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PubMed1994

Health, sleep, and mood perceptions reported by airline crews flying short and long hauls.

The present study is part of a major questionnaire survey of work environment and health of air crew in the Scandinavian Airline System (SAS) Norway in 1989. The 1240 respondents (response rate 83%) answered 250 questions about health, job-strain, well-being, sleep problems, organization, and communication. The study charts self-reported incidences of health problems focusing on differences between cockpit and cabin crews. The study also evaluates possible effects of transmeridian and short distance flying on health, taking into account gender, job demands, working conditions of the respondents, and aircraft design. Common problems, reported by more than 30%, are dry skin, lower back pain, colds, fatigue, and sleep disturbances. Pilots report least, while female cabin attendants register most problems. Crews flying long distance transmeridian routes report more health problems than short distance personnel. Among pilots, irritability, fatigue, sleep disturbances, and low back pain are the most frequently reported problems. Cabin attendants more often complain of skin and eye disorders, digestive disturbances, and musculoskeletal pains. The study supports earlier findings that transmeridian air travel causes digestive disturbances, fatigue, and sleep disturbances in both cockpit and cabin crews of both genders. Among female cabin attendants, there is a nonsignificant tendency of more menstrual disorders among those flying long hauls.

Aerospace Medicine↗

PubMedDate not supplied

Frequency of snoring and symptoms of sleep apnea among Pakistani medical students.

BACKGROUND: Snoring and its related problem, sleep apnea, are very common. They occur in all ages and both sexes. Frequency varies in different communities therefore studies of other countries are invalid for Pakistan. The aim of this study is to assess the frequency of snoring and emergence of symptoms of sleep apnea among the affluent class young adult Pakistani population. METHODS: Subjects were evaluated through a questionnaire. Questions pertained to quality of sleep, intensity and frequency of snoring and presence of symptoms such as waking up choking, morning headaches and morning dry mouth. Data were collected for age, sex, height and weight. Subjects were also asked if they took alcohol or any drugs. RESULTS: A total of 111 subjects, M:F = 2:3, age range between 18-23 years, responded to the survey. The frequency of snoring was 27% in males and 12% in females, with males admitting to snoring more night in the week than the females. 92% of both males and females graded their snoring as being softer than the sound of talking. 15% of the males and 38% of the females said they snored in every body position. Percentages of male and female snorers exhibiting symptoms of sleep apnea were very similar, with choking arousals at 6% and 5% respectively. CONCLUSION: This study was done on the young Pakistani population for the determination of frequency of snoring and the emergence of symptoms of sleep apnea. The results are similar to studies done on the adult population with snoring more common and louder among the males.

Adolescent↗

PubMed2000

A comparison of sleep profiles in patients with dementia with lewy bodies and Alzheimer's disease.

INTRODUCTION: Sleep disturbances are common in healthy old age and in dementia syndromes. Polysomnography has demonstrated typical changes in both Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) with AD being characterised by sundowning and sleep apnoea and DLB patients showing more disturbances of movement control during sleep. The technical difficulties associated with EEG sleep recordings mean that polysomnography is not possible out of specialist centres. OBJECTIVES: To use questionnaires to assess the frequency of sleep disturbances in patients with Alzheimer's disease and dementia with Lewy bodies. METHOD: The sleep profiles of twenty patients with AD and 17 with DLB were assessed using three questionnaires, one designed to assess night time sleep disturbance, one day time sleepiness and the last carer burden. The sleep questionnaires were repeated in a subgroup after treatment with a cholinesterase inhibitor (rivastigmine). RESULTS: Level of sleep disturbance in both groups was high. DLB patients had more overall sleep disturbance, more movement disorders whilst asleep and more abnormal day time sleepiness. Treatment with rivastigmine produced a trend towards normalisation of sleep profile in a small number of subjects. CONCLUSIONS: Both groups have extensive sleep problems. The DLB and AD groups have different sleep profiles that are of diagnostic importance and may suggest different treatment strategies. The results are consistent with those found from polysomnographic assessment and suggest that the questionnaires used are sensitive to detect differences previously documented with polysomnography.

Aged↗

PubMed2003

Skin picking and sleep disturbances: relationship to anxiety and need for research.

Pathological excoriation (PE) or skin picking is seen in nearly 2% of patients attending dermatology clinics and is often associated with anxiety, stress and frequent help-seeking behaviors. While anxiety and stress are thought to cause poor sleep in the general population, not all anxious people, even those with disabling anxiety disorders, necessarily suffer from insomnia or other sleep problems. The relationship between anxiety symptoms and poor sleep, therefore, remains unclear and sleep quality in PE is unknown. We examined the sleep quality and levels of anxiety in dermatological patients with PE. Dermatological patients with (n = 10) and without (n = 10) PE and healthy controls (n = 10) were assessed on standardized and validated measures of subjective sleep quality [Pittsburgh Sleep Quality Index (PSQI)], anxiety (Spielberger State and Trait Anxiety Inventory; modified Zung Anxiety Scale), stress (Perceived Stress Scale) and work and social disability [Sheehan Disability Inventory subscale (SDI-4)]. Patients with dermatological complaints as a group reported poorer sleep quality, higher scores on Spielberger State and Zung anxiety, perceived stress, and SDI-4. Among both groups of dermatological patients, only the PE group had significantly poor sleep, high anxiety, and perceived stress compared to healthy controls. In the dermatological patients with PE, PSQI-global scores were significantly positively correlated to Spielberger State and Zung Anxiety scores. Dermatological patients with PE are more anxious and have poorer subjective sleep compared to dermatological patients without PE and healthy. Future research is needed to elucidate these relationship factors and to develop new behavioral and drug treatments for the management of PE.

Adult↗

PubMed1990

Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children.

61 snoring children selected for adenotonsillectomy, mainly for recurrent tonsillitis, were compared with a matched group of 31 healthy children for symptoms of sleep apnoea, extent of sleep hypoxaemia, and amount of sleep disturbance. The studies were repeated six months postoperatively, and after six months in the healthy children. Preoperatively, 61% of the children had degrees of sleep hypoxaemia above normal and 65% had abnormally disturbed sleep. A questionnaire administered to the parents about their children showed abnormal patterns of answers about sleep problems daytime sleepiness, hyperactivity, aggression, learning difficulties, restless sleep, and odd sleeping positions. After adenotonsillectomy, the abnormal hypoxaemia, excessive sleep disturbance, and multiple symptoms almost resolved; a growth spurt also occurred.

Adenoidectomy↗

PubMed2000

Gender differences in Parkinson's disease symptom profile.

Gender symptom differences were studied in 948 subjects with Parkinson's disease (PD) using a questionnaire covering the most common symptoms associated with PD at debut (SP-1) and at present (SP-2). The symptoms most frequently reported by both genders were: tremor, fumblingness, writing problems, rigidity and fatigue. At SP-1 females reported neck-pain and low back pain more frequently than males. At SP-2 subjects reported an increased number of symptoms. The following symptoms were more frequent among males than females: writing difficulties, fumblingness, gait problems, speech problems, increased flow of saliva, lack of initiative. Sleep problems were common in both sexes with inability to turn in bed and calf muscle cramps in a high percentage. A majority of female subjects find their symptoms (e.g. depression) constantly distressing. Although depression is not one of primary reported symptoms (36%) attention is called for, due to the problem with compliance to treatment regimes. About 30% do not report having tremor and rigidity. This study indicates the usefulness of a symptom profile instrument capable of capturing the many symptoms involved in PD. Such an instrument could be used to detect apparent mistakes in medication and thereby increase the function and quality of life for the individual.

Aged↗

PubMed2003

Patients' views on follow up of colorectal cancer: implications for risk communication and decision making.

BACKGROUND: Medical views about the clinical value and potential detrimental effect on quality of life of postoperative follow up are divided. There is no literature on the views of British patients with colorectal cancer towards the follow up process. AIM: To investigate patients' views and experiences of follow up of colorectal cancer, and to assess their attitudes towards suggested changes to follow up policy. PATIENTS AND METHODS: A total of 156 asymptomatic and disease-free patients with colorectal cancer were identified from the follow up clinic. Recurrence-free status was confirmed through retrieval of computerised clinic letters. A postal survey using a 39 item piloted questionnaire was undertaken. Data analysis generated descriptive statistics and logistic regression models. RESULTS: A response rate of 61% (95) was obtained. Among these respondents, 63% (60) had undergone initial surgery within three years of the time of the survey, and 86% (82) patients expected a further follow up appointment. Majorities of the sample, ranging from 71% (67) to 96% (91), expressed satisfaction with respect to clinic delays, staff conduct and knowledge about their case, consultation time, and being able to discuss personal problems freely. However some patients reported difficulty in discussing sexual problems at the clinic. Appointment imminence caused anxiety, sleep problems, and decreased appetite in 35% (35), 27% (26), and 8 % (8) of patients respectively. However, 78% (74) patients felt reassured and optimistic for the future after receiving results. Such optimism is not necessarily justified in terms of estimated mortality risks. A majority (78%, 66) stated that they would value finding out about the presence of recurrence even if there would be no survival benefit. Nearly half of the sample (48%, 43) felt that they would disagree with the cessation of follow up in any circumstances. Only 47% (42) and 27% (24) indicated that they would accept follow up by a specialist nurse or their general practitioner, respectively. Attitude to follow up was unrelated to reported anxiety before appointments. Only 22% (19) of the sample could identify risk indicators for recurrence, but 64% (61) agreed that they would like to be told what to look for. DISCUSSION: A sample of patients with colorectal cancer expressed a high degree of satisfaction with hospital follow up. Although a substantial minority reported suffering from pre-visit anxiety, most felt that this disadvantage was compensated for by reassuring results, and believed that investigations did not have a significant negative impact on their quality of life. Respondents valued hospital follow up, and half would reject complete discharge or alternative forms of follow up. These findings demonstrate that patients have a different perception of the risk of recurrence than clinicians who would consider the survival prospects for most patients to be more or less unaffected by follow up interventions. Attempted modifications to follow up policies should be introduced with caution, and should take account of patient understanding of medical reasoning. The findings also raise questions about risk communication with patients.

Attitude to Health↗

PubMed2001

Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial.

To establish the efficacy of melatonin treatment in childhood sleep onset insomnia, 40 elementary school children, 6 to 12 years of age, who suffered more than 1 year from chronic sleep onset insomnia, were studied in a double-blind, placebo-controlled study. The children were randomly assigned to receive either 5-mg melatonin or placebo. The study consisted of a 1-week baseline, consecutively followed by a 4-week treatment period. After that period, treatment was continued if the parents wished so. The study's impact was assessed by measurements of lights-off time, sleep onset, and wake-up time, recorded in a diary (n = 33). Sleep onset was also recorded with an actigraph (n = 25). Endogenous dim light melatonin onset was measured in saliva (n = 27). Sustained attention was evaluated with the Bourdon-Vos reaction time test (n = 36). In the melatonin group, mean (95% CI) lights-off time advanced 34 (6-63) minutes, diary sleep onset 63 (32-94) minutes, actigraphic sleep onset 75 (36-114) minutes, and melatonin onset 57 (24 to 89) minutes; total sleep time increased 41 (19-62) minutes. In the placebo group, these parameters did not shift significantly. The change during the 4-week treatment period differed between the treatment groups significantly as to lights-off time, diary and actigraphic sleep onset, sleep duration, and melatonin onset. There were no significant differences between the treatment groups in the change of sleep latency, wake-up time, and sustained attention reaction times. Mild headache occurred in 2 children during the first 2 days of the melatonin treatment. Eighteen months after the start of the trial, in 13 of the 38 children who could be followed up, melatonin treatment was stopped because their sleep problem was solved and in 1 child because sleep was not improved. Twelve children used melatonin 5 mg, the other 1.0 to 2.5 mg. One child developed mild generalized epilepsy 4 months after the start of the trial. The results show that melatonin, 5 mg at 6 PM, was relatively safe to take in the short term and significantly more effective than placebo in advancing sleep onset and dim light melatonin onset and increasing sleep duration in elementary school children with chronic sleep onset insomnia. Sustained attention was not affected.

Child↗

PubMed2002

Children, sleep, and behavior: a complex association.

Pediatric sleep physiology begins with development of the sleep/wake cycle, and the origins of active versus quiet sleep. The 24-hour circadian cycle becomes established at 3-6 months. Sleep disorders during infancy commonly include mild, usually self-limited conditions such as sleep-onset association disorder, excessive nighttime feedings, and poor limit-setting. These require behavioral management to avoid long-term deleterious sleep habits. In contrast, other sleep disorders are more ominous, including SIDS, central congenital hypoventilation syndrome, and sleep apnea. Childhood is generally considered the golden age of sleep, with brief latency to sleep onset, high efficiency, and easy awakening. Yet parasomnias, psychological factors, and sleep disturbances associated with common disorders such as ADHD disrupt the idealistic notion of childhood being a period of unfettered sleep. Adolescents have sleep requirements similar to adults, posing a challenge for them to adapt to school schedules and increasingly demanding lifestyles. Narcolepsy, usually diagnosed in adolescence or early adulthood, is a lifelong sleep disorder and has led to the identification of the hypocretin/orexin neurotransmitter system. Research advances in the complex interrelationships between developmental neurobiology, sleep disorders and behavior will lead to an enhanced understanding of the pathophysiology of sleep problems and lead to novel therapeutic strategies for sleep disturbances in children.

Adolescent↗

PubMed2002

Health and social circumstances of women admitted to a private mother baby unit. A descriptive cohort study.

BACKGROUND: The health and social circumstances of economically advantaged mothers who are caring for infants with unsettled behaviour or feeding difficulties has been under investigated. METHODOLOGY: An observational survey of consecutive admissions to one private hospital's mother baby unit in Melbourne admitted with infant feeding or sleeping problems. RESULTS: Of 146 eligible participants, 109 (75%) completed the questionnaire. All had partners and previous employment in the professional/managerial sector. There were low rates of previous psychiatric illness, family history of psychiatric illness, childhood sexual abuse or current domestic violence, despite which most felt currently unwell. They had experienced high rates of reproductive difficulties, (6.5% IVF conception, 25% invasive prenatal testing, 26% antenatal admission, and 53% operative delivery). Many (52%) perceived their postnatal obstetric care as unsatisfactory. Breastfeeding problems were common (29% had experienced mastitis). Severe sleep deprivation associated with frequent infant night time waking was universal. Partner's working hours greatly exceeded the community average and many women felt under supported and unable to confide in their partners. More than half reported serious, coincidental life events. CONCLUSION: Some economically advantaged mothers experience such significant postpartum ill health they seek hospital admission.

Adult↗

PubMed1991

Polysomnography and sleep disorder centers.

Sleep disorders are common in our society. It is estimated that there are 50 million people in the United States who suffer to varying degrees from sleep problems. A great deal has been learned about sleep during the past 40 years. Much of this knowledge has been obtained by the use of PSG, which consists of the simultaneous recording of several physiologic parameters from a patient just prior to and during sleep. Much of the technology utilized in PSG are based on individual tests developed many years ago. Current published data permit the conclusion that PSG is useful for the diagnostic evaluation of patients with sleep-related breathing disorders, may be helpful in the evaluation of suspected cases of narcolepsy wherein other findings are inconclusive or contradictory, and may be helpful in cases of parasomnias and/or suspected epilepsy wherein the distinction between seizure activity and other forms of sleep disturbance is uncertain. Current data do not permit a firm conclusion as to the clinical effectiveness of PSG in other symptoms of sleep disturbance such as insomnia. Current, ongoing clinical trials are expected to provide information addressing this point, and several agencies (NINDS, ADAMHA, and NIA) have expressed their intent to encourage the organization of prospective trials to determine the ultimate clinical utility of SDC and PSG techniques. A physician need not be present during PSG in an SDC.

Evaluation Studies as Topic↗

PubMed1985

Differentiation of back pain patients using a pain questionnaire.

A specially designed pain questionnaire was administered to 52 consecutive out-patients referred to an orthopaedic clinic of a general hospital over a two week period because of pain in the lower back. A clinical evaluation, based on the patients' markings on 'pain drawings', and on the degree of compatibility between their reported pain symptoms and the results of physical examinations, led to the classification of 21 cases (40%) as psychogenic. The answers of these patients to the questionnaire differed in several aspects from those of the remaining 60%. Pain was more severe, multiform and enduring, and had a more pervasive influence on their life situation; they included a higher frequency of family problems, changes of employment, stress experienced at work, sleeping problems, and 'specialist shopping'. Without being aware of which patients were classified as psychogenic cases, the orthopaedic surgeons made less auspicious prognoses for these patients and also found the questionnaire more helpful in evaluating them. When asked to rate the intensity of the patients' pain, the surgeons, unlike the patients, avoided extreme ratings. Comparing the two scales used (a six-step verbal scale and a 10 cm graphic rating scale (GRS) for rating pain intensity, patients found the GRS to be more meaningful. The words occupied different relative positions on the verbal scale and the GRS, and their position on the GRS fluctuated according to whether they denoted general pain or pain during attacks. The findings suggest that the questionnaire is a useful screening tool for identifying patients requiring further psychological evaluation.

Adult↗

PubMed1999

Sleep and behavior problems among preschoolers.

This study described the relationship between amount of sleep and behavior problems among preschoolers. Participants were 510 children aged 2 to 5 years who were enrolled through 68 private pediatric practices. Parents reported on the amount of sleep their child obtained at night and in 24-hour periods. With demographic variables controlled, regression models were used to determine whether sleep was associated with behavior problems. The relationship between less sleep at night and the presence of a DSM-III-R psychiatric diagnosis was significant (odds ratio = 1.23, p = .026). Less night sleep (p < .0001) and less sleep in a 24-hour period (p < .004) were associated with increased total behavior problems on the Child Behavior Checklist; less night sleep (p < .0002) and less 24-hour sleep (p < .004) were also associated with more externalizing problems on that measure. Further research is needed to ascertain whether sleep is playing a causal role in the increase of behavior problems.

Child Behavior Disorders↗

PubMed2001

[Sleep disorders in patients treated with continuous ambulatory peritoneal dialysis].

BACKGROUND: A lot of patients with end stage renal disease with the necessity of renal replacement therapy have some sleep problems. The aim of this study was to get basic information about the sleep of patients treated with continuous ambulatory peritoneal dialysis (CAPD), mainly their subjective view on their sleep, including comparison with hemodialyzed patients (HD). METHODS: All patients treated with continuous ambulatory peritoneal dialysis in two dialysis centres were given a simple questionnary containing 20 questions concerning sleep. It was filled in by all these patients--25 patients (mean age 58.1 years)--12 men and 13 women. Data obtained from 103 hemodialyzed patients from the same two-dialysis centres were used for comparison (mean age 60.4 years)--61 men and 42 women (the same questionnary). RESULTS: 40% of CAPD patients regard their sleep as bad. Thirty six percent of patients have problems with falling asleep, 32% awake three times or more during the night and 28% snore or have some breath problems. CAPD patients feel more frequently tired after the night (32% vs. 18.4% HD), more patients sleep during the day (64% vs. 5.15% HD) and fewer patients feel restlessness of legs (36% vs. 45.6% HD). These differences are not statistically significant. CONCLUSION: Occurrence of sleep disorders and their characteristics in patients on CAPD is similar to that in hemodialyzed patients.

Adult↗

PubMed2004

Long-term mental distress, bone mineral density and non-vertebral fractures. The Tromsø Study.

The purpose of this study was to examine, prospectively, the risk of non-vertebral fractures and low bone mineral density in a population-based cohort with respect to indicators of subjective mental distress. In 1979-1980 all males born 1925-1959 and all females born 1930-1959 living in Tromsø were invited (21,441; response rate, 78%). The same individuals were invited to the subsequent studies in 1986-1987 and 1994-1995 (74% attended the first two, and 71% attended all three surveys). Non-vertebral fractures were registered by linkage to the hospital X-ray register for the period 1988-1995, and forearm bone mineral density (BMD) was available in a subsample of 4,690 who had attended three times. Questions about mental distress (depression, insomnia and coping problems) were repeated three times and analyzed as cumulated exposure. Women who reported being depressed at two time points had an adjusted odds ratio (OR) =2.5 (95% confidence interval [CI] 1.3-4.9) for sustaining a non-vertebral fracture and OR=3.1 (95% CI 1.3-7.2) for sustaining an osteoporotic fracture, compared with those without depression on any occasion. The corresponding odds ratios for those with coping problems at two time points were slightly higher, whereas sleeping problems seem only to be weakly associated with non-vertebral fractures. The pattern of associations and the magnitude of OR estimates were mainly the same in women younger than 50 years and those 50 years and older. Women using nerve medicine and reporting depression twice had an odds ratio of 4.4 (95% CI 1.1-17.7) for sustaining a non-vertebral fracture, and those using nerve medicine and reporting coping problems twice had a corresponding OR 4.7 (95% CI 1.2-18.4). Among men no significant associations were found for either fracture type. No association was found between mean BMD and number of times reporting depression, insomnia or coping problems, in women or men. Long-term mental distress is associated with risk of all non-vertebral fractures and osteoporotic fractures in middle-aged women, but not in men. Mental distress itself seems to be more important than the use of nerve medicine.

Absorptiometry, Photon↗

PubMed1989

What happens to babies exposed to phencyclidine (PCP) in utero?

Fifty-seven infants exposed to phencyclidine (PCP) in utero were followed for the first year of life. Thirty-six (65%) of the 55 for whom birth records were available manifested symptoms of neonatal narcotic withdrawal syndrome, including 16 (52%) of those whose mothers denied opiate abuse during pregnancy. Temperament problems were noted in 47% of the babies and sleep problems in 14%. The majority of infants grew normally, but a larger than expected number started out small and remained small. Testing using the Bayley Scales of Infant Development at age one year revealed a mental development index (mean +/- SD) of 94 +/- 10 and a psychomotor development index of 98 +/- 10. Attachment behavior was abnormal in 17%. Most infants were cared for by their natural mother. Further studies are needed to determine later effects of in utero PCP exposure, as well as effects on the infants being raised by women who have used PCP. Phencyclidine toxicity needs to be considered when evaluating babies with signs of neonatal narcotic withdrawal syndrome.

Birth Weight↗

PubMed2006

Self-reported changes to nighttime sleep after traumatic brain injury.

OBJECTIVES: To explore subjective sleep reports from people in the chronic stages of traumatic brain injury (TBI) and to examine the extent and nature of sleep complaints in this population. DESIGN: Survey. SETTING: All participants were community based at the time of data collection. PARTICIPANTS: Sixty-three subjects with TBI consecutively recruited after discharge from rehabilitation and 63 age- and sex-matched controls from the general community. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A 7-day self-reported sleep-wake diary assessing sleep and wake times, sleep onset latency, frequency, and duration of nocturnal awakenings and daytime naps; a general sleep questionnaire used to evaluate sleep changes and quality; and the Epworth Sleepiness Scale to measure daytime sleepiness. RESULTS: Group-wise comparisons showed a significantly higher frequency of reported sleep changes after TBI (80%) relative to the control group (23%), supporting previous findings. The TBI group reported more nighttime awakenings and longer sleep onset latency; these changes were more frequently reported by participants with TBI with milder injuries. Increased levels of anxiety and depression were associated with increased reporting of sleep changes. CONCLUSIONS: These findings confirm the experience of changes to sleep after TBI and may at least in part account for the reported increased daytime sleepiness in this population. Sleep disturbance should be addressed during rehabilitation. Treatments need to focus on correcting the underlying cause of the sleep problem and to address patients' subjective experiences of their sleep, possibly through education and mood stabilization.

Adolescent↗

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↗