Biomedical subjects

Avi Sadeh

Publications and source records attributed to Avi Sadeh.

17 recordsLinked to original sources

PubMed2006

Sleep in children with attention-deficit hyperactivity disorder: a meta-analysis of polysomnographic studies.

The links between sleep and attention-deficit hyperactivity disorder (ADHD) have been a topic for intense ongoing research and clinical interest. Previous narrative literature reviews conveyed a consensus that parents of children with ADHD are more likely to report sleep problems in their children in comparison to parents of control children. However, when objective measures are considered the results appear to be more complex and inconsistent. This review is based on a meta-analysis of relevant polysomnographic studies. We assessed measures related to sleep architecture, breathing disorders, and periodic limb movements in sleep (PLMS), and the role of potential moderators such as age, gender, and other methodological factors. The meta-analysis revealed only one significant combined effect that indicates that children with ADHD are more likely than controls to suffer from PLMS. Factors such as age, gender, inclusion of adaptation night, and comorbidity appear to play a moderating role in the associations between sleep characteristics and ADHD. To provide new insight regarding the links between sleep and ADHD research in this field should adopt new strict guidelines and consider the role of multiple pertinent moderating factors.

Attention Deficit Disorder with Hyperactivity↗

PubMed2006

Reduced auditory processing capacity during vocalization in children with Selective Mutism.

BACKGROUND: Because abnormal Auditory Efferent Activity (AEA) is associated with auditory distortions during vocalization, we tested whether auditory processing is impaired during vocalization in children with Selective Mutism (SM). METHODS: Participants were children with SM and abnormal AEA, children with SM and normal AEA, and normally speaking controls, who had to detect aurally presented target words embedded within word lists under two conditions: silence (single task), and while vocalizing (dual task). To ascertain specificity of auditory-vocal deficit, effects of concurrent vocalizing were also examined during a visual task. RESULTS: Children with SM and abnormal AEA showed impaired auditory processing during vocalization relative to children with SM and normal AEA, and relative to control children. This impairment is specific to the auditory modality and does not reflect difficulties in dual task per se. CONCLUSIONS: The data extends previous findings suggesting that deficient auditory processing is involved in speech selectivity in SM.

Auditory Perception↗

PubMed2006

Sleep, sleepiness, and behavior problems in children with headache.

The purpose of this study was to assess sleep, daytime sleepiness, and behavior problems in children suffering from headaches and in controls, with a special focus on the role of gender. A clinical group of 28 children with persistent headache complaints and a control group of 108 healthy children were included. Sleep was assessed by actigraphy and diaries. Behavior problems were assessed by parental reports. In comparison with the control group, the sleep quality of the clinical group was poorer and they complained more about excessive daytime sleepiness. Children suffering from headache showed higher levels of internalizing behavior problems. Gender was found to be a moderating factor for the relationships between headache and sleep. Compared with control girls, girls suffering from headaches had poorer sleep quality, whereas the opposite was true for the boys. The results highlight the importance of assessing sleep, daytime sleepiness, and psychologic adjustment in children complaining about headaches as an integral part of their routine assessment.

Adaptation, Psychological↗

PubMed2006

Behavioral treatment of bedtime problems and night wakings in infants and young children.

This paper reviews the evidence regarding the efficacy of behavioral treatments for bedtime problems and night wakings in young children. It is based on a review of 52 treatment studies by a task force appointed by the American Academy of Sleep Medicine to develop practice parameters on behavioral treatments for the clinical management of bedtime problems and night wakings in young children. The findings indicate that behavioral therapies produce reliable and durable changes. Across all studies, 94% report that behavioral interventions were efficacious, with over 80% of children treated demonstrating clinically significant improvement that was maintained for 3 to 6 months. In particular, empirical evidence from controlled group studies utilizing Sackett criteria for evidence-based treatment provides strong support for unmodified extinction and preventive parent education. In addition, support is provided for graduated extinction, bedtime fading/positive routines, and scheduled awakenings. Additional research is needed to examine delivery methods of treatment, longer-term efficacy, and the role of pharmacological agents. Furthermore, pediatric sleep researchers are strongly encouraged to develop standardized diagnostic criteria and more objective measures, and to come to a consensus on critical outcome variables.

Behavior Therapy↗

PubMed2005

Cognitive-behavioral treatment for childhood sleep disorders.

Sleep problems are very prevalent during childhood and may have adverse developmental impact. The efficacy of a number of cognitive-behavioral interventions for the most prevalent problems such as difficulty falling asleep and night-wakings has been repeatedly demonstrated with relatively rapid outcomes and high success rates. Preventive interventions in infancy have shown some promise in lowering the rates of sleep problems in infants of trained parents. Cognitive-behavioral interventions have also been proposed for childhood parasomnias (sleepwalking, night terrors, nightmares, and rhythmic behaviors), however, very limited research has been conducted to assess the efficacy of these interventions. Specific methodological issues, limitations and needs have been identified in the clinical literatures. These issues include: (a) integrating objective sleep assessment methods in clinical research; (b) identifying the specific curative factors of various effective interventions; (c) the absence of long-term follow-up studies for assessing relapse problems; (d) assessing the role of mode of delivery (i.e., professional consultation versus written information) in treatment efficacy; and (e) the need to expand the research on clinical interventions for the parasomnias.

Biomedical Research↗

PubMed2005

Sleep/wake patterns derived from activity monitoring and maternal report for healthy 1- to 5-year-old children.

STUDY OBJECTIVES: To describe behavioral sleep/wake patterns of young children from actigraphy and mothers' reports, assess age-group and sex differences, describe daytime napping, and investigate the impact of family demographic variables on sleep-wake measures. DESIGN: Cross-sectional sample of children wore actigraphs for 1 week; mothers kept concurrent diaries. SETTING: Children studied in their homes. PARTICIPANTS: 169 normal healthy children in 7 age groups (12, 18, 24, 30, 36, 48, and 60 months old); 84 boys and 85 girls. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Nocturnal sleep/wake measures estimated from activity recordings using a validated algorithm; mothers' reports of nocturnal sleep/wake patterns and daytime naps obtained from concurrent diaries. Bedtimes and sleep start times were earliest and time in bed and sleep period times were longest for 12-month-old children. Rise time, sleep end time, and nocturnal sleep minutes did not differ across age groups. Actigraphic estimates indicated that children aged 1 to 5 years slept an average of 8.7 hours at night. Actigraph-based nocturnal wake minutes and wake bouts were higher than maternal diary reports for all age groups. Daytime naps decreased monotonically across age groups and accounted for most of the difference in 24-hour total sleep over age groups. Children in families with lower socioeconomic status had later rise times, longer time in bed, more nocturnal wake minutes and bouts, and more night-to-night variability in bedtime and sleep period time. Children with longer naps slept less at night. CONCLUSIONS: Individual differences in sleep/wake measures reflect characteristics of children, parents, or parent-child interactions.

Age Factors↗

PubMed2004

Psychosocial situations, quality of depression and schizophrenia in adolescents.

The relationships between acute life events and type of depression were evaluated among inpatient adolescents with schizophrenia. Forty-two adolescent inpatients were assessed, 25 with schizophrenia and 17 with personality disorder. Acute life events and other psychosocial situations were identified with the ICD-10 Axis V semistructured interviews. The Depression Equivalent Questionnaire for Adolescents (DEQ-A) and the Positive and Negative Symptom Scale (PANSS) were used to measure quality and severity of depression. In the patients with schizophrenia, psychosocial situations were related to the anaclitic type of depression, whereas in the subjects with personality disorder, they were highly correlated with introjective depression. In the schizophrenic group, the psychosocial situations related to depression were of a more intrapersonal nature and, in the personality-disordered group, they were more interpersonal. Environmental factors play an important role in the course of schizophrenia in adolescents and should remain a focus of study. Object relations theory may be of heuristic value in the investigation of these factors.

Adolescent↗

PubMed2004

Sleep and neurobehavioral functioning in boys with attention-deficit/hyperactivity disorder and no reported breathing problems.

STUDY OBJECTIVE: To investigate by objective measures the neurobehavioral correlates of sleep patterns in boys with attention-deficit/hyperactivity disorder (ADHD) and no reported breathing problems and in control children. DESIGN: Sleep assessment was conducted for 5 consecutive days and neurobehavioral assessment was conducted in the morning of the third day of measurement in children with ADHD and no breathing problems and control children. SETTING: The neurobehavioral assessment was conducted in the school; sleep was assessed in the home. PARTICIPANTS: 25 controls and 24 boys diagnosed with ADHD between 7 and 11 years of age. MEASUREMENTS: Sleep was monitored using actigraphy for 5 consecutive nights. A computerized neurobehavioral evaluation system was used to assess children's neurobehavioral functioning. RESULTS: Canonical correlation analyses revealed different patterns of associations between sleep and neurobehavioral functioning for the 2 groups. Significant relationships were found between measures of sleep and performance on complicated neurobehavioral tasks in the control group but not in the ADHD group. In addition, children with ADHD had increased instability of sleep parameters compared to the controls. CONCLUSIONS: The findings highlighted the distinct nature of associations between sleep and neurobehavioral functioning in boys with ADHD children and no reported breathing problems compared to controls. Despite the similarity between symptoms caused by sleep fragmentation and symptoms of ADHD, these appear to be different clinical conditions. The source of inattentiveness in children should be identified for best planning of clinical intervention.

Attention Deficit Disorder with Hyperactivity↗

PubMed2004

Balance dysfunction in childhood anxiety: findings and theoretical approach.

A recent special issue of the Journal of Anxiety Disorders, reviewed the experimental and clinical findings related to comorbidity of balance disorders and anxiety [J. Anxiety Disord. 15 (2001) 1.]. The studies mentioned in that issue were based mostly on adult subjects but prevalence of balance disorders in childhood anxiety is yet to be established. We have tested a small sample of children diagnosed for general or separation anxiety disorder and a control group of normal children. Extensive neurological examination revealed no clinically relevant vestibular impairment. Nevertheless, detailed questionnaires and balance tests confirmed an excessive sensitivity of anxiety disordered children to balance-challenging situations. Moreover, balance-challenging tasks triggered more balance mistakes and slower performance in anxiety versus control children. These findings support the notion of subclinical balance disorder in childhood anxiety. Results are discussed in terms of the two-stage theory of learning, which predicts that anxiety disorder may be an offshoot of lasting balance dysfunction.

Anxiety↗

PubMed2004

Effects of stress on sleep: the moderating role of coping style.

The aim of this prospective quasi-experimental study was to assess the role of coping style as a factor moderating the relationship between stress and sleep. Sleep of 36 students was assessed by means of actigraphy and daily logs during low-stress and high-stress periods. The high-stress period was the week that the students were evaluated for acceptance to graduate programs in clinical psychology. The low-stress period was a regular academic week. The students' ways of coping were assessed during the baseline low-stress period using the COPE inventory. Data analysis revealed that a high emotion-focused coping score was significantly predictive of reduction in sleep time from the low- to the high-stress period. These results suggest that coping style is a key factor in assessing the relationship between stress and sleep.

Adaptation, Psychological↗

PubMed2004

A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample.

OBJECTIVE: To develop and validate (using subjective and objective methods) a brief infant sleep questionnaire (BISQ) that would be appropriate for screening in pediatric settings. DESIGN: Two studies were performed to assess the properties of the BISQ. Study I compared BISQ measures with sleep diary measures and objective actigraphic sleep measures for clinical (N = 43) and control (N = 57) groups of infants (5-29 months of age). The second study was based on an Internet survey of 1028 respondents who completed the BISQ posted on an infant sleep web site. RESULTS: In study I, BISQ measures were found to be correlated significantly with sleep measures derived from actigraphy and sleep diaries. BISQ measures (number of night wakings and nocturnal sleep duration) were the best predictors for distinguishing between clinical and control samples. High test-retest correlations (r >.82) were demonstrated for BISQ measures for a subsample of 26 infants. Study II provided a developmental perspective on BISQ measures. The study demonstrated that BISQ measures derived from a large Internet survey provided developmental and sleep ecology-related findings that corresponded to the existing literature findings on sleep patterns in early childhood. CONCLUSIONS: The findings provide psychometric, clinical, and ecologic support for the use of the BISQ as a brief infant sleep screening tool for clinical and research purposes. Potential clinical cutoff scores are provided.

Child, Preschool↗

PubMed2002

Sleep-wake patterns in preterm infants and 6 month's home environment: implications for early cognitive development.

AIMS: This study examined the relationship between early organization of sleep-wake states and developmental outcome at 6-month-old premature infants. STUDY DESIGN: This was a prospective randomized study that evaluated the sleep-wake states of healthy premature infants in the nursery environment for two successive 72-h periods, at 32 and 36 weeks gestational age. SUBJECTS: Thirty-four healthy premature infants. OUTCOME MEASURES: Three sleep-wake parameters: percent of quiet sleep, activity level and total amount of sleep, were studied with miniature activity monitors attached to the infant's ankles. The rearing environments of the infants were also assessed at 6 months of age, using the HOME Inventory. Finally, child developmental status was recorded by means of the Mental Development Index (MDI) of the Bayley Scales for Infant Development, at a chronological age of 6 months. RESULTS: Lower total time spent in night sleep, higher mean level of night activity level, and a later rich home environment were all predictive of higher Bayley scores (MDI) at a chronological age of 6 months. Regression analysis indicated that early biological maturity was more strongly related to the child's developmental status than later home environment, although both contributed to the prediction. CONCLUSIONS: These results suggest that biological factors may be significant predictors early in development, whereas the impact of environmental influences increases with development.

Child Development↗

PubMed2002

The role of actigraphy in sleep medicine.

During the last decade actigraphy (activity-based monitoring) has become an essential tool in sleep research and sleep medicine. The validity, reliability and limitations of actigraphy for documenting sleep-wake patterns have been addressed. Normative data on sleep-wake patterns across development have been collected. Multiple studies have documented the adequacy of actigraphy to distinguish between clinical groups and to identify certain sleep-wake disorders. Actigraphy has also been shown to be effective in documenting the effects of various behavioral and medical interventions on sleep-wake patterns. Actigraphy is less useful for documenting sleep-wake in individuals who have long motionless periods of wakefulness (e.g. insomnia patients) or who have disorders that involve altered motility patterns (e.g. sleep apnea). Potential users should be aware of a number of pitfalls of actigraphy: (1) validity has not been established for all scoring algorithms or devices, or for all clinical groups; (2) actigraphy is not sufficient for diagnosis of sleep disorders in individuals with motor disorders or high motility during sleep; (3) the use of computer scoring algorithms without controlling for potential artifacts can lead to inaccurate and misleading results.

Humans↗

PubMed2002

Young Israelis' reactions to the Rabin assassination: two perspectives.

The study analyzed the responses of 713 Israeli adolescents, aged 12-17, to 3 open questions regarding their behavior following Rabin's assassination. Participants' explanations for their own behavior and for the youth's behavior as a whole were analyzed and compared. Adolescents responded mainly with pain and authentic grief. Because explanations were elicited from two different perspectives, results of the comparison were discussed with reference to the actor--observer hypothesis (E. E. Jones & R. E. Nisbett, 1972). Participants' responses were also analyzed as a function of gender, age and political stance. Girls, older children, and supporters of Rabin's peace policy expressed their grief more strongly.

Adolescent↗

PubMed2002

Sleep-wake patterns in children with intrauterine growth retardation.

The purpose of this study was to characterize the sleep patterns of children with intrauterine growth retardation, known to be at risk for neurodevelopmental disorders, and seek a possible correlation with behavior, concentration, and attention problems. The sleep patterns of 26 children with intrauterine growth retardation aged 4 to 7 years were compared with those of 47 control children using activity monitors (actigraphs). In addition, data were collected from the parents regarding sleep habits, behavior, concentration, and attention. Children with intrauterine growth retardation aged 4 to 7 years were found to have a tendency toward poorer quality of sleep than their matched controls. This inclination was statistically significant only for one sleep measure, the true sleep time. A tendency toward increased fragmentation of sleep, prolonged waking, and decreased sleep efficiency, although not statistically significant in this study, was demonstrated. Our results showed that 58% of the children with intrauterine growth retardation, compared with 40% of the children in the control group, could be defined as "poor sleepers" (sleep efficiency lower than 90% or three or more waking episodes per night). This disturbed sleep profile is probably an integral part of the neurodevelopmental profile typical of these at-risk children. No significant correlations were found between sleep quality and behavior, concentration, and attention problems.

Attention Deficit Disorder with Hyperactivity↗

PubMedDate not supplied

Sleep, neurobehavioral functioning, and behavior problems in school-age children.

The aim of this study was to examine the associations between sleep and neurobehavioral functioning (NBF) in school-age children. These variables were assessed for 135 unreferred, healthy school children (69 boys and 66 girls), from second-, fourth-, and sixth-grade classes. Objective assessment methods were used on the participants in their regular home settings. Sleep was monitored using actigraphy for 5 consecutive nights; and NBF was assessed using a computerized neurobehavioral evaluation system, administered twice, at different times of the day. Significant correlations between sleep-quality measures and NBF measures were found, particularly in the younger age group. Children with fragmented sleep were characterized by lower performance on NBF measures, particularly those associated with more complex tasks such as a continuous performance test and a symbol-digit substitution test. These children also had higher rates of behavior problems as reported by their parents on the Child Behavior Checklist. These results highlight the association between sleep quality, NBF, and behavior regulation in child development; and raise important questions about the origins of these associations and their developmental and clinical significance.

Attention↗

PubMedDate not supplied

The effects of sleep restriction and extension on school-age children: what a difference an hour makes.

This study assessed the effects of modest sleep restriction and extension on children's neurobehavioral functioning (NBF). The sleep of 77 children (age: M = 10.6 years; range = 9.1-12.2 years) was monitored for 5 nights with activity monitors. These children (39 boys and 38 girls) were all attending regular 4th- and 6th-grade classes. Their NBF was assessed using computerized tests on the 2nd day of their normal sleep schedule. On the 3rd evening, the children were asked to extend or restrict their sleep by an hour on the following 3 nights. Their NBF was reassessed on the 6th day following the experimental sleep manipulation. Sleep restriction led to improved sleep quality and to reduced reported alertness. The sleep manipulation led to significant differential effects on NBF measures. These effects may have significant developmental and clinical implications.

Child↗