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Barry ES, D'Souza L. Maternal depressive symptoms and mother-infant cosleeping (including room sharing and bedsharing): a systematic review. J Clin Sleep Med 2024; 20:1517-1533. [PMID: 38648117 PMCID: PMC11367717 DOI: 10.5664/jcsm.11164] [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] [Indexed: 04/25/2024]
Abstract
STUDY OBJECTIVES Maternal depressive symptoms (MDS) affect most women during the first year postpartum. Mothers provide most of the nighttime care for infants, so studying the relationship between MDS and infant sleep location (ISL) is highly relevant to understanding maternal mental health over the first year of life and beyond. Infant sleep is studied by anthropologists, health care providers, and psychologists, with very little communication across disciplines. This review aimed to determine whether there is a predictive relationship between MDS and ISL. METHODS This systematic review searched 6 databases with terms related to maternal mood and ISL. Final analysis included 14 published studies, analyzed with narrative synthesis and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies directly compared ISL and MDS. RESULTS Five studies showed no relationship between ISL and MDS, and 1 study found bedsharing reduced MDS. Five studies found cosleeping was related to higher MDS although directionality is mixed or missing, and 3 studies found an association at some ages or for some populations only. Examining studies according to type of infant sleep assessment, study design, age of infant, or breastfeeding status failed to detect consistent patterns. CONCLUSIONS A variety of study designs, types and definitions of variable measures, sample recruitment, and study outcomes prevent detection of a consistent relationship between MDS and ISL. We explore reasons for the elusive nature of a relationship and make recommendations for future research in MDS and ISL, including crossdisciplinary collaborations. CITATION Barry ES, D'Souza L. Maternal depressive symptoms and mother-infant cosleeping (including room sharing and bedsharing): a systematic review. J Clin Sleep Med. 2024;20(9):1517-1533.
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Affiliation(s)
- Elaine S Barry
- Human Development and Family Studies, The Pennsylvania State University, Fayette, Lemont Furnace, Pennsylvania
| | - Levita D'Souza
- Faculty of Education, Monash University, Clayton, Victoria, Australia
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Augustin M, Wenzel AS, Licata-Dandel M, Breeman LD, Bilgin A, Wolke D, Ziegler M, Mall V, Friedmann A. App-based intervention for parents of children with crying, sleeping, and feeding problems: Usability, usefulness and implications for improvement. Internet Interv 2024; 35:100700. [PMID: 38221943 PMCID: PMC10784306 DOI: 10.1016/j.invent.2023.100700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024] Open
Abstract
Background There is a lack of evidence-based app guidance for parents of children with crying, sleeping, and feeding problems who are often highly burdened and not likely to seek professional help. A new psychoeducational app for parents providing scientifically sound information via text and videos, a diary function, selfcare strategies, a chat forum and a regional directory of specialized counseling centers may serve as a low-threshold intervention for this target group. Objective We investigated how parents perceived the app in terms of the following: (1) overall impression and usability, (2) feedback on specific app functions regarding usefulness and (3) possible future improvements. Methods Our clinical sample of N = 137 parents of children aged from 0 to 24 months was recruited from a cry baby outpatient clinic in Southern Germany between 2019 and 2022. A convergent parallel mixed methods design was used to collect and analyse cross-sectional data on app evaluation. After app use within the framework of a clinical trial, parents filled in an app evaluation questionnaire. Results Most participants used the app at least once a week (86, 62.8 %) over an average period of 19.06 days (SD = 15.00). Participants rated overall impression and usability as good, and the informational texts, expert videos and regional register of counseling centers as appealing and useful. The diary function and chat forum were found to be helpful in theory, but improvements in implementation were requested, such as a timer function for the diary entry. Regarding future functionality, parents posed several suggestions such as the option to contact counseling centers directly via app, and the inclusion of the profile of their partners. Conclusions Positive ratings of overall impression, usability, and specific app functions are important prerequisites for the app to be effective. App-based guidance for this target group should include easy-to-use information. The app is intended to serve as a secondary preventive low-threshold offer and to complement professional counseling.
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Affiliation(s)
- Michaela Augustin
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Anne Sophie Wenzel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Maria Licata-Dandel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
- Department of Psychology, Charlotte-Fresenius-University, Infanteriestr.11a, 80797 Munich, Germany
| | - Linda D. Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, Netherlands
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester CO4 3SQ, United Kingdom
| | - Dieter Wolke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom
- Department of Psychology, University of Warwick, Coventry CV4 7HL, United Kingdom
| | - Margret Ziegler
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Volker Mall
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Anna Friedmann
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
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Usluoglu F, Balık EA. Child therapists' views and experiences of video conference psychotherapy with children. CURRENT PSYCHOLOGY 2023:1-12. [PMID: 37359580 PMCID: PMC10251325 DOI: 10.1007/s12144-023-04820-w] [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] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
Although important research on remote psychotherapies was conducted for many years, the COVID-19 pandemic has accelerated the spread of remote therapies. However, studies focusing on children and the family population are still quite new. Exploration of therapists' views and experiences of using online psychotherapy interventions is of importance. In addition to these, confusion caused by referring to remote therapies with different names and using them for different purposes and forms makes it difficult to know which evidence is available for tools and forms. Therefore, this study aims to investigate psychotherapists' views and experiences of video conferencing psychotherapy (VCP) for children using a qualitative description method. In line with this purpose, semi-structured individual interviews were conducted with seven female specialists who conducted VCP with children in different cities in Turkey. Data collected from the interviews were analyzed using an inductive content analysis approach. Analysis results indicated two themes and ten sub-themes that described benefits, new opportunities as well as limitations and difficulties of VCP provided to children. Results showed that VCP enhanced accessibility for both therapists and children and their families, enabled comfort and flexibility, and was economic. Besides, such psychotherapy was found to increase fathers' participation in psychotherapy. On the other hand, difficulties are experienced in therapeutic relationships in the VCP process; the child's characteristics affected the applicability of the psychotherapy; maintaining focus became difficult; lack of materials and toys affected psychotherapy applications; children's connecting to psychotherapy from home caused privacy issues; and technological problems affected communication and sustainability.
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Affiliation(s)
- Feyruz Usluoglu
- Psychology Department, Toros University, Yenişehir, Mersin, 33150 Turkey
| | - Elif Aybike Balık
- Psychology Department, Toros University, Yenişehir, Mersin, 33150 Turkey
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Schnatschmidt M, Lollies F, Schlarb AA. Can a parental sleep intervention in an individual setting improve the maternal and paternal sense of competence and parent-child interaction in parents of young sleep-disturbed children? findings from a single-arm pilot intervention study. BMC Psychol 2022; 10:243. [PMID: 36316716 PMCID: PMC9623967 DOI: 10.1186/s40359-022-00945-y] [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: 06/06/2022] [Revised: 09/07/2022] [Accepted: 10/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In early childhood sleep and regulatory problems, parental factors are often impaired but essential to overcoming them. This study aims to examine, in parents of young sleep-disturbed children, whether mothers' and fathers' sense of parenting competence were increased and dysfunctional parent-child interactions reduced with a parental sleep intervention, whether these changes were sustained over a 12-month follow-up period and if children's symptomatic parameters could be related factors. METHODS A total of 57 families with sleep-disturbed children aged 6 months to 4 years entered this single-arm pilot study. Each parent pair participated in six weekly individual face-to-face sessions of a multimodal cognitive-behavioral sleep intervention. The Parenting Sense of Competence Scale, Parental Stress Index Short Form, Child's Sleep Diary and Child's Questionnaire on Crying, Eating and Sleeping were obtained pre-, post-, 3, 6 and 12 months after the intervention. RESULTS Maternal sense of competence and dysfunctional mother-child interaction improved significantly up to 6 months after the intervention. Factors related to lower maternal competence were the child's more frequent nightly food intake and more crying due to defiance; factors related to dysfunctional mother-child interaction were more frequent crying episodes, more crying due to defiance and more eating difficulties; factors related to increased maternal competence were less duration of child's night waking, less bed-sharing and lower frequency of crying episodes; factors related to increased paternal competence were less child's nightly food intake and fewer episodes of unexplained and unsoothable crying; and factors related to improved father-child interaction were less frequent child's night waking and fewer unexplained and unsoothable crying episodes. CONCLUSION For parents of sleep-disturbed young children, an intervention that addresses the child's sleep could be promising to increase the parental sense of competence and reduce dysfunctional parent-child interactions, especially for mothers. Child symptomatic parameters may change, together with the parental sense of competence and parent-child interaction of both parents, after the intervention. Mothers with children with more severe symptomatology perceive their parenting competence as lower on average and their mother-child interaction as more dysfunctional. Future research with a larger sample and a randomized controlled design is needed. TRIAL REGISTRATION The study was retrospectively registered at the German Clinical Trials Register (ID: DRKS00028578; registration date: 21.03.2022).
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Affiliation(s)
- Marisa Schnatschmidt
- grid.7491.b0000 0001 0944 9128Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501 Bielefeld, Germany
| | - Friederike Lollies
- grid.7491.b0000 0001 0944 9128Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501 Bielefeld, Germany
| | - Angelika A. Schlarb
- grid.7491.b0000 0001 0944 9128Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501 Bielefeld, Germany
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Schnatschmidt M, Lollies F, Schlarb AA. A single-arm pilot study: can a parental sleep intervention for sleep-disturbed young children in individual settings improve children's sleep, crying, eating, and parental distress in mothers and fathers? BMC Pediatr 2022; 22:578. [PMID: 36207683 PMCID: PMC9541003 DOI: 10.1186/s12887-022-03631-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Early sleep problems co-occur with crying, eating problems, and parental distress. This study investigates the impact of a parent-focused intervention to improve child sleep with the following aims: (1) To assess the impact on child sleep (sleep onset latency, frequency and duration of nighttime awakenings, frequency of bed-sharing, and nighttime food intake, total nighttime sleep duration, and sleep efficiency), child crying (frequency of crying episodes, of unexplained and unsoothable crying and of crying out of defiance), child eating difficulties, and parental distress of mothers and fathers. (2) To assess the maintenance of any changes in these areas longitudinally, at 3-month, 6-month, and 12-month follow-ups. (3) To explore at the within-subjects level, how children’s sleep, crying, eating, and parental distress changed together across all study measurement points. Methods In this single-arm pilot study, the parents of 60 children participated in six individual sessions of a parent-focused multimodal age-adjusted cognitive-behavioral intervention to improve child sleep. Parents of 39 children (46% girls, age in months M = 22.41, SD = 12.43) completed pre- and at least one measure after the intervention. Sleep diary, questionnaire for crying, feeding, sleeping, and parental stress index (short-form) were assessed pre, post, three, six, and 12 months after the intervention. Results Significantly, sleep (decreased sleep onset latency, frequency, duration of nighttime awakenings, bed-sharing, nighttime food intake; increased total nighttime sleep duration, sleep efficiency), crying (reduced frequency of crying episodes, unexplained and unsoothable crying), and parental distress (reduced) changed, which remained partially stable over follow-up. The frequency of crying episodes decreased with fewer nighttime awakenings; morning crying with increased nighttime feeding; unexplained and unsoothable crying with higher sleep efficiency; crying due to defiance with more nighttime awakenings, sleep efficiency, and bed-sharing. Eating problems decreased with shorter night awakenings and time; maternal distress with fewer nighttime awakenings, paternal with less child’s nighttime feeding, unexplained and unsoothable crying, and time. Conclusions A parental sleep intervention for sleep-disturbed young children could be promising to reduce children’s sleep problems, crying, eating problems and parental distress. Future studies should consider more personal contact during the follow-up to reduce the drop-out rate and a randomized-controlled design. Trial registration The study was retrospectively registered at the German Clinical Trials Register (ID: DRKS00028578, registration date: 21.03.2022). Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03631-5.
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Affiliation(s)
- Marisa Schnatschmidt
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany.
| | - Friederike Lollies
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany
| | - Angelika A Schlarb
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany
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Gronski M. Occupational Therapy Interventions to Support Sleep in Children From Birth to Age 5 Years. Am J Occup Ther 2022; 76:23909. [PMID: 36125512 DOI: 10.5014/ajot.2022.049552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. This Evidence Connection article provides a case report of a young child receiving early intervention services. I describe the occupational therapy evaluation and intervention processes for supporting this child's sleep routines in the home and early childhood education settings. A systematic review on this topic was published in the March/April 2020 issue of the American Journal of Occupational Therapy and in AOTA's Occupational Therapy Practice Guidelines for Early Childhood: Birth-Age 5 Years. Each article in this series summarizes the evidence from published reviews on a given topic and presents an application of the evidence to a related clinical case. Evidence Connection articles illustrate how the research evidence from the reviews can be used to inform and guide clinical decision making.
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Affiliation(s)
- Meredith Gronski
- Meredith Gronski, OTD, OTR/L, CLA, FAOTA, is Associate Professor and Chair, Department of Occupational Therapy, Methodist University, Fayetteville, NC;
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Zhu H, Xiao L, Tu A. Effectiveness of technology-based interventions for improving sleep among children: a systematic review and meta-analysis. Sleep Med 2022; 91:141-150. [DOI: 10.1016/j.sleep.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/20/2022] [Indexed: 10/19/2022]
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Modularized iCBT‑I self-learn training for university staff-prevention and early intervention in the SARS-CoV-2 crisis: A pilot study. SOMNOLOGIE 2021; 25:29-37. [PMID: 33649702 PMCID: PMC7903869 DOI: 10.1007/s11818-021-00301-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 11/08/2022]
Abstract
Background Insomnia is a widespread disease in adults and has a high prevalence rate. As sleep disturbances are a risk factor concerning mental and physical health, prevention and early intervention are necessary. Thus, the aim of this study was to implement a self-learning prevention and early intervention training for university staff members. We adapted an established cognitive behavioral therapy for insomnia (CBT-I) intervention as an online version for use during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) crisis. Methods Development and adaptation procedure of the internet-based CBT‑I (iCBT-I) prevention and early intervention training is described. Sessions and topics are shown in detail. The Online Sleep Prevention and Treatment Acceptance questionnaire (OSTA) and the Online Sleep Prevention and Treatment Feedback questionnaire (OSTF) were used to assess acceptance. Sleep problems of university staff members were assessed using the Pittsburgh Sleep Questionnaire (PSQI). Results The online-adapted version consisted of seven modules. Contents of sessions and topics were implemented based on video clips. Drawings were added to information regarding sleep and sleep hygiene as well as addressing stress and cognitions. In all, 15 individuals participated in this pilot study. The new iCBT‑I self-learning prevention training was well accepted. In addition, participants scored the online version as helpful based on the OSTA. Prior to online training, 89% of the participants reported impaired sleep quality or insomnia symptoms, and 56% had a PSQI score over 10. After training 78% of participants showed reduced sleep problems according to PSQI and 56% reached clinically significant enhancement. In addition, after training 44% were healthy sleepers. Discussion This is the first iCBT‑I prevention and early intervention training for university staff members. The training by participants was very well accepted and they scored the videos as very helpful. Sleep problems decreased after online training. However, further studies with larger samples and more sleep-related assessment strategies, e.g., actigraphy and sleep log, are necessary.
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Sleep apps for children—a critical view. SOMNOLOGIE 2021. [DOI: 10.1007/s11818-021-00297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Background
During the last few years, technology support for various health-related areas is becoming increasingly common. Not only are nutrition apps or sports apps available, but apps regarding sleep are also available. As the prevalence of sleep disturbances in infancy and childhood is quite high, supportive strategies are necessary to help families to sleep healthy. Thus, this study addresses the topic of sleep apps for babies and children.
Methods
Sleep apps were searched using different strings. Age-oriented apps were scored using different criteria which were theoretically based (e.g., description, costs, downloads).
Results
We found 573 sleep apps using the Apple App Store and Google Play Store with the search strings “sleep” and “app” and “baby” or “children”. Of these, 15.4% were not declared for children or babies. Content of most apps was lullabies or music and songs. Sleep-related aspects as sleep information or sleep education was very rare.
Conclusions
There is a new field of sleep help—with sleep apps used by families. Because of the high prevalence concerning sleep problems, the market concerning sleep helping apps is well used. However, most of the sleep apps did not have declarations concerning age and other factors. Parents should be careful using sleep apps for their offspring.
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Himawan KK, Underwood M, Bambling M, Edirippulige S. Being single when marriage is the norm: Internet use and the well-being of never-married adults in Indonesia. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01367-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Schnatschmidt M, Cattarius B, Schneider B, Jud A, Schlarb AA. Wie ist die Lage in Einrichtungen für frühkindliche Regulationsstörungen in Deutschland? ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2021. [DOI: 10.1026/1616-3443/a000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Frühkindliche Regulationsprobleme stehen in Verbindung mit Schlafproblemen und unsicherem Elternverhalten. Störungsspezifische Behandlungsansätze sind vielfältig und unterscheiden sich deutlich hinsichtlich Qualität und Evidenzgrad. Fragestellung: Häufigkeiten von Schlafproblemen, elterliche Unsicherheiten, therapeutisch / beraterische Grundorientierungen und Konzepte werden erfasst und Unterschiede zwischen Einrichtungsarten untersucht. Methode: Die Umfrage wurde mit interdisziplinären Experten entwickelt. Eine deutschlandweite Datenbank (622 Einrichtungen) mit einer finalen Stichprobe von N = 160 wurde erstellt. Ergebnisse: Schlafprobleme gelten als häufigster Anmeldegrund (59 %), unsicheres Erziehungsverhalten als mehrheitlich relevant (66 %). Über 16 Behandlungskonzepte werden angewandt; je nach Einrichtungsart eher systemische ( d = 0.5), körperorientierte ( d = 0.5) oder somatisch-medizinische ( d = 0.7) Verfahren. Schlussfolgerung: Die schlafspezifische Expertise der Fachkräfte sollte gesichert sowie Transparenz und Überprüfbarkeit von Qualitätsstandards weiterentwickelt werden.
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Affiliation(s)
- Marisa Schnatschmidt
- Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie, Universität Bielefeld
| | - Barbara Cattarius
- Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie, Universität Bielefeld
| | - Barbara Schneider
- Zentrum für Neuropädiatrie und Schlafmedizin, Kinderkrankenhaus St. Marien, Landshut
| | - Andreas Jud
- Kinder- und Jugendpsychiatrie / Psychotherapie, Universitätsklinikum Ulm
- Soziale Arbeit, Hochschule Luzern, Luzern, Schweiz
| | - Angelika A. Schlarb
- Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie, Universität Bielefeld
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Hiscock H, Ng O, Crossley L, Chow J, Rausa V, Hearps S. Sleep Well Be Well: Pilot of a digital intervention to improve child behavioural sleep problems. J Paediatr Child Health 2021; 57:33-40. [PMID: 32770791 DOI: 10.1111/jpc.15106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/09/2020] [Accepted: 07/17/2020] [Indexed: 01/03/2023]
Abstract
AIM To investigate whether a digital sleep intervention improves child and care giver sleep and psychosocial outcomes. METHODS A total of 120 families with children aged 2-13 years, reporting moderate to severe child behavioural sleep problems, were recruited from a hospital sleep clinic waitlist or the community. Children from non-English speaking families, with known intellectual disability (IQ < 70) or severe medical problems excluded. Tailored behavioural sleep strategies were delivered to primary care givers via a smart phone app and complementary website. Eligible families completed a baseline questionnaire and child 'sleep check' then received the digital sleep intervention for 5 weeks, and then completed a post questionnaire. OUTCOMES care giver report of child sleep as no/mild versus moderate/severe problem over past month (primary outcome); problem child sleep patterns (Brief Infant Sleep Questionnaire or Child Sleep Habits Questionnaire), child temperament, care giver mental health (Kessler 6), care giver sleep, health service use for their child's sleep and time off work/activities to access services. RESULTS At follow up, care givers reported fewer moderate/severe child sleep problems (84.6-40.7%), improved problem child sleep patterns, better temperament and improved care giver mental health. Care giver sleep quality and quantity remained unchanged. Health service use (averaged over a 6-month period pre- and post-intervention) fell from 18.9% pre- to 14.1% post-intervention. CONCLUSION A digital sleep intervention appears promising in improving sleep in children with moderate/severe behavioural sleep problems, and care giver mental health. It may be a useful alternative to face-to-face management of behavioural sleep problems.
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Affiliation(s)
- Harriet Hiscock
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Health Services Research Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Olivia Ng
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Louise Crossley
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jennifer Chow
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Vanessa Rausa
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Stephen Hearps
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Meltzer LJ, Wainer A, Engstrom E, Pepa L, Mindell JA. Seeing the Whole Elephant: a scoping review of behavioral treatments for pediatric insomnia. Sleep Med Rev 2020; 56:101410. [PMID: 33387973 DOI: 10.1016/j.smrv.2020.101410] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 01/07/2023]
Abstract
Pediatric insomnia is common, impacting up to a third of typically-developing, healthy children, and over 80% of children with neurodevelopmental disorders or chronic medical conditions. Previous reviews of behavioral interventions for pediatric insomnia have had a limited focus on a single age group, a specific population, and/or only randomized controlled trials. Furthermore, few reviews have considered non-sleep outcomes of both children and their parents. This scoping review provides a broader context, including studies regardless of research design or population, along with sleep and non-sleep study outcomes. Clear gaps in the literature were identified, highlighting the need for additional research in different populations, including school-age children and adolescents, racial/ethnic groups around the world, as well as youth with medical or psychiatric disorders. In addition, more research is needed on different features of treatment, including the delivery mode, involvement of all family members, non-sleep outcomes, and long-term follow-up.
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Affiliation(s)
- Lisa J Meltzer
- National Jewish Health, 1400 Jackson Street, G311, Denver, CO 80206, USA.
| | - Allison Wainer
- University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Box F496, Aurora, CO 80045, USA
| | - Erin Engstrom
- University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Box F496, Aurora, CO 80045, USA
| | - Lauren Pepa
- University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Box F496, Aurora, CO 80045, USA
| | - Jodi A Mindell
- Saint Joseph's University, 5600 City Ave, Philadelphia, PA 19131, USA; Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
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Schlarb AA, Schulte H, Selbmann A, Och I. Online cognitive behavioral group therapy (iCBT-I) for insomnia for school children and their parents: Adaptation of an established treatment (KiSS training). SOMNOLOGIE 2020; 24:259-266. [PMID: 33192170 PMCID: PMC7650574 DOI: 10.1007/s11818-020-00280-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Due to the SARS-CoV‑2 crisis, online adaptation of sleep trainings is necessary. As sleep disturbances in school children are common, prevention of chronification is essential. The aim of this study was to adapt an established age-oriented cognitive behavioral therapy for insomnia (CBT-I) group training for 5–10-year-old children with insomnia and their parents to an online version (group iCBT-I). Methods The adaptation procedure and structure of the iCBT‑I are described. To assess acceptance the Online Sleep Treatment Acceptance questionnaire (OSTA) and the Online Sleep Treatment Feedback questionnaire (OSTF) were implemented. In addition, trainers filled in the Adherence and Feasibility Questionnaire for Online Sleep Treatment (AFOST). Sleep problems were assessed using a structured interview for sleep disorders in children and clinical interview, and the Children’s Sleep Habit Questionnaire (CSHQ-DE). Emotional problems were evaluated with the Child Behavior Checklist (CBCL 4-18). Results This pilot study included 12 parents and 6 children fulfilling insomnia criteria prior to online training. The adapted online version consisted of three parental sessions, whereas child-oriented sessions were transferred into videoclips. The new group iCBT‑I was well accepted by parents. Parents scored the online version as helpful and time saving based on the OSTA and trainers estimated the adapted version to be feasible and effective. According to AFOST, adherence was given. After training, 67% of children showed reduced sleep problems according to parental rating. Conclusion Parental acceptance of a group iCBT‑I for school children and their parents was very good and parents scored the videos for their children as very helpful. Trainers declared the adapted version to be feasible. A further study with a larger sample is necessary.
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Affiliation(s)
- Angelika A Schlarb
- Department of Psychology and Sports Science, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Hannah Schulte
- HaKiJu Hochschulambulanz für Kinder und Jugendliche und ihre Familien, Bielefeld University, Morgenbreede 12, 33615 Bielefeld, Germany
| | - Anika Selbmann
- HaKiJu Hochschulambulanz für Kinder und Jugendliche und ihre Familien, Bielefeld University, Morgenbreede 12, 33615 Bielefeld, Germany
| | - Ina Och
- HaKiJu Hochschulambulanz für Kinder und Jugendliche und ihre Familien, Bielefeld University, Morgenbreede 12, 33615 Bielefeld, Germany
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Clark GF, Kingsley KL. Occupational Therapy Practice Guidelines for Early Childhood: Birth-5 Years. Am J Occup Ther 2020; 74:7403397010p1-7403397010p42. [PMID: 32365324 DOI: 10.5014/ajot.2020.743001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE This Practice Guideline provides stakeholders with a condensed summary of a large number of effectiveness studies. It is a valuable tool for facilitating decision making related to occupational therapy interventions for children ages birth-5 yr. OBJECTIVE Early childhood (birth-5 yr) is a critical period in which the foundation of key life occupations is developed (e.g., eating, dressing, play, learning, social participation, rest and sleep, and chores). The development of cognitive, motor, social-emotional, and self-care skills is important to support these occupations. This Practice Guideline synthesizes recent systematic reviews (SRs) on these areas of development to promote decision making for and high-quality interventions with this population. METHOD Four SRs related to cognition, mental health, motor function, and ADLs analyzed studies published from 2010 to 2017 retrieved from six electronic databases (MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane). RESULTS A total of 196 articles were included in the SRs, which served as a guide to final clinical recommendations. Case studies describe translation and application to practice. CONCLUSION and Recommendations: A variety of interventions within the domain of occupational therapy were found to support the development of cognitive, social-emotional, motor, and self-care skills. Although some of these interventions are typically implemented by occupational therapy practitioners, others can be implemented by parents after training or by teams working in preschool settings. These findings should be used to inform evidence-based practice provided by occupational therapy practitioners working in various early childhood settings. WHAT THIS ARTICLE ADDS This Practice Guideline gives occupational therapy practitioners clear information about which interventions will be effective for specific outcomes. Better intervention choices mean better outcomes for young children and their families.
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Affiliation(s)
- Gloria Frolek Clark
- Gloria Frolek Clark, PhD, OTR/L, BCP, FAOTA, is an occupational therapist in private practice, Adel, Iowa;
| | - Karrie L Kingsley
- Karrie L. Kingsley, OTD, OTR/L, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
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Abstract
OBJECTIVE To describe the perceptions of (1) parents, childcare, and health care providers regarding sleep health among multiethnic infants and toddlers living with socioeconomic adversity, (2) factors that contribute to sleep health and its consequences, and (3) best ways to promote sleep health in these children. METHODS Nested within a larger community-engaged mixed methods study, we used a descriptive qualitative design to describe the experience of multiethnic young parents who were raising 6- to 36-month-old children, pediatric health care providers, and childcare providers living and working in an urban under-resourced community. Semistructured interviews with 25 parents and 16 providers were conducted, transcribed, coded, and analyzed using thematic analysis by a 6-member research team. Interviews continued until themes were saturated. RESULTS Parent responses and provider responses resulted in overlapping and divergent findings. Common themes among all respondents were the importance of sleep, interest and desire for more sleep health information, and common environmental/social impediments to healthy family sleep. Divergent themes included the importance of bedtime routines and timing, views on the family bed, importance of naps, and healthy sleep aids. Childcare centers were suggested as good sites for sleep health promotion programs. CONCLUSION Sleep is a topic of interest and importance for young families. There are unique family challenges to be considered in any sleep health promotion program tailored to the needs of the community. The voices of parents and community providers are valuable assets informing the development of novel family-friendly approaches for decreasing sleep disparities and improving the health of young children and families.
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Abstract
Prior to the COVID-19 pandemic, few pediatric sleep medicine clinicians routinely engaged in telemedicine visits because thorough examinations were difficult to perform; there was lack of consistent reimbursement; and many clinicians were busy with their in-office practices. This article reviews how telemedicine has been explored in pediatric sleep medicine prior to the pandemic, current applications of telemedicine, challenges, and reimagining pediatric sleep within the realm of telemedicine.
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Affiliation(s)
- Shalini Paruthi
- Sleep Medicine and Research Center, St. Luke's Hospital, 232 South Woods Mill Road, Chesterfield, MO 63017, USA; Pediatrics, Saint Louis University School of Medicine, St Louis, MO, USA.
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Gronski M, Doherty M. Interventions Within the Scope of Occupational Therapy Practice to Improve Activities of Daily Living, Rest, and Sleep for Children Ages 0-5 Years and Their Families: A Systematic Review. Am J Occup Ther 2020; 74:7402180010p1-7402180010p33. [PMID: 32204772 DOI: 10.5014/ajot.2020.039545] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Research studies supporting occupational therapy interventions to address feeding, toileting, and sleep can be applied to practice in early intervention and preschool settings to improve the outcomes of young children and their families. OBJECTIVE To examine the effectiveness of interventions within the scope of occupational therapy practice to improve activities of daily living, rest, and sleep for children ages 0-5 yr and their families. DATA SOURCES Five databases (MEDLINE, PsycINFO, CINAHL, OTseeker, ERIC) and Evidence-Based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, and Database of Abstracts of Reviews of Effectiveness were searched for studies published between January 2000 and March 2017. STUDY SELECTION AND DATA COLLECTION Inclusion criteria were Levels I-III evidence, being within occupational therapy's scope of practice, including participants with a mean age younger than 6 yr, and addressing self-care, activities of daily living, and rest and sleep. FINDINGS Forty articles were appraised, and three themes emerged: interventions to address feeding and eating, interventions to address toileting, and interventions to address rest and sleep. Additional subthemes of behavioral approaches, parent and caregiver education, and contextual intervention were revealed. CONCLUSIONS AND RELEVANCE Occupational therapy practitioners should consider the use of interventions with moderate or strong evidence as described in this review. Limitations include risk of bias and limited evidence for several interventions. WHAT THIS ARTICLE ADDS This article provides a broader perspective on evidence-based practice by examining studies within the scope of occupational therapy practice published outside of current occupational therapy publications. The review includes studies from nutrition, nursing, and psychology, which address interdisciplinary care, family coaching and education, and behavioral approaches within the professional scope of occupational therapy to improve the functional performance, routines, and quality of life for young children and their caregivers.
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Affiliation(s)
- Meredith Gronski
- Meredith Gronski, OTD, OTR/L, CLA, is Assistant Professor and Chair, Department of Occupational Therapy, Methodist University, Fayetteville, NC;
| | - Meghan Doherty
- Meghan Doherty, OTD, OTR/L, is Assistant Professor, Department of Occupational Science and Occupational Therapy, Saint Louis University, St. Louis, MO
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Spiegelhalder K, Acker J, Baumeister H, Büttner-Teleaga A, Danker-Hopfe H, Ebert DD, Fietze I, Frase L, Klein S, Lehr D, Maun A, Mertel I, Richter K, Riemann D, Sauter C, Schilling C, Schlarb AA, Specht M, Steinmetz L, Weeß HG, Crönlein T. Digitale Behandlungsangebote für Insomnie – eine Übersichtsarbeit. SOMNOLOGIE 2020. [DOI: 10.1007/s11818-020-00238-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungDigital angebotene psychologische Interventionen gegen Schlafstörungen sind aktuell ein sehr intensiv bearbeitetes Forschungsthema. In dieser Übersichtsarbeit werden Originalarbeiten und Metaanalysen zu diesem Thema zusammengefasst. Hierbei zeigt sich, dass die internetbasierte kognitive Verhaltenstherapie für Insomnie (KVT-I) bei Erwachsenen durchweg sehr effektiv ist mit allenfalls leicht geringeren Effektstärken als die gleiche Behandlung mit physischer Präsenz von Therapeuten und Patienten. Behandlungseffekte zeigen sich dabei auch für sekundäre Outcome-Parameter wie Depressivität, Angst, Fatigue und Lebensqualität. Hingegen lassen die Forschung zur Wirksamkeit der internetbasierten KVT‑I bei Erwachsenen mit komorbiden psychischen Störungen oder körperlichen Erkrankungen sowie die Forschung zur Frage, wieviel Therapeutenkontakt in die Behandlung integriert werden sollte, anscheinend noch keine abschließenden Antworten zu. In diesen Bereichen scheint weitere Forschung notwendig zu sein scheint.
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Beresford B, McDaid C, Parker A, Scantlebury A, Spiers G, Fairhurst C, Hewitt C, Wright K, Dawson V, Elphick H, Thomas M. Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbance in children with neurodisabilities: a systematic review. Health Technol Assess 2019; 22:1-296. [PMID: 30382936 DOI: 10.3310/hta22600] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is uncertainty about the most appropriate ways to manage non-respiratory sleep disturbances in children with neurodisabilities (NDs). OBJECTIVE To assess the clinical effectiveness and safety of NHS-relevant pharmacological and non-pharmacological interventions to manage sleep disturbance in children and young people with NDs, who have non-respiratory sleep disturbance. DATA SOURCES Sixteen databases, including The Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE, were searched up to February 2017, and grey literature searches and hand-searches were conducted. REVIEW METHODS For pharmacological interventions, only randomised controlled trials (RCTs) were included. For non-pharmacological interventions, RCTs, non-randomised controlled studies and before-and-after studies were included. Data were extracted and quality assessed by two researchers. Meta-analysis and narrative synthesis were undertaken. Data on parents' and children's experiences of receiving a sleep disturbance intervention were collated into themes and reported narratively. RESULTS Thirty-nine studies were included. Sample sizes ranged from 5 to 244 participants. Thirteen RCTs evaluated oral melatonin. Twenty-six studies (12 RCTs and 14 before-and-after studies) evaluated non-pharmacological interventions, including comprehensive parent-directed tailored (n = 9) and non-tailored (n = 8) interventions, non-comprehensive parent-directed interventions (n = 2) and other non-pharmacological interventions (n = 7). All but one study were reported as having a high or unclear risk of bias, and studies were generally poorly reported. There was a statistically significant increase in diary-reported total sleep time (TST), which was the most commonly reported outcome for melatonin compared with placebo [pooled mean difference 29.6 minutes, 95% confidence interval (CI) 6.9 to 52.4 minutes; p = 0.01]; however, statistical heterogeneity was extremely high (97%). For the single melatonin study that was rated as having a low risk of bias, the mean increase in TST was 13.2 minutes and the lower CI included the possibility of reduced sleep time (95% CI -13.3 to 39.7 minutes). There was mixed evidence about the clinical effectiveness of the non-pharmacological interventions. Sixteen studies included interventions that investigated the feasibility, acceptability and/or parent or clinician views of sleep disturbance interventions. The majority of these studies reported the 'family experience' of non-pharmacological interventions. LIMITATIONS Planned subgroup analysis was possible in only a small number of melatonin trials. CONCLUSIONS There is some evidence of benefit for melatonin compared with placebo, but the degree of benefit is uncertain. There are various types of non-pharmacological interventions for managing sleep disturbance; however, clinical and methodological heterogeneity, few RCTs, a lack of standardised outcome measures and risk of bias means that it is not possible to draw conclusions with regard to their effectiveness. Future work should include the development of a core outcome, further evaluation of the clinical effectiveness and cost-effectiveness of pharmacological and non-pharmacological interventions and research exploring the prevention of, and methods for identifying, sleep disturbance. Research mapping current practices and exploring families' understanding of sleep disturbance and their experiences of obtaining help may facilitate service provision development. STUDY REGISTRATION This study is registered as PROSPERO CRD42016034067. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Adwoa Parker
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Gemma Spiers
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Heather Elphick
- Department of Respiratory Medicine, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Megan Thomas
- Blenheim House Child Development Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
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Schlarb AA, Schneider B. Schlaf im Säuglingsalter. SOMNOLOGIE 2018. [DOI: 10.1007/s11818-018-0186-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Friedrich A, Claßen M, Schlarb AA. Sleep better, feel better? Effects of a CBT-I and HT-I sleep training on mental health, quality of life and stress coping in university students: a randomized pilot controlled trial. BMC Psychiatry 2018; 18:268. [PMID: 30157894 PMCID: PMC6114783 DOI: 10.1186/s12888-018-1860-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/23/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The SWIS sleep training for university students showed promising results regarding subjective and objective sleep parameters. As sleep disorders and impaired sleep quality are closely related to various aspects of mental health, the current study examines the effects of the SWIS sleep training on mental health in university students. METHODS Fifty six university students (M = 25.84, SD = 5.06) participated in the study, 68% were women. Forty one were randomly assigned to the SWIS treatment (pre-post-follow-up), 15 to a Waiting List Control condition (WLC, pre-post). Besides sleep-related measures, the students completed four online questionnaires measuring mental health, quality of life and stress coping strategies. Effect sizes for the pre-post data were compared between the conditions, long-term effects were calculated with repeated measures ANOVA or Friedman ANOVA. Long-term clinical changes were analyzed with the Reliable Change Index (RCI). RESULTS The pre-post comparisons between SWIS and WLC revealed lower depression scores in both conditions, a better physical state in the SWIS condition and less maladaptive stress coping strategies in the WLC students. The long-term results of SWIS provided significant improvements regarding the students' somatic complaints, reduced anxiety, an improved physical state and a better quality of life with moderate to large effect sizes. Most of the significant improvements occurred between pre- and follow-up measurement. These statistically significant results were also reflected in clinically significant changes from pre- to follow-up-test. CONCLUSIONS SWIS and WLC condition both improved in two mental health variables immediately after the training. These findings may be explained by unspecific treatment expectation effects in the WLC. Interestingly, most mental health outcomes showed significant improvements after 3 months, but not immediately after the training. These positive long-term effects of the SWIS training on mental health indicate that the transfer of strategies might simply need more time to affect the students' mental health. TRIAL REGISTRATION The current study was retrospectively registered at German Clinical Trials Register (ID: DRKS00014338 , registration date: 20.04.2018, enrolment of first participant: 14.04.2015).
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Affiliation(s)
- Anja Friedrich
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of children and adolescents, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
| | - Merle Claßen
- 0000 0001 0944 9128grid.7491.bFaculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of children and adolescents, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Angelika A. Schlarb
- 0000 0001 0944 9128grid.7491.bFaculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of children and adolescents, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany
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Schlarb AA. [Therapy of insomnia and nightmares in childhood and adolescence]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2018; 46:383-391. [PMID: 30141741 DOI: 10.1024/1422-4917/a000608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Therapy of insomnia and nightmares in childhood and adolescence Abstract. Sleep problems and sleep disorders have a high prevalence in childhood and adolescence. Normally, such conditions persist and often become chronic. Daytime impairments are widespread with concentration deficits, mental problems, and also a higher suicide risk. Therefore, early and effective interventions are necessary. As symptoms change with age, therapy should be adjusted accordingly. Various strategies for infants and toddlers, schoolchildren, and adolescents will be named. In addition, evidence of these therapy strategies will be shown. All in all, more randomized controlled studies addressing children and adolescents are needed. Furthermore, studies with children and adolescents suffering from comorbid disorders or mental disorders and sleep problems should be conducted.
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Affiliation(s)
- Angelika A Schlarb
- 1 Abteilung für Psychologie, Fakultät für Psychologie und Sportwissenschaft, Bielefeld
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Schlarb AA, Bihlmaier I, Velten-Schurian K, Poets CF, Hautzinger M. Short- and Long-Term Effects of CBT-I in Groups for School-Age Children Suffering From Chronic Insomnia: The KiSS-Program. Behav Sleep Med 2018; 16:380-397. [PMID: 27645834 DOI: 10.1080/15402002.2016.1228642] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE/BACKGROUND This intervention study evaluates the short- and long-term effects of cognitive behavior therapy for insomnia (CBT-I) in groups for school-age children and their parents, named the KiSS-program. CBT-I was implemented in three sessions for children and three sessions for parents. PARTICIPANTS AND METHODS All in all, 112 children with chronic childhood insomnia were randomly assigned to a wait-list (WL) control or treatment condition. RESULTS According to subjective measures as well as objective wrist actigraphy, children in the CBT-I condition reported greater improvements in sleep behavior immediately after the treatment compared to the WL group. Improvements in sleep behavior after CBT-I persisted over the 3-, 6-, and 12-month follow-up assessments. CONCLUSIONS The present study is the first randomized controlled trial that provides evidence for the long-term effectiveness of CBT-I in treating school-age children with chronic insomnia.
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Affiliation(s)
- Angelika A Schlarb
- a Department of Psychology and Sports , Bielefeld University , Bielefeld , Germany.,b Department of Psychology , University of Tuebingen , Tuebingen , Germany
| | - Isabel Bihlmaier
- b Department of Psychology , University of Tuebingen , Tuebingen , Germany
| | - Kerstin Velten-Schurian
- b Department of Psychology , University of Tuebingen , Tuebingen , Germany.,c Department of Psychiatry , University of Tuebingen , Tuebingen , Germany
| | - Christian F Poets
- d Childrens Clinic, Department for Neonatology , University of Tuebingen , Tuebingen , Germany
| | - Martin Hautzinger
- b Department of Psychology , University of Tuebingen , Tuebingen , Germany
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Genuneit J, Brockmann PE, Schlarb AA, Rothenbacher D. Media consumption and sleep quality in early childhood: results from the Ulm SPATZ Health Study. Sleep Med 2018; 45:7-10. [DOI: 10.1016/j.sleep.2017.10.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 10/26/2017] [Accepted: 10/28/2017] [Indexed: 11/16/2022]
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Corkum PV, Reid GJ, Hall WA, Godbout R, Stremler R, Weiss SK, Gruber R, Witmans M, Chambers CT, Begum EA, Andreou P, Rigney G. Evaluation of an Internet-Based Behavioral Intervention to Improve Psychosocial Health Outcomes in Children With Insomnia (Better Nights, Better Days): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e76. [PMID: 29581089 PMCID: PMC5891669 DOI: 10.2196/resprot.8348] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Up to 25% of 1- to 10-year-old children experience insomnia (ie, resisting bedtime, trouble falling asleep, night awakenings, and waking too early in the morning). Insomnia can be associated with excessive daytime sleepiness and negative effects on daytime functioning across multiple domains (eg, behavior, mood, attention, and learning). Despite robust evidence supporting the effectiveness of behavioral treatments for insomnia in children, very few children with insomnia receive these treatments, primarily due to a shortage of available treatment resources. OBJECTIVE The Better Nights, Better Days (BNBD) internet-based program provides a readily accessible electronic health (eHealth) intervention to support parents in providing evidence-based care for insomnia in typically developing children. The purpose of the randomized controlled trial (RCT) is to evaluate the effectiveness of BNBD in treating insomnia in children aged between 1 and 10 years. METHODS BNBD is a fully automated program, developed based on evidence-based interventions previously tested by the investigators, as well as on the extant literature on this topic. We describe the 2-arm RCT in which participants (500 primary caregivers of children with insomnia residing in Canada) are assigned to intervention or usual care. RESULTS The effects of this behavioral sleep eHealth intervention will be assessed at 4 and 8 months postrandomization. Assessment includes both sleep (actigraphy, sleep diary) and daytime functioning of the children and daytime functioning of their parents. Results will be reported using the standards set out in the Consolidated Standards of Reporting Trials statement. CONCLUSIONS If the intervention is supported by the results of the RCT, we plan to commercialize this program so that it is sustainable and available at a low cost to all families with internet access. TRIAL REGISTRATION ClinicalTrials.gov NCT02243501; https://clinicaltrials.gov/show/NCT02243501 (Archived by WebCite at http://www.webcitation.org/6x8Z5pBui).
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Affiliation(s)
- Penny V Corkum
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health Centre, Halifax, NS, Canada
| | - Graham J Reid
- Department of Psychology, University of Western Ontario, London, ON, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Children's Health Research Institute & Lawson Health Research Institute, London, ON, Canada
| | - Wendy A Hall
- School of Nursing, Faculty of Applied Science, University of British Columbia, Vancouver, BC, Canada
| | - Roger Godbout
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| | - Robyn Stremler
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Shelly K Weiss
- Division of Neurology, Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Reut Gruber
- Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, QC, Canada
- Attention Behavior and Sleep Lab, Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
| | - Manisha Witmans
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Christine T Chambers
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Esmot Ara Begum
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Pantelis Andreou
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Gabrielle Rigney
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
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Item Reduction, Scoring, and First Validation of the ACCEPTance by the Patients of their Treatment (ACCEPT©) Questionnaire. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 10:81-92. [PMID: 27456210 DOI: 10.1007/s40271-016-0187-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The objectives of this study were to finalize, develop the scoring, and explore the psychometric properties of the ACCEPTance by the Patients of their Treatment (ACCEPT©) questionnaire, as well as to provide the first elements for its interpretation and guidance for its future use. METHODS ACCEPT© was finalized according to reference methods including testing in a pilot study, i.e., a multi-center, observational, longitudinal study conducted in France, in collaboration with a network of pharmacists. Principal component analysis using Varimax rotation was performed. The loadings of items on components in the principal component analysis were used to inform item selection. Validity of the measurement model of ACCEPT© was confirmed using Multi-trait/Multi-item Analysis based on item-scale Spearman correlations. Internal consistency reliability of the questionnaire was assessed by determining the Cronbach's α coefficient. Linear and logistic regressions were used to identify predictors of general acceptance, and to study predictors of persistence. RESULTS A total of 189 patients were included. The final version of ACCEPT© is composed of 25 items, distributed in seven dimensions providing a comprehensive appraisal of acceptance of long-term medication, with six scores measuring acceptance of treatment specific attributes and one score measuring general treatment acceptance. The measurement properties of ACCEPT© were overall fairly satisfactory. Regressions showed that Acceptance/Effectiveness is a predictor of general acceptance. However, no predictor of persistence could be identified. CONCLUSION The self-administered ACCEPT© questionnaire is a valid and reliable instrument for the assessment of patients' acceptance of long-term medication. Disease-specific and large prospective studies are needed to assess the ability of ACCEPT
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Luik AI, Kyle SD, Espie CA. Digital Cognitive Behavioral Therapy (dCBT) for Insomnia: a State-of-the-Science Review. CURRENT SLEEP MEDICINE REPORTS 2017; 3:48-56. [PMID: 28553574 PMCID: PMC5427093 DOI: 10.1007/s40675-017-0065-4] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Over the past decade, digital solutions have been developed to support the dissemination of Cognitive Behavioral Therapy (CBT). In this paper, we review the evidence for and implications of digital CBT (dCBT) for insomnia. RECENT FINDINGS We propose three categories of dCBT, which differ in the amount of clinician time needed, level of automatization, costs, and scalability: dCBT as support, guided dCBT, and fully automated dCBT. Consistent evidence has been published on the effectiveness of dCBT to address insomnia disorder, in a variety of populations, with effects extending into well-being. Important gaps in the literature are identified around moderators and mediators of dCBT, cost-effectiveness, and the implementation of dCBT. SUMMARY The evidence base for dCBT is rapidly developing and already suggests that dCBT for insomnia is effective. However, further science and digital innovation is required to realize the full potential of dCBT and address important clinical questions.
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Affiliation(s)
- Annemarie I. Luik
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, OMPI G, South Parks Road, Oxford, OX1 3RE UK
- Big Health Ltd, London, UK
| | - Simon D. Kyle
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, OMPI G, South Parks Road, Oxford, OX1 3RE UK
| | - Colin A. Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, OMPI G, South Parks Road, Oxford, OX1 3RE UK
- Big Health Ltd, London, UK
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Brandhorst I, Bernhardt C, Hautzinger M, Schlarb AA. Die Cortisol-Aufwachreaktion bei Müttern junger Kinder mit Schlafproblemen. SOMNOLOGIE 2017. [DOI: 10.1007/s11818-016-0070-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cattarius BG, Schlarb AA. Gegenseitige Beeinflussung von Eltern und Babys in ihrem Schlafverhalten. SOMNOLOGIE 2016. [DOI: 10.1007/s11818-016-0064-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Corkum P, Lingley-Pottie P, Davidson F, McGrath P, Chambers CT, Mullane J, Laredo S, Woodford K, Weiss SK. Better Nights/Better Days—Distance Intervention for Insomnia in School-Aged Children With/Without ADHD: A Randomized Controlled Trial. J Pediatr Psychol 2016; 41:701-13. [DOI: 10.1093/jpepsy/jsw031] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 03/21/2016] [Indexed: 11/13/2022] Open
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Parent-child bed-sharing: The good, the bad, and the burden of evidence. Sleep Med Rev 2016; 32:4-27. [PMID: 27107752 DOI: 10.1016/j.smrv.2016.03.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 12/30/2022]
Abstract
The practice of parent and child sharing a sleeping surface, or 'bed-sharing', is one of the most controversial topics in parenting research. The lay literature has popularized and polarized this debate, offering on one hand claims of dangers, and on the other, of benefits - both physical and psychological - associated with bed-sharing. To address the scientific evidence behind such claims, we systematically reviewed 659 published papers (peer-reviewed, editorial pieces, and commentaries) on the topic of parent-child bed-sharing. Our review offers a narrative walkthrough of the many subdomains of bed-sharing research, including its many correlates (e.g., socioeconomic and cultural factors) and purported risks or outcomes (e.g., sudden infant death syndrome, sleep problems). We found general design limitations and a lack of convincing evidence in the literature, which preclude making strong generalizations. A heat-map based on 98 eligible studies aids the reader to visualize world-wide prevalence in bed-sharing and highlights the need for further research in societies where bed-sharing is the norm. We urge for multiple subfields - anthropology, psychology/psychiatry, and pediatrics - to come together with the aim of understanding infant sleep and how nightly proximity to the parents influences children's social, emotional, and physical development.
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Michels N, De Henauw S, Eiben G, Hadjigeorgiou C, Hense S, Hunsberger M, Konstabel K, Molnár D, Moreno LA, Siani A, De Bourdeaudhuij I, Pigeot I. Effect of the IDEFICS multilevel obesity prevention on children's sleep duration. Obes Rev 2015; 16 Suppl 2:68-77. [PMID: 26707017 DOI: 10.1111/obr.12327] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 08/30/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND According to recent findings, short sleep duration is associated with overweight in children. However, primary prevention efforts aimed at achieving adequate sleep among children are scarce. Therefore, the 'Identification and prevention of Dietary-induced and lifestyle-induced health EFfects In Children and infantS' (IDEFICS) study implemented a multilevel intervention that included sleep duration as a key behavioural target. The aim of this study is to evaluate sleep duration among children participating in the IDEFICS study. METHODS The IDEFICS nocturnal sleep intervention was included as part of stress reduction educational messages aimed at parents and children. Sleep was assessed by a parental 24-h recall (only weekdays; n = 8,543) and by a diary (weekdays and weekends separately; n = 4,150). Mixed linear models tested the intervention effect on sleep duration change between baseline when children were 2-9.9 years of age (2007/2008) and follow-up (2009/2010). Logistic mix models were used to study the intervention effect on the presence of TV in the children's bedroom (one of the intervention messages; n = 8,668). Additionally, parents provided qualitative data regarding exposure to the intervention. RESULTS About 51.1% of the parents in the intervention regions reported awareness of the sleep intervention. A small intervention effect was seen on weeknight sleep duration in that the decrease in sleep duration over 2 years was smaller in the intervention (15 min) as compared with control regions (19 min) (p = 0.044). There was no overall intervention effect on weekend sleep duration or on the presence of a TV in the bedroom. A small significant time effect between baseline and follow-up was found on bedroom TV presence depending on self-reported intervention exposure (3% increase in TV presence in exposed versus 6.6% increase in non-exposed). Children without a TV in the bedroom had longer nocturnal sleep duration. DISCUSSION The sleep component of the intervention did not lead to clinically relevant changes in sleep duration. Future interventions aimed at young children's sleep duration could benefit from more specific and intense messaging than that found in the IDEFICS intervention. Future research should use objective measures of sleep duration as well as intermediate outcomes (sleep knowledge, sleep environment and sleep practices).
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Affiliation(s)
- N Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Health Sciences, Vesalius, University College Ghent, Ghent, Belgium
| | - G Eiben
- Section for Epidemiology and Social Medicine, University of Gothenburg, Gothenburg, Sweden
| | - C Hadjigeorgiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - S Hense
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - M Hunsberger
- Section for Epidemiology and Social Medicine, University of Gothenburg, Gothenburg, Sweden
| | - K Konstabel
- National Institute for Health Development, Tallinn, Estonia
| | - D Molnár
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - A Siani
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany
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Corrêa CDC, Blasca WQ, Berretin-Felix G. Health promotion in obstructive sleep apnea syndrome. Int Arch Otorhinolaryngol 2015; 19:166-70. [PMID: 25992174 PMCID: PMC4399197 DOI: 10.1055/s-0034-1390327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/25/2014] [Indexed: 11/23/2022] Open
Abstract
Introduction Obstructive sleep apnea syndrome (OSAS), which is commonly underdiagnosed, has a high occurrence in the world population. Health education concerning sleep disorders and OSAS should be implemented. Objectives The objective was to identify studies related to preventive actions on sleep disorders, with emphasis on OSAS. Data Synthesis A literature review was conducted using Lilacs, Medline, PubMed, and Scopus by combining the following keywords: "Health Promotion," "Sleep Disorders," "Primary Prevention," "Health Education," and "Obstructive Sleep Apnea Syndromes." Initially, 1,055 papers, from 1968 to 2013, were located, with the majority from the Scopus database. The inclusion criteria were applied, and four articles published between 2006 and 2012 were included in the present study. Conclusions The studies on preventive actions in sleep disorders, with emphasis on OSAS, involved the general population and professionals and students in the health field and led to increased knowledge on sleep disorders and more appropriate practices.
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Affiliation(s)
- Camila de Castro Corrêa
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, Universidade de São Paulo, Bauru, São Paulo, Brazil
| | - Wanderléia Quinhoneiro Blasca
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, Universidade de São Paulo, Bauru, São Paulo, Brazil
| | - Giédre Berretin-Felix
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, Universidade de São Paulo, Bauru, São Paulo, Brazil
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Meltzer LJ, Mindell JA. Systematic review and meta-analysis of behavioral interventions for pediatric insomnia. J Pediatr Psychol 2014; 39:932-48. [PMID: 24947271 DOI: 10.1093/jpepsy/jsu041] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To evaluate and quantify the evidence for behavioral interventions for pediatric insomnia. METHODS Meta-analysis of 16 controlled trials and qualitative analysis of 12 within-subject studies were conducted (total n = 2,560). RESULTS Meta-analysis found significant effects for four specified sleep outcomes: sleep-onset latency, number of night wakings, and duration of night wakings, and sleep efficiency, with small to large effect sizes across the controlled clinical trials involving typical children. No significant effects were found for the two studies conducted with special needs populations. Finally, within-subjects studies demonstrated significant effects for all sleep outcomes with large effect sizes. Risk of bias assessment and GRADE ratings of the quality of the evidence are described. CONCLUSION Moderate-level evidence supports behavioral interventions for pediatric insomnia in young children. However, low evidence for children, adolescents, and those with special needs (due to a lack of studies that met inclusion criteria) highlights the need for future research.
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Affiliation(s)
- Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Department of Psychology, Saint Joseph's University, and Sleep Center, Children's Hospital of Philadelphia
| | - Jodi A Mindell
- Department of Pediatrics, National Jewish Health, Department of Psychology, Saint Joseph's University, and Sleep Center, Children's Hospital of Philadelphia Department of Pediatrics, National Jewish Health, Department of Psychology, Saint Joseph's University, and Sleep Center, Children's Hospital of Philadelphia
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