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Fuller-Rowell TE, Zeringue MM, Saini EK, Sultana S, El-Sheikh M. Changes in actigraphy-assessed sleep from childhood to adolescence: The role of neighborhood socioeconomic disadvantage. Sleep Health 2025:S2352-7218(25)00073-7. [PMID: 40393838 DOI: 10.1016/j.sleh.2025.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 04/01/2025] [Accepted: 04/02/2025] [Indexed: 05/22/2025]
Abstract
OBJECTIVES Few studies have examined longitudinal effects of neighborhood socioeconomic disadvantage on objectively assessed sleep outcomes among youth. This study examined neighborhood disadvantage as a predictor of changes in actigraphy-assessed sleep over a 6-8-year period from childhood to adolescence. Racial/ethnic differences in effects were also considered. METHODS Participants were 339 children residing in small towns and semirural contexts within the Southeastern region of the United States (Mage T1 = 10.3years, SD = 0.8; 46% female; 36% Black, 64% White; Mage T2 = 17.6years, SD = 0.8). Sleep duration (from onset to wake time) and quality/continuity (efficiency and long wake episodes) were assessed using wrist actigraphy. Neighborhood disadvantage was assessed from established census tract measures geocoded to childhood residential addresses. RESULTS Sleep duration decreased between childhood and adolescence and sleep quality/continuity increased. Neighborhood disadvantage was associated with decreases in sleep quality/continuity from childhood to adolescence, but was not associated with sleep duration. Neighborhood effects remained significant after adjusting for family socioeconomic status. Interaction effects between neighborhood disadvantage and race indicated that the magnitude of neighborhood effects on changes in sleep quality/continuity were larger for Black youth than for White youth. CONCLUSIONS This study is the first to show that objectively assessed neighborhood disadvantage is associated with longitudinal changes in actigraphy-assessed sleep quality from childhood to adolescence, and that this association was larger for Black youth than for White youth. The results suggest that neighborhood factors may be key to addressing widening racial disparities in sleep across this developmental period.
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Affiliation(s)
- Thomas E Fuller-Rowell
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, United States.
| | - Megan M Zeringue
- Department of Psychology, Middle Tennessee State University, Murfreesboro, Tennessee, United States
| | - Ekjyot K Saini
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania, United States
| | - Samia Sultana
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, United States
| | - Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, United States
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2
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Matzliach O, Horwitz A, Ran-Peled D, Tikotzky L. A longitudinal study of the bi-directional relations between parental bedtime and nighttime involvement and infant sleep. Sleep Med 2025; 129:55-66. [PMID: 39986048 DOI: 10.1016/j.sleep.2025.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 02/05/2025] [Accepted: 02/09/2025] [Indexed: 02/24/2025]
Abstract
OBJECTIVE This longitudinal study assessed the prospective bidirectional links between parental involvement during bedtime and nighttime and infants' sleep during the first year of life. METHODS The sample included 207 families at 4 months, 177 at 8 months, and 154 at 12 months. Infant sleep was assessed at home for seven nights using actigraphy, sleep diaries, and the Brief Infant Sleep Questionnaire (BISQ). Parental bedtime and nighttime involvement were reported daily by parents through sleep diaries at all time points. RESULTS Concomitant associations (controlling for sleeping arrangements) were found between parental bedtime and nighttime involvement and between infant objective and reported sleep quality measures (i.e., number of night-wakings, wake after sleep onset [WASO], and subjective infant sleep problems). Structural Equation Modeling analyses demonstrated significant prospective associations: Higher parental bedtime involvement at 4 months predicted an increase in infant number of night-wakings from 4 to 8 months. Moreover, higher levels of parental bedtime and nighttime involvement at 8 months predicted an increase in infant WASO from 8 to 12 months. Only one SEM model demonstrated a significant cross-lagged link from infant sleep quality to parental involvement: More perceived infant sleep problems at 4 months predicted a decrease in parental bedtime involvement from 4 to 8 months. CONCLUSIONS The findings suggest that higher levels of parental involvement in soothing the infant to sleep at bedtime and nighttime predict poorer infant sleep quality. Only limited evidence was found for infant-driven links.
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Affiliation(s)
- Ofek Matzliach
- Department of Psychology, Ben-Gurion University of the Negev, Israel
| | - Avel Horwitz
- Department of Psychology, Ben-Gurion University of the Negev, Israel
| | - Dar Ran-Peled
- Department of Psychology, Ben-Gurion University of the Negev, Israel
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev, Israel.
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3
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Breda M, Lucchini M, Barnett N, Bruni O. Early identification of sleep phenotypes in infants by videosomnography: a cross-sectional study. J Clin Sleep Med 2025; 21:867-874. [PMID: 39906982 PMCID: PMC12048309 DOI: 10.5664/jcsm.11576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 01/20/2025] [Accepted: 01/23/2025] [Indexed: 02/06/2025]
Abstract
STUDY OBJECTIVES We aimed to identify different sleep phenotypes in infancy, relying on auto-videosomnography metrics. METHODS In this cross-sectional study, objective infant sleep metrics of 623 infants aged 9-13 months, recruited among users of Nanit baby monitors in the United States, were obtained from Nanit auto-videosomnography (1 week of data averaged) in the children's natural sleep environment. A cluster analysis was conducted to group infants based on sleep metrics. RESULTS Three reproducible and stable sleep phenotypes were identified: Long Sleepers (n = 338), Interrupted Sleepers (n = 130), and Short Sleepers (n = 155). All sleep metrics were statistically significantly different in the 3 groups. Long Sleepers had longer nighttime sleep duration than Interrupted and Short Sleepers. Interrupted Sleepers presented more awakenings than Short and Long Sleepers and more parental interventions. Short Sleepers presented later bedtimes and earlier wake times compared with Long and Interrupted Sleepers. Nighttime sleep efficiency was better in Long Sleepers than in Interrupted and Short Sleepers, but Short Sleepers presented better sleep efficiency than Interrupted Sleepers. CONCLUSIONS Cluster analysis based on objective sleep metrics offers a novel multidimensional approach for the early identification of infants' sleep patterns. Phenotyping sleep patterns is extremely important in identifying the risk for developing neurobehavioral disorders, because night wakings and reduced sleep duration in infancy might be predictive of the development of emotional and behavioral problems later in childhood. CITATION Breda M, Lucchini M, Barnett N, Bruni O. Early identification of sleep phenotypes in infants by videosomnography: a cross-sectional study. J Clin Sleep Med. 2025;21(5):867-874.
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Affiliation(s)
- Maria Breda
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | | | | | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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Zhang Z, Abdeta C, Chelly MS, del Pozo-Cruz J, Draper CE, Engberg E, Florindo A, Germana L, Ghofranipour F, Guan H, Ha ASC, Hamdouchi AE, Tang HK, Hossain MS, Jambaldorj B, Kim DH, Koh D, Kontsevaya A, Löf M, Lubree H, Jáuregui A, Munambah N, Mwase-Vuma T, Oluwayomi A, Pham BN, Reilly JJ, Staiano AE, Suherman A, Tanaka C, Tanui S, Teo WP, Tremblay MS, Turab A, Užičanin E, Veldman SLC, Webster EK, Wickramasinghe VP, Widyastari DA, Okely A. Geocultural differences in preschooler sleep profiles and family practices: an analysis of pooled data from 37 countries. Sleep 2025; 48:zsae305. [PMID: 39715306 PMCID: PMC11985386 DOI: 10.1093/sleep/zsae305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 12/03/2024] [Indexed: 12/25/2024] Open
Abstract
STUDY OBJECTIVES To examine (1) multidimensional sleep profiles in preschoolers (3-6 years) across geocultural regions and (2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, and Latin America) and the Minority World (the Western world). METHODS Participants were 3507 preschoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n = 1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences. RESULTS Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children's bedroom (Eastern Europe, Latin America, South Asia: OR = 5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR = 7.05-49.86), compared to the Minority World. CONCLUSIONS Preschoolers' sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, School of Education, University of Wollongong, Wollongong, Australia
| | - Chalchisa Abdeta
- Early Start, School of Education, University of Wollongong, Wollongong, Australia
| | - Mohamed Souhaiel Chelly
- Research Laboratory (LR23JS01), Higher Institute of Sport and Physical Education of Ksar Saîd, University of Manouba, Tunis, Tunisia
| | - Jesús del Pozo-Cruz
- School of Health and Society, University of Wollongong, Wollongong, Australia
- Department of Physical Education and Sport, University of Seville, Seville, Spain
- Epidemiology of Physical activity and Fitness Across Lifespan Research Group (EPAfit), University of Seville, Seville, Spain
| | - Catherine E Draper
- SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Alex Florindo
- School of Arts, Sciences, and Humanities, Universidade de Sao Paulo Escola de Artes Ciencias e Humanidades, Sao Paulo, Brazil
| | - Leyna Germana
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Fazlollah Ghofranipour
- Department of Health Education and Health Promotion, Tarbiat Modares University, Tehran, Iran
| | - Hongyan Guan
- Department of Early Childhood Development, Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Amy Sau-Ching Ha
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong
| | - Asmaa El Hamdouchi
- Unité de Recherche en Nutrition et Alimentation, Centre National de l’Énergie des Sciences et des Techniques Nucléaires, Rabat, Morocco
| | - Hong K Tang
- Department of Epidemiology, Faculty of Public Health, Pham Ngoc Thach University of Medicine’s Fund for Science, Ho Chi Minh City, Vietnam
| | - Mohammed Sorowar Hossain
- Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh
| | - Bayasgalan Jambaldorj
- National Centre for Public Health, Mongolia Ministry of Health, Ulaanbaatar, Mongolia
| | - Dong Hoon Kim
- Korea Institute of Child Care and Education, Seoul, Republic of Korea
| | - Denise Koh
- Centre of Community Education and Well-being, Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Anna Kontsevaya
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia
| | - Marie Löf
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Himangi Lubree
- Vadu Rural Health Program, KEM Hospital Research Centre, Rasta Peth, Pune, India
| | - Alejandra Jáuregui
- Department of Physical Activity and Healthy Lifestyles, The National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - Nyaradzai Munambah
- Rehabilitation Sciences Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Aoko Oluwayomi
- Department of Human Kinetics and Health Education, University of Lagos, Lagos, Nigeria
| | - Bang Nguyen Pham
- Population Health and Demography Unit, PNG Institute of Medical Research, Goroka, Papua New Guinea
| | - John J Reilly
- Physical Activity and Health Group, Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Amanda E Staiano
- Division of Population and Public Health Science, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Adang Suherman
- Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, Indonesia
| | - Chiaki Tanaka
- Department of Human Nutrition, Tokyo Kasei Gakuin University, Tokyo, Japan
| | | | - Wei-Peng Teo
- National Institute of Education, Physical Education and Sports Science Department, Nanyang Technological University, Singapore
| | - Mark S Tremblay
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Ali Turab
- Precision Health Consultants (PHC Global), Karachi, Pakistan
| | - Edin Užičanin
- Faculty of Physical Education and Sport, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | | | - E Kipling Webster
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, United States
| | | | - Dyah Anantalia Widyastari
- Thailand Physical Activity Knowledge Development Centre, Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Anthony Okely
- School of Health and Society, University of Wollongong, Wollongong, Australia
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Wang Y, Zhao Z, Zhang MR, Zhang Y, Yan J, Jelsma E, Cham H, Alegría M, Yip T. Sleep as a Protective Factor: Multiple Forms of Discrimination and Substance Use Intention Among Racially and Ethnically Minoritized United States Youth. J Adolesc Health 2025; 76:718-726. [PMID: 39945682 PMCID: PMC11930617 DOI: 10.1016/j.jadohealth.2024.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 11/12/2024] [Accepted: 12/04/2024] [Indexed: 03/25/2025]
Abstract
PURPOSE Research has rarely examined biobehavioral factors in mitigating substance use (SU) risks associated with discrimination among racially and ethnically minoritized youth. This study investigated sleep duration as a potential moderator of the association between multiple forms of discrimination based on race and ethnicity, sexual orientation, and weight (i.e., multiple discrimination) and subsequent SU intention in this population. METHODS Data were drawn from a national, longitudinal sample of racially and ethnically minoritized early adolescents (N = 3,495, Mage = 11.52 years) participating in the Adolescent Brain Cognitive Development Study. Multiple discrimination was assessed through aggregated youth reports at 1-year follow-up (Y1) and 2-year follow-up (Y2). Sleep duration was assessed at Y2 via self-reports in the full sample and actigraphy over 3 weeks in a subsample (N = 1,404). Youth reported SU intention at Y2 and 3-year follow-up (Y3). Relevant sociodemographic and psychosocial covariates were included. RESULTS Path analyses showed that more exposure to multiple discrimination was associated with greater subsequent SU intention, controlling for prior SU intention levels. However, this association was only significant among adolescents with shorter sleep duration on weekdays, not among those who slept longer (above 9.6 hours based on self-reports or 7.5 hours based on actigraphy) on weekdays. Actigraphy sleep duration mean and variability also exhibited nuanced linkages with subsequent SU intention. DISCUSSION Findings highlighted sleep duration as a promising lever of change for preventative interventions aiming to curb SU among racially and ethnically minoritized youth in early development.
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Affiliation(s)
- Yijie Wang
- Department of Human Development and Family Sciences, Michigan State University, East Lansing, Michigan.
| | - Zhenqiang Zhao
- Department of Psychology, Fordham University, Bronx, New York
| | - Meng-Run Zhang
- Department of Psychology, Fordham University, Bronx, New York
| | - Youchuan Zhang
- Department of Human Development and Family Sciences, Michigan State University, East Lansing, Michigan
| | - Jinjin Yan
- Department of Psychology, Fordham University, Bronx, New York
| | - Elizabeth Jelsma
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, Texas
| | - Heining Cham
- Department of Psychology, Fordham University, Bronx, New York
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Tiffany Yip
- Department of Psychology, Fordham University, Bronx, New York
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Merín L, Nieto M, Sánchez-Arias L, Ros L, Latorre JM. Actigraphy-assessed sleep duration and quality and executive function in a sample of typically developing preschoolers. Eur Child Adolesc Psychiatry 2025; 34:1379-1390. [PMID: 39190152 PMCID: PMC12000266 DOI: 10.1007/s00787-024-02558-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/07/2024] [Indexed: 08/28/2024]
Abstract
Sleep is essential for cognitive development and brain maturation during early childhood. Studies focused on preschool populations using objective measures of sleep are still scarce. The objective of this study was to examine the associations between objective measures of sleep duration and quality with executive functioning in a 133 non-clinical sample of Spanish participants (Mage = 60.33 months, SD = 9.04; ages 41-77 months; 51.1% girls). Sleep was assessed for five weeknights using actigraphy; Shape School task was applied to assess inhibition and cognitive flexibility; and Word Span task was used to assess working memory. The results revealed that relation between sleep and executive functioning was significant for inhibition and working memory. Preschoolers with higher sleep efficiency showed better results in executive functioning tasks after controlling for the effect of age. Additionally, age and sleep duration and quality variables were predictive of inhibition, working memory, and cognitive flexibility. These results suggest that the different dimensions of sleep could play an important role in the development of executive functions during preschool age. Therefore, improving sleep could lead to an improvement in children's executive functioning in both clinical and educational contexts.
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Affiliation(s)
- Llanos Merín
- University of Castilla-La Mancha, Faculty of Medicine, Albacete, Spain
| | - Marta Nieto
- University of Castilla-La Mancha, Faculty of Medicine, Albacete, Spain.
| | | | - Laura Ros
- University of Castilla-La Mancha, Faculty of Medicine, Albacete, Spain
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Kahn M, Lucchini M, Oster E, Thakur S, Waugh M, Barnett N. Does Teething Disrupt Infant Sleep? A Longitudinal Auto-Videosomnography Study. J Pediatr 2025; 279:114461. [PMID: 39788183 DOI: 10.1016/j.jpeds.2025.114461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 12/15/2024] [Accepted: 01/04/2025] [Indexed: 01/12/2025]
Abstract
OBJECTIVE To examine prospectively the relationship between teething and infant sleep using objective sleep measurements. STUDY DESIGN Over a 4-week period, 849 infants aged 3-18 months (mean = 8.4 ± 1.8) from the US and Canada were monitored using auto-videosomnography, based on computer-vision technology to decode video footage from crib camera monitors. Parents also provided reports of tooth eruption timing, symptoms, and management strategies. Objective sleep metrics, including total sleep time, night-time awakenings, and parental crib visits, were compared between teething and nonteething nights using generalized estimating equations and changepoint analysis. RESULTS Both analytic approaches showed no significant differences in sleep metrics between teething and nonteething nights. Although over one-half of the parents reported sleep disturbances during teething, these subjective reports were not corroborated by the objective data. CONCLUSIONS These findings challenge the widely held belief that teething disrupts sleep and highlight the need for pediatric health care professionals to consider alternative explanations for infant sleep problems. Educating parents with evidence-based information may prevent potentially harmful management strategies for teething (eg, excessive use of analgesics and local anesthetics) and improve sleep problem management. Future research should explore these relationships using multiple objective measures and more diverse populations.
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Affiliation(s)
- Michal Kahn
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
| | | | - Emily Oster
- Department of Economics, Brown University, Providence, RI
| | | | - Mali Waugh
- Department of Developmental Psychology, The Graduate Center, City University New York, New York, NY
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8
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van Lee L, Meijer‐Krommenhoek Y, He T, van der Zee L, Verkade H. Sleep duration among breastfed, goat milk-based or cow's milk-based infant formula-fed infants: Post hoc analyses from a double-blind RCT. J Pediatr Gastroenterol Nutr 2025; 80:482-489. [PMID: 39698907 PMCID: PMC11874161 DOI: 10.1002/jpn3.12436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 11/09/2024] [Accepted: 11/18/2024] [Indexed: 12/20/2024]
Abstract
OBJECTIVES To determine total, night- and daytime sleep duration and waking frequency among infants exclusively fed goat milk-based infant formula (GMF) or cow's milk-based infant formula (CMF) enroled in a randomised controlled trial and compare these to a human milk (HM) fed reference group. METHODS Post hoc analysis from a double-blind randomised controlled trial in 304 healthy term infants was performed. Formula-fed infants were randomly assigned to receive exclusively GMF or CMF for a period of 112 days and compared to a reference group fed HM. Sleep was assessed using a 3-day 24-h diary before the five visits throughout the trial. The association between feeding type and sleep was studied longitudinally and cross-sectionally at the five visits. All models were adjusted for infant sex and study site of enrolment. For associations between formula-fed infants and the non-randomised HM group, additional adjustments were made. RESULTS Total sleep duration slowly and similarly decreased over the course of study duration for all groups, with a decrease of about an hour between the first and last measurement. Longitudinally, daytime sleep duration was significantly longer for GMF (mean 8.6 h, standard error [SE] 0.17) and HM (8.8, 0.18) fed infants as compared to CMF (8.1, 0.17; p < 0.05). Cross-sectional analyses show that infants fed GMF or HM had higher total sleep duration than infants fed CMF at all visits, with significant differences between the groups at Visits 3 and 4. CONCLUSIONS In infants fed GMF a significantly longer daytime sleep duration and a non-significant trend towards a longer total sleep duration were found when compared to infants fed CMF. These findings suggest that nutrition plays a role in sleep duration.
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Affiliation(s)
| | | | - Tao He
- Ausnutria B.V.Zwollethe Netherlands
| | | | - Henkjan Verkade
- Pediatric Gastroenterology & Hepatology, Department of Pediatrics, Beatrix Children's Hospital/University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Wang Y, Zhao Z, Zhang Y, Yan J, Zhang MR, Jelsma E, Johnson S, Cham H, Alegría M, Yip T. Race, Ethnicity, and Sleep in US Children. JAMA Netw Open 2024; 7:e2449861. [PMID: 39656455 PMCID: PMC11632548 DOI: 10.1001/jamanetworkopen.2024.49861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 10/17/2024] [Indexed: 12/13/2024] Open
Abstract
Importance Although racial and ethnic disparities are well documented in children's mean levels of sleep, particularly duration, evidence is mixed for sleep variability, an important sleep dimension of growing interest. Most research has also focused on comparisons of Black and White children, with limited attention to sleep variability disparities among other racially and ethnically minoritized groups such as Asian, Latinx, and multiracial children. Objective To investigate racial and ethnic disparities in children's mean levels of sleep and variability of sleep across multiple dimensions and diverse racial and ethnic groups using actigraphy data. Design, Setting, and Participants This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study, a national cohort study, from 21 study sites across the US. ABCD participants were recruited at baseline (2016-2018) using a multistage, stratified, probability sampling method. The current study used a subsample with reliable actigraphy data collected at 2-year follow-up (2018-2020). Data analysis occurred from July 2023 to October 2024. Exposures Parent-reported race and ethnicity at baseline. Sociodemographic, health, and contextual covariates of sleep were also included. Main Outcomes and Measures Actigraphy-assessed mean levels of sleep and sleep variability across multiple dimensions (duration, bedtime, risetime, efficiency, and latency) over 3 weeks. Results The analytic sample included 3868 children (mean [SD] age, 11.50 [0.67] years; 1913 female [49.5%]), of whom 104 (2.7%) were Asian, 347 (9.0%) were Black or African American, 801 (20.7%) were Latinx, 356 (9.2%) were multiracial, and 2260 (58.4%) were White. Asian, Black, Latinx, and multiracial children exhibited shorter sleep duration and later bedtime than White children. Importantly, compared with White children, bedtime variability was greater among Asian (β = 0.04; 95% CI, 0.01 to 0.07; P = .02), Black (β = 0.11 95% CI, 0.08 to 0.15; P < .001), Latinx (β = 0.08; 95% CI, 0.05 to 0.12; P < .001), and multiracial children (β = 0.08; 95% CI, 0.05 to 0.11; P < .001). Similarly, risetime variability was greater among Asian (β = 0.04; 95% CI, 0.01 to 0.07; P = .01), Black (β = 0.08; 95% CI, 0.04 to 0.12; P < .001), and Latinx (β = 0.06; 95% CI, 0.02 to 0.10; P < .01) children in comparison with White children. Black children exhibited the most profound disparities across mean levels (duration and bedtime) and variability of sleep (duration, bedtime, risetime, and efficiency) than other groups. Asian and multiracial children also exhibited some disparities sleep duration, efficiency, and efficiency variability, when compared with Latinx children. Conclusions and Relevance In this cross-sectional study of children's sleep disparities, racially and ethnically minoritized children exhibited disparities in mean levels and variability of sleep compared with their White peers. These findings suggest that policies and practices should target multiple sleep dimensions among diverse racial and ethnic groups to promote equitable pediatric sleep health.
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Affiliation(s)
- Yijie Wang
- Department of Human Development and Family Studies, Michigan State University, East Lansing
| | - Zhenqiang Zhao
- Department of Psychology, Fordham University, Bronx, New Jersey
| | - Youchuan Zhang
- Department of Human Development and Family Studies, Michigan State University, East Lansing
| | - Jinjin Yan
- Department of Psychology, Fordham University, Bronx, New Jersey
| | - Meng-Run Zhang
- Department of Psychology, Fordham University, Bronx, New Jersey
| | - Elizabeth Jelsma
- Department of Human Development and Family Studies, Michigan State University, East Lansing
| | - Shadane Johnson
- Department of Psychology, Fordham University, Bronx, New Jersey
| | - Heining Cham
- Department of Psychology, Fordham University, Bronx, New Jersey
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Tiffany Yip
- Department of Psychology, Fordham University, Bronx, New Jersey
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10
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Zuccarini M, Riva M, Aceti A, Corvaglia L, Scher A, Guarini A, Sansavini A. Night Sleep, Parental Bedtime Practices and Language Development in Low-Risk Preterm and Full-Term Late Talkers: A Longitudinal Study in the Third Year of Life. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1393. [PMID: 39594968 PMCID: PMC11592692 DOI: 10.3390/children11111393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 10/31/2024] [Accepted: 11/07/2024] [Indexed: 11/28/2024]
Abstract
Background: Studies on night sleep and parental bedtime practices and their associations with language development in populations at risk of language delay and neonatal conditions, such as late talkers and preterm children, are scarce. Objectives: Our objective was to longitudinally examine the development of night sleep (total night sleep difficulties, settling, night waking, and co-sleeping), parental bedtime practices (total parental bedtime practices, active physical comforting, encouraging autonomy, and leaving to cry), and expressive language (word and sentence production), and their associations in low-risk preterm and full-term late talkers from 31 to 37 months of age. Methods: Parents of 38 late talkers, 19 low-risk preterm and 19 full-term children, completed the Italian versions of the Infant Sleep Questionnaire, the Parental Interactive Bedtime Behavior Scale, and the MacArthur-Bates Communicative Development Inventory Words and Sentences Long Form. Results: Late talkers' night sleep difficulties, such as settling to sleep and night waking, decreased over time, with low-risk preterm late talkers experiencing more night waking and co-sleeping than full-term peers. Parents reported that instances of active physical comforting and leaving to cry also decreased, with parents of low-risk preterm late talkers reporting higher active physical comforting scores than parents of full-term peers. Improvements in parental practices of encouraging autonomy were significantly associated with increased sentence production from 31 to 37 months. Conclusions: Findings highlight the importance of monitoring night sleep in preterm and full-term late talkers. They also suggest that populations vulnerable to sleep and language delays may particularly benefit from targeted interventions promoting autonomy in their bedtime routines, which, in turn, could support their language development trajectories.
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Affiliation(s)
- Mariagrazia Zuccarini
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, Via Filippo Re 6, 40126 Bologna, Italy;
| | - Martina Riva
- Department of Psychology “Renzo Canestrari”, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy; (M.R.); (A.G.)
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy
| | - Arianna Aceti
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (A.A.); (L.C.)
- Department of Medical and Surgical Sciences, University of Bologna, via Massarenti, 9, 40138 Bologna, Italy
| | - Luigi Corvaglia
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; (A.A.); (L.C.)
- Department of Medical and Surgical Sciences, University of Bologna, via Massarenti, 9, 40138 Bologna, Italy
| | - Anat Scher
- Department of Counseling and Human Development, University of Haifa, Abba Khoushy Ave 199, Haifa 3498838, Israel;
| | - Annalisa Guarini
- Department of Psychology “Renzo Canestrari”, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy; (M.R.); (A.G.)
| | - Alessandra Sansavini
- Department of Psychology “Renzo Canestrari”, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy; (M.R.); (A.G.)
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11
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Kelly RJ, Thompson MJ, El-Sheikh M. Exposure to parental interpartner conflict in adolescence predicts sleep problems in emerging adulthood. Sleep Health 2024; 10:576-582. [PMID: 39054157 DOI: 10.1016/j.sleh.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/13/2024] [Accepted: 06/22/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES Parental interpartner conflict is a highly prevalent form of family risk that is stressful for adolescents with ramifications for their sleep. Multiple studies have demonstrated that adolescents from high-conflict homes are at risk for sleep problems. Building on this literature, we conducted novel analyses and investigated whether exposure to interpartner conflict in adolescence predicts sleep problems in the subsequent developmental period of emerging adulthood. METHODS We used a rigorous four-wave design spanning 8years (collected between 2012-2020). At wave 1, participants were 245 adolescents from diverse backgrounds (M age=15.74years; 67% White/European American, 33% Black/African American; 52% girls). Individuals participated again in their adolescence at wave 2 (M age=16.77) and wave 3 (M age=17.69). Participants returned for wave 4 in emerging adulthood (M age=22.97). Adolescents reported on their parents' interpartner conflict (intense and frequent conflict). Sleep duration (minutes) and quality (efficiency, long wake episodes) were measured using actigraphy. RESULTS After controlling for autoregressive effects and several covariates, findings from a structural equation model revealed that greater exposure to parental interpartner conflict in adolescence predicted reduced sleep efficiency and more long wake episodes in emerging adulthood. CONCLUSIONS Results build on the literature to consider sleep in the family context and are among the first to illustrate that exposure to parental interpartner conflict in adolescence predicts sleep problems in emerging adulthood. Continued investigations into the antecedents of sleep problems in emerging adulthood may benefit from considering past exposure to family risk.
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Affiliation(s)
- Ryan J Kelly
- Department of Individual, Family and Community Education, University of New Mexico, Albuquerque, New Mexico, USA.
| | - Morgan J Thompson
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
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12
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Fangupo LJ, Haszard JJ, Russell-Camp T, Taylor RW, Richards R, Galland BC, Camp J. The measurement of young children's nocturnal sleep health and the development of the Perception of Infant and Toddler Sleep Scale (PoITSS) in Aotearoa New Zealand whānau (families). Sleep Health 2024; 10:567-575. [PMID: 39129127 DOI: 10.1016/j.sleh.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/13/2024] [Accepted: 07/03/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVES To modify an existing questionnaire Brief Infant Sleep Questionnaire - Revised (BISQ-R) to ensure that it is suitable to measure nocturnal sleep health in a diverse sample of young children from Aotearoa New Zealand whānau (families), and to develop a "Perception of Infant and Toddler Sleep Scale" (PoITSS) to use as a primary outcome measurement in an upcoming trial. METHODS Items from the BISQ-R were adapted for use among ethnically diverse whānau, and tested online with caregivers of 0-2 year old children. A PoITSS score was generated by scaling the responses from three of the questionnaire items to create a value between 0 (very poor) and 10 (very good). Caregivers provided qualitative feedback about the ease of interpreting and answering questionnaire items. RESULTS Caregivers of 957 children (35% Māori, 12% Pacific) completed the questionnaire. Few differences in children's nocturnal sleep were observed by demographic characteristics. The mean PoITSS score was 6.9 (SD 2.3) and was slightly higher among Māori children (mean difference 0.4, 95% CI 0.1, 0.7). Test-retest indicated good reliability (ICC=0.81). While the majority (86%) of caregivers did not find it difficult to answer any of the items which formed the PoITSS, qualitative feedback indicated that simple modifications to some items would help ensure that they would be well understood by most caregivers. CONCLUSIONS Items from the BISQ-R were successfully adapted, and the PoITSS scale was shown to be appropriate, for use in ethnically diverse Aotearoa New Zealand whānau with young children.
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Affiliation(s)
- Louise J Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | | | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Barbara C Galland
- Department of Women and Children's Health, University of Otago, Dunedin, New Zealand
| | - Justine Camp
- Department of Medicine, University of Otago, Dunedin, New Zealand.
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13
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Bucko AG, Armstrong B, McIver KL, McLain AC, Pate RR. Longitudinal Associations Between Physical Activity and Sleep Duration in Infants and Toddlers. Pediatr Exerc Sci 2024:1-7. [PMID: 39255962 DOI: 10.1123/pes.2023-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/26/2024] [Accepted: 06/21/2024] [Indexed: 09/12/2024]
Abstract
PURPOSE This study examined longitudinal associations between average physical activity (PA) levels in children and their sleep duration, and whether changes in PA levels are associated with their sleep duration. METHODS Data were collected on 108 children at 4 time points: when children were 6, 12, 18, and 24 months of age (44% female, 50% Non-Hispanic White). PA was assessed using accelerometry. Children's daytime, nighttime, and 24-hour sleep duration were measured with actigraphy. Linear mixed model analyses estimated the associations between average PA levels over time and changes in PA over time, treating each sleep duration variable as an outcome in separate linear mixed model analyses. RESULTS Children with higher total PA levels slept less during the day compared with children with lower total PA levels over the 2-year period. The strength of the relationship between a child's PA levels and their 24-hour sleep duration decreased as they approached 24 months of age. CONCLUSIONS The results suggest that while PA may be developmentally beneficial overall, it appears that its relationship with sleep duration is not clinically relevant in very young children.
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Affiliation(s)
- Agnes G Bucko
- College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC,USA
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Kerry L McIver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
- South Carolina First Steps to School Readiness, Columbia, SC,USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC,USA
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14
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Simard V, Aubry-Guzzi MA, Chapleau I, Moënner M, François N, Champagne N. Changes in Sleep of Families After the Arrival of an Autism Service Dog. J Autism Dev Disord 2024:10.1007/s10803-024-06546-5. [PMID: 39249574 DOI: 10.1007/s10803-024-06546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2024] [Indexed: 09/10/2024]
Abstract
This study aimed to investigate the changes in sleep quality and quantity among families following the arrival of an autism service dog. We hypothesized that the sleep of the child or adolescent with autism spectrum disorder (assessed objectively with actigraphy and subjectively with a parent-reported sleep diary), and of both parents (assessed by self-reported diaries) would improve after the dog's arrival. The sleep of 18 youths (15 boys) aged from 5 to 16 years (M = 8.86), and of their parents (14 mothers, 11 fathers) was assessed for a 5- to 7-day period before (pretest) and eight to ten weeks after the dog's arrival (posttest). A designated parent (the same at the pretest and posttest) completed the sleep diary of the child, who wore an actiwatch in the meantime. Significant improvement in most sleep parameters was observed from pretest to posttest for the child and the mother, as reported in the sleep diaries. However, there was no improvement in the child's sleep when assessed objectively. Fathers' sleep duration increased after the dog's arrival, when adjusting for the child's age. All significant effects had medium to large sizes. This study provides the first quantitative evidence of the positive effect of autism service dogs on the sleep of families. These findings suggest that the dog's presence may increase the sense of safety for the child, who would resume sleeping faster or stay in the bedroom after nocturnal awakenings, leading to improved parents' sleep.
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Affiliation(s)
- Valérie Simard
- Departement of Psychology, Université de Sherbrooke, 150 Place Charles-Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada.
- Charles-Le Moyne Research Center, Longueuil, QC, Canada.
- Research Center of the Sainte-Justine University Hospital, Montreal, QC, Canada.
| | - Marie-Aude Aubry-Guzzi
- Departement of Psychology, Université de Sherbrooke, 150 Place Charles-Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada
| | - Isabelle Chapleau
- Departement of Psychology, Université de Sherbrooke, 150 Place Charles-Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada
| | - Marina Moënner
- Departement of Psychology, Université de Sherbrooke, 150 Place Charles-Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada
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15
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Rischard ME, Buck TR, Pruiksma KE, Johns A, Cromer LD. Construction and Initial Examination of Inter-Rater Reliability of a Structured Clinical Interview for DSM-5-TR Sleep Disorders (SCISD) - Kid. Behav Sleep Med 2024; 22:593-610. [PMID: 38457486 DOI: 10.1080/15402002.2024.2324035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
STUDY OBJECTIVES To construct and evaluate the inter-rater reliability of the Structured Clinical Interview for DSM-5-TR Sleep Disorders - Kid (SCISD-Kid). METHOD The SCISD-Kid was modeled on the adult SCISD-R and accounted for pediatric developmental and sociocultural factors. Fifty sleep-disturbed children (Mage = 11.9, SD = 2.9) and 50 caregivers responded to the final SCISD-Kid. Video recordings were double-scored to evaluate inter-rater reliability. RESULTS The final SCISD-Kid contained approximately 90 questions. Eight of the nine covered disorders had prevalence rates sufficient for analyses for both samples (i.e., k > 2). Inter-rater reliability was examined using Cohen kappa coefficients (κ); reliability estimates ranged from excellent to good. For youth, restless legs syndrome yielded the lowest reliability (.48), while nightmare disorder, narcolepsy, and NREM sleep arousal disorder - sleepwalking type showed the highest reliability (1.00). Across caregivers, NREM sleep arousal disorder - sleep terror type (.49) and hypersomnolence (.54) had the lowest reliability. In contrast, circadian rhythm - delayed sleep phase type, nightmare disorder, and NREM sleep arousal disorder - sleepwalking type showed the highest reliability (1.00). CONCLUSIONS The SCISD-Kid is a promising tool for screening sleep disorders. It showed good to excellent reliability across both samples. Next steps for validation will be discussed.
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Affiliation(s)
| | - Tara R Buck
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Kristi E Pruiksma
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA
| | - Aviva Johns
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Lisa D Cromer
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
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16
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Kahn M, Irwin C, Pillion M, Whittall H, Fitton J, Sprajcer M, Gradisar M. Sleepless on the road: Are mothers of infants with insomnia at risk for impaired driving? J Sleep Res 2024; 33:e14083. [PMID: 37904304 DOI: 10.1111/jsr.14083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/18/2023] [Accepted: 10/13/2023] [Indexed: 11/01/2023]
Abstract
Infant sleep problems have been associated with a myriad of adverse child and parent outcomes, yet whether these problems may pose a risk for parents on the road has received little research attention. This study sought to test whether mothers of infants with insomnia are at an elevated risk for vehicular crashes, by comparing their objectively measured driving performance with that of mothers of well-sleeping infants and with that of women without children. Fifty-four women from these three groups completed a simulated driving task. Outcome measures included standard deviation of lateral position, number of lane crossings, standard deviation of speed, average speed and maximum speed. Women additionally reported on their driving behaviour using the Driving Behaviour Questionnaire, and on sleep, sleepiness and insomnia symptoms using 7-day sleep diaries and questionnaires. Mothers of infants with insomnia demonstrated greater lane deviation (Wald = 9.53, p = 0.009), higher maximum speed (Wald = 6.10, p = 0.04) and poorer self-rated driving behaviour (Wald = 7.44, p = 0.02) compared with control groups. Analyses also indicated that driving performance in mothers of infants with insomnia tended to be poorer relative to control groups with the progression of time on task. While further research is needed to assess the scope of these effects, our findings suggest that parents, healthcare providers and policymakers should be aware of the potential consequences of infant sleep problems on road safety, and collaborate to establish strategies to mitigate these risks.
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Affiliation(s)
- Michal Kahn
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Meg Pillion
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Hannah Whittall
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Josh Fitton
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Madeline Sprajcer
- Appleton Institute, Central Queensland University, Adelaide, Australia
| | - Michael Gradisar
- Wink Sleep Pty Ltd, Adelaide, Australia
- Sleep Cycle AB, Gothenburg, Sweden
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17
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Burkart S, Beets MW, Pfledderer CD, von Klinggraeff L, Zhu X, St Laurent CW, van Hees VT, Armstrong B, Weaver RG, Adams EL. Are parent-reported sleep logs essential? A comparison of three approaches to guide open source accelerometry-based nocturnal sleep processing in children. J Sleep Res 2024; 33:e14112. [PMID: 38009378 PMCID: PMC11128474 DOI: 10.1111/jsr.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/28/2023]
Abstract
We examined the comparability of children's nocturnal sleep estimates using accelerometry data, processed with and without a sleep log. In a secondary analysis, we evaluated factors associated with disagreement between processing approaches. Children (n = 722, age 5-12 years) wore a wrist-based accelerometer for 14 days during Autumn 2020, Spring 2021, and/or Summer 2021. Outcomes included sleep period, duration, wake after sleep onset (WASO), and timing (onset, midpoint, waketime). Parents completed surveys including children's nightly bed/wake time. Data were processed with parent-reported bed/wake time (sleep log), the Heuristic algorithm looking at Distribution of Change in Z-Angle (HDCZA) algorithm (no log), and an 8 p.m.-8 a.m. window (generic log) using the R-package 'GGIR' (version 2.6-4). Mean/absolute bias and limits of agreement were calculated and visualised with Bland-Altman plots. Associations between child, home, and survey characteristics and disagreement were examined with tobit regression. Just over half of nights demonstrated no difference in sleep period between sleep log and no log approaches. Among all nights, the sleep log approach produced longer sleep periods (9.3 min; absolute mean bias [AMB] = 28.0 min), shorter duration (1.4 min; AMB = 14.0 min), greater WASO (11.0 min; AMB = 15.4 min), and earlier onset (13.4 min; AMB = 17.4 min), midpoint (8.8 min; AMB = 15.3 min), and waketime (3.9 min; AMB = 14.8 min) than no log. Factors associated with discrepancies included smartphone ownership, bedroom screens, nontraditional parent work schedule, and completion on weekend/summer nights (range = 0.4-10.2 min). The generic log resulted in greater AMB among sleep outcomes. Small mean differences were observed between nights with and without a sleep log. Discrepancies existed on weekends, in summer, and for children with smartphones and screens in the bedroom.
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Affiliation(s)
- Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christopher D Pfledderer
- University of Texas Health Science Center (UTHealth) at Houston, School of Public Health in Austin, Austin, Texas, USA
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, Texas, USA
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xuanxuan Zhu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christine W St Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Elizabeth L Adams
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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18
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de Sena S, Häggman M, Ranta J, Roienko O, Ilén E, Acosta N, Salama J, Kirjavainen T, Stevenson N, Airaksinen M, Vanhatalo S. NAPping PAnts (NAPPA): An open wearable solution for monitoring Infant's sleeping rhythms, respiration and posture. Heliyon 2024; 10:e33295. [PMID: 39027497 PMCID: PMC11255670 DOI: 10.1016/j.heliyon.2024.e33295] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 05/13/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Study objectives To develop a non-invasive and practical wearable method for long-term tracking of infants' sleep. Methods An infant wearable, NAPping PAnts (NAPPA), was constructed by combining a diaper cover and a movement sensor (triaxial accelerometer and gyroscope), allowing either real-time data streaming to mobile devices or offline feature computation stored in the sensor memory. A sleep state classifier (wake, N1/REM, N2/N3) was trained and tested for NAPPA recordings (N = 16649 epochs of 30 s), using hypnograms from co-registered polysomnography (PSG) as a training target in 33 infants (age 2 weeks to 18 months; Mean = 4). User experience was assessed from an additional group of 16 parents. Results Overnight NAPPA recordings were successfully performed in all infants. The sleep state classifier showed good overall accuracy (78 %; Range 74-83 %) when using a combination of five features related to movement and respiration. Sleep depth trends were generated from the classifier outputs to visualise sleep state fluctuations, which closely aligned with PSG-derived hypnograms in all infants. Consistently positive parental feedback affirmed the effectiveness of the NAPPA-design. Conclusions NAPPA offers a practical and feasible method for out-of-hospital assessment of infants' sleep behaviour. It can directly support large-scale quantitative studies and development of new paradigms in scientific research and infant healthcare. Moreover, NAPPA provides accurate and informative computational measures for body positions, respiration rates, and activity levels, each with their respective clinical and behavioural value.
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Affiliation(s)
- Sofie de Sena
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
| | - Matias Häggman
- School of Science, Department of Mathematics and Systems Analysis, Aalto University, Espoo, Finland
| | - Jukka Ranta
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Oleksii Roienko
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elina Ilén
- Department of Materials Science and Engineering, Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Natalia Acosta
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jonna Salama
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Turkka Kirjavainen
- Department of Paediatrics, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Nathan Stevenson
- Brain Modelling Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Manu Airaksinen
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
| | - Sampsa Vanhatalo
- BABA Center, Department of Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
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19
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Miller AE, Lang CE, Bland MD, Lohse KR. Quantifying the effects of sleep on sensor-derived variables from upper limb accelerometry in people with and without upper limb impairment. J Neuroeng Rehabil 2024; 21:86. [PMID: 38807245 PMCID: PMC11131201 DOI: 10.1186/s12984-024-01384-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Despite the promise of wearable sensors for both rehabilitation research and clinical care, these technologies pose significant burden on data collectors and analysts. Investigations of factors that may influence the wearable sensor data processing pipeline are needed to support continued use of these technologies in rehabilitation research and integration into clinical care settings. The purpose of this study was to investigate the effect of one such factor, sleep, on sensor-derived variables from upper limb accelerometry in people with and without upper limb impairment and across a two-day wearing period. METHODS This was a secondary analysis of data collected during a prospective, longitudinal cohort study (n = 127 individuals, 62 with upper limb impairment and 65 without). Participants wore a wearable sensor on each wrist for 48 h. Five upper limb sensor variables were calculated over the full wear period (sleep included) and with sleep time removed (sleep excluded): preferred time, non-preferred time, use ratio, non-preferred magnitude and its standard deviation. Linear mixed effects regression was used to quantify the effect of sleep on each sensor variable and determine if the effect differed between people with and without upper limb impairment and across a two-day wearing period. RESULTS There were significant differences between sleep included and excluded for the variables preferred time (p < 0.001), non-preferred time (p < 0.001), and non-preferred magnitude standard deviation (p = 0.001). The effect of sleep was significantly different between people with and without upper limb impairment for one variable, non-preferred magnitude (p = 0.02). The effect of sleep was not substantially different across wearing days for any of the variables. CONCLUSIONS Overall, the effects of sleep on sensor-derived variables of upper limb accelerometry are small, similar between people with and without upper limb impairment and across a two-day wearing period, and can likely be ignored in most contexts. Ignoring the effect of sleep would simplify the data processing pipeline, facilitating the use of wearable sensors in both research and clinical practice.
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Affiliation(s)
- Allison E Miller
- Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, MSC: 8502-66-1101, St. Louis, MO, 63018, USA.
| | - Catherine E Lang
- Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, MSC: 8502-66-1101, St. Louis, MO, 63018, USA
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, 63018, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63018, USA
| | - Marghuretta D Bland
- Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, MSC: 8502-66-1101, St. Louis, MO, 63018, USA
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, 63018, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63018, USA
| | - Keith R Lohse
- Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Avenue, MSC: 8502-66-1101, St. Louis, MO, 63018, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63018, USA
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20
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Hansen M, Simon KR, He X, Steele N, Thomas ML, Noble KG, Merz EC. Socioeconomic factors, sleep timing and duration, and amygdala resting-state functional connectivity in children. Front Psychiatry 2024; 15:1373546. [PMID: 38840942 PMCID: PMC11150855 DOI: 10.3389/fpsyt.2024.1373546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Reduced sleep health has been consistently linked with increased negative emotion in children. While sleep characteristics have been associated with neural function in adults and adolescents, much less is known about these associations in children while considering socioeconomic context. In this study, we examined the associations among socioeconomic factors, sleep duration and timing, and resting-state functional connectivity (rsFC) of the amygdala in children. Methods Participants were typically-developing 5- to 9-year-olds from socioeconomically diverse families (61% female; N = 94). Parents reported on children's weekday and weekend bedtimes and wake-up times, which were used to compute sleep duration and midpoint. Analyses focused on amygdala-anterior cingulate cortex (ACC) connectivity followed by amygdala-whole brain connectivity. Results Lower family income-to-needs ratio and parental education were significantly associated with later weekday and weekend sleep timing and shorter weekday sleep duration. Shorter weekday sleep duration was associated with decreased amygdala-ACC and amygdala-insula connectivity. Later weekend sleep midpoint was associated with decreased amygdala-paracingulate cortex and amygdala-postcentral gyrus connectivity. Socioeconomic factors were indirectly associated with connectivity in these circuits via sleep duration and timing. Discussion These results suggest that socioeconomic disadvantage may interfere with both sleep duration and timing, in turn possibly altering amygdala connectivity in emotion processing and regulation circuits in children. Effective strategies supporting family economic conditions may have benefits for sleep health and brain development in children.
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Affiliation(s)
- Melissa Hansen
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Katrina R. Simon
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Xiaofu He
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Nick Steele
- Molecular, Cellular and Integrative Neuroscience, Colorado State University, Fort Collins, CO, United States
| | - Michael L. Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Kimberly G. Noble
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
| | - Emily C. Merz
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
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21
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Touchette E, Fréchette-Boilard G, Petit D, Geoffroy MC, Pennestri MH, Côté S, Tremblay RE, Petitclerc A, Boivin M, Montplaisir J. Longitudinal study of childhood sleep trajectories and adolescent mental health problems. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae013. [PMID: 38559775 PMCID: PMC10981463 DOI: 10.1093/sleepadvances/zpae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/16/2024] [Indexed: 04/04/2024]
Abstract
Study Objective To investigate whether childhood sleep trajectories are associated with mental health symptoms such as social phobia, generalized anxiety, depression, attention deficit hyperactivity disorder (ADHD), conduct problems, and opposition at age 15. Methods A total of 2120 children took part in the Quebec Longitudinal Study of Child Development. Childhood sleep trajectories were computed from maternal reports at 2.5, 3.5, 4, 6, 8, 10, and/or 12 years. At age 15, 1446 adolescents filled out mental health and sleep questions. A path analysis model was assessed in the full sample. Results Four childhood nocturnal sleep duration trajectories were identified: (1) a short pattern (7.5%), (2) a short-increasing pattern (5.8%), (3) a 10 hours pattern (50.7%), and (4) an 11 hours pattern (36.0%). Three childhood sleep latency trajectories were found: (1) a short pattern (31.7%), (2) an intermediate pattern (59.9%), and (3) a long pattern (8.4%). Finally, two childhood wakefulness after sleep-onset trajectories were found: (1) a normative pattern (73.0%) and (2) a long pattern (27.0%). The path analysis model indicated that children following a long childhood sleep latency trajectory were more likely to experience symptoms of depression (β = 0.06, 95% CI: 0.01 to 0.12), ADHD (β = 0.07, 95% CI: 0.02 to 0.13), conduct problems (β = 0.05, 95% CI: 0.00 to 0.10) and opposition (β = 0.08, 95% CI: 0.02 to 0.13) at age 15. Conclusions This longitudinal study revealed that children presenting a long sleep latency throughout childhood are at greater risk of symptoms of depression, ADHD, conduct problems, and opposition in adolescence.
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Affiliation(s)
- Evelyne Touchette
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Québec city, Québec, Canada
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
| | | | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
- Department of Psychiatry, University of Montreal, Montréal, Québec, Canada
| | - Marie-Claude Geoffroy
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Marie-Hélène Pennestri
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
- Hôpital en Santé Mentale Rivière-des-Prairies, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, QC, Canada
| | - Sylvana Côté
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montréal, QC, Canada
| | - Richard E Tremblay
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Amélie Petitclerc
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Psychology, Laval University, Québec city, Québec, Canada
| | - Michel Boivin
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Psychology, Laval University, Québec city, Québec, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
- Department of Psychiatry, University of Montreal, Montréal, Québec, Canada
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22
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Crowe K, Spiro-Levitt C. Sleep-Related Problems and Pediatric Anxiety Disorders. Psychiatr Clin North Am 2024; 47:213-228. [PMID: 38302208 DOI: 10.1016/j.psc.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Sleep-related problems are highly prevalent among childhood and adolescent anxiety disorders. The objective of this review was to summarize the relevant clinical research literature as it pertains to the nature of the association between sleep-related problems and youth anxiety, developmental factors relevant to this association, and intervention efforts to target comorbid sleep challenges and anxiety. Limitations of the literature and future directions are discussed.
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Affiliation(s)
- Katherine Crowe
- Home for Anxiety, Repetitive Behaviors, OCD, and Related Disorders (HARBOR), 1518 Walnut Street, Suite 1506, Philadelphia, PA 19102, USA.
| | - Carolyn Spiro-Levitt
- Department of Child and Adolescent Psychiatry at Hassenfeld Children's Hospital at New York University (NYU) Langone, 1 Park Avenue, Seventh Floor, New York, NY 10016, USA
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23
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Dong H, Wu H, Yang G, Zhang J, Wan K. A multi-branch convolutional neural network for snoring detection based on audio. Comput Methods Biomech Biomed Engin 2024:1-12. [PMID: 38372231 DOI: 10.1080/10255842.2024.2317438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
Obstructive sleep apnea (OSA) is associated with various health complications, and snoring is a prominent characteristic of this disorder. Therefore, the exploration of a concise and effective method for detecting snoring has consistently been a crucial aspect of sleep medicine. As the easily accessible data, the identification of snoring through sound analysis offers a more convenient and straightforward method. The objective of this study was to develop a convolutional neural network (CNN) for classifying snoring and non-snoring events based on audio. This study utilized Mel-frequency cepstral coefficients (MFCCs) as a method for extracting features during the preprocessing of raw data. In order to extract multi-scale features from the frequency domain of sound sources, this study proposes the utilization of a multi-branch convolutional neural network (MBCNN) for the purpose of classification. The network utilized asymmetric convolutional kernels to acquire additional information, while the adoption of one-hot encoding labels aimed to mitigate the impact of labels. The experiment tested the network's performance by utilizing a publicly available dataset consisting of 1,000 sound samples. The test results indicate that the MBCNN achieved a snoring detection accuracy of 99.5%. The integration of multi-scale features and the implementation of MBCNN, based on audio data, have demonstrated a substantial improvement in the performance of snoring classification.
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Affiliation(s)
- Hao Dong
- School of Computer Science, Zhongyuan University of Technology, Henan, China
- School of Computing and Artificial Intelligence, Huanghuai University, Henan, China
| | - Haitao Wu
- School of Computing and Artificial Intelligence, Huanghuai University, Henan, China
- Henan Key Laboratory of Smart Lighting, Henan, China
| | - Guan Yang
- School of Computer Science, Zhongyuan University of Technology, Henan, China
| | - Junming Zhang
- School of Computing and Artificial Intelligence, Huanghuai University, Henan, China
- Henan Key Laboratory of Smart Lighting, Henan, China
- Henan Joint International Research Laboratory of Behavior Optimization Control for Smart Robots, Henan, China
- Zhumadian Artificial Intelligence and Medical Engineering Technical Research Centre, Henan, China
| | - Keqin Wan
- School of Computing and Artificial Intelligence, Huanghuai University, Henan, China
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24
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Liu F, Schrack J, Wanigatunga SK, Rabinowitz JA, He L, Wanigatunga AA, Zipunnikov V, Simonsick EM, Ferrucci L, Spira AP. Comparison of sleep parameters from wrist-worn ActiGraph and Actiwatch devices. Sleep 2024; 47:zsad155. [PMID: 37257489 PMCID: PMC10851854 DOI: 10.1093/sleep/zsad155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/03/2023] [Indexed: 06/02/2023] Open
Abstract
Sleep and physical activity, two important health behaviors, are often studied independently using different accelerometer types and body locations. Understanding whether accelerometers designed for monitoring each behavior can provide similar sleep parameter estimates may help determine whether one device can be used to measure both behaviors. Three hundred and thirty one adults (70.7 ± 13.7 years) from the Baltimore Longitudinal Study of Aging wore the ActiGraph GT9X Link and the Actiwatch 2 simultaneously on the non-dominant wrist for 7.0 ± 1.6 nights. Total sleep time (TST), wake after sleep onset (WASO), sleep efficiency, number of wake bouts, mean wake bout length, and sleep fragmentation index (SFI) were extracted from ActiGraph using the Cole-Kripke algorithm and from Actiwatch using the software default algorithm. These parameters were compared using paired t-tests, Bland-Altman plots, and Deming regression models. Stratified analyses were performed by age, sex, and body mass index (BMI). Compared to the Actiwatch, the ActiGraph estimated comparable TST and sleep efficiency, but fewer wake bouts, longer WASO, longer wake bout length, and higher SFI (all p < .001). Both devices estimated similar 1-min and 1% differences between participants for TST and SFI (β = 0.99, 95% CI: 0.95, 1.03, and 0.91, 1.13, respectively), but not for other parameters. These differences varied by age, sex, and/or BMI. The ActiGraph and the Actiwatch provide comparable absolute and relative estimates of TST, but not other parameters. The discrepancies could result from device differences in movement collection and/or sleep scoring algorithms. Further comparison and calibration is required before these devices can be used interchangeably.
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Affiliation(s)
- Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Linchen He
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Community and Population Health, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vadim Zipunnikov
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, USA
| | - Adam P Spira
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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25
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Kelly RJ, Gillis BT, El-Sheikh M. Longitudinal relations between interpartner aggression and internalizing symptoms among couples: The moderating role of sleep. J Sleep Res 2024; 33:e14013. [PMID: 37572050 PMCID: PMC11760190 DOI: 10.1111/jsr.14013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/14/2023]
Abstract
Recipients of interpartner aggression often experience internalizing symptoms. However, individual differences exist, and elucidation of factors that attenuate or exacerbate risk are needed to explicate relations and better inform interventions aimed at reducing mental health sequelae of interpartner aggression. Sleep problems compromise coping abilities and are known to exacerbate risk for mental health problems in the context of family risk. We examined whether sleep problems moderated the extent to which the recipients of interpartner aggression experience internalizing symptoms over time. At the first wave, 194 couples participated (M age [women] = 41.81 years, SD = 5.85; M age [men] = 43.75 years, SD = 6.74; 71% White/European American, 26% Black/African American, 3% other race/ethnicity). Two years later, couples returned for a second wave. Psychological and physical forms of interpartner aggression were measured using self- and partner-reports. Sleep duration (minutes) and sleep quality (efficiency) were derived using actigraphy, and subjective sleep/wake problems were also assessed. Individuals self-reported on their own internalizing symptoms. After controlling for autoregressive effects, sleep moderated the extent to which the recipients of interpartner aggression experienced internalizing symptoms longitudinally. Lower sleep efficiency and more subjective sleep/wake problems among women exacerbated the extent to which interpartner aggression forecasted their internalizing symptoms. Lower sleep efficiency among men magnified relations between interpartner aggression and their internalizing symptoms. Findings help understand the multiplicative influence that family risk and sleep problems have on mental health over time.
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Affiliation(s)
- Ryan J. Kelly
- University of New Mexico, Albuquerque, New Mexico, USA
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26
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Liu J, Ji X, Rovit E, Pitt S, Lipman T. Childhood sleep: assessments, risk factors, and potential mechanisms. World J Pediatr 2024; 20:105-121. [PMID: 36441394 PMCID: PMC9702880 DOI: 10.1007/s12519-022-00628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep problem is a highly prevalent health issue among pediatric populations across the world. In this review, we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children. Potential biological, psychosocial, and environmental mechanisms as well as research gaps in the literature are also discussed. DATA SOURCES A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info. Both relevant data based and systematic reviews are included. RESULTS This paper summarizes many risk factors for childhood sleep problems, including biological (e.g., genetics, gender, age and puberty, prenatal factors, postnatal factors); nutritional (e.g., macronutrients, micronutrients, omega-3 fatty acids, obesity); environmental (e.g., heavy metals, noise, light, air pollution); interpersonal (e.g., family, exposure to violence, screen media use, physical injury); and community/socioeconomic variables (e.g., racial/ethnicity and cultural factors, neighborhood conditions and socioeconomic status, school factors, public health disasters/emergencies), to better understand the development of sleep problems in children. CONCLUSIONS Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological, environmental, and psychosocial risk factors and contributors. A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.
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Affiliation(s)
- Jianghong Liu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Xiaopeng Ji
- School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, 19716, USA
| | - Elizabeth Rovit
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
| | - Susannah Pitt
- Geisinger Commonwealth School of Medicine, Scranton, PA, 18510, USA
| | - Terri Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
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27
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Mehmood A, Almajwal AM, Addas A, Zeb F, Alam I, Sehar B. Exploring the relationship of cognitive function with and without COVID-19 recovered schizophrenic patients. Front Public Health 2024; 11:1306132. [PMID: 38235158 PMCID: PMC10791931 DOI: 10.3389/fpubh.2023.1306132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/09/2023] [Indexed: 01/19/2024] Open
Abstract
Background The Coronavirus disease 2019 (COVID-19) is linked to the deterioration of cognitive function among individuals suffering from schizophrenia. The purpose of this study was to compare the cognitive performance of schizophrenic patients before and after COVID-19. Methods A longitudinal cohort study involving a sample of 219 individuals diagnosed with schizophrenia was enrolled between June 2022 and May 2023. The participants were split into two groups infected with COVID-19 (n = 165) and not infected with COVID-19 (n = 54). The data were gathered via a questionnaire on demographic characteristics, the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Activities of Daily Living (ADL) scale, and the Insomnia Severity Index (ISI). Results The repeated-measures ANOVA showed that Among patients diagnosed with COVID-19, there was a deterioration in global cognitive function (before COVID-19 = -2.45 vs. after COVID-19 = -3.02, p = 0.007), working memory (before COVID-19 = -2.76 vs. after COVID-19 = -3.34, p < 0.00 1), motor speed (before COVID-19 = -1.64 vs. after COVID-19 = -2.12, p < 0.001), attention and speed of information processing (before COVID-19 = -1.93 vs. after COVID-19 = -1.16, p = 0.008). multi-variable analysis showed that several factors as having a secondary grade of education (β = 0.434), experiencing insomnia (β = 0.411)and the interaction between COVID-19 diagnosis and cognition at baseline (β = 0.796) were significantly associated with cognitive deficits. At the same time, no significant associations were found between global cognition and clinical symptoms, autonomy, or depression (p > 0.05). Conclusion The COVID-19 pandemic has significantly impacted various cognitive functions, such as verbal memory, working memory, and global cognition. Insomnia has been identified as the predominant determinant of cognitive impairment, alongside the confirmation of a COVID-19 diagnosis. Additional research is imperative to elucidate the diversification of cognitive functionality observed in individuals diagnosed with schizophrenia who have acquired COVID-19.
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Affiliation(s)
- Anam Mehmood
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ali Madi Almajwal
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Addas
- Department of Civil Engineering, College of Engineering, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Landscape Architecture Department, Faculty of Architecture and Planning, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Falak Zeb
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Iftikhar Alam
- Department of Human Nutrition and Dietetics, Bacha Khan University Charsadda, KPK, Pakistan
| | - Bismillah Sehar
- Department of Health and Social Sciences, University of Bedfordshire, Luton, United Kingdom
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28
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Arts J, Chinapaw MJM, Gubbels JS, Verhoeff AP, Brons A, Veldman S, Lettink A, Altenburg TM. Development and content validity of an application to assess 24-hour movement behaviors in 0-4-year-old children involving end-users and key stakeholders: the My Little Moves app. Int J Behav Nutr Phys Act 2024; 21:2. [PMID: 38167442 PMCID: PMC10763169 DOI: 10.1186/s12966-023-01552-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recently, research focus has shifted to the combination of all 24-h movement behaviors (physical activity, sedentary behavior and sleep) instead of each behavior separately. Yet, no reliable and valid proxy-report tools exist to assess all these behaviors in 0-4-year-old children. By involving end-users (parents) and key stakeholders (researchers, professionals working with young children), this mixed-methods study aimed to 1) develop a mobile application (app)-based proxy-report tool to assess 24-h movement behaviors in 0-4-year-olds, and 2) examine its content validity. METHODS First, we used concept mapping to identify activities 0-4-year-olds engage in. Parents (n = 58) and professionals working with young children (n = 21) generated a list of activities, sorted related activities, and rated the frequency children perform these activities. Second, using multidimensional scaling and cluster analysis, we created activity categories based on the sorted activities of the participants. Third, we developed the My Little Moves app in collaboration with a software developer. Finally, we examined the content validity of the app with parents (n = 14) and researchers (n = 6) using focus groups and individual interviews. RESULTS The app has a time-use format in which parents proxy-report the activities of their child, using eight activity categories: personal care, eating/drinking, active transport, passive transport, playing, screen use, sitting/lying calmly, and sleeping. Categories are clarified by providing examples of children's activities. Additionally, 1-4 follow-up questions collect information on intensity (e.g., active or calm), posture, and/or context (e.g., location) of the activity. Parents and researchers considered filling in the app as feasible, taking 10-30 min per day. The activity categories were considered comprehensive, but alternative examples for several activity categories were suggested to increase the comprehensibility and relevance. Some follow-up questions were considered less relevant. These suggestions were adopted in the second version of the My Little Moves app. CONCLUSIONS Involving end-users and key stakeholders in the development of the My Little Moves app resulted in a tailored tool to assess 24-h movement behaviors in 0-4-year-olds with adequate content validity. Future studies are needed to evaluate other measurement properties of the app.
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Affiliation(s)
- Jelle Arts
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Jessica S Gubbels
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, 6200 MD, The Netherlands
| | - Arnoud P Verhoeff
- Public Health Service Amsterdam, Sarphati Amsterdam, 1018 WT, Amsterdam, The Netherlands
- Department of Sociology, University of Amsterdam, 1018 WV, Amsterdam, The Netherlands
| | - Annette Brons
- Digital Life Center, Amsterdam University of Applied Sciences, Wibautstraat 3B, Amsterdam, 1091 GM, The Netherlands
| | - Sanne Veldman
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annelinde Lettink
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
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29
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Zhang L, Sasser J, Doane LD, Peltz J, Oshri A. Latent Profiles of Sleep Patterns in Early Adolescence: Associations With Behavioral Health Risk. J Adolesc Health 2024; 74:177-185. [PMID: 37815759 PMCID: PMC10841331 DOI: 10.1016/j.jadohealth.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE The present study characterized sleep profiles in a national longitudinal sample of early adolescents and examined whether profiles predicted later behavioral problems. METHODS Three waves of data (2016-2021) were obtained from the Adolescent Behavior and Cognitive Development study, including 3,326 participants with both weekday and weekend sleep data measured by Fitbit wearables (age range 10.58-13.67 years; 49.3% female). Latent profile analysis was utilized to identify sleep profiles using multiple sleep indicators (duration, latency, efficiency, wake minutes, wake counts, and midpoint). We then explored whether demographic predictors predicted profile membership and tested the latent sleep profiles' predictive utility of internalizing and externalizing symptoms. RESULTS Four profiles were identified: average sleep (40.39%), high duration & high wakefulness (28.58%), high efficiency, low duration &low wakefulness (16.86%), and low duration & low efficiency (14.17%). Participants with older age, males, higher body mass index, and advanced pubertal status were more likely to be classified in the low duration & low efficiency profile than the average group. Participants with lower income, minority identification, older age, and higher body mass index were more likely to be classified in the high efficiency, low duration &low wakefulness than the average group. Participants with lower parental education and males were more likely to be in the high sleep duration & high wakefulness than the average group. The low duration & low efficiency group had the highest attention problems, social problems, and rule-breaking behaviors. DISCUSSION Our findings highlight unique sleep patterns in early adolescence and their prospective links with internalizing and externalizing problems.
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Affiliation(s)
- Linhao Zhang
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia.
| | - Jeri Sasser
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Jack Peltz
- Department of Psychology, SUNY Brockport, Brockport, New York
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia
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Santi D, Debbi V, Costantino F, Spaggiari G, Simoni M, Greco C, Casarini L. Microbiota Composition and Probiotics Supplementations on Sleep Quality-A Systematic Review and Meta-Analysis. Clocks Sleep 2023; 5:770-792. [PMID: 38131749 PMCID: PMC10742335 DOI: 10.3390/clockssleep5040050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
The gut microbiota (GM) plays a crucial role in human health. The bidirectional interaction between GM and the central nervous system may occur via the microbiota-gut-brain axis, possibly regulating the sleep/wake cycle. Recent reports highlight associations between intestinal dysbiosis and sleep disorders, suggesting that probiotics could ameliorate this condition. However, data are poor and inconsistent. The aim of this quantitative metanalytic study is to assess the GM composition in sleep disturbances and evaluate probiotics' effectiveness for managing sleep disorders. A systematic review was carried out until July 2022 in online databases, limiting the literature research to human studies and English language articles. No significant GM diversity between patients with sleep disturbances versus healthy controls was found, revealed by α-diversity, while β-diversity is missing due to lack of proper reporting. However, probiotics supplementation significantly reduced the self-assessed parameter of sleep quality and disturbances Pittsburgh Sleep Quality Index (PSQI) score compared with the placebo. No difference in the Epworth Sleepiness Scale (ESS) score was found. While available data suggest that GM diversity is not related to sleep disturbances, probiotics administration strongly improves sleep quality as a subjective perception. However, heterogeneity of data reporting in the scientific literature should be considered as a limitation.
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Affiliation(s)
- Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Valentina Debbi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
| | - Francesco Costantino
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Center for Genomic Research, University of Modena and Reggio Emilia, 41126 Modena, Italy
| | - Carla Greco
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Livio Casarini
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Center for Genomic Research, University of Modena and Reggio Emilia, 41126 Modena, Italy
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Li J, Wu C, Pan J, Wang F. Few-shot EEG sleep staging based on transductive prototype optimization network. Front Neuroinform 2023; 17:1297874. [PMID: 38125309 PMCID: PMC10730933 DOI: 10.3389/fninf.2023.1297874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Electroencephalography (EEG) is a commonly used technology for monitoring brain activities and diagnosing sleep disorders. Clinically, doctors need to manually stage sleep based on EEG signals, which is a time-consuming and laborious task. In this study, we propose a few-shot EEG sleep staging termed transductive prototype optimization network (TPON) method, which aims to improve the performance of EEG sleep staging. Compared with traditional deep learning methods, TPON uses a meta-learning algorithm, which generalizes the classifier to new classes that are not visible in the training set, and only have a few examples for each new class. We learn the prototypes of existing objects through meta-training, and capture the sleep features of new objects through the "learn to learn" method of meta-learning. The prototype distribution of the class is optimized and captured by using support set and unlabeled high confidence samples to increase the authenticity of the prototype. Compared with traditional prototype networks, TPON can effectively solve too few samples in few-shot learning and improve the matching degree of prototypes in prototype network. The experimental results on the public SleepEDF-2013 dataset show that the proposed algorithm outperform than most advanced algorithms in the overall performance. In addition, we experimentally demonstrate the feasibility of cross-channel recognition, which indicates that there are many similar sleep EEG features between different channels. In future research, we can further explore the common features among different channels and investigate the combination of universal features in sleep EEG. Overall, our method achieves high accuracy in sleep stage classification, demonstrating the effectiveness of this approach and its potential applications in other medical fields.
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Affiliation(s)
| | | | | | - Fei Wang
- School of Software, South China Normal University, Guangzhou, China
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Dias CC, Pinto TM, Figueiredo B. Maternal Prenatal Depressive Symptoms and Infant Sleep Problems: The Role of Infant Temperament and Sex. Behav Sleep Med 2023; 21:695-711. [PMID: 36533573 DOI: 10.1080/15402002.2022.2155162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex. METHODS The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems. RESULTS While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex. CONCLUSIONS Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.
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Affiliation(s)
| | - Tiago Miguel Pinto
- School of Psychology, University of Minho, Braga, Portugal
- Lusófona University, HEI-Lab, Porto, Portugal
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Kahn M, Barnett N, Gradisar M. Let's Talk about Sleep Baby: Sexual Activity Postpartum and Its Links with Room Sharing, Parent Sleep, and Objectively Measured Infant Sleep and Parent Nighttime Crib Visits. JOURNAL OF SEX RESEARCH 2023; 60:1247-1258. [PMID: 35763039 DOI: 10.1080/00224499.2022.2092050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The postpartum period may pose a considerable challenge for both parent sleep and sexual activity. This study assessed the links between partnered sexual frequency and satisfaction postpartum and parent sleep, infant sleep, parent nighttime caregiving, and parent-infant room sharing. Participants were 897 parents of infants aged 1-18-months (M = 8.8 ± 4.3, 49% girls). Parents completed an online survey about their sexual frequency and satisfaction, sleep, relationship satisfaction, depression, and demographic characteristics. Infant sleep and parent nighttime crib visits were measured objectively using auto-videosomnography during 2-weeks, with 8,460 nights assessed. Results indicated that the frequency of partnered sexual activity was 3.8 ± 4.2 times per month. Frequency of sexual activity increased with infant age, yet increases beyond the first 6 months postpartum were non-significant. Adjusted GEE modeling revealed that more parent nighttime crib visits were significantly associated with lower sexual frequency, regardless of infant age. Other parent and infant sleep-related factors were not significantly linked with sexual frequency in adjusted models. Moreover, sexual satisfaction was not associated with parent nighttime caregiving, parent or infant sleep, or parent-infant sleeping arrangements in adjusted models, suggesting that it may not be susceptible to the effects of disrupted sleep in the postpartum period. These findings suggest that it is not infant or parent sleep disruption per se, but rather parent nighttime engagement with the infant that is associated with parent sexual activity frequency. Longitudinal investigations are warranted to examine the directional pathways of these links.
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Affiliation(s)
- Michal Kahn
- College of Education, Psychology and Social Work, Flinders University
| | | | - Michael Gradisar
- College of Education, Psychology and Social Work, Flinders University
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Tikotzky L, Ran-Peled D, Ben-Zion H. A preliminary study on the performance of the Nanit auto-videosomnography scoring system against observed video scoring and actigraphy to estimate sleep-wake states in infants. Sleep Health 2023; 9:611-617. [PMID: 37716834 DOI: 10.1016/j.sleh.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/25/2023] [Accepted: 07/22/2023] [Indexed: 09/18/2023]
Abstract
GOAL AND AIMS To examine the performance of the Nanit auto-videosomnography scoring system as a measure of sleep-wake states in infants compared to observed video scoring and actigraphy. FOCUS TECHNOLOGY Nanit's auto-videosomnography scoring system. REFERENCE Observed video scoring and actigraphy. SAMPLE Sixteen U.S. infants (age: 4-8 months). DESIGN Infants' sleep was assessed with the Nanit camera and actigraphy (micromotion logger sleep watch). Fifty nights were included in the analyses. Nanit's videos were processed via a computer vision algorithm and were scored by trained observers. Actigraphic data were scored with the validated Sadeh algorithm. CORE ANALYTICS Bland-Altman plots and epoch-by-epoch analyses (sensitivity, specificity, and total accuracy). ADDITIONAL ANALYTICS Specificity values for each night separately. CORE OUTCOMES Nanit estimates of sleep minute were not significantly different from observed sleep minute, but Nanit overestimated sleep minute relative to actigraphy by 17 minutes. Nanit overestimated wake minutes (wake after sleep onset by 5.3 minutes relative to observed scoring and underestimated wake after sleep onset by 19.1 minutes relative to actigraphy. The epoch-by-epoch analyses revealed that Nanit reached 97.8% sensitivity in classifying sleep and 60.4% specificity in classifying wake compared to observed scoring. The rates compared to actigraphy were 99.3% for sensitivity and 51.7% for specificity. IMPORTANT ADDITIONAL OUTCOMES Specificity values were lower for infants with lower wake after sleep onset. CORE CONCLUSION This preliminary study suggests that Nanit is highly accurate in detecting infant sleep compared to observed scoring and actigraphy. Specificity values are within the range of those reported previously for actigraphy devices that are commonly used in pediatric sleep research.
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Affiliation(s)
- Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel.
| | - Dar Ran-Peled
- Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Hamutal Ben-Zion
- Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
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Touchette E, Rousseau M, Simard V, St-Amand A. Portrait of sleep in preschoolers involved with Child Protective Services and from the community. Sleep Med 2023; 110:166-171. [PMID: 37595433 DOI: 10.1016/j.sleep.2023.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVES The objectives of this exploratory study were: 1) to draw a portrait of sleep, using actigraphic sleep measures, sleep diaries and a validated sleep questionnaire in preschoolers (3- to 5-year-olds) involved with Child Protective Services (CPS) and to compare it with preschoolers from the community, not involved with CPS and 2) to verify whether the sleep differences between the two groups persisted after adjusting for covariates (sociodemographic and child characteristics). METHODS A total of 92 preschoolers aged from 3 to 5 years (49,5 ± 7,0 months) participated in the study (n = 22 preschoolers involved with CPS and n = 70 preschoolers from the community). Actigraphic sleep parameters were recorded using the child's non-dominant wrist over 72 h during weekdays and sleep diaries were filled out by parents (for nighttime) and childcare specialists (for daytime). Parents filled out the Child Sleep Habits Questionnaires (CSHQ) to measure their perception of their child's sleep. Chi-square tests, ANOVAs, and linear regressions were used to analyze the data and adjust for covariates (sociodemographic and child characteristics). RESULTS Preschoolers involved with CPS took longer to fall asleep and signaled significantly fewer nighttime awakenings to their parents compared to the group of preschoolers from the community. These significant effects were still present after adjusting for covariates (sociodemographic and child characteristics). CONCLUSIONS Understanding the underpinnings of these sleep differences by exploring their possible links with daytime cortisol production, sleep ecology and parent-child attachment are interesting avenues for future research.
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Affiliation(s)
- Evelyne Touchette
- Department of Psychoeducation and Social Work, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada; Research Unit on Children's Psychosocial Maladjustment, Québec, Canada; Centre d'études avancées en médecine du sommeil, Montréal, Canada.
| | - Michel Rousseau
- Department of Psychoeducation and Social Work, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada
| | - Valérie Simard
- Department of Psychology, Université de Sherbrooke, Québec, Canada; Research Center of the Sainte-Justine University Hospital, Québec, Canada; Charles-Le Moyne Research Center, Québec, Canada
| | - Annick St-Amand
- Department of Psychoeducation and Social Work, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada
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O'Sullivan R, Bissell S, Hamilton A, Bagshaw A, Richards C. Concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions: A systematic review and meta-analysis. Sleep Med Rev 2023; 71:101814. [PMID: 37422998 DOI: 10.1016/j.smrv.2023.101814] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
The purpose of this systematic review and meta-analysis is to delineate the concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions (NDCs). A systematic literature search identified 31 studies that compare objective and subjective estimates of sleep parameters in autism, ADHD or rare genetic syndromes associated with intellectual disability. The meta-analyses revealed smaller mean differences and larger correlations indicative of greater concordance for parameters associated with sleep scheduling compared to parameters associated with sleep duration and night awakenings. Relative to objective measures, subjective measures produced: 1) greater estimates of total sleep time, sleep efficiency and time in bed; and 2) lower estimates of wake after sleep onset and number of night awakenings. Subgroup analyses also revealed differences in concordance between measurement comparison types (e.g., stronger correlations between actigraphy and sleep diaries, compared to actigraphy and questionnaires) and NDC diagnostic groups. The results predominantly replicate concordance trends observed in typically-developing samples, although some NDC-specific patterns of concordance were identified. This indicates that objective and subjective sleep measures retain broadly similar properties across populations, although researchers and clinicians should be cautious of the impact of NDC-related characteristics on sleep parameter estimates. These findings should inform sleep assessment design and the interpretation of sleep parameter estimates in NDCs, increasing the rigour of sleep parameter description across research and clinical settings.
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Affiliation(s)
- Rory O'Sullivan
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK.
| | - Stacey Bissell
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Anna Hamilton
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Andrew Bagshaw
- School of Psychology, University of Birmingham, UK; Centre for Human Brain Health, University of Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
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Horwitz A, Bar-Shachar Y, Ran-Peled D, Finkelstein O, Ben-Zion H, Bar-Kalifa E, Meiri G, Tikotzky L. Sleep of mothers, fathers, and infants: a longitudinal study from pregnancy through 12 months. Sleep 2023; 46:zsad029. [PMID: 36788476 DOI: 10.1093/sleep/zsad029] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
STUDY OBJECTIVES This study assessed and compared mothers' and fathers' sleep trajectories from pregnancy and throughout the first year of the infant's life. We also examined associations between maternal, paternal, and infant sleep. METHODS Two hundred and thirty-two couples were recruited for the study during pregnancy. Data were collected during pregnancy and at 4, 8, and 12 months postpartum. Maternal, paternal, and infant sleep were monitored at home for seven nights, using actigraphy, sleep diaries, and the Insomnia Severity Index (ISI). RESULTS Mothers showed more impaired sleep quality than fathers, at all assessments, whereas fathers had shorter sleep duration. Based on the ISI, about 70% of mothers and 50% of fathers showed at least subclinical insomnia at the different assessments. Trajectory analyses (controlling for feeding method and sleeping arrangements) demonstrated a significant deterioration in diary-based and actigraphy sleep quality for both parents, from pregnancy to 4 months. Both parents and infants had an increase in sleep quality from 4 to 12 months, though some parental sleep variables showed a quadratic pattern with a decrease in sleep quality at 8 months. Statistically significant triadic associations at the different assessments were found between mothers', fathers', and infants' sleep. Maternal and infant sleep measures were more strongly correlated than paternal and infant sleep. CONCLUSIONS The findings highlight the importance of considering the family context of sleep, by demonstrating similarities and differences in the changes that sleep undergoes in new mothers and fathers and by showing how sleep is interrelated between all family members.
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Affiliation(s)
- Avel Horwitz
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yael Bar-Shachar
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dar Ran-Peled
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Omer Finkelstein
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hamutal Ben-Zion
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eran Bar-Kalifa
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Meiri
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Zeringue MM, Saini EK, Fuller-Rowell TE, Hinnant JB, El-Sheikh M. Neighborhood environment and adolescent sleep: The role of family socioeconomic status. Sleep Med 2023; 109:40-49. [PMID: 37413781 PMCID: PMC10529799 DOI: 10.1016/j.sleep.2023.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES Socioeconomic status (SES) and neighborhood context are influential predictors of adolescent sleep, yet little is known about how they may interact to influence sleep. We examined multiple dimensions of family SES as moderators of associations between neighborhood risk and multiple sleep parameters. METHODS Participants were 323 adolescents (Mage = 17.4 years, SD = 0.86; 48% male; 60% White/European American, 40% Black/African American). Sleep was assessed using 7 nights of actigraphy from which sleep duration (minutes from onset to wake time), efficiency, long wake episodes, and variability in minutes over the week were derived. Youth reported on their sleep/wake problems and sleepiness, as well as their perceptions of safety and violence in their neighborhoods. Parents reported on SES indices, including income-to-needs ratio and perceived financial stability. RESULTS Lower SES (income-to-needs, perceived financial stability) was associated with lower sleep efficiency and more frequent long wake episodes. Lower neighborhood safety and greater community violence concerns were related to greater subjective sleep problems. Moderation effects illustrated two general patterns. For actigraphy-derived sleep variables, lower neighborhood safety was associated with poor sleep only among youth from lower-income families. For subjective sleep/wake problems and daytime sleepiness, associations between neighborhood risk and sleep difficulties were pronounced for higher SES youth, while lower SES youth had greater sleep problems regardless of neighborhood factors. CONCLUSIONS Findings suggest that several dimensions of SES and neighborhood risk may be consequential for adolescents' sleep. Moderation effects highlight the significance of considering multiple contextual influences towards a better understanding of adolescents' sleep.
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Chandler-Mather N, Betts J, Donovan C, Shelton D, Dawe S. Understanding the impacts of childhood adversity on sleep problems in children with fetal alcohol spectrum disorder: A comparison of cumulative and dimensional approaches. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1702-1712. [PMID: 37442612 DOI: 10.1111/acer.15152] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/04/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND The developmental impacts of prenatal alcohol exposure (PAE) and postnatal exposure to adversity are typically considered in isolation. However, both contribute independently to sleep problems. Children with fetal alcohol spectrum disorder (FASD) have PAE and significant sleep disturbances. What is not clear is the relative contribution to these disturbances of exposure to early life adversity. This study examined how exposure to such adversity impacts frequent insomnia symptoms and nightmares in children with FASD and "At Risk" designations. METHODS We compared two approaches to modeling adversity in children who had undergone a diagnostic assessment for FASD: a cumulative risk approach that sums adversities to create a total score and an approach that treats exposure to threat and deprivation as independent dimensions. Data on caregiver-reported exposure to adversity and sleep problems for 63 children (aged 3 years 4 months to 7 years 8 months) were extracted from clinical archives. Cumulative risk, threat exposure, and deprivation exposure scores were computed and were tested as predictors of insomnia symptoms and nightmares. All analyses controlled for age and gender. RESULTS There were high rates of caregiver-reported sleep problems with 60.3% (n = 38) of children having nightmares and 44.4% (n = 28) having a frequent insomnia symptom. The cumulative risk analysis showed that for every additional exposure to adversity, the odds of having a caregiver-reported insomnia symptom increased by 38%. The dimensional analysis showed no relationship between deprivation and sleep problems. However, every additional exposure to threat increased the odds of nightmares by 93%. CONCLUSIONS Exposure to postnatal adversity contributes to sleep disturbances in children with FASD, with unique roles for cumulative risk and the threat dimension of adversity. The implications of these findings for the etiology and treatment of sleep disturbances in children with FASD are discussed.
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Affiliation(s)
- Ned Chandler-Mather
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Joseph Betts
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Caroline Donovan
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Doug Shelton
- Community Child Health, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
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40
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Bastien L, Théoret R, Bernier A, Godbout R. Habitual sleep and intraindividual variability of sleep in gifted children: an actigraphy study. J Clin Sleep Med 2023; 19:925-934. [PMID: 36710429 PMCID: PMC10152359 DOI: 10.5664/jcsm.10484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/31/2023]
Abstract
STUDY OBJECTIVES Giftedness is a multidimensional condition. It is increasingly put forward that gifted children (GC) could be a population at high risk for sleep problems. The current study investigated GC and typically developing children for their habitual sleep, night-to-night sleep variability, and parental reports of child sleep. METHODS The sample consisted of 62 GC (31 girls; mean age = 9.63 ± 1.71 years) and 62 typically developing children (31 girls; mean age = 9.68 ± 1.68 years). Groups were age and sex matched. Giftedness was identified using Renzulli's 3-factor definition of giftedness. Sleep duration, quality, and night-to-night variability were assessed using actigraphy. Parents were asked to complete the short-form version of the Children's Sleep Habits Questionnaire to report on their child's sleep. Groups were compared with independent sample t-tests and chi-square analyses. RESULTS GC displayed lower sleep efficiencies, more wake time after sleep onset, and more night-to-night sleep variability than typically developing children. GC were found to experience less social jetlag compared to typically developing children, and they also showed more clinically significant sleep problems as reported by parents. CONCLUSIONS Sleep maintenance and stability tend to be challenged in GC. While there is growing evidence that greater sleep variability is associated with poorer physical and emotional health, studies have yet to examine these associations in GC specifically to get a better understanding of giftedness. Overall, there is a need for research focused on both predictors and consequences of sleep patterns and sleep variability in GC. CITATION Bastien L, Théoret R, Bernier A, Godbout R. Habitual sleep and intraindividual variability of sleep in gifted children: an actigraphy study. J Clin Sleep Med. 2023;19(5):925-934.
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Affiliation(s)
- Laurianne Bastien
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
- Sleep Laboratory and Clinic, Rivière-des-Prairies Mental Health Hospital, Montréal, Quebec, Canada
| | - Rachel Théoret
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
- Sleep Laboratory and Clinic, Rivière-des-Prairies Mental Health Hospital, Montréal, Quebec, Canada
| | - Annie Bernier
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
| | - Roger Godbout
- Sleep Laboratory and Clinic, Rivière-des-Prairies Mental Health Hospital, Montréal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Quebec, Canada
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Kahn M, Barnett N, Gradisar M. Implementation of Behavioral Interventions for Infant Sleep Problems in Real-World Settings. J Pediatr 2023; 255:137-146.e2. [PMID: 36375604 DOI: 10.1016/j.jpeds.2022.10.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To compare the real-world frequency, timing, duration, difficulty, and helpfulness of 3 infant Behavioral Sleep Intervention (BSI) approaches: Unmodified Extinction, Modified Extinction, and Parental Presence and to examine the effectiveness and safety of these approaches by comparing infant sleep, parent sleep, daytime sleepiness, depression, and parent-infant bonding between parents who had and had not implemented these interventions. STUDY DESIGN Participants were 2090 parents (75% mothers, 79% White/Caucasian) of US infants (49% girls) aged 3-18 months (M = 9.1, SD = 4.1). Parents completed online questionnaires regarding their infant's sleep, their own sleep, daytime sleepiness, depression levels, and parent-infant bonding. Infant sleep was assessed via objective-albeit exploratory-autovideosomnography data obtained from the 14 days prior to survey completion. RESULTS Sixty-four percent of parents reported implementing BSIs. The average age at intervention was 5.3 months (SD = 2.6). Unmodified and Modified Extinction were rated as significantly more difficult to implement compared with Parental Presence but also as more helpful, shorter, and quicker to show improvements. Infant nighttime sleep was longer and more consolidated in the Unmodified and Modified Extinction groups compared with the Parental Presence and non-BSI groups. No differences were found between BSI groups in parent sleep, sleepiness, depression, or parent-infant bonding. CONCLUSIONS Implementation of BSIs outside clinical settings is pervasive and occurs earlier than generally recommended. Unmodified and Modified Extinction were associated with longer and more consolidated infant sleep. Despite concerns regarding the potential harm of BSIs, implementation of these approaches was not linked with negative outcomes, providing additional evidence for their safety and effectiveness.
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Affiliation(s)
- Michal Kahn
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia.
| | | | - Michael Gradisar
- Wink Sleep Pty Ltd, Adelaide, South Australia, Australia; Sleep Cycle AB, Gothenburg, Sweden
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Gillis BT, Hinnant JB, Erath SA, El-Sheikh M. Relationship between family income and trajectories of adjustment in adolescence: Sleep and physical activity as moderators. J Adolesc 2023; 95:494-508. [PMID: 36458567 DOI: 10.1002/jad.12131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Youth from lower-income families experience adjustment problems at higher rates than higher-income peers. While adolescents have little control over family income, they do have some agency over their sleep and physical activity, two factors that have been shown to mitigate the risk of maladjustment. To test this, sleep and physical activity were examined as moderators of the longitudinal relationship between family income (indexed by income-to-needs ratio) and trajectories of adolescent adjustment problems. METHODS Participants included a socioeconomically diverse community sample of 252 US youth (53% female; 33% Black, 67% White) in 2012-2015. Actigraphy-based sleep duration and quality were indexed, respectively, by minutes (sleep onset to wake excluding awakenings) and efficiency (% minutes scored as sleep from onset to wake). Physical activity and adjustment were youth-reported. Outcomes included internalizing (anxious/depressive) and rule-breaking behavior. Latent growth models estimated trajectories of adjustment across ages 16 and 18 years conditional on family income, sleep, physical activity, and their interactions. RESULTS Relationships between family income and change in internalizing symptoms were moderated by sleep minutes, and associations between income and change in internalizing symptoms and rule-breaking behavior were moderated conjointly by sleep efficiency and physical activity. CONCLUSIONS Under conditions of high-quality sleep and more physical activity, adolescents with lower income reported fewer adjustment problems. Conversely, youth with both poor sleep and low physical activity were at the highest risk for maladjustment over time. Findings enhance understanding of individual differences in trajectories of mental health associated with bioregulation, health behaviors, and the sociocultural context.
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Affiliation(s)
- Brian T Gillis
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - J Benjamin Hinnant
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Stephen A Erath
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
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Yu H, Song Y, Wang Y, Wang X, Li H, Feng X, Yu M. The Impact of Temperature on 24-Hour Movement Behaviors among Chinese Freshmen Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4970. [PMID: 36981878 PMCID: PMC10049201 DOI: 10.3390/ijerph20064970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Human populations worldwide have experienced substantial climate change issues. Gaps in scientific literature remain regarding the relationship between temperature and 24-hour movement behavior among people. The purpose of this study is to examine the impact of temperature on 24-hour movement behavior including physical activity (PA), sedentary behavior (SB) and sleep duration among university students living in Beijing, China. METHODS We conducted follow-up health surveys on 44,693 freshmen students enrolled at Tsinghua University from 2012 to 2018. PA and SB were measured by using the short version of the International Physical Activity Questionnaire (IPAQ-s); sleep duration was estimated by using The Pittsburgh Sleep Quality Index (CPSQI). Corresponding temperature data measured by the Beijing Meteorological Service were collected to include average daily temperature from the nearest weather station to Tsinghua university. The data were analyzed using linear individual fixed-effect regressions. RESULTS An increase in temperature (temperature range 2.29-28.73 °C) by 1 °C was associated with an increase in 0.66 weekly minutes of vigorous physical activity (VPA) (95% confidence interval [CI] = 0.49, 0.82), an increase in 0.56 weekly minutes of moderate physical activity (MPA)(95% CI = 0.32, 0.79), an increase in 1.21 weekly minutes of moderate to vigorous physical activity (MVPA) (95% CI = 0.90, 1.53), an increase in 0.55 weekly minutes of walking (95% CI = 0.31, 0.78), an increase in 1.76 weekly minutes of total PA (95% CI = 1.35, 2.17), and a reduction in 1.60 weekly minutes of sleeping (95% CI = -2.09, -1.11). There was no significant correlation between temperature and sedentary behavior among participants. CONCLUSIONS Temperature was significantly positively correlated with physical activity levels in the Chinese freshmen students, and significantly negatively correlated with sleep duration. Replication of this study is warranted among various populations within China. The evidence of this novel study focused on understanding the relationship between climate change and 24-hour movement behaviors among people for developing effective adaptation strategies to climate change to improve people's health behavior. This study has important implications for future study, as knowledge of the impact of temperature on movement behavior may help in the interpretation of their results and translate into improving people's health behavior.
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Affiliation(s)
- Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Yiling Song
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Yangyang Wang
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Xiaoxin Wang
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Haoxuan Li
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Xiaolu Feng
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou 310058, China
| | - Miao Yu
- Renmin University of China Libraries, Beijing 100872, China
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Lee J, Clark PC, Spratling R. Transitioning a Research Protocol for Videosomnography to Assess Sleep and Nighttime Caregiving Activities in School-Aged Children With Developmental Disabilities During the COVID-19 Pandemic. J Pediatr Health Care 2023; 37:133-136. [PMID: 36528485 PMCID: PMC9647040 DOI: 10.1016/j.pedhc.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The COVID-19 pandemic significantly affected children with developmental disabilities (DDs)' sleep. Videosomnography is a noninvasive, portable time-lapse video recording system to objectively obtain a child's sleep-wake behaviors and parents' caregiving activities in a natural environment. METHOD From September 2020 to February 2021, we conducted a feasibility study using actigraphy (in mothers) and videosomnography in children with DDs for seven consecutive nights to assess sleep and nighttime caregiving activities. Because of the pandemic, we developed and implemented alternative data collection strategies, such as delivering a "study package" with easy-to-follow written instructions and emailed video-recorded instructions on recording a child's sleep. RESULTS We aimed to enroll 10 mothers and 10 school-aged children with DDs and achieved this goal. Nine out of 10 mothers completed video recordings of their child's sleep, with only 10% missing data for videosomnography. DISCUSSION This paper shared adaptations to our videosomnography protocol and lessons learned.
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Hansen M, Simon KR, Strack J, He X, Noble KG, Merz EC. Socioeconomic disparities in sleep duration are associated with cortical thickness in children. Brain Behav 2023; 13:e2859. [PMID: 36575851 PMCID: PMC9927856 DOI: 10.1002/brb3.2859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/11/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Disrupted sleep has been consistently linked with lower academic achievement and worse mental health in children. Less is understood about sleep as a potential factor underlying socioeconomic differences in brain morphometry in children. The goals of this study were to investigate the associations among socioeconomic factors, sleep duration, and brain morphometry in children, and to examine the roles of the sleep environment and family routines in these associations. METHODS Participants were 5- to 9-year-old children from socioeconomically diverse families (N = 94; 61% female). Parents reported on children's weekday and weekend sleep durations, sleep environment, and family routines. High-resolution, T1-weighted structural magnetic resonance imaging (MRI) data were acquired. Analyses focused on cortical thickness, cortical surface area, and amygdala and hippocampal volume. RESULTS Results indicated that lower family income-to-needs ratio and parental education were significantly associated with shorter weekday sleep duration in children. Shorter weekday sleep duration was significantly associated with reduced thickness in the left middle temporal, right postcentral, and right superior frontal cortices and smaller basolateral but not centromedial amygdala volume. Family routines significantly mediated the associations of family income-to-needs ratio and parental education with weekday sleep duration in children. CONCLUSION These results contribute to our understanding of sleep factors as proximal mechanisms through which socioeconomic context may alter neural development during childhood.
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Affiliation(s)
- Melissa Hansen
- Department of PsychologyColorado State UniversityFort CollinsColoradoUSA
| | - Katrina R. Simon
- Department of Human DevelopmentTeachers College, Columbia UniversityNew YorkUSA
| | - Jordan Strack
- Department of PsychologyColorado State UniversityFort CollinsColoradoUSA
| | - Xiaofu He
- Department of PsychiatryColumbia University Irving Medical CenterNew YorkUSA
| | - Kimberly G. Noble
- Department of Human DevelopmentTeachers College, Columbia UniversityNew YorkUSA
| | - Emily C. Merz
- Department of PsychologyColorado State UniversityFort CollinsColoradoUSA
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Tabar YR, Mikkelsen KB, Shenton N, Kappel SL, Bertelsen AR, Nikbakht R, Toft HO, Henriksen CH, Hemmsen MC, Rank ML, Otto M, Kidmose P. At-home sleep monitoring using generic ear-EEG. Front Neurosci 2023; 17:987578. [PMID: 36816118 PMCID: PMC9928964 DOI: 10.3389/fnins.2023.987578] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction A device comprising two generic earpieces with embedded dry electrodes for ear-centered electroencephalography (ear-EEG) was developed. The objective was to provide ear-EEG based sleep monitoring to a wide range of the population without tailoring the device to the individual. Methods To validate the device ten healthy subjects were recruited for a 12-night sleep study. The study was divided into two parts; part A comprised two nights with both ear-EEG and polysomnography (PSG), and part B comprised 10 nights using only ear-EEG. In addition to the electrophysiological measurements, subjects filled out a questionnaire after each night of sleep. Results The subjects reported that the ear-EEG system was easy to use, and that the comfort was better in part B. The performance of the system was validated by comparing automatic sleep scoring based on ear-EEG with PSG-based sleep scoring performed by a professional trained sleep scorer. Cohen's kappa was used to assess the agreement between the manual and automatic sleep scorings, and the study showed an average kappa value of 0.71. The majority of the 20 recordings from part A yielded a kappa value above 0.7. The study was compared to a companioned study conducted with individualized earpieces. To compare the sleep across the two studies and two parts, 7 different sleeps metrics were calculated based on the automatic sleep scorings. The ear-EEG nights were validated through linear mixed model analysis in which the effects of equipment (individualized vs. generic earpieces), part (PSG and ear-EEG vs. only ear-EEG) and subject were investigated. We found that the subject effect was significant for all computed sleep metrics. Furthermore, the equipment did not show any statistical significant effect on any of the sleep metrics. Discussion These results corroborate that generic ear-EEG is a promising alternative to the gold standard PSG for sleep stage monitoring. This will allow sleep stage monitoring to be performed in a less obtrusive way and over longer periods of time, thereby enabling diagnosis and treatment of diseases with associated sleep disorders.
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Affiliation(s)
- Yousef R. Tabar
- Department of Electrical and Computer Engineering, Aarhus University, Aarhus, Denmark
| | - Kaare B. Mikkelsen
- Department of Electrical and Computer Engineering, Aarhus University, Aarhus, Denmark
| | | | - Simon L. Kappel
- Department of Electrical and Computer Engineering, Aarhus University, Aarhus, Denmark
| | | | | | | | | | | | | | - Marit Otto
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark
| | - Preben Kidmose
- Department of Electrical and Computer Engineering, Aarhus University, Aarhus, Denmark,*Correspondence: Preben Kidmose,
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Insomnia in Infancy, Childhood, and Adolescence. Sleep Med Clin 2023; 18:135-145. [PMID: 37120157 DOI: 10.1016/j.jsmc.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Insomnia is the most prevalent sleep disorder in youth, tends to persist over time, and is associated with a myriad of adverse outcomes. This paper synthesizes the current evidence regarding the phenomenology, prevalence, assessment, consequences, cause, and treatment of pediatric insomnia, highlighting areas that warrant further research and addressing the unique characteristics of this disorder in infants, children, and adolescents.
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Kearns JC, Lachowitz M, Bishop TM, Pigeon WR, Glenn CR. Agreement between actigraphy and sleep diaries: A 28-day real-time monitoring study among suicidal adolescents following acute psychiatric care. J Psychosom Res 2023; 164:111097. [PMID: 36455300 PMCID: PMC9839523 DOI: 10.1016/j.jpsychores.2022.111097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/08/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the agreement between, and adherence to, wrist actigraphy and digital sleep diaries as methods for sleep assessment among high-risk adolescents in the 28 days following discharge from acute psychiatric care. Sleep parameters included: number of nighttime awakenings (NWAK), sleep efficiency (SE), sleep onset latency (SOL), total sleep time (TST), and wake after sleep onset (WASO). METHODS Fifty-three adolescents (12-18 years) were recruited following discharge from acute psychiatric care for suicide risk. Adolescents completed a baseline assessment followed by a 28-day monitoring period with daily sleep diaries and continuous wrist actigraphy. Bland-Altman and multi-level models examined agreement. RESULTS Adherence to actigraphy was high, but lower for sleep diaries; a similar pattern of adherence emerged on weekdays vs. weekends. Bland-Altman analyses revealed no clinically meaningful bias for sleep parameters (except NWAK), but the limits of agreement make interpretation ambiguous. Our base model indicated strong agreement between actigraphy and sleep diaries for TST (r = 0.850), moderate for SOL (r = 0.325) and SE (r = 0.322), and weak for WASO (r = -0.049) and NWAK (r = 0.114). A similar pattern emerged with the insomnia severity models with baseline insomnia influencing agreement on all parameters. There were significant weekday-weekend differences for WASO and NWAK, but not for SOL, SE, and TST. CONCLUSION Results suggest that it may be beneficial to find a modeling approach to account for the concordant and discordant information and relevant time-level variables.
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Affiliation(s)
- Jaclyn C Kearns
- Department of Psychology, University of Rochester, Rochester, NY, USA.
| | | | - Todd M Bishop
- VA Center for Excellence for Suicide Prevention, Finger Lakes Healthcare System, Canandaigua, NY, USA; Sleep and Neurophysiology Research Lab, Department of Psychiatry, University of Rochester Medical Center Rochester, Rochester, NY, USA
| | - Wilfred R Pigeon
- VA Center for Excellence for Suicide Prevention, Finger Lakes Healthcare System, Canandaigua, NY, USA; Sleep and Neurophysiology Research Lab, Department of Psychiatry, University of Rochester Medical Center Rochester, Rochester, NY, USA
| | - Catherine R Glenn
- Department of Psychology, Old Dominion University, Norfolk, VA, USA; Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
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da Silva EC, Carneiro JR, de Almeida Fonseca Viola PC, Confortin SC, da Silva AAM. Association of Food Intake with Sleep Durations in Adolescents from a Capital City in Northeastern Brazil. Nutrients 2022; 14:nu14235180. [PMID: 36501210 PMCID: PMC9735429 DOI: 10.3390/nu14235180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/26/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022] Open
Abstract
(1) Background: During adolescence, there are significant changes in food consumption, such as reducing the consumption of in natura or minimally processed foods and increasing the consumption of ultra-processed foods. Thus, eating habits can influence sleep duration and, consequently, affect the quality of life of young people. This study thus aims to estimate the association of consumption of in natura or minimally processed, processed, and ultra-processed foods with sleep durations in adolescents. (2) Methods: This is a cross-sectional study including 964 adolescents (18 to 19 years old) from the 1997 to 1998 birth cohort in São Luís, Maranhão. Food consumption was assessed using the food frequency questionnaire (FFQ) and stratified based on the NOVA classification. Sleep duration was verified using accelerometry in hours. The analysis of the association between the consumption of in natura or minimally processed, processedand ultra-processed foods with sleep durations in adolescents used crude and adjusted linear regression (by gender, age, skin color, education, economic class, work, consumption of alcohol, smoking, screen time, physical activity, use of illicit drugs, anxiety, depressive symptoms, and lean and fat mass). A directed acyclic graph (DAG) was used to determine the minimum set of adjustment factors. (3) Results: Of the 964 individuals evaluated, 52.0% were female. The mean sleep duration was 6 h (± 0.95). In the crude and adjusted analyses, no association was observed between food consumption according to the degree of processing and adolescent sleep durations. (4) Conclusion: There was no association between the consumption of in natura or minimally processed, processed, and ultra-processed foods with sleep durations.
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Affiliation(s)
- Emanuellen Coelho da Silva
- Department of Public Health, School of Nutrition, Federal University of Maranhão, São Luís 65020-905, MA, Brazil
- Correspondence: ; Tel.: +55-983-272-9670
| | - Juliana Ramos Carneiro
- Department of Public Health, School of Medicine, Federal University of Maranhão, São Luís 65020-905, MA, Brazil
| | - Poliana Cristina de Almeida Fonseca Viola
- Nutrition Department, Nutrition Teacher at the Health Sciences Center, Federal University of Piauí, Teresina 64049-550, MA, Brazil
- Postgraduation Program in Collective Health, Department of Public Health, Federal University of Maranhão, São Luís 65020-905, MA, Brazil
| | - Susana Cararo Confortin
- Postgraduation Program in Collective Health, Department of Public Health, Federal University of Maranhão, São Luís 65020-905, MA, Brazil
| | - Antônio Augusto Moura da Silva
- Postgraduation Program in Collective Health, Department of Public Health, Federal University of Maranhão, São Luís 65020-905, MA, Brazil
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Wong MM, Brower KJ, Conroy DA, Craun EA. Convergence Between the Child Behavior Checklist Sleep Items, Actigraphy and Other Sleep Measures Among Children of Parents with Alcoholic Disorders and Controls. Nat Sci Sleep 2022; 14:2107-2121. [PMID: 36471754 PMCID: PMC9719267 DOI: 10.2147/nss.s324002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose The Child Behavior Checklist (CBCL) is a widely used instrument of children psychosocial functioning. CBCL sleep items have been used in both clinical settings and research. To date, few empirical studies have examined the relationships between CBCL sleep items and other sleep measures such as actigraphy and validated sleep questionnaires. This study extends the literature by examining these relationships in a group of children of parents with an alcohol use disorder (COAs) and matched controls. Participants and Methods Two hundred and forty-eight children aged 8-12 (48% COAs; 50% girls; Mean age =10.37 (Standard deviation = 1.47)), participated in this study. Data presented here were taken from Time 1 of a larger prospective study designed to understand the relationship between sleep and alcohol use. All participants were naïve to alcohol and other illicit drugs. Parents completed the Achenbach CBCL and the Pediatric Sleep Questionnaire (PSQ). Participants wore an actigraph watch on their non-dominant wrists for one week and filled out the Youth Self-Report (YSR). Results Multiple regression analyses showed that CBCL sleep items (eg, "trouble sleeping") correlated with related actigraphy (eg, shorter total sleep time and longer sleep onset latency) and Pediatrics Sleep Questionnaire (PSQ) items (eg, sleep difficulties and daytime sleepiness). Logistic regression analyses indicated that CBCL items (eg, "trouble sleeping) predicted similar items in the Youth Self Report (YSR) (eg, trouble sleeping). Structural equation modeling analyses showed that the latent variable "CBCL sleep" correlated significantly with the latent variables of actigraphy (r = -0.54, p < 0.001), PSQ (r = 0.93, p < 0.001) and YSR (r = 0.38, p < 0.01). These associations were largely the same for COAs and controls. Conclusion CBCL items were significantly associated with actigraphy variables, a validated sleep measure (PSQ) and youth report of sleep for both COAs and non-COAs.
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Affiliation(s)
- Maria M Wong
- Department of Psychology, Idaho State University, Pocatello, ID, 83209, USA
| | - Kirk J Brower
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Deirdre A Conroy
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Elizabeth A Craun
- Department of Psychology, Idaho State University, Pocatello, ID, 83209, USA
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