Home About us Contact
|
Home About us Contact | ||
|
|
||
Sleep Problems (sleep + problem)
Selected AbstractsChildhood Sleep Problems, Response Inhibition, and Alcohol and Drug Outcomes in Adolescence and Young AdulthoodALCOHOLISM, Issue 6 2010Maria M. Wong Background:, To our knowledge, no prospective studies examine the relationships among childhood sleep problems, adolescent executive functioning, and substance outcomes (i.e., substance use and substance-related problems). In this study, we examined whether childhood sleep problems predicted adolescent sleep problems and response inhibition. We also tested whether adolescent sleep problems and poor response inhibition mediated the relationship between childhood sleep problems and substance (alcohol and drug) outcomes in young adulthood. Methods:, Study participants were 292 boys and 94 girls (M = 4.85, SD = 1.47) from a community sample of high-risk families and controls. Results:, When compared to their counterparts, those with trouble sleeping in childhood were twice as likely to have the same problem in adolescence. Childhood overtiredness predicted poor response inhibition in adolescence. Persistent trouble sleeping from childhood to adolescence and response inhibition in adolescence mediated the relationship between childhood sleep problems and drug outcomes in young adulthood, whereas overtiredness in childhood directly predicted alcohol use outcomes and alcohol-related problems in young adulthood. Conclusions:, This is the first study showing a long-term relationship between childhood sleep measures and subsequent alcohol and drug outcomes. The developmental and clinical implications of these findings were discussed. Prevention and intervention programs may want to consider the role of sleep problems and response inhibition on substance use and abuse. [source] Sleep Problems in Early Childhood and Early Onset of Alcohol and Other Drug Use in AdolescenceALCOHOLISM, Issue 4 2004Maria M. Wong Abstract: Background: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood. Methods: This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families. Results: Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use. Conclusions: This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed. [source] Habitual snoring in an outpatient population in JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2000Yuhei Kayukawa MD Abstract In order to investigate the occurrence and history of sleep problems in Japan, the 11-Centre Collaborative Study on Sleep Problems (COSP) project was carried out. Complaints of snoring are examined, and its prevalence, risk factors and screening reliability are discussed. The subjects who participated in the study were 6445 new outpatients from a general hospital. They were asked to answer a sleep questionnaire that consisted of 34 items with seven demographic items; each item was composed of four grades of frequency. In order to offset possible seasonal variations in sleep habits, data were collected across four seasons. Sleep patterns, insomnia, hypersomnia, parasomnia and circadian rhythm sleep disorders were covered. Habitual snoring was seen in 16.0% of males and 6.5% of females. Male predominance was noted. From these data, the relationship between habitual snoring and sleep complaints was statistically analyzed. Habitual snorers (HS) were observed to wake up more frequently during sleep (17.8% of males, 21.5% of females) than were non-habitual snorers (NHS; 6.6% of males, 9.7% of females). Mid-sleep awakening of HS was also more frequent than it was for NHS; however, there were no differences in difficulty in falling asleep and early morning awakening. Body mass index, cigarette smoking and alcohol consumption were also correlated with habitual snoring. [source] Behavioral Sleep Modification May Revert Transformed Migraine to Episodic MigraineHEADACHE, Issue 8 2007Anne H. Calhoun MD Background.,Sleep problems have been linked with headaches for more than a century, but whether the headaches are the cause or the result of the disrupted sleep is unknown. Objectives.,We previously reported that nonrestorative sleep and poor sleep habits are almost universal in a referral population of women with transformed migraine (TM). Since cognitive behavioral therapy is effective in improving sleep quality in individuals with poor sleep hygiene, we designed a randomized, placebo-controlled study to assess the impact of such treatment on TM. We hypothesized that behavioral sleep modification (BSM) would be associated with improvement in headache frequency and intensity and with reversion to episodic migraine. Methods.,Subjects were 43 women with TM referred to an academic headache center. After obtaining informed consent, patients were randomized to receive either behavioral sleep instructions or placebo behavioral instructions in addition to usual medical care. Subjects recorded headaches in standardized diaries. The first postintervention visit was scheduled at 6 weeks. At that visit, the blind was broken and all subjects received BSM instructions. A final visit was scheduled 6 weeks later. Results.,Compared to the placebo behavioral group, the BSM group reported statistically significant reduction in headache frequency [F (1, 33 = 12.42, P=.001)] and headache intensity [F(1, 33 = 14.39, P= .01)]. They were more likely to revert to episodic migraine ,2 (2, n = 43) = 7.06, P= .029. No member of the control group reverted to episodic migraine by the first postintervention visit. By the final visit, 48.5% of those who had received BSM instructions had reverted to episodic migraine. Conclusions.,In this pilot study of women with TM, we found that a targeted behavioral sleep invention was associated with improvement in headache frequency, headache index, and with reversion to episodic migraine. [source] Night-time frequency, sleep disturbance and general health-related quality of life: Is there a relation?INTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2009Koji Yoshimura Objectives: We conducted a community-based study to determine the relationship among night-time frequency, sleep disturbance and general health-related quality of life (GHQL). Methods: A total of 2271 participants, men and women, aged 41,70 and randomly selected in three Japanese towns completed a postal questionnaire survey. This questionnaire included: the International Prostate Symptom Score, the overall incontinence score of the International Consultation of Incontinence Questionnaire Short Form for lower urinary tract symptoms, the Pittsburg Sleep Quality Index for sleep problems, the Medical Outcome Study Short Form-8 for GHQL, and medical history of disease, cigarette smoking, and alcohol consumption. A multiple regression model was used for statistical analysis, and P < 0.05 was considered significant. Results: Although night-time frequency by itself was closely associated with most aspects of GHQL, this association disappeared in four domains (general health perception, vitality, mental health and emotional role) and in the two summary scores of the Medical Outcome Study Short Form-8 after inclusion of the influence of sleep problems represented by the total score on the Pittsburg Sleep Quality Index. However, three domains (physical function, physical role, and social function) remained significantly associated with night-time frequency. Sleep problems were by far the worst risk factor for the deterioration of GHQL. Conclusions: Night-time frequency appeared to be associated with GHQL mainly by affecting sleep conditions, a symptom that independently influenced some aspects of GHQL. [source] Sleep in individuals with Cri du Chat syndrome: a comparative studyJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2009A. P. H. M. Maas Abstract Background Sleep problems are common in individuals with intellectual disability. Little is known about sleep in children and adults with Cri du Chat syndrome (CDC). Method Sleep was investigated in 30 individuals with CDC using a sleep questionnaire. Sleep problems and sleep behaviours in individuals with CDC were compared with individuals with non-specific intellectual disabilities (NS) (n = 30) and Down's syndrome (DS) (n = 30). Results Nine individuals with CDC (i.e. 30%) had a sleep problem, compared with seven individuals with NS (i.e. 23%) and three individuals with DS (i.e. 10%). Though there were few differences between diagnostic groups, night waking problems were most common in CDC. Individuals with CDC frequently showed behaviours related to disordered breathing and poor-quality sleep. Several behaviours related to sleep had a higher occurrence in CDC than in DS (P < 0.05) but not in NS. Conclusions It is concluded that individuals with CDC do not have an increased probability of sleep problems as compared with other individuals who share similar demographic characteristics. Hypotheses about causes of night waking problems in CDC are generated and suggestions for future research of sleep in individuals with CDC are given. [source] Sleep problems and daytime problem behaviours in children with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2002R. Didden Abstract Background Sleep problems are common among children with intellectual disability (ID). Method The present study assessed the prevalence of severe sleep problems in a sample of children (n=286) with mild to profound ID who lived at home with their parents(s) in the Netherlands. It also explored relationships between severe sleep problems, and family and child variables. Demographic information, data on children's sleep behaviours and parent variables were collected using questionnaires. Results Severe settling problems, night waking and early waking were present in 4.2%, 10.8% and 4.2% of cases, respectively; 16.1% of children had at least one type of sleep problem. Children with a severe sleep problem had more severe levels of ID, used medication more often, had a greater frequency of epilepsy, were younger, had a greater frequency of cerebral palsy, and showed more daytime drowsiness and daytime napping than children without a severe sleep problem. Furthermore, children with a severe sleep problem showed more severe levels of daytime problem behaviours; for example, aggression, non-compliance and hyperactivity. Conclusion The results of the present study are discussed with regard to the assessment and treatment of sleep problems in children with ID. [source] Sleep problems and daytime somnolence in a German population-based sample of snoring school-aged childrenJOURNAL OF SLEEP RESEARCH, Issue 1 2007STEFFEN EITNER Summary Habitual snoring is associated with daytime symptoms like tiredness and behavioral problems. Its association with sleep problems is unclear. We aimed to assess associations between habitual snoring and sleep problems in primary school children. The design was a population-based cross-sectional study with a nested cohort study. The setting was twenty-seven primary schools in the city of Hannover, Germany. Habitual snoring and sleep problems were assessed in primary school children using an extended version of Gozal's sleep-disordered breathing questionnaire (n = 1144). Approximately 1 year later, parents of children reported to snore habitually (n = 114) and an equal number of children who snored never or occasionally were given the Sleep Disturbance Scale for Children, a validated questionnaire for the assessment of pediatric sleep problems. Snoring status was re-assessed using the initial questionnaire and children were then classified as long-term habitual snorers or ex-habitual snorers. An increasing prevalence of sleep problems was found with increasing snoring frequency for sleep-onset delay, night awakenings, and nightmares. Long-term habitual snorers were at significantly increased risk for sleep,wake transition disorders (e.g. rhythmic movements, hypnic jerks, sleeptalking, bruxism; odds ratio, 95% confidence interval: 12.0, 3.8,37.3), sleep hyperhidrosis (3.6, 1.2,10.8), disorders of arousal/nightmares (e.g. sleepwalking, sleep terrors, nightmares; 4.6, 1.3,15.6), and excessive somnolence (i.e. difficulty waking up, morning tiredness, daytime somnolence; 6.3, 2.2,17.8). Ex-habitual snorers were at increased risk for sleep,wake transition disorders (4.4, 1.4,14.2). Habitual snoring was associated with several sleep problems in our study. Long-term habitual snorers were more likely to have sleep problems than children who had stopped snoring spontaneously. [source] Sleep problems, sleepiness and daytime behavior in preschool-age childrenTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 12 2009Beth Goodlin-Jones Background:, Sleep problems are a common complaint of parents of preschool children. Children with neurodevelopmental disorders have even more disrupted sleep than typically developing children. Although disrupted nighttime sleep has been reported to affect daytime behavior, the pathway from sleep disruption to sleep problems, to impairments in daytime performance or behavior is not clear. This multi-method, preliminary study assessed this path in 68 children with autism, matched to 57 children with developmental delay without autism and 69 children developing typically. Methods:, Actigraphy, structured questionnaires, laboratory assessments, and parent reports were obtained in 194 children. Results:, Controlling for diagnosis and developmental age of the child, nighttime sleep problems determined by parent reports were significantly associated with decrements in daytime behavior, also measured by parent report instruments. However, actigraph-defined sleep problems and objective measures of daytime sleepiness were not associated with decrements in daytime performance. Conclusions:, Parent report measures substantiate relationships between disrupted sleep patterns and waking behavior. Further understanding of the pathway from sleep disorders to daytime sleepiness and decrements in waking performance, however, may require more rigorous methods of assessment such as polysomnography and the multiple sleep latency test. [source] Sleep in individuals with Cri du Chat syndrome: a comparative studyJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2009A. P. H. M. Maas Abstract Background Sleep problems are common in individuals with intellectual disability. Little is known about sleep in children and adults with Cri du Chat syndrome (CDC). Method Sleep was investigated in 30 individuals with CDC using a sleep questionnaire. Sleep problems and sleep behaviours in individuals with CDC were compared with individuals with non-specific intellectual disabilities (NS) (n = 30) and Down's syndrome (DS) (n = 30). Results Nine individuals with CDC (i.e. 30%) had a sleep problem, compared with seven individuals with NS (i.e. 23%) and three individuals with DS (i.e. 10%). Though there were few differences between diagnostic groups, night waking problems were most common in CDC. Individuals with CDC frequently showed behaviours related to disordered breathing and poor-quality sleep. Several behaviours related to sleep had a higher occurrence in CDC than in DS (P < 0.05) but not in NS. Conclusions It is concluded that individuals with CDC do not have an increased probability of sleep problems as compared with other individuals who share similar demographic characteristics. Hypotheses about causes of night waking problems in CDC are generated and suggestions for future research of sleep in individuals with CDC are given. [source] Melatonin and sleep disorders associated with intellectual disability: a clinical reviewJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 1 2007S. G. Sajith Abstract Background Melatonin is used to treat sleep disorders in both children and adults with intellectual disability (ID), although it has no product license for such use. The evidence for its efficacy, potential adverse effects and drug interactions are reviewed in the context of prescribing to people with ID. Methods A literature search was performed using multiple electronic databases. More literature was obtained from the reference lists of papers gathered through the searches. Results Most of the studies were uncontrolled and the few controlled trials available were of small size. Melatonin appears effective in reducing sleep onset latency and is probably effective in improving total sleep time in children and adolescents with ID. It appears to be ineffective in improving night-time awakenings. Melatonin is relatively safe for short-term use. Its safety for long-term use is not established. Potential drug interactions, possible effects on puberty and concerns regarding the use of melatonin in epilepsy, asthma and depressive disorders are discussed. Conclusions Melatonin appears to be an effective sleep-initiator for children and adolescents with ID and probably has a similar effect for adults. There may be heterogeneity of response depending on the nature of the sleep problem and cause of the ID or associated disabilities. Further studies are necessary before firm conclusions can be drawn and guidelines for the use of melatonin for people with ID formulated. [source] Sleep problems and daytime problem behaviours in children with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2002R. Didden Abstract Background Sleep problems are common among children with intellectual disability (ID). Method The present study assessed the prevalence of severe sleep problems in a sample of children (n=286) with mild to profound ID who lived at home with their parents(s) in the Netherlands. It also explored relationships between severe sleep problems, and family and child variables. Demographic information, data on children's sleep behaviours and parent variables were collected using questionnaires. Results Severe settling problems, night waking and early waking were present in 4.2%, 10.8% and 4.2% of cases, respectively; 16.1% of children had at least one type of sleep problem. Children with a severe sleep problem had more severe levels of ID, used medication more often, had a greater frequency of epilepsy, were younger, had a greater frequency of cerebral palsy, and showed more daytime drowsiness and daytime napping than children without a severe sleep problem. Furthermore, children with a severe sleep problem showed more severe levels of daytime problem behaviours; for example, aggression, non-compliance and hyperactivity. Conclusion The results of the present study are discussed with regard to the assessment and treatment of sleep problems in children with ID. [source] Consequences of youth tobacco use: a review of prospective behavioural studiesADDICTION, Issue 7 2006M. Mathers ABSTRACT Background Cigarette smoking represents a significant health problem and tobacco has been identified as causing more preventable diseases and premature deaths than any other drug. Although health consequences from smoking have been documented, there has been a surprising lack of research into behavioural consequences. Aims To review what is known of the long-term relationship between patterns of tobacco use prior to age 18 years and behavioural consequences in adulthood. Method A literature search of electronic abstraction services from 1980 to September 2005 was conducted. To be included in the review, studies had to have large, representative samples, be longitudinal studies with baseline age under 18 years and follow-up age 18 years or older and clarify effects due to attrition, leaving 16 articles that met the inclusion criteria. Two reviewers evaluated each paper. Findings Adolescent tobacco use predicts a range of early adult social and health problems. Surprisingly few studies met the inclusion criteria. The limited evidence available suggests that adolescent tobacco smoking increases the likelihood of early adult tobacco use and the initiation of alcohol use or the development of alcohol-related problems. The link between adolescent tobacco use and subsequent cannabis use was not resolved convincingly from the studies summarized. The effects of tobacco use on later illicit drug use tended to fall away when adjusting for underlying risk factors. Existing studies of the effects of tobacco use on later mental health have many limitations. Nevertheless, a finding that youth tobacco use may predict subsequent mental health problems deserves further investigation. The possible effects of tobacco use on academic/social problems and sleep problems also warrant further investigation. Conclusion This review highlights links between youth tobacco use and subsequent behavioural and mental health problems. It provides health care professionals with evidence of the possible harmful effects of youth tobacco smoking on later social, emotional, and behavioural well-being. [source] Sleep Disturbances Reported by Refractory Partial-onset Epilepsy Patients Receiving PolytherapyEPILEPSIA, Issue 7 2006Xiao Xu Summary:,Purpose: Although sleep disturbances are common in epilepsy, few studies examined the prevalence and impact of sleep disturbance in epilepsy patients. This study investigates these in a cross-sectional survey. Methods: We surveyed 201 adult partial-onset epilepsy patients taking stable regimens of two or more antiepileptic medications. Community-based U.S. neurologists recorded patient demographic and clinical information. Patients completed the Medical Outcomes Study (MOS) Sleep Scale, the Quality of Life in Epilepsy-10 instrument (QOLIE-10), and the EuroQol-5D (EQ-5D). We evaluated the associations of sleep with health-related quality of life and clinical and demographic characteristics by using correlation coefficients and analysis of variance. Results: Mean (SD) age was 44.2 (12.5); 34% of patients had diagnosed sleep disturbances; 10% received prescription sleep medications. Patients with sleep disturbance reported poorer mean QOLIE-10 (55.2 vs. 63.7; p = 0.006) and EQ-5D (0.49 vs. 0.71; p < 0.001) scores relative to those without sleep disturbances. The mean (SD) MOS Sleep Problems Index score was 36.2 (20.8), worse than the general population mean of 26. Patients with physician-reported anxiety or depression had more sleep problems than did those without these comorbidities. Higher Sleep Problems Index scores were significantly (p < 0.001) correlated with poorer QOLIE-10 (r=,0.49) and EQ-5D (r=,0.56) scores. Patients experiencing a seizure within the past week reported higher MOS Sleep Problems Index scores than did those with a less-recent seizure (41.5 vs. 32.8; p = 0.003). Conclusions: Diagnosed and self-reported sleep disturbances in patients with partial-onset epilepsy are frequently overlooked, but are negatively associated with everyday functioning and well-being, and therefore contribute significantly to the burden of epilepsy. [source] Modifiable Risk Factors for Migraine Progression (or for Chronic Daily Headaches),Clinical LessonsHEADACHE, Issue 2006Marcelo E. Bigal MD Herein we summarize clinical issues gleaned from a full peer-reviewed article on modifiable risk factors for migraine. Since migraine is progressive in some but not in most individuals, identifying patients at risk for progression is crucial. Key interventions include: (1) Decrease headache frequency with behavioral and pharmacologic interventions; (2) Monitor the body mass index and encourage maintenance of normal weight; (3) Avoid medication overuse; (4) Avoid caffeine overuse; (5) Investigate and treat sleep problems and snoring; (6) Screen and treat depression and other psychiatric comorbidities. These recommendations have not been demonstrated to improve outcomes in longitudinal studies. [source] Self-report of memory and affective dysfunction in association with medication use in a sample of individuals with chronic sleep disturbanceHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2000Mary Pat McAndrews Abstract Benzodiazepines produce memory disturbance after acute administration. It is not clear whether chronic use of benzodiazepines is hazardous to memory processes. Epidemiological data indicate that a large proportion (10,30 per cent) of individuals with sleep dysfunction take hypnotic aids for a year or longer. The purpose of the present study was to evaluate self-reported memory dysfunction in a sample of individuals who considered their sleep disturbance sufficiently severe to seek investigation in sleep clinics. It was hypothesized that individuals taking benzodiazepines for sleep would report greater perceived everyday memory failures than individuals taking other sleep aids or no medication. Questionnaires were given to 368 individuals referred into the study by investigators in six sleep disorders clinics. All respondents completed a lengthy (700-item) questionnaire, which included scales assessing memory difficulties, affective status and sleep disturbance. Respondents also reported any medication use for sleep problems and duration of use of the current drug. Information on medication use was reported by 289 participants. Fifty-six per cent of respondents reported using some form of psychoactive medication (antidepressants, benzodiazepines, Zopiclone). Twenty-two per cent reported using no medication. Analysis of covariance showed that these medications had no detectable effect on subjective memory difficulties during chronic use, F(4,226)=1·34, p=0·25. Copyright © 2000 John Wiley & Sons, Ltd. [source] Maternal Psychosocial Adversity and the Longitudinal Development of Infant SleepINFANCY, Issue 5 2008Alison Cronin Research has identified associations between indicators of social disadvantage and the presence of child sleep problems. We examined the longitudinal development of infant sleep in families experiencing high (n = 58) or low (n = 64) levels of psychosocial adversity, and the contributions of neonatal self-regulatory capacities and maternal settling strategies to this development. Assessments of infant sleep at 4-, 7-, and 12-weeks postpartum indicated no differences in sleeping difficulties between high- and low-adversity groups. However, more infant sleep difficulties were reported in the high- versus low-adversity groups at 12- and 18-month follow-ups. Neonatal self-regulatory capacities were not related to the presence or absence of adversity, or to subsequent infant sleep quality. However, there were group differences in maternal settling strategies that did predict subsequent infant sleep difficulties. The pattern of sleep disturbance observed in association with maternal psychosocial adversity at 18-months was consistent with risk for broader impairments in child functioning. [source] Preschool-age adopted Chinese children's sleep problems and family sleep arrangementsINFANT AND CHILD DEVELOPMENT, Issue 5 2009Tony Xing Tan Abstract Designed to examine the relationship between family sleep arrangements and children's sleep problems in families with preschool-age children adopted from China, this study documented types of sleep arrangements and explored the nature and sources of advice received by parents on co-sleeping. Mothers of 480 children provided survey data on their children's night-time sleep locations, sleep and wake schedules, and changes in sleep arrangements. Children's sleep problems were measured with the Sleep Problem Scale of the Child Behavior Checklist. Descriptive and qualitative analyses showed that most children (71.3%) had a single exclusive sleep location (e.g. solitary sleeping, sharing bedroom with a sibling, sleeping in parents' bedroom, or co-sleeping with parents) and the rest used a combination of two or three different locations. Children with more sleep problems were more likely to have more sleep locations and to co-sleep or share a bedroom with parents. Parents of children with more sleep problems were more likely to seek advice on co-sleeping. When they did, paediatricians were more likely than extended family members and fellow adoptive parents to recommend against co-sleeping. Careful integration of the descriptive and qualitative data permitted us to draw the conclusion that sleep arrangements reflected parental responsiveness to children's sleep behaviours. Copyright © 2009 John Wiley & Sons, Ltd. [source] A model for predicting behavioural sleep problems in a random sample of Australian pre-schoolersINFANT AND CHILD DEVELOPMENT, Issue 5 2007Wendy A. Hall Abstract Behavioural sleep problems (childhood insomnias) can cause distress for both parents and children. This paper reports a model describing predictors of high sleep problem scores in a representative population-based random sample survey of non-Aboriginal singleton children born in 1995 and 1996 (1085 girls and 1129 boys) in Western Australia. Longitudinal repeated data were collected up to age 4 years by caregiver report. Children's sleep rhythmicity levels in their first year, as well as conflicted and lax parenting in their second year, predicted higher scores on the sleep problem scale from the Child Behaviour Checklist/2,3 in the children's third year. Higher scores on the sleep problem scale in the children's third year predicted higher scores on the aggressive behaviour subscale of the Child Behaviour Checklist/4,16. The results support a model in which sleep problems mediated the relationship between parental conflict and aggressive behaviour, even when controlling for maternal depression, which has been associated with children's aggressive behaviour. Copyright © 2007 John Wiley & Sons, Ltd. [source] Learning to sleep through the night: Solution or strain for mothers and young children?INFANT MENTAL HEALTH JOURNAL, Issue 3 2009Gary R. Germo Is the process of helping infants and young children learn to sleep through the night a solution to family sleep problems or does it exacerbate matters for mother and child? Retrospective and current accounts from a nonclinical, convenience sample of 102 mothers of preschool-aged children provided information on sleep issues from early infancy through preschool age. Child, mother, and parenting characteristics, along with family sleep arrangements, were differentially related to the age at which children learned to sleep through the night and to the extent of difficulty that characterized this experience. Mothers who indicated more difficulty as their children learned to sleep through the night also reported more depressive symptoms and more strain in the mother,child relationship. Later age at sleeping through the night was more common among early bedsharers, but timing of sleeping through the night was not associated with preschool children's reported independence in several nonsleep domains. Sleep arrangements and the importance placed on sleeping through the night were the strongest contributors to variance explained in whether children learned to sleep through the night during infancy or toddlerhood. When advising parents about sleep interventions, practitioners should seek to understand whether families' parenting values fit their nighttime sleep practices. [source] Prenatal cocaine exposure and infant sleep at 7 months of age: The influence of the caregiving environmentINFANT MENTAL HEALTH JOURNAL, Issue 4 2006Pamela Schuetze The primary goal of this study was to examine sleep problems in a sample of cocaine-exposed 7-month-old infants and to determine if maternal psychopathology mediated any existing association between substance exposure and sleep behaviors. We also examined the differences in sleep behaviors of cocaine-exposed infants in parental custody and cocaine-exposed infants in nonparental custody. Participants were 65 cocaine-exposed and 53 nonexposed infants and their primary caregivers who were recruited at delivery and assessed at 7 months of infant age. As expected, women who used cocaine during pregnancy had more psychiatric symptoms than nonusers. Prenatal exposure to heavier amounts of cocaine was significantly related to more severe sleep difficulties, and maternal anxiety mediated this association. Approximately 28% of cocaine mothers lost custody of their infants by 7 months of age. Nonmaternal caregivers had significantly fewer symptoms of psychopathology than the cocaine-using women who retained custody of their children. Infants who were in nonparental care at 7 months of age also had less severe sleep problems than did infants who remained in parental care. [source] Sleep patterns, sleep disturbances and sleepiness in retired Iranian eldersINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2009Seyed Kazem Malakouti Abstract Objectives Complaints of sleep disturbance increase with age and many studies have reported on the relationship of sleep problems to the greater use of health services, physical and mental morbidity, functional decline, and all causes of mortality. This study aimed to examine sleep patterns and sleep disturbances in Iranian elders and correlate their sleep quality to their health status. Methods Four hundred men and women, aged 60 years or older, were interviewed by trained interviewers regarding their physical and mental health status. The Pittsburghh Sleep Quality Index, the Epworth Sleepiness Scale (ESS), and a General Health Questionnaire (GHQ) were then administered to each participant. The data gathered were analyzed using ,2 -test, t -test, and one-way analysis of variance and logistic regression. Results The results indicated that the majority of participants (82.6%) suffered from poor sleep quality and approximately one-third (29.2%) experienced sleepiness during the daytime. Difficulty falling asleep (p,,,0.001) and maintaining sleep (p,,,0.01) and the feeling of being too hot at night (p,,,0.005) were significantly more prevalent in women, but men suffered more from leg twitching (p,,,0.01). Being female (OR,=,2.52), and having GHQ scores of more than 11 (OR,=,4.14) increased the risk of poor sleep quality considerably. Conclusion Promoting sleep hygiene education of elders in primary health care services are recommended. Copyright © 2009 John Wiley & Sons, Ltd. [source] Factor structure of the Cornell Scale for Depression in Dementia among Japanese poststroke patientsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2002Andrea S. Schreiner Abstract Background The present study reports on the first translation and use of the Cornell Scale for Depression in Dementia (CSDD) (Alexopoulos, Abrams, Young, & Shamoian, 1988) among poststroke patients (n,=,101) in Japan. Objectives The study had three main purposes: 1. To examine the factor structure of the CSDD among Japanese poststroke patients; 2. To compare this with the factor structure identified for Anglo-American Alzheimer's (AD) patients; and 3. To examine the prevalence and covariates of depressive symptoms among the Japanese stroke survivors. Methods Poststroke patients and their caregivers (n,=,202), at a random sample of neurological hospitals in western Japan, were interviewed using the study instruments. Data was also collected from patient charts. All subjects at each site who met the study criteria participated in the study. Results The four-factor solution for poststroke subjects was analogous to that found among AD patients with 2 main exceptions. In contrast to AD patients: 1. Physical complaints were unrelated to depressed mood in stroke patients; and 2. Agitation and psychosis loaded with depressed mood in stroke patients rather than as a separate unique factor as in AD patients. However, in the exploratory 5-factor model, agitation and suicidal ideation comprised a unique factor. Using standard cutoff scores for the CSDD, 58.2% of poststroke patients had scores suggesting possible depression. CSDD scores were not related to functional ability, or stroke characteristics such as aphasia or right or left-sided paralysis. However, scores were significantly higher among subjects,2 years poststroke. Feelings of irritability, anxiety, sadness, and sleep problems were most prevalent. Discussion Despite the prevalence of depressive symptoms, none of the subjects were currently receiving any mental health treatment. Findings suggest that symptoms differ by poststroke duration, which may necessitate different treatment approaches. Copyright © 2002 John Wiley & Sons, Ltd. [source] The Clinical Interview Schedule , Sinhala version: validation in a community setting in Sri LankaINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2002Shiranee Champika Wickramasinghe Abstract The Clinical Interview Schedule , Revised (CIS-R) was validated in a clinic setting for adolescents 15,19 years of age in Sri Lanka. The interview schedule was translated into Sinhala and modified to include sections introducing each symptom group. One-hundred-and-thirty-one adolescents attending a psychiatric clinic for the first time were interviewed by a lay interviewer using CIS-R (Translated). They had previously been examined and rated by a psychiatrist using local (emic) diagnostic procedures. All the filtering questions showed a high level of sensitivity (80%,96%). None of the questions in the sleep problems and phobias sections were effective at discriminating between those who did and did not show significant symptoms in these areas according to the psychiatrist. The internal consistency of the sections of the interview schedule (when these two sections were excluded) varied between 0.60 and 0.82. Linear regression showed that, when both sections were excluded, 97% of the variation of total score could be explained. Therefore, it was decided to exclude the sleep problems and phobias sections from the modified interview schedule. As the population samples are likely to be different from clinic samples it is necessary to test the validity again in a community sample before confirming the validity of the modified interview schedule. Copyright © 2002 Whurr Publishers Ltd. [source] Night-time frequency, sleep disturbance and general health-related quality of life: Is there a relation?INTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2009Koji Yoshimura Objectives: We conducted a community-based study to determine the relationship among night-time frequency, sleep disturbance and general health-related quality of life (GHQL). Methods: A total of 2271 participants, men and women, aged 41,70 and randomly selected in three Japanese towns completed a postal questionnaire survey. This questionnaire included: the International Prostate Symptom Score, the overall incontinence score of the International Consultation of Incontinence Questionnaire Short Form for lower urinary tract symptoms, the Pittsburg Sleep Quality Index for sleep problems, the Medical Outcome Study Short Form-8 for GHQL, and medical history of disease, cigarette smoking, and alcohol consumption. A multiple regression model was used for statistical analysis, and P < 0.05 was considered significant. Results: Although night-time frequency by itself was closely associated with most aspects of GHQL, this association disappeared in four domains (general health perception, vitality, mental health and emotional role) and in the two summary scores of the Medical Outcome Study Short Form-8 after inclusion of the influence of sleep problems represented by the total score on the Pittsburg Sleep Quality Index. However, three domains (physical function, physical role, and social function) remained significantly associated with night-time frequency. Sleep problems were by far the worst risk factor for the deterioration of GHQL. Conclusions: Night-time frequency appeared to be associated with GHQL mainly by affecting sleep conditions, a symptom that independently influenced some aspects of GHQL. [source] Evidence-Based Recommendations for the Assessment and Management of Sleep Disorders in Older PersonsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2009AGSF, Harrison G. Bloom MD Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert-based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder. [source] Effect of Antipsychotic Withdrawal on Behavior and Sleep/Wake Activity in Nursing Home Residents with Dementia: A Randomized, Placebo-Controlled, Double-Blinded Study The Bergen District Nursing Home StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Sabine Ruths MD Objectives: To explore the effect on sleep/wake activity and on behavioral and psychological symptoms of the withdrawal of antipsychotic medications from nursing home (NH) patients with dementia. Design: Randomized, placebo-controlled, double-blind trial. Setting: NHs in Bergen, Norway. Participants: Thirty patients (mean age 83.5) taking haloperidol, risperidone, or olanzapine for nonpsychotic symptoms. Intervention: Study participants were randomly assigned to withdrawal (intervention group) or continued treatment with antipsychotic medications (reference group) for 4 consecutive weeks. Measurements: Behavioral rating using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and actigraphy. Results: After antipsychotic withdrawal, behavioral scores remained stable or improved in 11 of 15 patients, whereas four had worsening scores. Actigraphy revealed decreased sleep efficiency after drug discontinuation and increased 24-hour and night activity in both groups. Actigraphy records of nighttime and daytime activity indicated sleep problems and restlessness, in terms of the NPI-Q. One patient was restarted on antipsychotics. Conclusion: Antipsychotic drug withdrawal affected activity and sleep efficiency over the short term. Increases in total activity and impaired sleep quality after drug discontinuation should be monitored, because the long-term effect of these changes is not known. The NPI-Q and actigraphy are feasible tools that disclose relevant changes occurring during antipsychotic withdrawal in NH patients with dementia. Their use in clinical practice should be substantiated by larger studies. [source] Sleep disturbance experiences among perimenopausal women in TaiwanJOURNAL OF CLINICAL NURSING, Issue 15 2009Hsiu-Chin Hsu Aim., To generate a descriptive theory framework regarding the experiences of sleep disturbances among perimenopausal women in Taiwan. Background., Although studies show that some perimenopausal women are troubled by sleep problems, little information was found about the subjective experiences of sleep disturbances among these women. Research is required to explore women's feelings or perceptions in dealing with their sleep problems. These understandings will be important to help alleviate perimenopausal women's sleep problems. Design., A grounded theory research design was applied. Method., Twenty-one Taiwanese sleep disturbed women, aged 46,57 years, participated in in-depth interviews. Results., ,Getting back a good night's sleep' was the core theme for describing and guiding the process of the women's sleep disturbance experiences. During the process, ,disturbed sleep' was identified as the antecedent condition that included subcategories: easy awakening, difficulty falling asleep, inner worries, physical discomfort and genetic and bodily constitution. Analyses showed five categories (some with subcategories) of the sleep disturbed women: (i) worsening health status , physical exhaustion, impaired social interactions, emotional swings and decreased work performance; (ii) living with lonely nights , self-help and endurance; (iii) a search for resources to relieve sleep difficulties , doctor shopping, trying alternative therapies, exercising and seeking support; (iv) vicious cycle and (v) acceptance of insomnia. Conclusions., Women expected to relieve their sleep disturbance by finding comprehensive counselling or by their body constitution responding to treatment. Healthcare providers need to value women's individual concerns and subjective voices. Providers must seek out sleep counselling instead of simply prescribing drugs for their sleep difficulties. Relevance to clinical practice., It is crucial to integrate perimenopausal sleep care by implementing a multidimensional approach such as sleep assessment laboratories, sleep counselling, complementary alternative medicine, sleep strategies and support groups. [source] Factual memories of ICU: recall at two years post-discharge and comparison with delirium status during ICU admission , a multicentre cohort studyJOURNAL OF CLINICAL NURSING, Issue 9 2007Brigit L Roberts RN, IC Cert Aims and objective., To examine the relationship between observed delirium in ICU and patients' recall of factual events up to two years after discharge. Background., People, the environment, and procedures are frequently cited memories of actual events encountered in ICU. These are often perceived as stressors to the patients and the presence of several such stressors has been associated with the development of reduced health-related quality of life or post-traumatic stress syndrome. Design., Prospective cohort study using interview technique. Method., The cohort was assembled from 152 patients who participated in a previously conducted multi-centre study of delirium incidence in Australian ICUs. The interviews involved a mixture of closed- and open-ended questions. Qualitative responses regarding factual memories were analysed using thematic analysis. A five-point Likert scale with answers from ,always' to ,never' was used to ask about current experiences of dream, anxiety, sleep problems, fears, irritability and/or mood swings. Scoring ranged from 6 to 30 with a mid-point value of 18 indicating a threshold value for the diagnosis of post-traumatic stress syndrome. A P -value of <0·05 was considered significant for all analyses. Results., Forty-one (40%) out of 103 potential participants consented to take part in the follow-up interview; 18 patients (44%) had been delirious and 23 patients (56%) non-delirious during the ICU admission. The non-participants (n = 62) formed a control group to ensure a representative sample; 83% (n = 34) reported factual memories either with or without recall of dreaming. Factual memories were significantly less common (66% cf. 96%) in delirious patients (OR 0·09, 95%CI 0·01,0·85, p = 0·035). Five topics emerged from the thematic analysis: ,procedures', ,staff', ,comfort', ,visitors', and ,events'. Based on the current experiences, five patients (12%, four non-delirious and one delirious) scored ,18 indicative of symptoms of post-traumatic stress syndrome; this did not reach statistical significance. Memory of transfer out of ICU was less frequent among the delirious patients (56%, n = 10) than among the non-delirious patients (87%, n = 20) (p = 0·036). Conclusion., Most patients have factual memories of their ICU stay. However, delirious patients had significantly less factual recall than non-delirious patients. Adverse psychological sequelae expressed as post-traumatic stress syndrome was uncommon in our study. Every attempt must be made to ensure that the ICU environment is as hospitable as possible to decrease the stress of critical illness. Post-ICU follow-up should include filling in the ,missing gaps', particularly for delirious patients. Ongoing explanations and a caring environment may assist the patient in making a complete recovery both physically and mentally. Relevance to clinical practice., This study highlights the need for continued patient information, re-assurance and optimized comfort. While health care professionals cannot remove the stressors of the ICU treatments, we must minimize the impact of the stay. It must be remembered that most patients are aware of their surroundings while they are in the ICU and it should, therefore, be part of ICU education to include issues regarding all aspects of patient care in this particularly vulnerable subset of patients to optimize their feelings of security, comfort and self-respect. [source] Cognitive-behavioral treatment for chronic nightmares in trauma-exposed persons: assessing physiological reactions to nightmare-related fearJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2010Jamie L. Rhudy Abstract Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psychological distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N=40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiological and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implications are discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1,18, 2010. [source] | |||||||||||||||||||||||||||||||