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Lolli L, Bonanno D, Lopez E, Di Salvo V. Night-to-night variability of objective sleep outcomes in youth Middle Eastern football players. Sleep Med 2024; 117:193-200. [PMID: 38564918 DOI: 10.1016/j.sleep.2024.03.023] [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: 12/07/2023] [Revised: 02/19/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To describe components of night-to-night variation in objective measures of sleep. METHODS We conducted a secondary data analysis of consecutive and chronologically ordered actigraphy-based measurements for time in bed (min), time asleep (min), and wake-after-sleep onset (min). This investigation examined 575 individual night-based measures available for a sub-sample of fifty-two, male youth Middle Eastern football players tracked over a 14-day surveillance period (chronological age range: 12.1 to 16 years). Distinct multivariable-adjusted generalized additive models included each objective sleep outcome measure as dependent variable and disaggregated components of variation for night measurement-by-sleep period interaction, week part (weekday or weekend), and study participant random effects from within-subject night-to-night sleep variation. RESULTS The within-subject standard deviation (SD) of ±98 min (95% confidence interval [CI], 92 to 104 min) for time in bed, ±87 min (95%CI, 82 to 93 min) for time asleep, and ±23 min (95%CI, 22 to 25 min) for wake-after-sleep-onset overwhelmed other sources of variability and accounted for ∼44% to 53% of the overall night-to-night variation. The night measurement-by-fragmented sleep period interaction SD was ±83 min (95%CI, 44 to 156 min) for time in bed, ±67 min (95%CI, 34 to 131 min) for time asleep, and ±15 min (95%CI, 7 to 32 min) for wake-after-sleep-onset that accounted for ∼22% to 32% of each sleep outcome measure overall variability. CONCLUSIONS Substantial random night-to-night within-subject variability poses additional challenges for strategies aiming to mitigate problems of insufficient and inconsistent sleep that are detrimental to school learning and youth athlete development processes.
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Affiliation(s)
- Lorenzo Lolli
- Aspire Academy, Football Performance & Science Department, Doha, Qatar; Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK.
| | - Daniele Bonanno
- Aspire Academy, Football Performance & Science Department, Doha, Qatar
| | - Emmanuel Lopez
- Aspire Academy, Football Performance & Science Department, Doha, Qatar
| | - Valter Di Salvo
- Aspire Academy, Football Performance & Science Department, Doha, Qatar; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
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A Cross-Sectional Comparative Study of Sleep Disturbances in Children with ADHD and Matched Controls. Brain Sci 2022; 12:brainsci12091158. [PMID: 36138894 PMCID: PMC9496794 DOI: 10.3390/brainsci12091158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Systematic reviews conducted on sleep disturbances in attention deficit hyperactivity disorder (ADHD) have found inconsistent results due to the presence of several moderating variables which were not controlled for in previous studies. The aim of this study was to examine sleep disturbances in children with ADHD compared to their typically developing peers after controlling for moderating variables (age, sex, medication status, body mass index, and psychiatric and medical comorbidities). Methods: ADHD was diagnosed using DSM-IV-TR criteria (Diagnostic and Statistical Manual of Mental Disorders) and Conners’ Parent Rating Scales. Children recruited (aged 6−12 years) for the ADHD group (n = 40) met the following criteria: IQ > 80, unmedicated, and no psychiatric or medical comorbidities. The control group consisted of age- and sex-matched typically developing peers (n = 40). Sleep was assessed subjectively (through parent reported questionnaires and sleep logs) and objectively (using video polysomnography). Results: 65% of children with ADHD had a sleep disorder, as compared to 17% of controls. The ADHD group reported more sleep disturbances and disorders, both on subjective measures and objective measures. Conclusions: Sleep disturbances and primary sleep disorders in children with ADHD exist independent of moderating variables and differences in sleep assessment methods, thereby bolstering support for previously documented literature on the ADHD and sleep connection.
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Trickett J, Hill C, Austin T, Johnson S. The Impact of Preterm Birth on Sleep through Infancy, Childhood and Adolescence and Its Implications. CHILDREN 2022; 9:children9050626. [PMID: 35626803 PMCID: PMC9139673 DOI: 10.3390/children9050626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
There is emergent literature on the relationship between the development of sleep-wake cycles, sleep architecture, and sleep duration during the neonatal period on neurodevelopmental outcomes among children born preterm. There is also a growing literature on techniques to assess sleep staging in preterm neonates using either EEG methods or heart and respiration rate. Upon discharge from hospital, sleep in children born preterm has been assessed using parent report, actigraphy, and polysomnography. This review describes the ontogeny and measurement of sleep in the neonatal period, the current evidence on the impact of preterm birth on sleep both in the NICU and in childhood and adolescence, and the interaction between sleep, cognition, and social-emotional outcomes in this population.
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Affiliation(s)
- Jayne Trickett
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7RH, UK
- Correspondence:
| | - Catherine Hill
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- Department of Sleep Medicine, Southampton Children’s Hospital, Southampton SO17 1BJ, UK
| | - Topun Austin
- Neonatal Intensive Care Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK;
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK;
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Bondopadhyay U, Diaz-Orueta U, Coogan AN. A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder. J Atten Disord 2022; 26:149-224. [PMID: 33402013 DOI: 10.1177/1087054720978556] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD. METHODS Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD. RESULTS 148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep. CONCLUSION Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.
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Affiliation(s)
- Upasana Bondopadhyay
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
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Ziegler M, Kaiser A, Igel C, Geissler J, Mechler K, Holz NE, Becker K, Döpfner M, Romanos M, Brandeis D, Hohmann S, Millenet S, Banaschewski T. Actigraphy-Derived Sleep Profiles of Children with and without Attention-Deficit/Hyperactivity Disorder (ADHD) over Two Weeks-Comparison, Precursor Symptoms, and the Chronotype. Brain Sci 2021; 11:brainsci11121564. [PMID: 34942866 PMCID: PMC8699578 DOI: 10.3390/brainsci11121564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Although sleep problems are common in children with ADHD, their extent, preceding risk factors, and the association between neurocognitive performance and neurobiological processes in sleep and ADHD, are still largely unknown. We examined sleep variables in school-aged children with ADHD, addressing their intra-individual variability (IIV) and considering potential precursor symptoms as well as the chronotype. Additionally, in a subgroup of our sample, we investigated associations with neurobehavioral functioning (n = 44). A total of 57 children (6-12 years) with (n = 24) and without ADHD (n = 33) were recruited in one center of the large ESCAlife study to wear actigraphs for two weeks. Actigraphy-derived dependent variables, including IIV, were analyzed using linear mixed models in order to find differences between the groups. A stepwise regression model was used to investigate neuropsychological function. Overall, children with ADHD showed longer sleep onset latency (SOL), higher IIV in SOL, more movements during sleep, lower sleep efficiency, and a slightly larger sleep deficit on school days compared with free days. No group differences were observed for chronotype or sleep onset time. Sleep problems in infancy predicted later SOL and the total number of movements during sleep in children with and without ADHD. No additional effect of sleep problems, beyond ADHD symptom severity, on neuropsychological functioning was found. This study highlights the importance of screening children with ADHD for current and early childhood sleep disturbances in order to prevent long-term sleep problems and offer individualized treatments. Future studies with larger sample sizes should examine possible biological markers to improve our understanding of the underlying mechanisms.
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Affiliation(s)
- Mirjam Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
- Correspondence: ; Tel.: +49-(0)-621-1703-4911
| | - Anna Kaiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Christine Igel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Julia Geissler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, University of Würzburg, 97080 Würzburg, Germany; (J.G.); (M.R.)
| | - Konstantin Mechler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Nathalie E. Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, 6525 EN Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, 6525 EN Nijmegen, The Netherlands
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, Philipps-University Marburg and University Hospital Marburg, 35039 Marburg, Germany;
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, 35032 Marburg, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany;
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, University of Würzburg, 97080 Würzburg, Germany; (J.G.); (M.R.)
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zürich, 8032 Zürich, Switzerland
- Center for Integrative Human Physiology, University of Zürich, 8057 Zürich, Switzerland
- Neuroscience Center Zürich, Swiss Federal Institute of Technology, University of Zürich, 8057 Zürich, Switzerland
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
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Darweesh AEDM, El Beh KA, Hashem MM, Nagy NES. Shorter rapid eye movement sleep duration in children with attention-deficit /hyperactivity disorder: the impact on quality of life. Sleep Med 2021; 87:77-84. [PMID: 34534746 DOI: 10.1016/j.sleep.2021.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The relationship of sleep with attention deficit hyperactivity disorder (ADHD) remains complex and unclear. The current study aimed to compare the subjective and objective sleep parameters among children with and without ADHD. Moreover, to address the effect of sleep parameters on the quality of life (QoL). METHODS We assessed 42 participants who were children with ADHD (aged 6-12 years), with predominant combined presentation (23), compared to 42 healthy children, who underwent a sleep study assessment subjectively (the Children's Sleep Habits Questionnaire), and objectively (one-night Polysomnographic recording). Also, parents completed the pediatric quality of life inventory (PedsQL-P). RESULTS Children with ADHD had more subjective sleep problems. ADHD patients also had a significant decrease in total sleep time and sleep efficiency, spending more time in wake and N1 sleep stages. Moreover, they had significantly lower rapid eye movement (REM)sleep duration and less duration of deep sleep stages. Multivariate regression analysis showed that REM sleep duration was the most contributing and predictive factor to QoL and school function impairment. CONCLUSION Children with ADHD have a significantly lower sleep quantity and poor sleep quality. In addition, short REM sleep duration independently contributes to further deterioration in different areas of QoL.
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Affiliation(s)
- Alaa El-Din M Darweesh
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Khaled A El Beh
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mustafa M Hashem
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Nahla El-Sayed Nagy
- Institute of Psychiatry, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
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7
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Sanabra M, Gómez-Hinojosa T, Alcover C, Sans O, Alda JA. Effects of stimulant treatment on sleep in attention deficit hyperactivity disorder (ADHD). Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Melegari MG, Vittori E, Mallia L, Devoto A, Lucidi F, Ferri R, Bruni O. Actigraphic Sleep Pattern of Preschoolers With ADHD. J Atten Disord 2020; 24:611-624. [PMID: 27708108 DOI: 10.1177/1087054716672336] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To assess the features of sleep in preschoolers with ADHD by means of questionnaire and actigraphy. Method: Twenty-five ADHD and 21 age-matched typically developing (TD) preschool children underwent the Child Behavior Checklist (CBCL) for ages 1½ to 5 and Pre-School-Age Psychiatric Assessment interview. Sleep was assessed by means of a modified Sleep Disturbance Scale for Children and wrist actigraphy for at least 5 days. Results: Children with ADHD, compared with TD, showed higher scores in CBCL Withdrawal (58.83 vs. 51.15, p < .0001), Attention Problems (69.88 vs. 51.54, p < .0001), and Aggressive Behavior (59.46 vs. 51.08, p < .0001) dimensions; they also showed increased actigraphic nocturnal activity (activity index 31.57 vs. 25.74, p < .05); and night-to-night variability for sleep minutes (56.44 vs. 32.79, p < .01), mean wake episodes (1.34 vs. 0.98, p < .05), mean activity (2.64 vs. 1.71, p < .05), and activity index (5.15 vs. 3.77, p < .05). Conclusion: This pilot study in preschoolers with ADHD showed increased motor activity during sleep and night-to-night variability for sleep duration and motor activity.
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Affiliation(s)
| | - Elena Vittori
- Centro Ricerca e Cura Balbuzie e disturbi della voce e del linguaggio, Rome, Italy
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9
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Langberg JM, Breaux RP, Cusick CN, Green CD, Smith ZR, Molitor SJ, Becker SP. Intraindividual variability of sleep/wake patterns in adolescents with and without attention-deficit/hyperactivity disorder. J Child Psychol Psychiatry 2019; 60:1219-1229. [PMID: 31231801 PMCID: PMC6800768 DOI: 10.1111/jcpp.13082] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prior studies examining the sleep of adolescents with and without attention-deficit/hyperactivity disorder (ADHD) have relied on mean values such as average sleep duration, which masks intraindividual variability (IIV). The objective was to investigate whether adolescents with ADHD have greater IIV of sleep/wake patterns than adolescents without ADHD using actigraphy and daily sleep diaries. METHOD Adolescents (ages 13.17 ± 0.40 years; 45% female) with (n = 162) and without (n = 140) ADHD were recruited from middle schools at two sites. Participants wore actigraphs and completed sleep diaries for an average of 2 weeks. RESULTS Multilevel models were conducted with sex, sleep medication use, ADHD medication use, number of days with data, and social jetlag controlled for in analyses. For actigraphy, adolescents with ADHD had greater variability for time in bed, sleep onset and offset, and wake after sleep onset than adolescents without ADHD. For sleep diary data, adolescents with ADHD had greater variability in bedtime, wake time, sleep duration, sleep onset latency, sleep quality, and night wakings than adolescents without ADHD. Social jetlag was a significant predictor of variability in sleep measures based on both actigraph and daily diaries; however, ADHD status was not associated with social jetlag. CONCLUSIONS This is the first study to show that adolescents with ADHD have more variable sleep/wake patterns than their peers using both objective and subjective sleep measures. IIV of sleep/wake patterns may be important for clinicians to assess and monitor as part of treatment. Research is needed to understand the mechanisms underlying increased IIV of sleep/wake patterns in adolescents with ADHD and potential consequences for daytime functioning.
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Affiliation(s)
- Joshua M. Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Rosanna P. Breaux
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Caroline N. Cusick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Cathrin D. Green
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Zoe R. Smith
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Stephen J. Molitor
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Xu X, Conomos MP, Manor O, Rohwer JE, Magis AT, Lovejoy JC. Habitual sleep duration and sleep duration variation are independently associated with body mass index. Int J Obes (Lond) 2017; 42:794-800. [PMID: 28895585 DOI: 10.1038/ijo.2017.223] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/31/2017] [Accepted: 09/03/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sleep plays a vital role in maintaining homeostasis and promoting health. Previous studies show that shorter sleep duration is associated with elevated body mass index (BMI) and other cardiovascular risk factors. The goal of this study was to investigate the effects of habitual sleep duration and nightly sleep duration variation based on daily device-recorded data on BMI and obesity-related biomarkers. METHODS In all, 748 individuals (50.6% females, 85.4% European-Americans, average age: 49.7 years old) participated in a commercial lifestyle coaching program beginning in July 2015. Daily sleep data were recorded by Fitbit Charge HR wristbands. Clinical laboratory blood tests were measured up to three times over a 12-month period. Linear regression models were used for cross-sectional analyses, and generalized estimating equations for longitudinal analyses. All models were adjusted for age, sex, geographic location, season, genetic ancestry inferred from whole genome sequencing data, and BMI (if applicable). Multiple testing issues were corrected by false discovery rate. RESULTS We calculated habitual sleep duration and nightly sleep duration variation. In general, females slept 15-min longer on average than males. A negative correlation was found between habitual sleep duration and BMI (β=-1.12, standard error=0.25, P<0.001). Moreover, we identified a positive correlation between sleep duration variation and BMI (β=2.97, standard error=0.79, P<0.001) while controlling for sleep duration, indicating that larger sleep duration variation is significantly and independently associated with increased BMI. CONCLUSIONS We explored the impact of habitual sleep duration and sleep duration variation, and identified that shorter habitual sleep duration and larger duration variation were independently associated with increased BMI.
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Affiliation(s)
- X Xu
- Research Department, Arivale Inc, Seattle, WA, USA
| | - M P Conomos
- Research Department, Arivale Inc, Seattle, WA, USA
| | - O Manor
- Research Department, Arivale Inc, Seattle, WA, USA
| | - J E Rohwer
- Research Department, Arivale Inc, Seattle, WA, USA
| | - A T Magis
- Research Department, Arivale Inc, Seattle, WA, USA
| | - J C Lovejoy
- Research Department, Arivale Inc, Seattle, WA, USA.,Institute for Systems Biology, Seattle, WA, USA
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Becker SP, Sidol CA, Van Dyk TR, Epstein JN, Beebe DW. Intraindividual variability of sleep/wake patterns in relation to child and adolescent functioning: A systematic review. Sleep Med Rev 2016; 34:94-121. [PMID: 27818086 DOI: 10.1016/j.smrv.2016.07.004] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 01/09/2023]
Abstract
Substantial research attention has been devoted to understanding the importance and impact of sleep in children and adolescents. Traditionally, this has focused on mean sleep variables (e.g., a child's "typical" or average sleep duration), yet research increasingly suggests that intraindividual variability (IIV) of sleep/wake patterns (sometimes referred to as sleep variability or night-to-night variability) regularly occurs and may have implications for adjustment. A systematic search of five electronic databases identified 52 empirical studies published between 2000 and 2015 that examined correlates of sleep IIV in children and adolescents, with a recent increase in the publication rate of such studies. Identified studies were often atheoretical and included post hoc analyses, though IIV in select aspects of sleep does appear to be associated with increasing age/pubertal status, non-White race, physical and neurodevelopmental conditions (e.g., attention-deficit/hyperactivity disorder; autism), psychopathology symptoms (e.g., anxiety, depression, inattention), body weight, stress, aspects of cognitive functioning, and poorer sleep functioning/habits. The limited intervention work examining sleep IIV in adolescents is promising, though studies are needed using more rigorous intervention designs. Clinical sleep recommendations may not only need to address overall sleep duration and sleep habits but also the stability of sleep duration and timing. It will be important for future research examining sleep IIV in children and adolescents to use a developmental framework in advancing theory pertaining to the causes, mechanisms, moderators, and outcomes of sleep IIV in youth, and a conceptual model is proposed to help guide such efforts.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Craig A Sidol
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Tori R Van Dyk
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jeffery N Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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