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PubMed2006

Prenatal mood disturbance predicts sleep problems in infancy and toddlerhood.

BACKGROUND: Experimental animal data link prenatal stress with sleep disturbance in offspring, but the link in humans is unclear. AIMS: To investigate the link between prenatal maternal anxiety and depression and infant sleep disturbance from 6 to 30 months of age. STUDY DESIGN: Longitudinal prospective study of a large birth cohort from pregnancy to 30 months. Questionnaire measures of anxiety and depression were completed by mothers at 18 and 32 weeks gestation and at 8 weeks and 8 months postpartum. SUBJECTS: The ALSPAC cohort, a prospective community study of women in the UK who have been followed since pregnancy. OUTCOME MEASURES: Measures of total sleep time, number of awakenings, and broadly defined sleep problems were available on children at ages 6, 18, and 30 months. RESULTS: Reliable measures of total sleep time, nighttime awakenings, and sleep problems were identified at 6, 18, and 30 months. Higher levels of prenatal maternal anxiety and depression predicted more sleep problems at 18 and 30 months, after controlling for postnatal mood and obstetric and psychosocial covariates; the association was not restricted to clinical extremes. No link with total sleep time was observed. CONCLUSIONS: Mood disturbance in pregnancy has persisting effects on sleep problems in the child, a finding that is consistent with experimental animal research. The findings add to a growing literature showing that maternal prenatal stress, anxiety, and depression may have lasting effects on child development.

Adult↗

PubMed1999

The relationship between dialysis adequacies and sleep problems in hemodialysis patients.

This research examined the relationship between the incidence of sleep problems and hemodialysis adequacy (Kt/V) in hemodialysis patients. In addition, this study identified demographic variables that may be related to sleep problems of hemodialysis patients. The research design was cross-sectional, descriptive, and correlational. A convenience sample (n = 50) included 25 male and 25 female hemodialysis subjects from a private, for profit ambulatory dialysis clinic. The primary researcher interviewed subjects using a questionnaire that included demographics and questions regarding sleep habits. Two significant results were found. For subjects in the study aged 65 and older, increased dialysis adequacies were associated with a decreased number of awakenings at night. Second, women, regardless of age and education, reported using more sleep medications than men. Overall, this study did not find a relationship between sleep problems and dialysis adequacies. Further research is needed to increase awareness and understanding of the complexities of sleep problems in renal patients.

Adult↗

PubMed1997

Correlates of sleep problems among men: the Vietnam Era Twin Registry.

The Vietnam Era Twin (VET) Registry includes 14,800 male twins born 1939-55 and in military service in 1964-75. A mailed health survey including the Jenkins Sleep Questionnaire was sent to 11,959 members and 8,870 (74.2%) provided responses on the frequency of sleep problems in the previous month. Prevalence of those experiencing conditions at least 1 day per month was 67.2% for waking often, 61.5% for waking tired/worn out, 48.1% for trouble falling asleep and 48.6% for awakening early. Ordinal logistic regression analysis was used to estimate sleep problems from demographic, behaviour and lifestyle characteristics, and morbid conditions. Black (vs. white) race, older age, church/religious group participation, social support, employment, cigarette smoking, light physical activity, and strenuous physical activity were associated with lower risk of one or more sleep problems. Eleven morbid conditions with a prevalence of 1% or more, coffee consumption, heavy alcohol consumption, and Framingham Type A behaviour pattern were associated with a higher risk of sleep problems. These analyses suggest that sleep problems may be one of the mechanisms relating reduced quality of life to many physical and behavioural characteristics. Fortunately, a number of the risk factors associated with sleep problems are lifestyle characteristics which, if modified, may reduce sleep problems.

Adult↗

PubMed2004

[Sleep problems and bedtime routines in infants in a cross cultural perspective].

UNLABELLED: Intercultural studies induced many controversies in the characteristics associated with sleep problems. OBJECTIVES: The aim of this study was three fold: (1) to compare sleep problem frequency in two culturally different populations; (2) to analyze if some particular bedtime routines ("co-sleeping", "distal" or "proximal" parent-infant interaction) are associated to trouble; (3) to show influence of the cultural context to trouble. POPULATION: This study examines bedtime routines in French infants aged 12 to 24 months in maternal and infant's protect center (PMI) in Lyon and la Réunion island, for a sleep - cross cultural approach. Three hundred infants were enrolled in the survey. RESULTS: We showed prominent sleep problems in la Réunion's group (35%) in comparison with the group in Lyon (17%) (P <0.005). Regression analysis allowed to draw relations between several factors and the sleep problems. Hence, proximal bedtime routines and interactions (CR =0.530, P =0.05), "co-sleeping" (CR =0.989, P =0.005) and parental presence at bedtime until infant falls asleep (CR =0.595, P =0.04) are significantly associated with sleep problems. These attitudes are more frequent in la Réunion's group. CONCLUSION: Our study confirms literature data and asks question about cultural meaning for these inadequate behaviors in relation to mother-infant separation distress. Acculturation notion is called forth in la Réunion's group.

Child, Preschool↗

PubMed1997

Sleep problems of elementary school children. A community survey.

OBJECTIVE: To examine the prevalence, co-occurrence, and correlates of sleep problems among elementary school children. DESIGN: Survey. SETTING: General community. PARTICIPANTS: The parents of 987 children aged 5 to 12 years completed an anonymous survey distributed in their children's schools. MAIN OUTCOME MEASURES: The survey form asked about background characteristics, children's sleep environment, sleep habits, adult interventions, sleep history, and specific sleep problems. RESULTS: Bedtime resistance was the most prevalent sleep problem (27%). Sleep-onset delays (11.3%), night waking (6.5%), morning wake-up problems (17%), and fatigue complaints (17%) were also common. Among children with sleep-onset problems, 80% displayed bedtime resistance, while 34% of bedtime resisters had onset problems. Onset problems correlated with more fears, night waking, psychiatric and medical conditions, the need for reassurance and caregiver proximity, and history of sleep problems. Bedtime resistance was associated with an inconsistent bedtime and falling asleep away from bed. Those who display delayed sleep onset and bedtime resistance also wake later, suggesting that sleep-phase delays may maintain these problems. CONCLUSIONS: The results confirm bedtime resistance as parents principal sleep-related complaint for this age group but reveal a subgroup more prone to insomnia, night waking, and anxiety-related features. Phase delay findings suggest the importance of limits around wake-up time as well as bedtime. The results highlight the importance of distinctly evaluating bedtime resistance, sleep onset, sleep maintenance, waking, and emotional adjustment.

Child↗

PubMed2000

Prevalence and correlates of self-reported sleep problems among Chinese adolescents.

STUDY OBJECTIVES: This study examined the prevalence and correlates of sleep problems in Chinese adolescents. DESIGN AND SETTING: An epidemiological questionnaire survey was carried out in five high schools in Shandong Province of Mainland China. PARTICIPANTS: A total of 1365 adolescents between the ages of 12 and 18 years comprising 823 boys and 542 girls. MEASUREMENTS AND INTERVENTIONS: The participants completed a self-administered questionnaire regarding sleep duration, sleep problems, stressful life events, lifestyles, and personal and family characteristics. RESULTS: Mean sleep duration at night was 7.64 hours (SD = 0.86) and decreased with increasing age. Of the sample, 16.9% (95% CI = 13.2-20.5%) reported insomnia symptoms including difficulty initiating sleep (10.8%), difficulty maintaining sleep (6.3%), and early morning awakening (2.1%). Nightmares were reported more frequently by girls (chi2=20.09, p<0.001). Only 2.3% of the sample had ever taken hypnotic medication during the past month. Almost 22% of the subjects went to bed later than 12:00 PM at least once a week. Multiple logistic regression analysis showed that greater age, being at senior high school, doing no habitual physical exercise, poor physical health, self-selection of diet, longer distance from home to school, and life stress experienced during the past 12 months were significantly associated with an increased risk of insomnia. CONCLUSIONS: Self-reported sleep problems in Chinese adolescents are common and associated with multiple factors. These findings suggest the need for comprehensive programs to prevent sleep problems in adolescents.

Adolescent↗

PubMed1997

Sleep problems in children of affectively ill mothers.

The objective of the study was to determine whether the frequency and severity of sleep problems were greater in children of affectively ill mothers than in children of control mothers. Sleep problems were studied in children of mothers with a diagnosis of unipolar (N = 38) and bipolar (N = 23) affective illness and children of mothers with no current or past psychiatric diagnosis (N = 24). Mothers' reports on the Child Behavior Checklist (CBCL) were obtained three times, 4 years apart, on sibling pairs (ages 1.5-3.5 and 5-8 years, respectively, at first assessment). In addition, on the third assessment, the Diagnostic Interview for Children and Adolescents was filled out by mothers and children. In both siblings, sleep problems, as assessed through the CBCL, were more frequent and severe in children of affectively ill mothers. In younger siblings, the persistence of sleep problems was more frequent in children of affectively ill mothers. Co-occurrence of sleep problems among siblings was more frequent in children of affectively ill mothers than in those of control mothers.

Adult↗

PubMed2000

Sleep problems in white-collar male workers in an electric equipment manufacturing company in Japan.

In order to clarify poor sleep habits and prevalence in sleep problems (disturbances) of healthy male white-collar workers and the relationship of these to age and job type, a total of 1,161 Japanese employees of an electric equipment manufacturing company (aged 23 to 59, mean 37 years) were surveyed by means of a mailed questionnaire. The workers were asked about eleven sleep habits. They were also divided into four groups according to age and job type: 23-29 (n = 226), 30-39 (n = 597), 40-49 (n = 225) and 50-59 (n = 113); managerial (n = 209), professional (n = 336), technical (n = 475) and clerical (n = 134). In this study, the sleep problems were defined as who had at least one of the following four poor sleep habits: 1) taking more than 30 minutes to fall asleep, 2) awakening during sleep (ADS) almost every day, 3) early morning awakening (EMA) almost every day, and 4) excessive daytime sleepiness (EDS) at work almost every day. Analyses showed that sleep problems were present in 26.0% of workers; the problems were most serious among workers aged 50 years and more (36.0%) which may be due to a significant increase in the prevalence rate of EMA. The results revealed that sleep problems are common in male white-collar daytime workers. The findings also suggest a need for increased attention to sleep problems in older workers and younger ones with EDS at work.

Adult↗

PubMed1986

Sleep in middle childhood--a longitudinal study of sleep problems in a large sample of Dunedin children aged 5-9 years.

Complaints of sleeping difficulties in a large group of New Zealand children were studied prospectively over four years from 5 to 9 years of age. No association was found between sleeping difficulties and the sex, intelligence, or educational attainments of the child. Mothers who described their child as anxious or who were poor sleepers themselves tended to report sleeping problems in their child more frequently. There was no association between sleeping problems and teacher ratings of behaviour problems. Children who reported sleep problems also tended to report other problems. There was low agreement between parents and children. Only 0.3% of the total sample had a problem which persisted over the whole period.

Analysis of Variance↗

PubMed1989

Sleep problems in healthy preadolescents.

Few data currently exist concerning the sleep problems of preadolescents. A parent report questionnaire concerning sleep habits and problems was developed. The questionnaires were completed by the parents of 1000 unscreened elementary school children attending the third, fourth, and fifth grades. The schools were randomly selected from an urban area. Of the 1000 questionnaires, 972 were completed and could be used for statistical analysis. Among the parents, 24% reported sleeping poorly and 12% regularly relied on sedatives to induce sleep. Sleep difficulties lasting more than 6 months were present in 43% of the children. In 14% (132 of 972), sleep latency was longer than 30 minutes, and more than one complete arousal occurred during the night at least two nights per week. The following variables were seen among the poor sleepers: lower parental educational and professional status, parents who were more likely to be divorced or separated, and more noise or light in the rooms were they slept. They also presented a higher incidence of somnambulism, somniloquia, and night fears (nightmares and night terrors) than the children who slept well. Boys who slept poorly were significantly more likely to have insomniac fathers (P less than .010). Regular use of sedatives was described in 4% (5 of 132) of the children who slept poorly. Among the "poor sleepers," 21% (33 of 132) had failed 1 or more years at school. School achievement difficulties were encountered significantly more often among the poor sleepers than among the children without sleep problems (P = .001). Of the families with children suffering from sleep problems, 28% expressed a desire for counseling.(ABSTRACT TRUNCATED AT 250 WORDS)

Belgium↗

PubMed2002

Severe sleep problems in infancy associated with subsequent development of attention-deficit/hyperactivity disorder at 5.5 years of age.

UNLABELLED: The aim of this five-year prospective study was to follow and compare a group of children with severe sleep problems in infancy with a control group regarding development of symptoms of attention-deficit/hyperactivity disorder (ADHD). Factors in infancy were sought which were associated with development of ADHD in later childhood. A total community sample of 2518 infants aged 6-18 mo was approached with a questionnaire, and 83% responded. Data from the collection procedure point to a non-selective dropout. A case group of those children aged 6-12 mo who fulfilled specific criteria for severe and chronic sleep problems (n = 27) was compared with a control group of equal size, matched for age and gender. At the age of 5.5 y, seven of the children in the sleep problem group met the criteria for the diagnosis of ADHD based on an in-depth assessment by a multidisciplinary team. None of the control children qualified for the diagnosis. This difference is statistically significant. Comparisons between the children with ADHD and the rest of the problem group showed that given severe infant sleep problems, the following characteristics in infancy were associated with subsequent diagnosis of ADHD: psychosocial problems in the family, bedtime struggles and long sleep latency at bedtime. Owing to the small sample size, the results are considered preliminary. CONCLUSION: Approximately one in four children with severe sleep problems in infancy will later qualify for the diagnosis of ADHD. Infants with severe sleep problems, especially in combination with behavioural problems, high activity level and psychosocial problems in the family, deserve attention since neurodevelopmental problems seem to be prevalent in this category of children.

Age Factors↗

PubMed2001

Behavioural treatment for sleep problems in children with severe intellectual disabilities and daytime challenging behaviour: effect on mothers and fathers.

OBJECTIVES: The study aimed to assess the mental state of mothers and fathers following successful behavioural intervention for sleep problems in such children. DESIGN: A randomized controlled trial of behavioural interventions for sleep problems. METHODS: Parents of 15 children with severe intellectual disabilities, severe sleep problems, and challenging daytime behaviour received treatment for the child's sleep problem and were compared with 15 controls who received no treatment. Parental stress, sleepiness, locus of control, perceived control, and satisfaction with aspects of sleep were assessed. RESULTS: Successful treatment benefited the mothers, reducing stress, increasing perceived control and making them more satisfied with their sleep, their child's sleep, and their ability to cope with their child's sleep. Positive effects in the fathers were limited to increased satisfaction with their own sleep and their child's sleep; fathers tended to feel less control following treatment. Maternal sleepiness and perceived control, and aspects of parental satisfaction showed improvements in both the treatment and control groups. CONCLUSION: The effects of childhood sleep problems, and their resolution using behavioural interventions, may be different in mothers and fathers. This highlights the need to assess all family members in order to gain a greater understanding of how best to help families as a whole. The improvements in both control and treatment groups indicate that there may be non-specific effects of taking part in the study that played a therapeutic role.

Clinical Trial↗

PubMedDate not supplied

Sleep problems in pediatric practice: clinical issues for the pediatric nurse practitioner.

Sleep problems are highly prevalent in children and adolescents, but often go unrecognized and untreated in clinical settings. The purposes of this paper are to provide pediatric nurse practitioners with an understanding of the impact of sleep problems on children, their families, and on clinical pediatric practice; examine clinical practice issues that pediatric nurse practitioners identify as important regarding pediatric sleep; and provide practical information on current resources available for pediatric nurse practitioners and their patients on the prevention and treatment of pediatric sleep problems. The discussion of these issues incorporates results from a needs assessment survey on pediatric sleep completed by 317 pediatric nurse practitioners who attended the April 2003 Annual Conference of the National Association of Pediatric Nurse Practitioners.

Adult↗

PubMed2001

The association of dopamine agonists with daytime sleepiness, sleep problems and quality of life in patients with Parkinson's disease--a prospective study.

OBJECTIVE: Reports that dopamine agonists (DA) precipitate sudden daytime sleep episodes in Parkinson's disease (PD) patients have received widespread attention. It remains unclear if non-ergoline and ergoline DAs have differential sedating effects or if sedation rather represents a class effect of DAs. The aim of this study was the evaluation of sleep disturbances and the quality of life (QoL) in PD patients with different dopaminergic treatment strategies. PATIENTS AND METHODS: This analysis is part of the FAQT-study, a prospective German cohort study evaluating determinants of QoL in PD patients. A subgroup of 111 PD patients was evaluated twice, at baseline and after one year of follow-up, using standardised and validated questionnaires (Unified Parkinson's disease rating scale (UPDRS), Hoehn and Yahr classification, Center for Epidemiologic Studies Depression Scale (CESD), Short Form-36 (SF-36), Parkinson Disease Questionnaire (PDQ-39)). The impact of treatment strategies on sleep problems, daytime sleepiness, bad dreams and hallucinations, depression and QoL in PD patients was analysed separately for ergoline DAs, non-ergoline DAs and the patient group taking no DA. RESULTS: At baseline, sleep problems were reported by about one third of the patients with and without DA medication. Excessive daytime sleepiness (EDS) was higher in the two DA groups (ergoline 11.9%, non-ergoline 9.1%) than among patients not taking DAs (4.5 %). At follow-up, sleep problems in general had decreased among patients taking DAs continuously and among those newly taking DAs, while the sleep problems increased in patients discontinuing DAs. However, EDS had increased to 25% in patients newly taking DAs, and decreased to 15.9% in those taking them continuously. QoL scores at follow-up were slightly increased in the patient groups newly taking and discontinuing DAs (the latter except in physical functioning) while those on continuing DA-medication remained unchanged. CONCLUSION: No differential effects of ergoline or non-ergoline DAs on sleep problems were found. Different dopaminergic treatment strategies did not influence QoL. Our results support the evidence that sedation may be rather a class effect of DAs.

Aged↗

PubMedDate not supplied

Sleep in infants and young children: part two: common sleep problems.

Approximately 25% of children younger than 5 years experience some type of sleep problem. Whether the problem is acute or chronic, significant disruption to the child's sleep can occur and have a negative impact on the child and family. This article is the second in a two-part series on sleep in infants and young children. The purpose of this article is to provide fundamental information regarding common pediatric sleep problems for the clinician to use when assessing a child's sleep behaviors or addressing parental concerns. The definition, impact, and clinical evaluation of sleep problems are discussed.

Child↗

PubMed1999

Unravelling sleep problems in treated and untreated children with ADHD.

This study investigated parental perception of sleep problems in stimulant treated and untreated children with Attention Deficit Hyperactivity Disorder (ADHD). Parents of 135 psychiatric clinic referred children and 83 pediatric outpatients completed a sleep questionnaire and the Child Behavior Checklist. Moderate to severe "sleep problems" reportedly occurred at least once a week in 19.3% of children with ADHD, 13.3% of the psychiatric controls, and 6.2% of the pediatric controls. Children with ADHD treated with stimulants were reported to display a higher prevalence of nightly "severe" sleep problems than did untreated children with ADHD. Almost a third (29%) of stimulant treated ADHD children were reported to display increased sleep latency or insomnia every night versus 10% of untreated children with ADHD. Despite the high prevalence of sleep related problems in ADHD, the significance of the association between delayed sleep onset and ADHD with regard to etiology and management of ADHD is still poorly understood.

Adolescent↗

PubMed2002

Sleep problems among pupils in Benghazi, Libya.

OBJECTIVE: To find the prevalence of sleep problems among pupils, its possible causes and associated behaviors. METHODS: This study was carried out during 3-24 February 1996. We randomly selected a sample of (277) 5th graders (181 boys and 96 girls), from 3 public primary schools in 3 different socio-economic areas in Benghazi, Libya. We interviewed the pupils and the teachers by a pretested questionnaire concerning sleep, school achievement and other behaviors. Those pupils who sleep after 10:00 pm, or those having bad sleep characters, or both, twice or more a week in the last month, were considered suffering from sleep problems. According to their performance in the first semester in both Arabic and Mathematics, pupils were classified in to 3 groups (>70% in both the good group, 50-70% in both subjects or in one provided that the other was above 70% the average group, <50% in one or both subjects the poorly achieving group). RESULTS: This study shows high prevalence of sleep problems among pupils (28.9%), especially in a high-density area, with non-significant gender difference. Associated behaviors are bad school achievement, sleepiness and mood fluctuation. CONCLUSION: Parental ignorance, unawareness and bad child rearing and follow-up are evident, and considered to be the main cause of these problems, that needs intensive education towards better sleep hygiene.

Child↗

PubMed1979

[Sleep problems of the aging (author's transl)].

Sleep problems of the aging differ from adolescents clinicaly as well as in their EEG-pattern. They can be purely functional (exogenous or reactiv) however are frequently influenced by changes in the aging organism. Most common are cardio-vascular and pulmonary problems. The treatment of sleep disorders has to emphasize the improvement of these problems so that functional sleep difficulties can be treated successfully. It has to be recognized that elderly people can react paradoxically or overreact to all psychotropic agents including hypnotics.

Aged↗