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Biomedical subjects

C Acebo

Publications and source records attributed to C Acebo.

17 recordsLinked to original sources
PubMed1998

Parental report of sleep problems in children with attentional and learning disorders.

This study examined whether parents of children diagnosed with neurodevelopmental disorders (n = 79) report greater sleep-related problems in their offspring than do parents of normal community-based children (n = 86) on a research questionnaire developed to assess sleep and breathing problems, sleepiness, and behavioral problems. Clinical subgroups included: attention deficit/hyperactivity disorder (ADHD) (n = 43), learning disabilities (LD) (n = 11), and combined ADHD/LD (n = 25). Analyses revealed that parents of children with neurodevelopmental disorders report greater problems along all three dimensions than parents of normal control children. Sleep-related difficulties were reported at the same frequency across all three clinical subgroups. No significant difference between clinical and control groups was noted, however, in the reported length of sleep on weeknights. These preliminary findings suggest that sleep-related problems need to be routinely reviewed as part of the clinical evaluation of neurodevelopmental problems, because they may contribute to and/or exacerbate the behavioral manifestation of these disorders.

Analysis of Variance↗
PubMed1997

Effects of menopause and nasal occlusion on breathing during sleep.

Prevalence of sleep-disordered breathing (SDB) is reported to increase in menopausal women. We examined response to a nocturnal respiratory challenge (nasal occlusion) during overnight polysomnography in 31 women (45 to 55 yr). Thirteen were premenopausal, four perimenopausal, and 14 postmenopausal by history and hormonal assay. Nasal occlusion increased the apnea hypopnea index (AHI) (occlusion mean = 6.6 +/- 8.0 versus baseline mean = 1.6 +/- 2.6, p < 0.01) and arousal index (occlusion mean = 35.1 +/- 20.1 versus baseline mean = 20.7 +/- 11.6, p < 0.001), but did not change the oxygen saturation nadir in those with respiratory events (occlusion mean = 91.8 +/- 4.2 versus baseline mean = 92.0 +/- 11.6). Menopausal groups did not differ on AHI, arousal index, or oxygen saturation nadir in either condition. Key variables were compared between occlusion responders (n = 11) and nonresponders (n = 20). Responders and nonresponders were not distinguished by age, menopausal status, nor several cephalometric or anthropometric variables. Body mass index (31.1 +/- 8.5 versus 24.3 +/- 3.4, p < 0.003), neck circumference (34.0 +/- 2.5 versus 32.5 +/- 1.7 cm, p < 0.05), and mandibular-hyoid distance (18.5 +/- 3.8 versus 14.5 +/- 5.7 mm, p < 0.05) were greater in responders. These findings suggest hormonal factors may be less important than weight and facial morphology in midlife development of SDB in women.

Anthropometry↗
PubMed1997

An approach to studying circadian rhythms of adolescent humans.

The "long nights" protocol was designed to evaluate sleep processes and circadian rhythm parameters in young humans. A total of 19 children (10 boys, ages 11.2 to 14.1 years [mean = 12.7 +/- 1.0], and 9 girls, ages 12.2 to 14.4 years [mean = 13.1 +/- 0.7]) took part in the study. Sleep/wake initially was assessed at home using actigraphy and diary for 1 week on each child's self-selected schedule followed by an 8-night fixed light-dark (LD) condition, while sleeping from 22:00 to 08:00 h and wearing an eye mask to exclude as much light as possible. Phase measurements included 4-night mean actigraphically estimated sleep onset and offset as well as 1-night dim light salivary melatonin onset (DLSMO) phase at the end of each condition. Subjects then lived in the laboratory for 6 consecutive cycles: Day 1 LD = 14:10 h, lights out 22:00 to 08:00 h; Days 2-4 LD = 6:18 h, lights out 18:00 to 12:00 h; Days 5-6 = constant routine in continuous dim light (about 20 lux); Night 6 = 14 h recovery sleep. Phase markers (sleep onset, sleep offset, DLSMO) were significantly less dispersed after the fixed LD as compared to the self-selected condition, indicating efficacy of the LD protocol. Phase markers were correlated at the self-selected assessment (sleep onset vs. sleep offset r = .72; DLSMO vs. sleep onset r = .82; DLSMO vs. sleep offset r = .76) but not on the fixed schedule, probably due to restricted range. The constant routine provided additional phase markers, melatonin offset and midphase. Offset phase of melatonin secretion was significantly correlated with age (r = .62) and Tanner stage (r = .62). In conclusion, these preliminary data indicate a relationship between adolescent development and circadian phase. Thus, the long nights protocol is a feasible way in which to assess circadian parameters in young humans as well as to examine intrinsic sleep processes.

Adolescent↗
PubMed1996

The effects of regularizing sleep-wake schedules on daytime sleepiness.

The present study evaluated the differential effects of two manipulations of sleep-wake schedules on daily subjective ratings of daytime sleepiness of college undergraduate students. Two experimental conditions were compared: a sleep only group and a regularity group. Subjects in both conditions were given a lower limit for total sleep time (7.5 hours). Subjects in the regularity group received an additional instruction to keep a regular sleep schedule. The study was longitudinal and prospective. Following a baseline period (12 days), the experimental conditions were introduced. The experimental phase lasted 4 weeks and overall compliance was good. A follow-up phase (1 week) began 5 weeks past termination of the experimental phase. The findings indicated that when nocturnal sleep is not deprived, regularization of sleep-wake schedules is associated with reduced reported sleepiness. Subjects in the regular schedule condition reported greater and longer lasting improvements in alertness compared with subjects in the sleep only condition and reported improved sleep efficiency.

Adolescent↗
PubMed1996

Sleep, breathing, and cephalometrics in older children and young adults. Part I -- Normative values.

STUDY OBJECTIVES: Aims were (1) to provide normative values for sleep and sleep-related breathing variables and physical features (cephalometrics, body mass index [BMI], and tonsillar size) in older children/adolescents and young adults, (2) to describe sex and age group differences, and (3) to evaluate relationships between physical features and sleep-related breathing variables. DESIGN: Standard polysomnographic variables describing sleep and breathing were measured during a single night. Cephalometric measures were obtained from a standing lateral skull radiograph. SUBJECTS: Normal, healthy boys (n=23; mean age=13.3+/-2.1 years), girls (n=22; mean age =13.8+/-1.8 years), men (n=23; mean age=22.2+/-1.5 years), and women (n=24; mean age=22.4+/-1.8 years) with BMI less than 27 were evaluated. RESULTS: Sleep variables showed age group and sex differences consistent with published norms. Slow-wave sleep and rapid eye movement (REM) latency declined with age; transient arousals increased with age. Sleep-related breathing variables showed few changes related to age group or sex; small but statistically significant sex differences were found for arterial oxygen saturation nadir (lower in male subjects) and respiration disturbance index in non-REM sleep (greater in male subjects). Differences in cephalometric measures largely reflected normal growth and expected sex differences. No significant relationships between sleep-related breathing variables and physical findings were observed. CONCLUSIONS: These data provide well-controlled normative values for sleep, breathing, and cephalometrics in a group of normal older children, adolescents, and young adults. The data provide useful reference points for patients of these ages in whom sleep apnea is suspected, particularly since such clinical studies are normally based on first-night polysomnography. Furthermore, these values represent developmentally appropriate grouping of the data.

Adolescent↗
PubMed1996

Sleep, breathing, and cephalometrics in older children and young adults. Part II -- Response to nasal occlusion.

STUDY OBJECTIVES: We postulated that nasal occlusion would provide a challenge enabling us to assess factors predisposing development of sleep apnea in older children/adolescents and young adults. Factors of interest included sex, age, body mass index (BMI), tonsillar hypertrophy, and cephalometric measurements. DESIGN: Sleep and breathing variables were examined and compared for four groups of subjects between one baseline night and one night of nasal occlusion in a sleep research laboratory. SUBJECTS: Healthy, normal boys (n=23, mean age=13.3+/-2.1 years), girls (n=22, mean age=13.8+/-1.8 years), men (n=23, mean age=22.2+/-1.5 years), and women (n=24, mean age=22.4+/-1.8 years) were studied. MEASUREMENTS AND RESULTS: The following sleep and sleep-related breathing measures showed significant increases in all four groups from baseline to occlusion: percentage of stage 1, number of transient arousals, transient arousal index, apnea index, respiratory disturbance index (RDI), and mean apnea length. No significant relationships were found between occlusion-night RDI and tonsillar size, cephalometric variables, or BMI, either singly or in combination. CONCLUSIONS: Subjects' responses to nasal occlusion varied: most demonstrated a minimal and clinically insignificant increase in RDI; few showed a marked increase in RDI. Significant increases of sleep fragmentation -- even in the absence of frankly disturbed breathing -- indicate that nasal occlusion may secondarily affect waking function if prolonged over a series of nights.

Adolescent↗
PubMed1995

Role of infant crying in the early mother-infant dialogue.

This study examines the communicative role of crying by assessing the ability of infants to indicate different degrees of distress in different social circumstances. Behaviors of mother-infant pairs were observed in the home for 7-h periods when the infants were 2, 3, 4, and 5 wk old; and three weekly observations were made when the infants were 1 yr old. A Cry Responsiveness Index (CRI) was derived to quantify the degree to which a baby cried differentially during each observation. This statistic showed significant individual differences. The CRI scores were correlated with maternal measures during the early weeks and negatively correlated with "mother ignore" at one year. The CRI scores were unrelated to the total amount of crying. The results indicate that responsive infants have responsive mothers--or conversely, that responsive mothers have responsive infants. Thus, cry responsiveness is not a function of infant behavior alone but is inherently an expression of the dynamics of the mother-infant interactional system.

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↗
PubMed1993

A self-administered rating scale for pubertal development.

The purpose of this study was to assess the reliability and validity of a new self-rating scale to measure children's pubertal status without pictorial representations or interviews. The scale is an adaptation of an interview-based puberty-rating scale by Petersen, and included scores for each of five items rating physical development, an overall maturation measure, and a categorical maturation score designed to be similar to Tanner staging categories. Each measure was obtained from independent ratings by students and parents, and a 3-point categorical scale was also obtained from teachers. Subjects included 698 5th- and 6th-grade students (323 boys and 375 girls) from 61 schools and their parents and teachers. Fifth-grade students rated themselves and were rated by parents as less mature than 6th graders; 6th-grade girls were consistently rated more mature than boys of the same age. Significant correlations were found between parents and students for all of the measures for 6th-graders and 5th-grade girls and several measures for 5th-grade boys. This new scale is a useful tool for assessing pubertal status in settings that require noninvasive measures.

Adolescent↗
PubMed1993

Association between puberty and delayed phase preference.

Many teenagers go to bed and wake up significantly later than younger children, a developmental progression thought to reflect adolescent psychosocial processes. To determine whether biological processes may underlie a delay of phase preference in adolescents, 183 sixth-grade boys and 275 sixth-grade girls completed questionnaires for morningness/eveningness (M/E) and pubertal status. School environment and birth order were also evaluated. A significant relationship of pubertal status to M/E was found in girls, with a similar though nonsignificant trend in boys. No relationship between M/E and psychosocial factors was found. These data support involvement of a biological factor in the adolescent phase preference delay and indicate that our current understanding of adolescent sleep patterns may need revision.

Adolescent↗
PubMed1993

Stability and instability of sleep in older persons recorded in the home.

Using a nonintrusive procedure for sleep monitoring, four 24-hour recordings of 40 independently living women, 65-94 years, were made during a 3-month period. Although the subjects distributed their sleep over much of the day, all measures showed significant reliability: with four recordings, reliabilities (r44 values) were > 0.70; and with only one recording, reliabilities (r11) were > 0.40 [r11 for the respiratory disturbance index (RDI) was lower but still significant]. Within-individual variability over recordings was low for total sleep time (TST), sleep (S), and sleep efficiency (SE) and high for sleep latency (SL) and RDI. The mean TST was 7.6 hours, which is not markedly different from that of younger adults. Within the age range studied, there was no relationship between age and any of the variables, including the amount of within-individual variability. These results, using the Home Monitoring System (HMS), indicate that both stability and instability of sleep parameters characterize the sleep of older women. The nature of specific forms of individual variability needs to be explored as possible indices of aging as distinct from indications of neurobiological abnormalities.

Age Factors↗
PubMed1993

Parental reports of seasonal mood and behavior changes in children.

OBJECTIVE: The chief purpose of this study was to investigate the nature and prevalence of children's seasonal symptoms. METHOD: Parental reports of seasonal changes in six mood or behavioral symptoms (sleeping, eating, irritability, energy, withdrawal, and sadness) were surveyed for children living across the United States. The sample included 892 girls (mean age = 10.5 +/- 1.0 years) and 788 boys (mean age = 10.6 +/- 0.9 years), with a response rate of 46% for girls' parents and 39% for boys' parents. RESULTS: At least one winter recurring symptom was reported in 48.5% of children, as compared with 9.1% in fall and 10.8% in spring. Winter symptoms were reported equally in girls and boys with one exception ("is tired"); age effects were found for three symptoms only in girls ("sleep more," "is tired," and "withdraws"). Regional effects showed more winter symptoms reports in northern zones than in southern zones. CONCLUSIONS: Given the potential therapeutic benefit of light therapy in children with such seasonal patterns, careful assessment of seasonality is merited for children with winter mood and behavior problems.

Age Factors↗
PubMed1991

Sleep and apnea in the elderly: reliability and validity of 24-hour recordings in the home.

Two studies investigated the reliability and validity of measures of sleep and apnea using the home sleep monitoring system (HMS), which requires no instrumentation of the subject. From a pressure-sensitive pad on the subject's bed, signals from respiration and motility are recorded. These are scored for sleep and the occurrence of apneas, and the following measures are obtained: time in bed, total sleep time, number of awakenings from sleep, waking after sleep onset, sleep efficiency, and number of apneas. Overnight recordings of 14 adults were made concurrently with polysomnographic recordings in the New Haven Sleep Disorders Center. Significant agreement was found for each sleep measure and the apnea index. Four weekly 24-h recordings were made of eight elderly women, aged 62 to 90, in the home. There were significant individual differences and measurement reliability for each sleep measure and number of apneas. Some of the elderly showed highly episodic sleep patterns; and three of them showed high and variable apneas over the four weeks. These studies indicate the potential of the HMS for characterizing sleep in the elderly from nonintrusive, naturalistic observations in the home.

Adult↗
PubMed1991

Premature infants seek rhythmic stimulation, and the experience facilitates neurobehavioral development.

This was a clinical trials study of self-regulation of rhythmic stimulation in preterm infants. Infants were enrolled in three regional hospitals and followed in four outlying hospitals. Forty-five premature infants, 22 males and 23 females, enrolled at 29-33 weeks conceptional age (CA) received in the isolette either a "breathing" teddy bear (set to breathe at one-half the infant's quiet sleep respiration rate) or a nonbreathing bear. Using time-lapse videorecording at a 60:1 ratio, subjects were recorded for 3 days at the beginning of the Intervention period and again for 3 days, 2 weeks later. After discharge from the hospital, the sleep of the subjects was monitored in the home for a 24-hour period on weeks 1, 2, 3, 4, and 5 after expected date of birth (postterm). Infants with a breathing bear spent more time in contact with the bear, and increased their contact over the two weeks. Postterm, the "breathing bear babies" showed more quiet sleep and a greater increase in quiet sleep over weeks. The results indicate that premature infants ("prematures") are capable of organizing their motility to express a preference for rhythmic stimulation, and that the experience facilitates neurobehavioral development.

Acoustic Stimulation↗
PubMed1983

Infant crying and stability in the mother-infant relationship: a systems analysis.

Mother-infant interaction was studied using a general systems theory framework. 20 mother-infant pairs were observed in their home for a 7-hour period when the infants were 2, 3, 4, and 5 weeks of age. A measurement procedure was devised to assess, for each pair, the consistency over weeks in their allocation of time to 4 interactional contexts that make up the day: feeding, changing or bathing, social attention, and baby alone. The measure was called an Interactional Stability Score. Construct validity for this measure was investigated based on our hypothesis that high interactional stability would be strongly linked to low levels of crying during social attention. This hypothesis was confirmed. The results are interpreted within a general systems theory perspective--namely, that this measure of interactional stability is an empirical indicator of the degree of equilibrium within the relationship, at the level of patterning of interactional contexts. High stability scores represent consistency in allocation of time to the 4 contexts over weeks and not a rigidity in sequencing of these contexts, and thus appeared to reflect a dynamic process of mutual constraints on the behaviors of both partners.

Child Development↗