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Journal of Affective Disorders Feb 2023Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and...
BACKGROUND
Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and persistence) of dyssomnia in early childhood, and the parent, child, and family factors associated with dyssomnia.
METHODS
Longitudinal data of 700 children aged 0-8, gathered in the CIKEO cohort study in the Netherlands were analyzed. Dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency of >30 min. Least absolute shrinkage and selection operator (LASSO) was used to identify the parental, child, and family factors associated with the incidence and persistence of dyssomnias in children.
RESULTS
The mean age of the children (47 % girls) was 3.2 ± 1.9 years at baseline and 4.4 ± 1.8 years at follow-up. The prevalence of dyssomnias was 13.3 % and 15.4 % at baseline and follow-up, respectively. The incidence and persistence rates of dyssomnias at follow-up were 12.0 % and 37.6 %, respectively. New incidence of insomnia was associated with being a girl, having medical conditions, experiencing stressful life events, and lower parenting self-efficacy at baseline (P < 0.05). Higher levels of parental psychological distress were associated with the persistence of dyssomnias in children (P < 0.05).
CONCLUSIONS
Dyssomnias are common with a moderate persistent rate in young children. Several parental, child, and family factors in relation to the incidence and persistence of dyssomnias were identified. Preventive programs and interventions targeting modifiable factors, particularly parental psychological distress, parenting self-efficacy, and resilience to stressful life events, might benefit child sleep.
Topics: Female; Child; Humans; Child, Preschool; Infant; Male; Cohort Studies; Dyssomnias; Sleep; Sleep Initiation and Maintenance Disorders; Parents
PubMed: 36513160
DOI: 10.1016/j.jad.2022.12.012 -
Molecular Genetics and Metabolism Dec 2017The mucopolysaccharidosis (MPS) disorders are caused by deficiencies of specific lysosomal enzymes, resulting in progressive glycosaminoglycan (GAG) accumulation in... (Review)
Review
The mucopolysaccharidosis (MPS) disorders are caused by deficiencies of specific lysosomal enzymes, resulting in progressive glycosaminoglycan (GAG) accumulation in cells and tissues throughout the body. Excessive GAG storage can lead to a variety of somatic manifestations as well as primary and secondary neurological symptoms. Behavioral problems (like hyperactivity, attention difficulties, and severe frustration) and sleeping problems are typical primary neurological symptoms of MPS caused by GAG accumulation in neurons, and are frequently observed in patients with MPS I, II, III, and VII. As these problems often place a significant burden on the family, proper management is important. This review summarizes current insights into behavioral and sleeping problems in MPS disorders and the most optimal management approaches, as presented and discussed during a meeting of an international group of experts with extensive experience in managing and treating MPS.
Topics: Behavior Therapy; Brain; Central Nervous System Depressants; Child; Child Behavior; Child, Preschool; Congresses as Topic; Dyssomnias; Glycosaminoglycans; Humans; Mucopolysaccharidoses; Treatment Outcome
PubMed: 29170079
DOI: 10.1016/j.ymgme.2017.09.010 -
Journal of Cardiology Jan 2014Sleep apnea is evident in approximately 10% of adults in the general population, but in certain cardiovascular diseases, and in particular those characterized by sodium... (Review)
Review
Sleep apnea is evident in approximately 10% of adults in the general population, but in certain cardiovascular diseases, and in particular those characterized by sodium and water retention, its prevalence can exceed 50%. Although sleep apnea is not as yet integrated into formal cardiovascular risk assessment algorithms, there is increasing awareness of its importance in the causation or promotion of hypertension, coronary artery disease, heart failure, atrial arrhythmias, and stroke, and thus, not surprisingly, as a predictor of premature cardiovascular death. Sleep apnea manifests as two principal phenotypes, both characterized by respiratory instability: obstructive (OSA), which arises when sleep-related withdrawal of respiratory drive to the upper airway dilator muscles is superimposed upon a narrow and highly compliant airway predisposed to collapse, and central (CSA), which occurs when the partial pressure of arterial carbon dioxide falls below the apnea threshold, resulting in withdrawal of central drive to respiratory muscles. The present objectives are to: (1) review the epidemiology and patho-physiology of OSA and CSA, with particular emphasis on the role of renal sodium retention in initiating and promoting these processes, and on population studies that reveal the long-term consequences of untreated OSA and CSA; (2) illustrate mechanical, autonomic, chemical, and inflammatory mechanisms by which OSA and CSA can increase cardiovascular risk and event rates by initiating or promoting hypertension, atherosclerosis, coronary artery disease, heart failure, arrhythmias, and stroke; (3) highlight insights from randomized trials in which treating sleep apnea was the specific target of therapy; (4) emphasize the present lack of evidence that treating sleep apnea reduces cardiovascular risk and the current clinical equipoise concerning treatment of asymptomatic patients with sleep apnea; and (5) consider clinical implications and future directions of clinical research and practice.
Topics: Cardiovascular Diseases; Humans; Membrane Proteins; Positive-Pressure Respiration; Randomized Controlled Trials as Topic; Sleep Apnea, Central; Sleep Apnea, Obstructive; Tumor Suppressor Proteins
PubMed: 24084492
DOI: 10.1016/j.jjcc.2013.08.009 -
Sleep Medicine Reviews Apr 2023Actigraphy has a consolidated role in Insomnia and Circadian Rhythm Sleep-Wake Disorders (CRSWD) and recent studies have highlighted the use of actigraphy for narcolepsy... (Review)
Review
Actigraphy has a consolidated role in Insomnia and Circadian Rhythm Sleep-Wake Disorders (CRSWD) and recent studies have highlighted the use of actigraphy for narcolepsy and REM sleep behaviour disorder (RBD). This review aims at summarising the results of studies published over the last decade regarding the use of actigraphy. Thirty-five studies proved eligible, and results were analysed separately for insomnia, narcolepsy and RBD. Actigraphy showed to consistently differentiate insomnia patients from healthy controls. Furthermore, the application of advanced analytical techniques has been shown to provide both unique insights into the physiology of insomnia and sleep misperception and to improve the specificity of actigraphy in detecting wakefulness within sleep periods. Regarding narcolepsy, several studies showed that actigraphy can detect peculiar sleep/wake disruption and the effects of pharmacological treatments. Finally, although the number of studies in RBD patients is still limited, the available evidence indicates a reduced amplitude of the activity pattern, sleep-wake rhythm dysregulation and daytime sleepiness. Therefore, the potential use of these markers as predictors of phenoconversion should be further explored. In conclusion, quantitative actigraphy presents a renewed interest when considering the possibility of using actigraphy in clinical sleep medicine to diagnose, monitor, and follow sleep disorders other than CRSWD.
Topics: Humans; Actigraphy; Sleep Initiation and Maintenance Disorders; Sleep; Narcolepsy; Sleep Disorders, Circadian Rhythm; REM Sleep Behavior Disorder
PubMed: 36773596
DOI: 10.1016/j.smrv.2023.101762 -
American Family Physician Nov 1999Obstructive sleep apnea is a significant medical problem affecting up to 4 percent of middle-aged adults. The most common complaints are loud snoring, disrupted sleep... (Review)
Review
Obstructive sleep apnea is a significant medical problem affecting up to 4 percent of middle-aged adults. The most common complaints are loud snoring, disrupted sleep and excessive daytime sleepiness. Patients with apnea suffer from fragmented sleep and may develop cardiovascular abnormalities because of the repetitive cycles of snoring, airway collapse and arousal. Although most patients are overweight and have a short, thick neck, some are of normal weight but have a small, receding jaw. Because many patients are not aware of their heavy snoring and nocturnal arousals, obstructive sleep apnea may remain undiagnosed; therefore, it is helpful to question the bedroom partner of a patient with chronic sleepiness and fatigue. Polysomnography in a sleep laboratory is the gold standard for confirming the diagnosis of obstructive sleep apnea; however, the test is expensive and not widely available. Home sleep studies are less costly but not as diagnostically accurate. Treatments include weight loss, nasal continuous positive airway pressure and dental devices that modify the position of the tongue or jaw. Upper airway and jaw surgical procedures may also be appropriate in selected patients, but invasiveness and expense restrict their use.
Topics: Adult; Humans; Sleep Apnea, Obstructive
PubMed: 10593319
DOI: No ID Found -
Revista de Neurologia Jan 2014Pediatric insomnia is an extrinsic sleep disorder subdivided into two categories: behavioral insomnia and insomnia related to medical, neurological, and psychiatric... (Review)
Review
Pediatric insomnia is an extrinsic sleep disorder subdivided into two categories: behavioral insomnia and insomnia related to medical, neurological, and psychiatric diseases. This review will cover several types of insomnia, comorbidities and specific pediatric therapies according to clinical characteristics and age. Behavioral insomnia should be differentiated from pediatric insomnia due to medical conditions, mostly occurring during the first year of life. Multiple night awakenings and diurnal hypersomnolence are strong indicators of insomnia due to medical conditions. Insomnia during adolescence and pediatric insomnia associated with psychiatric comorbidity, cognitive disabilities and epilepsy, will be discussed in terms of diagnosis, clinical features and implications for treatment.
Topics: Adolescent; Behavior Therapy; Child; Child Behavior Disorders; Chronobiology Disorders; Cognition Disorders; Comorbidity; Diagnosis, Differential; Dyssomnias; Epilepsy; Food Hypersensitivity; Gastroesophageal Reflux; Humans; Hypnotics and Sedatives; Melatonin; Mental Disorders; Psychotropic Drugs; Sleep Disorders, Intrinsic; Sleep Initiation and Maintenance Disorders; Substance-Related Disorders
PubMed: 24343539
DOI: No ID Found -
American Family Physician Mar 2009Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, and it affects an estimated 20 percent of the population. Persons with excessive...
Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, and it affects an estimated 20 percent of the population. Persons with excessive daytime sleepiness are at risk of motor vehicle and work-related incidents, and have poorer health than comparable adults. The most common causes of excessive daytime sleepiness are sleep deprivation, obstructive sleep apnea, and sedating medications. Other potential causes of excessive daytime sleepiness include certain medical and psychiatric conditions and sleep disorders, such as narcolepsy. Obstructive sleep apnea is a particularly significant cause of excessive daytime sleepiness. An estimated 26 to 32 percent of adults are at risk of or have obstructive sleep apnea, and the prevalence is expected to increase. The evaluation and management of excessive daytime sleepiness is based on the identification and treatment of underlying conditions (particularly obstructive sleep apnea), and the appropriate use of activating medications.
Topics: Continuous Positive Airway Pressure; Disorders of Excessive Somnolence; Humans; Narcolepsy; Polysomnography; Sleep Apnea Syndromes; Work Schedule Tolerance
PubMed: 19275068
DOI: No ID Found -
European Respiratory Review : An... Sep 2019Both obstructive sleep apnoea (OSA) and chronic insomnia disorder are highly prevalent in the general population. Whilst both disorders may occur together by mere... (Review)
Review
Both obstructive sleep apnoea (OSA) and chronic insomnia disorder are highly prevalent in the general population. Whilst both disorders may occur together by mere coincidence, it appears that they share clinical features and that they may aggravate each other as a result of reciprocally adverse pathogenetic mechanisms. Comorbidity between chronic insomnia disorder and OSA is a clinically relevant condition that may confront practitioners with serious diagnostic and therapeutic challenges. Current data, while still scarce, advocate an integrated and multidisciplinary approach that seems superior over the isolated treatment of each sleep disorder alone.
Topics: Comorbidity; Humans; Lung; Respiration; Risk Factors; Sleep; Sleep Apnea Syndromes; Sleep Initiation and Maintenance Disorders; Treatment Outcome
PubMed: 31597675
DOI: 10.1183/16000617.0080-2019 -
Tidsskrift For Den Norske Laegeforening... Sep 2009Sleep-related breathing disorders (SRBD) is a term that includes several different diagnoses. This paper describes aetiology, diagnostics, treatment options and... (Review)
Review
BACKGROUND
Sleep-related breathing disorders (SRBD) is a term that includes several different diagnoses. This paper describes aetiology, diagnostics, treatment options and consequences of untreated disease, in children and adults.
MATERIAL AND METHOD
The paper is based on own clinical experience and literature identified through a non-systematic search of PubMed and various books.
RESULTS
The prevalence of SRDB in children and adults is about 10-15% and that for the most serious type, OSAS (Obstructive Sleep Apnoea Syndrome), is about 2-4%. A sleep study is required to confirm the diagnosis. The clinical symptoms of SRBD in adults are heavy snoring, observed apnoeas, gasping for air leading to frequent arousals, disturbed sleep and daytime sleepiness. Children are often hyperactive and have learning and behaviour difficulties. Untreated patients have increased mortality and morbidity. The primary treatment option for patients with medium to serious breathing disorders is continuous positive-pressure ventilation. Other treatment options are oral devices and surgery. In children, surgery (adenotonsilectomy) is the treatment of choice.
INTERPRETATION
OSAS is the most severe diagnosis among SRBD. Both adults and children show reduced cognitive function and quality of life. Various treatment options are available.
Topics: Adenoidectomy; Adult; Child; Continuous Positive Airway Pressure; Humans; Occlusal Splints; Otorhinolaryngologic Surgical Procedures; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Smoking Cessation; Tonsillectomy; Weight Loss
PubMed: 19756060
DOI: 10.4045/tidsskr.08.0497 -
Journal of Clinical Sleep Medicine :... Oct 2011For those endeavoring to develop better methods of measuring/quantifying sleepiness, the "Holy Grail" is a measure that is maximally objective, completely unobtrusive,... (Review)
Review
For those endeavoring to develop better methods of measuring/quantifying sleepiness, the "Holy Grail" is a measure that is maximally objective, completely unobtrusive, exquisitely sensitive, and absolutely specific (i.e., varies only as a function of sleepiness). By these criteria, physiological measures (e.g., based on brain activity such as EEG, fMRI, near-infrared spectroscopy, etc.) would appear to hold the most promise. However, from an operational standpoint, the utility of a sleepiness measure is derived not from its ability to sensitively reflect the brain's extant level of sleepiness per se, but from the implications that this level of sleepiness has for the individual's current and near-term ability to safely and efficiently perform operationally-relevant tasks. Thus, an ideal operationally-relevant sleepiness measure is one that is unobtrusively embedded in the actual operational task, and allows sleepiness-related performance deficits to be distinguished from performance deficits due to other causes. Toward this end, we have developed a PVT-derived metric that incorporates the entire distribution of responses within a PVT session, and reflects changes in the pattern of performance that can be used to identify and quantify "state instability"--the putative physiological state that specifically underlies sleepiness-induced performance deficits.
Topics: Biomarkers; Disorders of Excessive Somnolence; Humans; Psychomotor Performance; Sleep Deprivation
PubMed: 22003322
DOI: 10.5664/JCSM.1344