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PubMedDate not supplied

Sleep problems as possible predictors of intensified symptoms of autism.

Researchers have been placing an increased importance on discovering what variables contribute to better prognosis during behavioral interventions for children with autism. This article preliminarily identifies sleep problems that may exacerbate symptoms of autism; thus, possibly influencing effectiveness of daytime interventions. A data-base of parent report of sleep problems of children with autism (N=55), ranging from 5 to 12 years of age (M=8.2 years) was evaluated. Results suggested that fewer hours of sleep per night predicted overall autism scores and social skills deficits. Similarly, stereotypic behavior was predicted by fewer hours of sleep per night and screaming during the night. Increased sensitivity to environmental stimuli in the bedroom and screaming at night predicted communication problems. Finally, sensitivity to environmental stimuli in the bedroom also predicted fewer developmental sequence disturbances. The results indicate that sleep problems and the diagnostic characteristics of autism may be related. However, future research must be completed to determine the specific relationship.

Autistic Disorder↗

PubMed2002

Sleep problems in children and young adults with developmental disabilities: home-based functional assessment and treatment.

Sleep problems such as settling problems, frequent night waking, and early waking are prevalent as well as persistent with children and young adults with developmental disabilities who live at home. In this study, results of pretreatment functional assessment suggested that parental attention may have shaped and maintained the sleep problems with four participants. Effectiveness of extinction of parental attention, that is planned ignoring, was assessed on number of minutes of nighttime disruptive behaviors. Treatment resulted in a normalized sleep pattern in all cases and effects were maintained across time.

Adolescent↗

PubMed1997

Identification and treatment of sleep problems in the elderly.

For many adults, changes in sleep occur with aging. An estimated 15 million elderly, or 50% of older Americans, experience some sleep problem. The elderly complain that their sleep is more fragmented and that as they have gotten older, they experience more daytime sleepiness. Laboratory studies have confirmed these complaints. Research has shown that it is not the need for sleep that decreases with age, but rather the ability to sleep. Circadian rhythm disturbances, sleep disorders such as sleep disordered breathing and periodic movements in sleep, medical illness, medication use, and impaired cognitive functioning all contribute to poor sleep and decreased daytime alertness. In institutionalized elderly, sleep is even more disturbed and disrupted. With careful assessment, many of these problems can be addressed and treated, and sometimes cured.

Journal Article↗

PubMed1991

[Sleep problems and use of hypnotics in a nursing home. An inventory].

An inventory has been made on sleeping problems and the use of hypnotics in a nursing home. Contrary to general opinion, the results show that admission to a nursing home does not have to lead to an increase of hypnotics and neuroleptics used. One third of the total patient population revealed severe subjective sleeping problems, for which, however, a therapeutic intervention was not always necessary. In particular somatic revalidation patients showed high percentages of sleeping complaints and medical treatment. A communication hypothesis is presented as a possible explanation: somatic patients are able to ask for medication contrary to psychogeriatric patients, for whom the caregiving network often initiates therapeutic intervention. Attention is focussed on a few sleep disturbing stimuli that often occur in the setting of a nursing home. Prevention of these stimuli implicates changes in the nursing care organization.

Aged↗

PubMed2001

Treatment of sleep problems in a 5-year-old boy with autism using behavioural principles.

This article presents a case study which is part of a larger project on sleep problems in children with autism. The successful treatment of sleep problems (night settling, night waking, and co-sleeping) in a boy of 5 years 4 months with autism is described. The intervention was based on behavioural principles and involved the parents attending an individually-run parent training programme. The programme consisted of an interview, three weekly training sessions and a review session. The parents learned how to use a bedtime routine, reinforcement, effective instructions, partner support strategies and extinction procedures. Once the techniques were implemented, the child learned how to settle himself to bed and how to sleep alone for the entire night. For this child, the results of the sleep programme were clinically significant as measured by a scale of goal achievement, and were maintained at a 3 month and a 12 month follow-up.

Autistic Disorder↗

PubMed2006

The prevalence and spectrum of sleep problems in women with transformed migraine.

OBJECTIVES: It is our clinical observation that patients with transformed migraine (TM) almost invariably report nonrestorative sleep. In this study we sought first to validate that clinical observation, then to describe the prevalence and spectrum of factors that might contribute to nonrestorative sleep in a TM population. BACKGROUND: Although headaches have been linked with sleep problems for over a century, there is little information about the spectrum or prevalence of specific sleep problems associated with TM in adults. METHODS: We conducted a detailed sleep interview on 147 consecutive women with TM. Subjective sleep quality was assessed by asking patients to describe their state upon awakening as "refreshed" or "tired." RESULTS: None of the 147 patients reported awakening "refreshed," and 83.7% stated that they awakened "tired." Sleep complaints were prevalent and varied in this population. CONCLUSIONS: Although the relationship between pain and sleep is complex and ill understood, we found a very high prevalence of nonrestorative sleep and a similarly high prevalence of modifiable poor sleep habits in patients with TM. Since behavioral approaches have been found effective in improving sleep quality in patients with poor sleep hygiene, we propose that studies be undertaken to assess the impact of such treatment on TM.

Adolescent↗

PubMed1986

Sleep problems in handicapped children: a preliminary study.

Data are reported from an exploratory study looking at the prevalence of sleep problems (broken sleep and limited hours of sleep) in a population of handicapped children. Some degree of difficulty occurred in over a third of the population. There were strong associations with age, a range of serious daytime behavioural difficulties and indices of family stress. Some support for distinct subgroups (night waking, limited hours) was obtained. The implications of these findings are discussed.

Adolescent↗

PubMed2003

The prevalence of restless legs syndrome among pregnant women in Japan and the relationship between restless legs syndrome and sleep problems.

STUDY OBJECTIVES: To clarify the prevalence of restless legs syndrome (RLS) in pregnant women living in Japan and to analyze the relationship between sleep problems and RLS, in order to discuss ways for pregnant women to obtain comfortable sleep and to improve the health of both the mother and child. DESIGN: A cross-sectional questionnaire survey. SETTING: 500 clinical institutions with maternity services were randomly sampled from a list of organizations identified in a survey by the Japan Association of Obstetricians and Gynecologists. Of these 500 institutions, 260 participated in the survey. PARTICIPANTS: 16,528 pregnant women living in Japan. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: In this survey of pregnant women, the prevalence of RLS was found to be 19.9%. An analysis was conducted on the relationship between RLS and other factors such as subjective evaluation of sleep, difficulty initiating sleep, difficulty maintaining sleep, early morning awaking, and excessive daytime sleepiness. The result of this analysis suggested that women with these sleep-related problems were more likely to have RLS than those without. In addition, RLS was more prevalent in the later stages of pregnancy. CONCLUSION: In the pregnant women in our survey, the prevalence of RLS was found to be 19.9%, which is higher than the prevalence of RLS that has been found in the general public in a previous study. This suggests that RLS-related sleep problems may be an important public health issue among pregnant women in Japan. This finding may have implications for attempts to improve sleep hygiene in this group.

Adult↗

PubMed1996

Sleep problems in children with Sanfilippo syndrome.

Sanfilippo syndrome is a rare degenerative disorder which has severe intellectual and behavioural sequelae, commonly including sleep problems. A parental questionnaire was used to gather information on the sleep patterns of 80 children with Sanfilippo syndrome (mean age 10 years 2 months). The majority were found to have sleep problems (78%). Many also exhibited other distressing and unusual night time behaviours (staying up all night, chewing the bedclothes or crying out suddenly), and a few laughed or sang. Such problems may have been more severe in those with Sanfilippo syndrome type B. In four of the families offered individually tailored behaviour-management advice there was immediate improvement, which was maintained at followup in two cases. These results demonstrate the usefulness of even such a minimal intervention, even in a very difficult population such as this.

Child↗

PubMed1991

Sleep patterns and sleep problems amongst people with mental handicap.

This paper is in two parts. The first part reviews the available literature describing sleep patterns of people with mental handicap and the nature and prevalence of sleep disorders amongst this client group. Both electroencephalographic studies and informant-based reports are included. The literature is small, particularly in terms of the latter reports, and most of the information from both E.E.G. and informant sources describes populations of children with mental handicap. The need for further investigation of sleep and sleep problems, particularly amongst adults with mental handicap, therefore, becomes evident. The second part presents the results of a detailed sleep survey of 120 adults with mental handicap, approximately half of whom were resident in hospital and half in the community. A descriptive summary of the total sample is provided. Fifteen per cent of the sample presented significant sleep problems, particularly in the form of intermittent wakenings. The results of comparisons between (1) good and poor sleepers (2) hospital and community residents and (3) people with mental handicap and 'normal' adults (using data from another study) are then presented. The relationships between sleep and daytime functioning and the potential usefulness of behavioural approaches to management of sleep pattern are discussed.

Adult↗

PubMed1999

Time perspective and sleep problems.

In this study of 137 university students, we examined the relationships among the five dimensions of the Zimbardo Time Perspective Inventory and three scales that measure aspects of sleep problems. All of the Zimbardo Inventory dimensions correlated significantly with each of the sleep problem-related scales. These data suggest that concern about time, regardless of the specific nature of individuals' time perspective, and certain sleep problems are significantly related.

Arousal↗

PubMed2001

Sleep problems: a predictor of long-term work disability? A four-year prospective study.

AIMS: This study investigates sleep problems as a predictor of long-term work disability. METHODS: Data from a community-based four-year prospective study were used. In 1990, all inhabitants of the municipality of Ullensaker, Norway, belonging to six age cohorts (20-22, 30-32, 40-42, 50-52, 60-62, and 70-72 years), were mailed a questionnaire. Of the 1,788 responders who were working and not older than 62 years, 1,426 (80%) returned a second questionnaire four years later (1994). RESULTS: Reporting mediocre or poor sleep (in contrast to good) in 1990 was significantly related to long-term work disability (> 8 weeks) during the previous 12 months in 1994 (odds ratio = 2.16; 95% confidence interval = 1.26-3.72), after adjustments for age, gender, civil status, body mass index, emotional symptoms, musculoskeletal pain, self-evaluated health, smoking, physical exercise, job satisfaction, and work characteristics. CONCLUSION: The study indicates that sleep problems are a predictor of long-term work disability.

Adult↗

PubMed2002

Physical exercise for sleep problems in adults aged 60+.

BACKGROUND: The prevalence of sleep problems in adulthood increases with age. While not all sleep changes are pathological in later life, severe disturbances may lead to depression, cognitive impairments, deterioration of quality of life, significant stresses for carers and increased healthcare costs. The most common treatment for sleep disorders (particularly insomnia) is pharmacological. The efficacy of non-drug interventions has been suggested to be slower than pharmacological methods, but with no risk of drug-related tolerance or dependency. Physical exercise, taken regularly, may promote relaxation and raise core body temperature in ways that are beneficial to initiating and maintaining sleep. OBJECTIVES: To assess the efficacy of physical exercise amongst older adults (aged 60 and above). SEARCH STRATEGY: We searched: MEDLINE (1966 - October 2001); EMBASE (1980 - January 2002), CINAHL ( 1982 - January 2002; PsychINFO 1887 to 2002; The Cochrane Library (Issue 1, 2002); National Research Register (NRR [2002]). Bibliographies of existing reviews in the area, as well as of all trial reports obtained, were searched. Experts in the field were consulted. SELECTION CRITERIA: Randomised controlled trials of physical exercise for primary insomnia where 80% or more of participants were over the age of 60. Participants must have been screened to exclude those with dementia and/or depression. DATA COLLECTION AND ANALYSIS: Abstracts of studies identified in searches of electronic databases were read and assessed to determine whether they might meet the inclusion criteria. Data were analysed separately depending on whether results had been obtained subjectively or objectively. MAIN RESULTS: One trial, including 43 participants with insomnia, examined the effectiveness of exercise in a population within an elderly population. At post-treatment, sleep onset latency improved slightly for both men and women. Total sleep duration, sleep onset latency and scores on a scale of global sleep quality showed significant improvement. Improvements in sleep efficiency were not significant. In some cases improvements indicated falls to below what are usually considered pathological levels but the wide confidence intervals and small sample size indicate that these findings must be interpreted with caution. REVIEWER'S CONCLUSIONS: When the possible side-effects of standard treatment (hypnotics) are considered, there is an argument to be made for clinical use of alternative treatments in the elderly. Exercise, though not appropriate for all in this population, may enhance sleep and contribute to an increased quality of life. Research involving exercise programmes designed with the elderly in mind is needed.

Aged↗

PubMed2003

Sleeping problems and health behaviors as mediators between organizational justice and health.

The aim of this longitudinal cohort study was to investigate whether sleeping problems and health behaviors (smoking, alcohol consumption, and sedentary lifestyle) mediate the association between organizational justice and employee health. Health indicators were minor psychiatric morbidity, as assessed by the General Health Questionnaire (U. Werneke, D. P. Goldberg, I. Yalcin, & B. T. Ustun, 2000), and poor self-rated health status. The results of logistic regression analysis of data for 416 male and 3,357 female hospital employees working during the 1998-2000 period in 10 Finnish hospitals suggest that sleeping problems are one of the underlying factors causing the adverse health effects of low organizational justice at work. No support for a mediating role of health behaviors between low organizational justice and health problems was obtained.

Adolescent↗

PubMed2005

The effect of escitalopram on sleep problems in depressed patients.

The results from three 8-week escitalopram studies in major depressive disorder are presented with respect to efficacy and the effect on sleep quality, both in the full population and the subpopulation of patients with sleep problems at baseline. Analysis of pooled data from these randomized, double-blind, placebo-controlled, studies in which citalopram was the active reference, showed a significant improvement for escitalopram-treated patients (n = 52.0) in the Montgomery-Asberg depression rating scale (MADRS) item 4 ('reduced sleep') scores at weeks 6 and 8 compared with placebo (n=398; p < 0.01) and at weeks 4, 6 and 8 (n = 403; p < 0.05) compared with citalopram.Escitalopram-treated patients with sleep problems (MADRS item 4 score > or = 4; n = 254) at baseline showed a statistically significant improvement in mean MADRS item 4 scores at weeks 4, 6 and 8 compared with patients treated with placebo (n = 191; p < 0.05) or citalopram (n = 193; p < 0.01). These patients also showed a statistically significant (p < 0.05) and clinically relevant improvement in MADRS total score after escitalopram treatment compared with citalopram at weeks 1, 4, 6 and 8 (observed cases) and endpoint (-2.45; last observation carried forward [LOCF]). Statistical significance in favour of escitalopram versus placebo treatment was found at all visits, including endpoint (-4.2; LOCF).Thus, these post-hoc analyses suggest that escitalopram has a significant beneficial effect compared with placebo or citalopram in reducing sleep disturbance in patients suffering from major depressive disorder. The effect of escitalopram in improving 'reduced sleep' scores was clearly seen in patients with more severe sleep disturbance at baseline. A further prospective study is needed to establish this useful clinical effect in insomniac depressives.

Adolescent↗

PubMedDate not supplied

The effectiveness of group therapy in treating children's sleeping problems.

The behavioural management approach to treating children's sleeping problems is being used by increasing numbers of health professionals. Despite this there are few formal evaluations of its effectiveness. In this study sleeping patterns of infants in a treatment and a control group were compared. Questionnaires about sleeping were given to mothers before treatment and afterwards, the questionnaires were given to mothers in the control group over a comparable period of time. Both groups of infants appeared to improve their sleeping over the period of the study, and no differences were found in the sleeping patterns of the two groups. The reasons for these findings are discussed.

Adult↗

PubMed1989

Cosleeping and sleep problems in Hispanic-American urban young children.

To assess whether the traditional pediatric prohibition against cosleeping in the parental bed requires reconsideration for urban ethnic minorities, cosleeping and sleep problems were studied in a sample of Hispanic-American, east Harlem, New York City, children 6 to 48 months of age. The incidence of frequent all-night cosleeping was found to be 21%, significantly higher than the documented rate of 6% found in a representative sample of white middle-American urban children of the same age and sex. For occasional cosleeping, however, there were no significant ethnic differences, and frequent part-night cosleeping was significantly less common than noted in the white sample. There were greater ethnic differences for sharing the parental bedroom compared with cosleeping in the parental bed, approximately 80% for Hispanic-Americans vs 10% for the white population. Within the Hispanic-American group, frequent all-night cosleeping was significantly more common among single parents and those living in multiple households and less common among infants and later-born children in the family. Frequent all-night cosleeping was also significantly associated with sleep problems.

Child, Preschool↗

PubMed2001

Sleep problems in primary school children: comparison between mainstream and special school children.

This paper reports on a study of the prevalence and social correlates of dyssomnias, features associated with obstructive sleep apnoea, and parasomnias in primary school children aged 4-12. Head teachers of schools selected randomly from lists of local primary and special schools were contacted by telephone and asked to distribute a questionnaire package to the parents of all pupils aged 4-12 years. In all, 890 parents of children from mainstream schools and 300 from special schools were approached. The response rates were 64.7% and 60%, respectively. The results showed that significantly higher proportions of children in special schools than in mainstream schools presented four of the five dyssomnias investigated and all of the features associated with obstructive sleep apnoea. In contrast, only two of the seven parasomnias were presented by higher proportions of the children in special schools. Age and gender differences for the two groups of children are presented. Finally, multiple correlations were computed between a range of child, family, and environmental characteristics and the three problems most frequently reported: frequency of settling problems; sleeping in the parents' bed; and night waking. The findings are discussed with reference to other studies of children's sleep problems, and the implications for treatment are considered.

Child↗