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Biomedical subjects

Daniel S Lewin

Publications and source records attributed to Daniel S Lewin.

6 recordsLinked to original sources
PubMed2006

Preliminary evidence for sleep complaints among children referred for anxiety.

BACKGROUND AND PURPOSE: Clinical observation suggests that sleep complaints are common among youth with anxiety disorders though empirical data documenting this co-occurrence of symptoms are generally unavailable. PATIENTS AND METHODS: Based on retrospective chart reviews, the current study examined rates of several types of parent-reported sleep complaints among a sample of (n=35) purely anxious children and adolescents (ANX). Sleep complaints were examined in terms of age (children versus adolescents) and type of anxiety diagnosis (generalized anxiety versus other anxious diagnoses). Rates of sleep complaints among anxious youth also were compared to those among (n=38) healthy control children and (n=33) children referred for sleep problems. RESULTS: The presence of at least one intermittent sleep complaint was reported by 83% of parents of ANX, with almost half reporting at least one frequent sleep complaint. Rates of sleep complaints among anxious children versus adolescents were similar. Children with generalized anxiety disorder (GAD) had a significantly greater number of sleep complaints than children with other types of anxiety disorders, though rates for specific items varied. Although parents of sleep-referred children reported the highest rates of sleep complaints overall, the frequency of several specific types of sleep complaints was highly similar among ANX and sleep-referred children. CONCLUSIONS: Findings indicate that certain sleep complaints are common among ANX. The need for appropriate assessment practices is discussed.

Adolescent↗
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↗
PubMed2003

Measuring mood and complex behavior in natural environments: use of ecological momentary assessment in pediatric affective disorders.

This article describes the theoretical background and methodology of ecological momentary assessment (EMA) and reports results from a pilot study using EMA techniques in 16 children and adolescents with affective disorders and 5 subjects who were healthy and at low risk to develop future affective disorders. Multiple daily assessments of the subjects' mood, thoughts, and behaviors were performed in their natural environments using brief interviews on cellular phone calls by the study staff and by wrist actigraphy. The pilot results demonstrated that the EMA methodology is feasible in this population, as 17 of 21 subjects were able to complete the entire 8-week protocol. The potential usefulness of the EMA methodology is illustrated by specific case reports. Potential applications of the EMA methodology to the study of neurobehavioral systems and the pathophysiology of pediatric affective disorders are discussed.

Adolescent↗
PubMed2002

Pathways to adolescent health sleep regulation and behavior.

There are several converging reasons to focus on sleep regulation in relation to healthy adolescent development: (a) Sleep appears to be particularly important during periods of brain maturation; (b) there are substantial biological and psychosocial changes in sleep and circadian regulation exist across pubertal development; (c) interactions between physical and psychosocial domains can lead to dramatic alterations in sleep patterns and habits during adolescence; (d) increasing evidence that many adolescents frequently obtain insufficient sleep exists; (e) there is mounting evidence that sleep deprivation has its greatest negative effects on the control of behavior, emotion, and attention, a regulatory interface that is critical in the development of social and academic competence, and psychiatric disorders; (f) the most obvious direct health consequences of insufficient sleep are high-risk behaviors associated with substance abuse and automobile accidents; (g) substantial evidence for bidirectional effects between sleep and behavioral/emotional regulation exists. Although the past decade has seen research progress in these areas, there continue to be major gaps in existing knowledge and a paucity of well-controlled studies to guide specific health policy decisions and recommendations regarding sleep in adolescence. In particular, there is need for improved understanding of the acute and chronic effects of inadequate sleep in adolescents, guidelines for defining adequate sleep in adolescents, and a better delineation of the links among sleep, behavior, and affect regulation. Finally, this paper briefly examines one specific application of this knowledge area regarding early starting times among some high schools.

Adolescent↗
PubMed2002

Preliminary evidence of behavioral and cognitive sequelae of obstructive sleep apnea in children.

OBJECTIVES: To characterize the daytime sequelae of obstructive sleep apnea (OSA) in children. BACKGROUND: OSA syndrome is a common disorder in children with estimates of prevalence ranging from 1.1 to 2.9%. Numerous studies have documented neuropsychological deficits in adults with OSA, although only a few preliminary studies have described these problems in children with OSA. METHODS: In the present study, otherwise healthy children with OSA (n=28), and a healthy age-matched comparison group (n=10) were assessed with standard measures of sleep, behavior, and cognitive function. RESULTS: Children with OSA had significantly more behavior problems than the healthy comparison group based on parents' reports (F=7.29, P<0.005). Children diagnosed with moderate to severe OSA had significantly lower scores on a timed cancellation task that assesses sustained attention (F=10.0, P<0.01). A significant association was found between OSA severity (rho=-86, P<0.01) and measures of verbal ability. CONCLUSIONS: These initial findings suggest that there are identifiable daytime sequelae of childhood OSA and that it is important to evaluate these daytime disturbances in making determinations about intervention.

Journal Article↗