoring. The discrepancy between parental and actigraphic measures increased over time, as did the number of omitted items from the parental daily logs. The results highlight some of the advantages as well as some of the limitations of actigraphic and parental monitoring of infant sleep, and they suggest that the two methods may have complementary roles in assessing intervention efficacy in this field.

Behavior Therapy↗