Sleep problems and daytime tiredness in Finnish preschool‐aged children‐a community survey

Background Sleep is important to the well‐being and development of children. Specially, small children are vulnerable to the effects of inadequate sleep. However, not much is known about the frequency of all types of sleep problems and daytime tiredness in preschool‐aged children. Objective To evaluate the prevalence of a wide spectrum of sleep problems, daytime tiredness and associations between these in 3‐ to 6‐year‐old Finnish children. Methods A population‐based study where parents of 3‐ to 6‐year‐old children (n= 904) living in Helsinki filled in the Sleep Disturbance Scale for Children (SDSC). Results Of the children, 45% had at least one sleep‐related problem occurring at least three times a week: 14.1% were unwilling to go to bed, 10.2% had difficulties in falling asleep, 10.2% had bruxism, 6.4% sleep talking, 2.1% sleep terrors, 8.2% had sleep‐related breathing problem, 11.2% had excessive sweating while falling asleep and 12.9% excessive sweating during sleep. Age and gender were related to phenotype of the sleeping problems. In multiple regression analysis, the difficulties in initiating and maintaining sleep were most strongly associated with tiredness in the morning and during the day. Conclusions Different types of sleep problems are frequent in preschool‐aged children. Poor sleep quality is associated with morning and daytime tiredness. In screening for sleep problems in children, attention should be paid not only to sleep amount but also to sleep quality.     

哈尔滨市学龄儿童睡眠状况研究

目的 了解哈尔滨市学龄儿童的睡眠状况,分析这一年龄段儿童主要存在的睡眠问题.方法 采用分级整群抽样方法,于2013年10-11月对哈尔滨市4个城区的6所小学、2 903名学龄儿童进行家庭社会环境与睡眠健康的问卷调查.结果 哈尔滨市学龄儿童睡眠时间不足发生率平时为72.1％,周末为41.9％.睡眠问题在学龄儿童中普遍存在,除夜醒问题外,其他类型睡眠问题均有显著的年龄别差异.影响儿童发生睡眠障碍的因素有是否参加补习班、特长班;是否服用影响神经系统的食物、药物;是否经常从事兴奋性活动;抚养人、母亲孕期及产后是否有情绪低落;是否患有食物或药物过敏等.结论 哈尔滨市学龄儿童睡眠时间普遍少,各类睡眠问题的发生率高,儿童睡眠健康问题应得到社会各方面的关心和重视.     

Sleep management — the hidden agenda

Summary The management of apparent sleep problems is often not straight-forward because of a proportion of clients attending with a 'hidden agenda', requiring more in-depth long-term treatment for psychological problems. This paper looks at a sample of 100 consecutive referrals to a community sleep clinic in the East End of London and attempts to address the question of who comes to the sleep clinic and why. A proportion of clients responded to brief intervention of a behavioural nature but 19% were referred on to other services for psycho-therapeutic help.     

Sleep Problems in Infants Decrease Following Massage Therapy

Infants and toddlers (M age = 1.5 years) with sleep onset problems were given daily massages by their parents for 15 minutes prior to bedtime for one month. Based on parent diaries the massaged versus the control children (who were read bedtime stories) showed fewer sleep delay behaviors and had a shorter latency to sleep onset by the end of the study. Forty-five minute behavior observations by an independent observer also revealed more time awake, alert and active and more positive affect in the massaged children by the end of the study.     

Sleep patterns in an urban-dwelling minority pediatric population

The current study examines the sleeping patterns of healthy, urban-dwelling, ethnic-minority children from lower socioeconomic standing using a validated screening measure, the abbreviated Child Sleep Habits Questionnaire (CSHQ). Parents of 52 children from well-care clinics of an inner-city children's hospital completed the abbreviated 33-item CSHQ, Hollingshead Index of Social Status, and a child health history. Mean child age was 6.71 years; range 4–10 years. Forty-four children were African American, and eight were Hispanic. Symptoms associated with sleep-disordered breathing, bedtime resistance, night waking and daytime sleepiness occurred more frequently in the current sample than the original validation sample. Parents of children in the current sample reported more concerns with sleep duration than the validation sample despite similar total sleep times. There were no group differences for sleep onset delay, sleep anxiety or parasomnias. Results suggest that healthy, ethnic-minority children living in impoverished, urban areas may have higher rates of snoring and more problematic sleep behaviors than children from middle-class, suburban environments. The potential impact of cultural and economic factors should be recognized during evaluations for sleep problems. As sleep-disordered breathing and excessive daytime sleepiness can negatively impact neurocognitive and behavioral functioning, screening of sleep habits during routine clinical care could help with identifying not only children at risk for sleep disorders but also those with poor sleep hygiene, thus providing opportunities for appropriate educational interventions.     

Sleep problems in pre-school children: a review of the literature

Summary This paper reviews the literature on sleep problems in preschool children, aiming to raise awareness of the current knowledge in this field. The article begins with a discussion of the prevalence of sleep problems in young children. Disorders of initiating and maintaining sleep are by far the most common type of sleep problem in this age group, and are therefore the focus of this review. The effects of sleep disturbance are examined, focusing on how parents often feel desperate and in need of support outside the family. The causes of sleep problems are considered and the complexity in identifying causal factors is highlighted. The article continues with an exploration of the treatment of sleep problems, suggesting that much of the advice given to parents is contradictory. The literature demonstrates that the use of medication is common, but it appears that this method of treatment is of limited benefit. It seems that behaviour modification or a psychodynamic approach may be much more successful, and the use of self-help manuals/booklets has been shown to be useful by some authors. Finally, preventative strategies are discussed highlighting the need for further research in this area.     

Twinship as a protective factor against behavioural and emotional problems at preschool age

Early attachment has both protective and risk factors as regards later mental health. In Finland, insecure-avoidant-type attachment is overrepresented. Does this indicate a risk for emotional and behavioural problems at preschool age? In this study, we examined and compared the association between attachment and mental health in Finnish singletons and twins. The attachment of 27 singletons and 58 twins with both parents had previously been examined at the age of 18 months using Preschool Assessment of Attachment criteria. At the age of 4, the children's emotional and behavioural symptoms were assessed using Child Behavior Checklist questionnaires reported by parents. The mothers and fathers reported significantly more behavioural and emotional problems at preschool age in singletons than in twins. Insecure-avoidant-type attachment to the mother was significantly associated with higher scores concerning withdrawal, somatic problems and total internalising symptoms among singleton preschoolers, whereas among twins, no such correlations were observed. The results thus suggest that twinship is a protective factor in the trajectory from toddler avoidant attachment to internalising problems at preschool age.     

Sleep problems in primary school children: comparison between mainstream and special school children

This paper reports on a study of the prevalence and social correlates of dyssomnias, features associated with obstructive sleep apnoea, and parasomnias in primary school children aged 4-12. Head teachers of schools selected randomly from lists of local primary and special schools were contacted by telephone and asked to distribute a questionnaire package to the parents of all pupils aged 4-12 years. In all, 890 parents of children from mainstream schools and 300 from special schools were approached. The response rates were 64.7% and 60%, respectively. The results showed that significantly higher proportions of children in special schools than in mainstream schools presented four of the five dyssomnias investigated and all of the features associated with obstructive sleep apnoea. In contrast, only two of the seven parasomnias were presented by higher proportions of the children in special schools. Age and gender differences for the two groups of children are presented. Finally, multiple correlations were computed between a range of child, family, and environmental characteristics and the three problems most frequently reported: frequency of settling problems; sleeping in the parents' bed; and night waking. The findings are discussed with reference to other studies of children's sleep problems, and the implications for treatment are considered.     

Sleep problems and “sleep-aids” in low birth weight children during the first three years

Bedtime patterns of 66 low birth weight children were compared to those of 109 normal birth weight children longitudinally at ages one, two and three years. At age one, the low birth weight children were less likely to have problems falling asleep and awakening during the night than the normal birth weight children. They were also less likely to use night lights and special blankets or other objects as aids to falling asleep, and more likely to engage in the self-contained pre-sleep activity of rhythmic body rocking. Although at ages two and three the two groups were comparable in terms of the frequency of sleep problems, the low birth weight children's higher frequency of self-rocking and lower frequency of use night lights and special objects continued over time.     

癫痫患者剥夺睡眠—睡眠与药物诱导睡眠脑电图的对照研究

目的探讨癫痫患者药物诱导睡眠和剥夺睡眠—睡眠脑电图(EEG)差别,评估两者对癫痫(EP)诊断价值。方法对临床上已确诊为癫痫患者364例,随机分为剥夺睡眠—睡眠和药物诱导睡眠两组,分别进行觉醒及睡眠EEG描记,并对两组病例睡眠周期及睡眠各期EEG表现分析对比。结果药物诱导睡眠组、剥夺睡眠—睡眠组常规清醒脑电图异常波阳性率分别为39.9%、41.7%,二组异常波检出率无显著差异(P>0.05);两组睡眠脑电图异常波阳性率分别为80.4%、85.0%,异常波阳性率剥夺睡眠—睡眠组略高于药物诱导睡眠组;癫痫样放电阳性率分别为59.9%、89.1%,两组癫痫样放电均易在NREM睡眠Ⅰ—Ⅱ期出现,癫痫样放电阳性率剥夺睡眠组明显高于药物诱导睡眠组,二者差异有统计学意义(P<0.001)。结论剥夺睡眠—睡眠、药物诱导睡眠均可提高癫痫诊断率,剥夺睡眠—睡眠联合诱发试验在癫痫病人的诊断中优于药物诱导睡眠诱发试验。     

Spanish version of the Sleep Self‐Report (SSR): factorial structure and psychometric properties

Background The Sleep Self‐Report (SSR) is a questionnaire initially created for use with a sample from the USA to assess sleep patterns and problems in school‐aged children. The objective of this study was to validate the SSR among a Spanish sample. Methods Participants were 1228 Spanish children from 8 to 12 years of age who completed the questionnaires at school anonymously. Results Internal consistency was good (ω= 0.85). Convergent validity with anxiety (r= 0.54) and perceived welfare (r=?0.53) measures, and divergent validity with a measure of academic performance and positive influence of peers (r=?0.22) were acceptable. Exploratory analysis suggested a factorial structure composed by four subscales: sleep quality, sleep anxiety, bedtime refusal and sleep routines. Confirmatory analysis indicated a good fit for the model (RMSEA = 0.04; GFI = 0.95; AGFI = 0.93; χ²/gl = 2.48). Conclusions The SSR has demonstrated to have good psychometric properties in the Spanish‐speaking sample of children. The factorial structure supported by exploratory and confirmatory analysis examines the most relevant areas of sleep in children. The satisfactory psychometric properties support the use of the Spanish version of the SSR by researchers and clinicians.     

长沙市中学生睡眠质量及影响因素分析

目的了解湖南省长沙市中学生睡眠质量及其影响因素,为采取有效措施改善中学生睡眠质量提供参考。方法采取分层整群随机抽样方法,对长沙市2 216 名中学生进行自制问卷、匹兹堡睡眠质量指数、青少年生活事件量表和自尊量表测评。结果长沙市中学生PSQI总分为(4.90±2.548)分,睡眠问题检出率为14.4%,其中农村中学生和高中学生睡眠问题分别高于城镇中学生和初中学生(P<0.01),PSQI总分与年龄、家庭暴力情况、负性生活事件和自尊评分呈正相关(r=0.051~0.316,P<0.05),与家庭经济情况、家庭关系情况和父母严格情况呈负相关(r=-0.202~-0.071,P<0.01);睡眠质量的影响因素包括生活事件总刺激量(β=0.260)、初高中(β=0.166)、家庭关系情况(β=-0.128)、自尊评分(β=0.112)、父母严格情况(β=-0.081)、家庭经济情况(β=0.081)。结论中学生睡眠质量与多种因素有关,应及时采取积极有效措施,促进中学生身心健康。     

Incidence and nature of feeding problems in young children referred to a paediatric HIV service in London: FEAD screening

A detailed screening assessment was carried out on two matched groups of young children; one group was HIV-infected and the other was not. Screening included assessments of growth, development and food intake. Parents were also interviewed about their child's feeding and mealtime behaviours. Half of the HIV-infected children were reported with serious feeding problems; significantly higher than in the uninfected group. More of the children in the HIV-infected group were found to have poorer growth and developmental weaknesses than in the uninfected group. A combination of physical and psychological factors are suggested as contributing to these feeding difficulties. Early monitoring of feeding behaviours, daily routines and food intake, together with systematic growth and developmental measures are suggested as important components in the care and management of HIV-infected children.     

The effects of age and gender on the prevalence of insomnia in a sample of the Saudi population

Objectives: The aim of this study was to determine the prevalence of insomnia among the Saudi adult population.

Study design: A cross-sectional insomnia survey was conducted at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. The presence of insomnia was defined by difficulty initiating sleep, early morning awakening, or frequent awakening, in addition to the second-day effect in the form of fatigue, tiredness, or changes in the mode because of lack of sleep.

Results: The crude prevalence of insomnia was 77.7% (95% CI?=?75.9–79.5%). The gender-adjusted prevalence of insomnia was higher for females, 88.7% (95% CI?=?86.4–90.7%) than for males, 70.4% (95% CI?=?67.8–72.9%), p-value?=?.001. The age-adjusted prevalence of insomnia was higher for the elderly, 93.7% (95% CI?=?90.6–96.0%) than for the middle aged, 79.8% (95% CI?=?77.4–82.1%), or for the young group, 64.2% (95% CI?=?59.9–68.4%), p-value?=?.001. The Chi-square analyses revealed that (1) being elderly, widowed/divorced, females, or housewives, (2) having a lack of education, and (3) excessive tea consumption were significantly associated with elevated risks for insomnia (p-values?Conclusions: Insomnia is most prevalent among Saudi females and the elderly Saudi population.     

南京市溧水区学龄前儿童睡眠状况及其对情绪与行为问题的影响

目的 探讨南京市溧水区学龄前儿童睡眠质量和情绪与行为的关系。 方法 2020年6—8月基于分层随机抽样,对南京市溧水区6个幼儿园的307名儿童进行研究,通过问卷调查采集儿童的基本信息和睡眠状况;采用长处和困难问卷(Strength and Difficulty Questionnaire, SDQ)了解儿童的情绪和行为问题发生情况,并用多因素logistic回归分析睡眠问题对儿童情绪及行为问题的影响。 结果 307名研究对象中,睡眠障碍者95名(30.94%),起床时间在7:00后、就寝时间在21:00后、夜间睡眠时间<8 h者分别有233名(75.90%)、169名(55.05%)、104名(33.88%);SDQ困难总分(>17分)有29名(9.45%);有睡眠障碍、就寝时间在21:00后及睡眠时间<8 h的学龄前儿童困难总分(>17分)检出率较高,差异有统计学意义(P<0.05)。多因素logistic回归结果显示:睡眠障碍 (OR=3.613, 95%CI:1.217~6.314, P=0.013)、就寝时间晚于21:00(OR=1.611, 95%CI:1.031~2.467, P=0.038)、睡眠时间<8 h (OR=1.238, 95%CI:1.136~2.691, P=0.006)是学龄前儿童发生情绪及行为问题的独立危险因素。 结论 睡眠障碍、就寝时间晚于21:00和夜间睡眠时间<8 h增加儿童情绪行为问题的发生风险,特别是多动的发生,提示家长应为儿童创造良好的睡眠环境与成长环境,对促进儿童身心健康成长具有重要意义。