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Sleep Duration and Sleep Problems in a Representative Sample of German Children and Adolescents  [PDF]
Angelika A. Schlarb, Marco D. Gulewitsch, Victoria Weltzer, Ute Ellert, Paul Enck
Health (Health) , 2015, DOI: 10.4236/health.2015.711154
Abstract: Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice.
Rising Prevalence and Neighborhood, Social, and Behavioral Determinants of Sleep Problems in US Children and Adolescents, 2003–2012  [PDF]
Gopal K. Singh,Mary Kay Kenney
Sleep Disorders , 2013, DOI: 10.1155/2013/394320
Abstract: We examined trends and neighborhood and sociobehavioral determinants of sleep problems in US children aged 6–17 between 2003 and 2012. The 2003, 2007, and 2011-2012 rounds of the National Survey of Children’s Health were used to estimate trends and differentials in sleep problems using logistic regression. Prevalence of sleep problems increased significantly over time. The proportion of children with <7 days/week of adequate sleep increased from 31.2% in 2003 to 41.9% in 2011-2012, whereas the prevalence of adequate sleep <5 days/week rose from 12.6% in 2003 to 13.6% in 2011-2012. Prevalence of sleep problems varied in relation to neighborhood socioeconomic and built-environmental characteristics (e.g., safety concerns, poor housing, garbage/litter, vandalism, sidewalks, and parks/playgrounds). Approximately 10% of children in neighborhoods with the most-favorable social environment had serious sleep problems, compared with 16.2% of children in neighborhoods with the least-favorable social environment. Children in neighborhoods with the fewest health-promoting amenities or the greatest social disadvantage had 37%–43% higher adjusted odds of serious sleep problems than children in the most-favorable neighborhoods. Higher levels of screen time, physical inactivity, and secondhand smoke exposure were associated with 20%–47% higher adjusted odds of sleep problems. Neighborhood conditions and behavioral factors are important determinants of sleep problems in children. 1. Introduction Sleep problems in children have significant impacts on their health and well-being [1–4]. Inadequate sleep in children has been shown to be associated with poor academic performance, behavioral problems, poor mental and physical health, obesity and weight gain, alcohol use, accidents, and injuries [1–15]. Research also suggests that these adverse health effects vary in relation to the amount or duration of sleep problems [2–6, 12–15]. The US data show that, compared to children and adolescents who do not experience any sleep problems during the week, those who experience inadequate sleep during the entire week have 3-4 times higher risks of serious behavioral problems, 4-5 times higher risks of depression and anxiety, 2.5 times higher risk of ADD/ADHD, 3.2 times higher risk of migraine headaches, 1.5 times higher risk of being in fair/poor overall health, 1.6 times higher risk of repeating a grade or having a problem at school, and 2.8 times higher risk of missing >2 weeks of school during a year [16–18]. Past research has examined the impact of a number of sociodemographic and
Identifying Adolescent Sleep Problems  [PDF]
Michelle A. Short, Michael Gradisar, Jason Gill, Danny Camfferman
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0075301
Abstract: Objectives To examine the efficacy of self-report and parental report of adolescent sleep problems and compare these findings to the incidence of adolescents who fulfill clinical criteria for a sleep problem. Sleep and daytime functioning factors that predict adolescents’ self-identification of a sleep problem will also be examined. Method 308 adolescents (aged 13–17 years) from eight socioeconomically diverse South Australian high schools participated in this study. Participants completed a survey battery during class time, followed by a 7-day Sleep Diary and the Flinders Fatigue Scale completed on the final day of the study. Parents completed a Sleep, Medical, Education and Family History Survey. Results The percentage of adolescents fulfilling one or more of the criteria for a sleep problem was inordinately high at 66%. Adolescent self-reporting a sleep problem was significantly lower than the adolescents who had one or more of the clinical criteria for a sleep problem (23.1% vs. 66.6%; χ2 = 17.46, p<.001). Parental report of their adolescent having a sleep problem was significantly lower than adolescent self-report (14.3% vs. 21.1%, p<.001). Adolescents who reported unrefreshing sleep were 4.81 times more likely to report a sleep problem. For every hour that bedtime was delayed, the odds of self-reporting a sleep problem increased by 1.91 times, while each additional 10 minutes taken to fall asleep increased the odds 1.40 times. Conclusion While many adolescents were found to have sleep patterns indicative of a sleep problem, only a third of this number self-identify having a sleep problem, while only a sixth of this number are indicated by parental report. This study highlights important features to target in future sleep education and intervention strategies for both adolescents and parents.
Sleep Insufficiency, Sleep Health Problems and Performance in High School Students
Xue Ming, Rebecca Koransky, Victor Kang, Sarah Buchman, Christina E. Sarris, and George C. Wagner
Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine , 2012, DOI: 10.4137/CCRPM.S7955
Abstract: A survey on sleep schedule, sleep health, school performance and school start times was conducted in 1,941 adolescents. A high level of early and circadian-disadvantaged sleep/wake schedules during weekdays was observed. Shorter sleep duration on weekdays was reported, especially in upper classmen. Complaints of inadequate sleep and sleepiness during weekdays, alarm clock use, and napping were prevalent. Night awakening and prolonged sleep onset were common and associated with poor school performance. Students with a sleep length of less than 7 hours on both weekdays and weekends exhibited poorer performance, while those who made up this sleep loss on weekends did not. The total number of poor sleep factors in an individual also correlated with poor school performance. Earlier school start times were associated with a perception of poor sleep quality, shorter sleep duration and more sleep health problems. We conclude that sleep inadequacies and sleep health problems were prevalent in this population, especially in those who started school earlier in the morning, and that these poor sleep factors were associated with school performance.
Sleep problems and functional disability in children with functional gastrointestinal disorders: An examination of the potential mediating effects of physical and emotional symptoms  [cached]
Schurman Jennifer,Friesen Craig A,Dai Hongying,Danda Caroline
BMC Gastroenterology , 2012, DOI: 10.1186/1471-230x-12-142
Abstract: Background Sleep disturbances are increasingly recognized as a common problem for children and adolescents with chronic pain conditions, but little is known about the prevalence, type, and impact of sleep problems in pediatric functional gastrointestinal disorders (FGIDs). The objectives of the current study were two-fold: 1) to describe the pattern of sleep disturbances reported in a large sample of children and adolescents with FGIDs; and, 2) to explore the impact of sleep by examining the inter-relationships between sleep disturbance, physical symptoms, emotional problems, and functional disability in this population. Methods Over a 3-year period, 283 children aged 8–17 years who were diagnosed with an FGID and a primary caretaker independently completed questionnaires regarding sleep, emotional functioning, physical symptoms, and functional disability during an initial evaluation for chronic abdominal pain at a pediatric tertiary care center. A verbal review of systems also was collected at that time. Descriptive statistics were used to characterize the pattern of sleep disturbances reported, while structural equation modeling (SEM) was employed to test theorized meditational relationships between sleep and functional disability through physical and emotional symptoms. Results Clinically significant elevations in sleep problems were found in 45% of the sample, with difficulties related to sleep onset and maintenance being most common. No difference was seen by specific FGID or by sex, although adolescents were more likely to have sleep onset issues than younger children. Sleep problems were positively associated with functional disability and physical symptoms fully mediated this relationship. Emotional symptoms, while associated with sleep problems, evidenced no direct link to functional disability. Conclusions Sleep problems are common in pediatric FGIDs and are associated with functional disability through their impact on physical symptoms. Treatments targeting sleep are likely to be beneficial in improving physical symptoms and, ultimately, daily function in pediatric FGIDs.
Sleep habits and sleep problems among Palestinian students  [cached]
Sweileh Waleed M,Ali Iyad A,Sawalha Ansam F,Abu-Taha Adham S
Child and Adolescent Psychiatry and Mental Health , 2011, DOI: 10.1186/1753-2000-5-25
Abstract: Aim The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates in Palestine. Association between self-reported sleep quality and self-reported academic achievement was also investigated. Methods Sleep habits and problems were investigated using a convenience sample of students from An-Najah National University, Palestine. The study was carried out during spring semester, 2009. A self-administered questionnaire developed based on The Diagnostic and Statistical Manual of Mental Disorders IV criteria and Pittsburgh Sleep Quality Index was used. Results 400 students with a mean age of 20.2 ± 1.3 were studied. Reported mean duration of night sleep in the study sample was 6.4 ± 1.1 hours. The majority (58.3%) of students went to bed before midnight and 18% of the total sample woke up before 6 am. Sleep latency of more than one hour was present in 19.3% of the students. Two thirds (64.8%) of the students reported having at least one nocturnal awakening per night. Nightmares were the most common parasomnia reported by students. Daytime naps were common and reported in 74.5% of the study sample. Sleep quality was reported as "poor" in only 9.8% and was significantly associated with sleep latency, frequency of nocturnal awakenings, time of going to bed, nightmares but not with academic achievement. Conclusion Sleep habits among Palestinian undergraduates were comparable to those reported in European studies. Sleep problems were common and there was no significant association between sleep quality and academic achievement.
Carmen Luci R. Lopes,Maria Alves Barbosa,Elisangela de S. Marques,Alexandra Isabel Amorim Lino
Revista Eletr?nica de Enfermagem , 2003,
Abstract: The precocious detention of visual problems is a measure of important primary assistance. Thus being,this work had as main objective, to verify the visual level of children and adolescents in Goiania (Goiás Brazil)public school, being used the simplified physical examination of health through Snellen Table. Of the 414evaluated children, 46 (11%) had presented visual deficiency and had been directed for oftalmological consultationin the Hospital of the Clinics of the Federal University of Goiás.
Behavioral and Emotional Problems in Adolescents with Tourette Syndrome  [PDF]
Hsueh-Ling Chang,Hsin-Yi Liang,Hwei-Shioun Wang,Chian-Shan Li
Chang Gung Medical Journal , 2008,
Abstract: Background: Patients with Tourette syndrome (TS) are at risk of an array of behavioraland emotional problems, resulting in social, academic and vocational functionimpairments. This study intended to examine the nature and severity ofbehavioral and emotional problems in Taiwanese TS adolescents.Methods: Forty TS adolescents with normal IQ and thirty age- and gender-matchednormal controls were evaluated using the Yale Global Tic Severity Scale(YGTSS) and the Child Behavioral Checklist (CBCL) to understand theseverity of tic symptoms, and behavioral and emotional problems. The maincaretakers of these adolescents were interviewed using the Chinese versionof the Schedule for Affective Disorders and Schizophrenia (CK-SADS) toconfirm their comorbid psychiatric diagnoses.Results: Most TS adolescents in this study had mild tic severity. TS adolescentsshowed significantly higher scores than normal controls in all CBCL subscales.The ‘total most severe tics’ YGTSS score was positively correlatedwith internalization behavior problems, externalization behavior problemsand aggressive behavior subscales of the CBCL. As TS adolescents gotolder, their CBCL scores decreased significantly in internalization behaviorproblems, externalization behavior problems, and obsessive-compulsive andaggressive behavior subscales.Conclusion: Taiwanese TS adolescents with mild to moderate tic severity still demonstratedprominent behavior and emotional problems. Although the severity ofbehavior and emotional problems decreased with increasing age, we stillsuggest systematic inquiry regarding the psychological well-being and psychiatriccomorbidities of young TS patients.
Sleep deprivation predisposes Gujarati Indian adolescents to obesity  [cached]
Shaikh Wasim,Patel Minal,Singh S
Indian Journal of Community Medicine , 2009,
Abstract: Background and Aim: Recent studies on various populations indicate that lack of sleep is one of the potential risk factors predisposing the youth to obesity. Since there is a significant rise in obesity among Indian youth and because research indicating the role of sleep in development of obesity among Indian population is scant, the current study was undertaken to assess the effect of sleep duration on adiposity among Gujarati Indian adolescents. Materials and Methods: A randomized cross-sectional study was done on 489 voluntarily participating Indian adolescents in the age group of 16-19 years. Participants were grouped into two categories 1). Adequate Sleep Duration at Night (more than seven hours, ASDN) and 2) Inadequate Sleep Duration at Night (less than seven hours, IASDN) as reported by the participants. The participants were later assessed for adiposity in terms of BMI, BF % , FM, FMI and waist circumference, meal frequency per day and physical activity status. Results: In both boys as well as girls, the BMI, BF%, FM and FMI were significantly lower in the ASDN group than the IASDN group. However, there was an insignificant difference in the meal frequency and physical activity status between the ASDN and IASDN group. Conclusion : Inadequate sleep duration increases adiposity among Gujarati Indian adolescents but further studies are required to find out the mechanisms through which sleep affects adiposity in this population.
Older Patients’ Experiences of Sleep in the Hospital: Disruptions and Remedies
Chau Yuen Lee, Lisa P.L. Low, and Sheila Twinn
The Open Sleep Journal , 2008, DOI: 10.2174/1874620900801010029]
Abstract: Complaints of disruptive sleep are common occurrences during hospitalization of older people, with unpleasant consequences arising when disrupted sleep is left unmanaged. This aim of this study was to explore the perceptions of Chinese older patients on the causes of sleep disturbance, sleeping pattern changes and sleep remedies that could be implemented to improve sleep quality during hospitalization. Sleep diaries and interviews highlighted that a crucial role of nurses is to listen and involve older patients into identifying their own sleep problems and sleep-promoting remedies they consider to work in their favour. Through understanding the sleep problems from patients’ perspectives, nurses can appreciate the significance of disrupted sleep for the person concerned and effectively design needs-based sleep interventions to manage the changing sleep patterns and sleep needs of patients in the clinical area.
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