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PubMed1996

[Epidemiological study of sleep disorders in patients in Swiss general practice].

The aim of the study was to assess the prevalence, severity, associated factors and diagnosis of sleep disorders in general practice. Over 700 patients were investigated with a multiple choice questionnaire in 24 general practices in Switzerland. To assess sleep disorders, criterion A for insomnia according DSM-III-R was applied. The prevalence of sleep disorders was 44%, 64% of these were classified as mild, 31% as moderate and 5% as severe. 50% of the female patients complained about insomnia compared to 36% in males. Retrospectively, 74% of the patients stated having suffered from sleep disorders for more than one year (mild 76%, moderate 69%, severe 75%). 70% of patients with mild, 42% with moderate and 30% of patients with severe insomnia didn't inform their physicians about their sleep difficulties on the occasion of an earlier consultations. Patients with moderate or severe insomnia felt moderately or markedly disabled in their quality of life (71%) and work (58%). To estimate general anxiety and depressive state, self-rating scales were used (STAI, D-S). In comparison to reference values for healthy volunteers, insomniac patients had significantly higher scores on both scales, which were associated with the severity of sleep disorders, corroborating the association of sleep disorders with anxiety disorders and depressions. The physicians diagnosed in 18% of insomniacs a psychiatric disease, in 52% a psychoreactive disorder and in 26% a somatic etiology. The study shows that sleep disorders are a frequent syndrome in general practice and often not reported to the physician; therefore, the patients should routinely be questioned about sleep problems, and associated psychiatric diseases should be considered.

Adult↗

PubMed2005

Sleep and risk-taking behavior in adolescents.

The primary purpose of this study was to examine the relationship between adolescents' sleep-wake patterns and risk-taking behavior. A second goal was to replicate the results obtained by Wolfson and Carskadon (1998) regarding adolescents' sleep habits. Three hundred eighty-eight adolescents (217 males, 171 females) completed the Sleep Habits Survey and the Youth Risk Behavior Survey. The results indicated that adolescents who reported longer weekend delay and higher levels of sleep problems also reported significantly higher levels of risk-taking behaviors, and students' weekend delay was also related to their academic performance in this sample. As in the sample studied by Wolfson and Carskadon (1998), the adolescents in this study exhibited changes in both weekday and weekend sleep habits across grade/age. However in the present study, only school-night total sleep time and weekend delay were related to adolescents' daytime functioning, with no significant relationships being found between weekend oversleep and daytime functioning. This provides partial support for the findings of Wolfson and Carskadon (1998). Overall, sleep-wake patterns were found to relate to risk-taking behavior during adolescence in this study.

Adolescent↗

PubMed2004

Symptoms of insomnia among adolescents in the lower Rio Grande Valley of Texas.

STUDY OBJECTIVES: To estimate the prevalence of symptoms of insomnia among adolescents living along the United States-Mexico border and to examine whether ethnicity and birthplace affect risk for such symptoms. DESIGN: Cross-sectional school-based survey using a version of the 2001 Youth Risk Behavior Survey, modified to elicit data on sleep problems. SETTING: A probability sample of 13 high schools selected from more than 40 high schools in the 4 southernmost counties in Texas-the Lower Rio Grande Valley-contiguous with Mexico. PARTICIPANTS: All ninth-grade students who agreed to participate (n = 5,118). MEASUREMENTS: The sleep module consisted of queries about trouble initiating asleep, trouble maintaining sleep, early morning waking, nonrestorative sleep, quality of sleep, and amount of sleep. RESULTS: Symptoms of insomnia were common, with 12.4% of respondents meeting symptom criteria for insomnia almost every day of the past month. Females were more likely to report insomnia, as were youths reporting lower socioeconomic status. Crude odds ratios suggested foreign-born and those who identified themselves as "Mexican" rather than "Mexican American" were at lower risk of insomnia. However, multivariate analyses eliminated these differences. CONCLUSIONS: More comparative research is needed to ascertain whether and how ethnic culture affects risk for disordered sleep.

Adolescent↗

PubMed1987

Controlled trial of trimeprazine tartrate for night waking.

Mild hypnotics are often recommended for young children with sleep problems. This study assesses the efficacy of trimeprazine tartrate in 1 to 3 year old children with persistent and severe night waking in a double blind crossover trial with placebo. Children on treatment with trimeprazine had significantly fewer wakings, less time awake at night, and more night time sleep compared with those on treatment with placebo. There were no differences in these sleep variables when the first and last (fourth) week of treatment with drugs were compared. Follow up observations showed no significant difference in any sleep variables from baseline measures. The results are consistent with the idea that trimeprazine tartrate may be a useful short term treatment for night waking in young children.

Child, Preschool↗

PubMed2003

Sleep duration from infancy to adolescence: reference values and generational trends.

OBJECTIVE: The main purpose of the present study was to calculate percentile curves for total sleep duration per 24 hours, for nighttime and for daytime sleep duration from early infancy to late adolescence to illustrate the developmental course and age-specific variability of these variables among subjects. METHODS: A total of 493 subjects from the Zurich Longitudinal Studies were followed using structured sleep-related questionnaires at 1, 3, 6, 9, 12, 18, and 24 months after birth and then at annual intervals until 16 years of age. Gaussian percentiles for ages 3 months to 16 years were calculated for total sleep duration (time in bed) and nighttime and daytime sleep duration. The mean sleep duration for ages 1 to 16 years was estimated by generalized additive models based on the loess smoother; a cohort effect also had to be included. The standard deviation (SD) was estimated from the loess smoothed absolute residuals from the mean curve. For ages 3, 6, and 9 months, an alternative approach with a simple model linear in age was used. For age 1 month, empirical percentiles were calculated. RESULTS: Total sleep duration decreased from an average of 14.2 hours (SD: 1.9 hours) at 6 months of age to an average of 8.1 hours (SD: 0.8 hours) at 16 years of age. The variance showed the same declining trend: the interquartile range at 6 months after birth was 2.5 hours, whereas at 16 years of age, it was only 1.0 hours. Total sleep duration decreased across the studied cohorts (1974-1993) because of increasingly later bedtime but unchanged wake time across decades. Consolidation of nocturnal sleep occurred during the first 12 months after birth with a decreasing trend of daytime sleep. This resulted in a small increase of nighttime sleep duration by 1 year of age (mean 11.0 +/- 1.1 hours at 1 month to 11.7 +/- 1.0 hours at 1 year of age). The most prominent decline in napping habits occurred between 1.5 years of age (96.4% of all children) and 4 years of age (35.4%). CONCLUSIONS: Percentile curves provide valuable information on developmental course and age-specific variability of sleep duration for the health care professional who deals with sleep problems in pediatric practice.

Adolescent↗

PubMed1989

Dietary replacement in preschool-aged hyperactive boys.

A 10-week study was conducted in which all food was provided for the families of 24 hyperactive preschool-aged boys whose parents reported the existence of sleep problems or physical signs and symptoms. A within-subject crossover design was used, and the study was divided into three periods: a baseline period of 3 weeks, a placebo-control period of 3 weeks, and an experimental diet period of 4 weeks. The experimental diet was broader than those studied previously in that it eliminated not only artificial colors and flavors but also chocolate, monosodium glutamate, preservatives, caffeine, and any substance that families reported might affect their specific child. The diet was also low in simple sugars, and it was dairy free if the family reported a history of possible problems with cow's milk. According to the parental report, more than half of the subjects exhibited a reliable improvement in behavior and negligible placebo effects. In addition, several nonbehavioral variables tended to improve while the children received the experimental diet, particularly halitosis, night awakenings, and latency to sleep onset.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

Patients' responses to distraction osteogenesis: a multi-centre study.

This investigation aimed to compare and contrast practical difficulties experienced by 54 children from three different centres (Mexico City, New York, Paris) treated with either extra-oral or intra-oral distraction devices. The possible effect of distraction osteogenesis on pain/sleeping difficulty, speech and eating problems and disturbance of recreational activities and alteration in sensation were investigated. It was expected that intra-oral devices would reduce the difficulties associated with the distraction process and their psychological effect on the child. Some benefits resulting from the use of intra-oral devices were identified, these included fewer sleeping problems (P = 0.006) and less disturbance of recreational activities (P = 0.002). However, eating and maintaining oral hygiene were more problematic with intra-oral devices the differences between the intra-oral and extra-oral groups was approaching significance at P = 0.07. A major disadvantage of the extra oral device was scarring. In both groups the alteration of lip sensation was temporary, pain was limited to the time of activation of the distraction device. A high level of patients' cooperation was mandatory for successful completion of the treatment.

Adolescent↗

PubMed2005

Subjective sleep disturbance and its correlates in middle-aged Hong Kong Chinese women.

OBJECTIVES: To examine the factors associated with subjective sleep disturbance in middle-aged Hong Kong Chinese women. METHODS: A total of 305 women aged 45-55 years were recruited at community-based women's clubs. Eligible subjects were of Chinese ethnicity and not taking oral contraceptives, hormone therapy or had received surgical removal of ovary. Standardized questionnaires, including sociodemographic, health and life-style variables, Pittsburgh Sleep Quality Index (PSQI), Greene Climacteric Scale (GCS) and Perceived Stress Scale were administered. RESULTS: About 18% of the sample complained of difficulty initiating sleep, difficulty maintaining sleep or early morning awakening at least three times per week in the past month. About 26% of the women were poor sleepers as defined by a global PSQI score >5. Sleep difficulty was one of the five most commonly reported climacteric symptoms. Cross-sectional analysis found that significantly more peri- and postmenopausal women had subjective sleep disturbance than premenopausal women. Multiple logistic regression analysis showed that women who had high levels of somatic complaints, psychological symptoms and perceived stress had a four to sixfold increased risk of reporting disturbed sleep. Menopausal status was not an independent predictor. CONCLUSIONS: Comparison of our findings with recent literatures suggested a lower prevalence of insomnia in Hong Kong Chinese middle-aged females than Caucasian women. Somatic complaints, psychological symptoms and perceived stress were independent risk factors for sleep disturbance. Clinicians should screen for sleep problems in middle-aged Chinese women with prominent somatic and psychological symptoms and perceived stress.

Cross-Sectional Studies↗

PubMed2006

Sleep and its disorders in older adults.

For many older adults, aging is associated with significant changes in sleep. There are a variety of potential causes, including primary sleep disorders, circadian rhythm disturbances, insomnia, depression, medical illness, and medications. As with younger adults, the diagnosis requires a thorough sleep history and an overnight sleep recording when appropriate. Treatment should address the primary sleep problem and can result in significant improvement in quality of life and daytime functioning in older adults.

Aged↗

PubMed2003

Working memory and sleep in 6- to 13-year-old schoolchildren.

OBJECTIVE: To study the associations between sleep quality/quantity and performance in auditory/visual working memory tasks of different load levels. METHOD: Sixty schoolchildren aged 6 to 13 years from normal school classes voluntarily participated. Actigraphy measurement was done during a typical school week for 72 consecutive hours. It was timed together with the working memory experiments to obtain information on children's sleep during that period. The n-back task paradigm was used to examine auditory and visual working memory functions. RESULTS: Lower sleep efficiency and longer sleep latency were associated with a higher percentage of incorrect responses in working memory tasks at all memory load levels (partial correlations, controlling for age, all p values < .05, except in visual 0-back and auditive 2-back tasks); shorter sleep duration was associated with performing tasks at the highest load level only (partial correlations, controlling for age,p < .05). Also in general linear models (controlling for age, gender, and socioeconomic status), sleep efficiency (F = 11.706, p = .050) and latency (F = 3.588, p = .034) were significantly associated with the mean incorrect response rate in auditory working memory tasks. CONCLUSIONS: Sleep quality and quantity affect performance of working memory tasks in school-age children. In children with learning difficulties the possibility of underlying sleep problems should be excluded.

Adolescent↗

PubMed2006

Daytime sleeping, sleep disturbance, and circadian rhythms in the nursing home.

OBJECTIVE: This study reports the frequency of abnormal daytime sleeping and identifies factors related to daytime sleeping, nighttime sleep disturbance, and circadian rhythm abnormalities among nursing home residents. METHODS: The authors conducted secondary analysis of data collected under usual care conditions within a nonpharmacologic sleep intervention trial. All residents from four Los Angeles nursing homes were screened for daytime sleeping (asleep>or=15% of observations, 9:00 am-5:00 pm). Consenting residents with daytime sleeping had two nights of wrist actigraphy to assess nighttime sleep disturbance (asleep<80%, 10:00 pm-6:00 am). Residents with nighttime sleep disturbance completed an additional 72-hour wrist actigraphy recording to assess circadian activity rhythms and light exposure. RESULTS: Sixty-nine percent of 492 observed residents had daytime sleeping, of whom 60% also had disturbed nighttime sleep. Sleep disturbance and daytime sleeping were rarely documented in medical records. Residents spent one-third of the day in their rooms, typically in bed, and were seldom outdoors or exposed to bright light. More time in bed and less social activity were significant predictors of daytime sleepiness. Ninety-seven percent of residents assessed had abnormal circadian rhythms. More daytime sleeping and less nighttime sleep were associated with weaker circadian activity rhythms. Later circadian rhythm acrophase (peak) was associated with more bright light exposure. CONCLUSION: Daytime sleepiness, nighttime sleep disturbance, and abnormal circadian rhythms were common in nursing home residents. Modifiable factors (e.g., time in bed) are associated with sleep/wake abnormalities. Mental health specialists should consider the complexity of factors causing sleep problems in nursing home residents.

Aged↗

PubMedDate not supplied

[Family dynamics: sleep quality of women caregivers of family members with Alzheimer disease].

This replication study/Riccio 1996) sets out to explore the Quality of sleep of 34 women primary caregivers of Alzheimer's Disease patients at home. A descriptive, correlational and longitudinal design has been used. Key aspects considered were the quality of nocturnal sleep, the daytime sleepiness, the hours of caring, the educational level, the employment, the time for personal needs and the levels of depression and anxiety. After an initial interview, the caregivers were asked to fill in several instruments to measure the variables taken into consideration. The caregivers presented poor quality in their sleep. Quality of nocturnal sleep was negatively affected by more hours of caring (p < 0.02), high depression and anxiety levels (p < 0.05 and 0.007 respectively). The education level, the employment outside home and the amount of time spent for themselves, positively affected the quality of sleep (p < 0.01, 0.04, 0.05 respectively). This research pointed out that hours of caring, directly and indirectly, cause sleep problem to Alzheimer's Disease caregivers enhancing nursing care implications.

Adult↗

PubMed1985

[Child psychiatric clientele and treatment with psychotropic drugs by established physicians in a rural small town area].

Questionnaires were sent to 214 country and small town physicians. Most of the responding physicians reported that they see and treat a substantial number of children with child psychiatric disorders, prescribing psychopharmacological agents about 16% of the time. 40 percent said they prescribe such drugs, whereas 42% said they do not, and 18% expressly rejected such drugs for children. Bedwetting, sleep problems, behavior disorders and hyperactivity were the problems most frequently treated with drugs, most commonly with neuroleptic agents. Parental expectations appear to have had a direct influence on physician prescribing behavior: The stronger these expectations, the more often the physician prescribed drugs. Physician interest in continuing education courses on psychopharmacological treatment was great. The survey results are compared with those of a similar study conducted in Hamburg in 1979 and some problems associated with drug treatment in child psychiatry discussed.

Child↗

PubMed1996

Childhood sleep disorders.

Sleep problems in children may differ in various ways from analogous problems in the adult. This is less because of neurophysiologic differences between the two groups than it is because of the child's greater level of dependency. Young children make few decisions on their own and, as a result, parent-child interactions become connected intimately to the child's sleep process at bedtime and throughout the night. Parental desires and expectations are at least as important as those of the child in determining the pattern of sleep that follows. Such interactions are most important when it comes to understanding causes of sleeplessness in the young child, and only by appreciating these interactions can the clinician serve a useful role in helping the family to understand and improve a young child's problematic sleep patterns.

Adult↗

PubMed1997

Behavioral and emotional problems in young preschoolers: cross-cultural testing of the validity of the Child Behavior Checklist/2-3.

The cross-cultural validity of the Child Behavior Checklist for Ages 2-3 (CBCL/2-3) was tested in three Dutch samples of children referred to mental health services, from the general population, and from a twin study. Six scales were derived from factor analyses and labeled Oppositional, Aggressive, and Overactive, which constituted a broadband Externalizing grouping; Withdrawn/Depressed and Anxious, which constituted a broadband Internalizing grouping; and Sleep Problems. Internal consistencies of the scales, their test-retest reliabilities, interparent agreement, discriminative power, predictive relations with problem ratings 2 years later, and relations to other instruments designed to measure general development and behavior problems were adequate, and highly comparable to psychometric properties in American samples. It was concluded that across languages and cultures behavioral/emotional problems of young preschoolers may be adequately assessed with the CBCL/2-3.

Chi-Square Distribution↗

PubMed2005

Sleep and quality of life in stable heart failure.

BACKGROUND: Functional performance and mental health are significant quality of life concerns for heart failure (HF) patients. Poor sleep also appears to be common. We examined the extent to which sleep was associated with functional performance and mental health among persons who had stable systolic HF. METHODS AND RESULTS: Sixty-one patients with stable systolic HF wore wrist actigraphs to record nocturnal sleep and daily activity for 3 days while living at home, performed 6-minute walks (6MWT), and completed the Pittsburgh Sleep Quality Index and the Medical Outcomes Study SF-36 questionnaire. Self-reported sleep quality and actigraph-recorded wake time and wake bout time explained 9% to 20% of the variance in the functional performance variables (daytime activity level, 6MWT, self-reported physical function), and mental health, after controlling for age, gender, comorbidity, and New York Heart Association class. Time in bed was negatively associated with functional performance. There were no statistically significant relationships between sleep duration and functional performance. CONCLUSIONS: Self-reported sleep quality and sleep continuity (sleep that is undisturbed by nocturnal awakenings) are associated with functional performance and mental health in stable systolic HF patients. Effective treatment of sleep problems may contribute to improvement in quality of life.

Adult↗

PubMed2002

Prevalence of insomnia and associated factors in South Korea.

INTRODUCTION: In Western countries, insomnia is associated with daytime impaired functioning, as well as physical and psychiatric illnesses. However, little information exists on insomnia in Asian countries. This study investigates the prevalence and correlates of insomnia in the general population of South Korea. METHODS: A representative sample of the South Korean general population composed of 3719 noninstitutionalized individuals aged 15 years or older were interviewed by telephone using the Sleep-EVAL system. The participation rate was 91.4%. The interviews covered sleep habits, sleep symptomatology, physical and psychiatric illnesses. DSM-IV sleep and psychiatric disorder diagnoses were also assessed. RESULTS: Insomnia symptoms occurring at least three nights per week were reported by 17.0% of the sample; difficulty initiating sleep (DIS) was mentioned by 4.0% of the sample, difficulty maintaining sleep (DMS) by 11.5%, early morning awakenings (EMA) by 1.8%, and nonrestorative sleep (NRS) by 4.7% of the sample. DSM-IV insomnia disorder diagnoses were found in 5% of the sample. Over 50% of subjects with insomnia symptoms reported important daytime consequences and another 20% reported mild or moderate consequences. However, the proportion of insomnia subjects seeking medical help for their sleep problems was very low (6.8%). CONCLUSIONS: As in Western countries, insomnia is widespread in South Korea, affecting nearly one in five individuals. Many of them would benefit from medical help; however, few insomnia subjects are consulting for this problem. An educational effort is needed for both the general population and the physicians.

Adolescent↗

PubMed1983

Sleep disturbances in aging: a theoretic and empiric analysis.

Empirical evidence suggests that elderly persons experience more frequent qualitative and quantitative sleep disturbances than persons of other age groups. These disruptions may be particularly detrimental to the elderly since their physiological tolerance for disequilibrium is more limited than that of younger persons. Some sleep changes, however, appear to be physiologically beneficial and adaptive and should not be inadvertently dampened with drugs or other measures. Considerably more research is needed to allow nurses to assess sleep problems and intervene to achieve the intended therapeutic effect with greater precision.

Adult↗