Cancer resources for providers in the rural community

The aim of the present study was to compare the sleep of 12 children with attention deficit hyperactivity disorder (ADHD) with that of 12 normal controls. The children were examined in their natural environment, using continuous actigraphic monitoring over several consecutive nights, as well as undergoing subjective parental reports. It was hypothesized that children diagnosed with ADHD would suffer from reduced sleep quality than children without ADHD. This hypothesis was supported by the actigraphic measures, but not supported by the subjective parental reports. It was also found that the sleep quality of the two groups differed over the course of the night, which suggests a difference in sleep architecture. Various possible explanations for these findings, their implications regarding the relationship between sleep and ADHD, and the resulting treatment ramifications are discussed, and suggestions for further research are provided.     

Actigraphic home-monitoring of the sleep patterns of in vitro fertilization children and their matched controls

The sleep patterns of 35 in vitro fertilization (IVF) children aged 19 to 57 months and their matched controls were evaluated by actigraphic home-monitoring for three consecutive nights. Actigraphic data were analysed by an automated scoring procedure developed in the authors' laboratory. There were no significant differences in activity levels between IVF multiple-birth subjects and their matched controls or between IVF singletons and their matched controls. In contrast, multiple-birth subjects had higher activity levels during sleep and lower sleep efficiency than singletons in both IVF and control groups. Sleep measures showed night-to-night stability in all groups.     

Universal Total Wrist Implant: experience with a carpal component fixed with three screws

The purpose of this report is to summarize data from a sample of 230 residents in eight nursing homes (NHs) that are relevant to the development of environmental and behavioral interventions for sleep. Four conclusions can be drawn: (1) there is strong evidence that the nighttime sleep of these residents was adversely affected by environmental noise and light; (2) residents appear to spend substantial time in bed and sleeping during the day; (3) there are significant differences between some homes in the amount of time that residents spend in bed and sleeping during the day, as well as the frequency of nighttime awakenings associated with environmental events; and (4) residents' preference and nighttime noise source data suggest that a multifaceted intervention to improve sleep hygiene could successfully implemented in the NH setting. An intervention addressing these issues may result in improved sleep and overall well-being for a substantial portion of the NH population.     

Relationships between nocturnal activity, parental ratings of daytime activity and measues from the Children's Sleep Behaviour Scale.

Monitored the nocturnal activity levels of 20 boys and 20 girls (mean age 10.46 yrs) from 12:00 AM to 6:00 AM over 2 consecutive nights in their homes. Frequency of sleep-related behaviors based on retrospective parental ratings was assessed by the Children's Sleep Behavior Scale (CSBS). Children who were rated high on sleep behaviors with an observable motor component were also more active during the night, thereby validating the motor subscale of the CSBS. Nocturnal activity was associated with another CSBS-derived sleep score that included items with positive affective content, such as laughing and smiling while asleep. Children who showed bedtime resistance behaviors and complained of difficulty going to sleep were not more active during the night. Gender, age, and parental perception of daytime activity levels were not related to objective measures of nocturnal activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family and individual factors associated with substance involvement and PTS symptoms among adolescents in greater New Orleans after Hurricane Katrina.

Objective: This study examined the influence of hurricane impact as well as family and individual risk factors on posttraumatic stress (PTS) symptoms and substance involvement among clinically referred adolescents affected by Hurricane Katrina. Method: A total of 80 adolescents (87% male; 13–17 years old; mean age = 15.6 years; 38% minorities) and their parents were interviewed at the adolescent's intake into substance abuse treatment, 16 to 46 months postdisaster. Independent measures included hurricane impact variables (initial loss/disruption and perceived life threat); demographic and predisaster variables (family income, gender, predisaster adolescent substance use, predisaster trauma exposure, and parental substance abuse); postdisaster family factors (parental psychopathology, family cohesion, and parental monitoring); and postdisaster adolescent delinquency. Results: Hierarchical multivariate regression analyses showed that adolescent substance involvement was associated with higher family income, lower parental monitoring (adolescent report), and more adolescent delinquency. Adolescent-reported PTS symptoms were associated with greater hurricane-related initial loss/disruption, lower family cohesion (adolescent report), and more adolescent delinquency, whereas parent-reported adolescent PTS symptoms were associated with greater parental psychopathology, lower parental monitoring (adolescent report), and lower family cohesion (parent report). Conclusions: The results suggest that hurricane impact was related only to adolescent-reported PTS. However, certain postdisaster family and individual risk factors (low family cohesion and parental monitoring, more adolescent delinquency) were associated both with adolescent substance involvement and with PTS symptoms. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with substance-abusing adolescents after disasters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infant sleep and parental sleep-related cognitions.

Infant sleep is a major source of distress in many families. The purpose of this study was to assess infant sleep and parental sleep-related cognitions about infant sleep in clinical and control samples. The clinical sample consisted of 48 infants referred to a sleep clinic because of night-wakings problems. The control sample included 48 infants with no parental complaints about sleep difficulties. Sleep of all participating infants was monitored for 1 week with actigraphs and parental daily logs. Parents completed 2 questionnaires testing their cognitions about infant sleep. As expected, significant group differences were found with regard to the sleep-quality measures and parental cognitions. Parental cognitions about difficulties in limit setting were associated with poorer sleep quality. Significant differences were found between fathers and mothers on the cognitions scales. The results highlight the links between parental cognitions and infant sleep and the unique perspective of each parent in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep, the common denominator for psychological adaptation.

Recently, the discovery of closer links of circadian rhythms with sleep quality has led to the development of better intervention methods for adaptation to shift work, circadian phase disruptions and mood disorders (depressions). This paper presents an overview of some of those findings, pointing out the contributions of Canadian psychology laboratories. The author concludes that more attention should be given to sleep and biological rhythms in research and training in both experimental and applied psychology, as well as in professional practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep patterns of children sleeping in residential care, in kibbutz dormitories and at home--a comparative study

The present study compares sleep patterns of two groups of children sleeping away from their families, in residential care (n = 31, age 3.7 +/- 1.7 years) and kibbutz (n = 29, age 3.7 +/- 1.8 years) dormitories, with age-matched children sleeping at home (n = 21, age 3.7 +/- 1.8 years). Sleep was monitored by wrist-worn actigraphs for three consecutive nights and assessed by sleep questionnaires, which were completed by parents of the kibbutz children and caretakers at residential care. Children in the residential care settled to sleep significantly earlier and slept longer than those children living in a kibbutz or at home. The longest period of uninterrupted sleep was more extended for children sleeping at home, compared to those sleeping in communal dormitories. Correlation analysis between various assessments of sleep and waking behaviors revealed a different pattern for kibbutz and residential care children. For the kibbutz children, there were significant correlations between difficulties falling asleep and various attributes of daytime tiredness. Conversely, in the residential care, difficulties falling asleep were significantly and positively correlated with parameters associated with daytime alertness. This pattern of correlations and the actigraphic data indicate that difficulties in falling asleep for children in residential care are probably a consequence of being put to bed too early and according to a rigid schedule, and not the result of emotional factors.     

Supporting Families in a High-Risk Setting: Proximal Effects of the SAFEChildren Preventive Intervention.

Four hundred twenty-four families who resided in inner-city neighborhoods and had a child entering 1st grade were randomly assigned to a control condition or to a family-focused preventive intervention combined with academic tutoring. SAFEChildren, which was developed from a developmental-ecological perspective, emphasizes developmental tasks and community factors in understanding risk and prevention. Tracking of linear-growth trends through 6 months after intervention indicated an overall eftect of increased academic performance and better parental involvement in school. High-risk families had additional benefits for parental monitoring, child-problem behaviors, and children's social competence. High-risk youth showed improvement in problem behaviors and social competence. Results support a family-focused intervention that addresses risk in low-income communities as managing abnormal challenges. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep problems in children with Sanfilippo syndrome

Sanfilippo syndrome is a rare degenerative disorder which has severe intellectual and behavioural sequelae, commonly including sleep problems. A parental questionnaire was used to gather information on the sleep patterns of 80 children with Sanfilippo syndrome (mean age 10 years 2 months). The majority were found to have sleep problems (78%). Many also exhibited other distressing and unusual night time behaviours (staying up all night, chewing the bedclothes or crying out suddenly), and a few laughed or sang. Such problems may have been more severe in those with Sanfilippo syndrome type B. In four of the families offered individually tailored behaviour-management advice there was immediate improvement, which was maintained at followup in two cases. These results demonstrate the usefulness of even such a minimal intervention, even in a very difficult population such as this.     

Parental involvement, psychological distress, and sleep: A preliminary examination in sleep-disturbed adolescents with a history of substance abuse.

The relationships between family environment and psychological distress and between psychological distress and sleep disturbance in adolescents are well established. However, less is known about the influence of family environment on sleep disturbance. The authors' goal is to examine the effects of parental involvement on psychological distress and sleep disturbance in 34 adolescents with a history of substance abuse. Linear regression techniques and confidence intervals were used to test the significance of mediation analyses. Lower levels of parental involvement were associated with higher levels of psychological distress, and higher levels of psychological distress were associated with lower sleep efficiency and more time spent in bed. Follow-up analyses found that higher levels of parental involvement were associated with earlier morning arising times, when controlling for psychological distress. These data indicate that psychological distress is important to consider when examining the relationship between parental involvement and sleep in adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transcutaneous oxygen pressure (TcPO2): advantages and limitations]

The aim of this study was to assess sleep and pulmonary function in asthmatic and control children. Forty children with well-controlled, stable asthma, and 34 controls (age range: 8.2 to 15.4 years) were monitored with wrist actigraphs and peak-flow meters for 3 consecutive days. In addition, asthma severity was assessed by subjective parental and self-rating scale and symptom checklist. Asthmatic children had poorer sleep quality in comparison to their controls, as manifested in lower percentages of quiet sleep (p < .05) and increased activity level during sleep (p < .05). As expected, asthmatic children had reduced morning peak expiratory flow measures (p < .01) and a higher evening-to-morning drop in peak expiratory flow (p < .005). Peak-flow measures were significantly correlated with subjective and objective sleep measures. In the asthmatic group, sleep measures were also correlated with subjective asthma severity indices and symptom checklists. We conclude that poorer sleep is associated with reduced pulmonary function. The reduced sleep quality, coupled with subjective reports of increased fatigue and reduced alertness found in asthmatic children, suggest that these children are at risk for developing neurobehavioral deficits associated with chronic sleep loss.     

Maternal emotional availability at bedtime predicts infant sleep quality.

In the present study, linkages were examined between parental behaviors (maternal practices) at bedtime, emotional availability of mothering at bedtime, and infant sleep quality in a cross-sectional sample of families with infants between 1 and 24 months of age. Observations of maternal behaviors and maternal emotional availability were conducted independently by 2 sets of trained observers who were blind to data being coded by the other. With infant age statistically controlled, specific maternal behaviors at bedtime were unrelated to infant sleep disruptions at bedtime and during the night. By contrast, emotional availability of mothering at bedtime was significantly and inversely related to infant sleep disruption, and, although these links were stronger for younger infants, they were significant for older infants as well. Maternal emotional availability was also inversely linked with mothers' ratings of whether their infants had sleep difficulties. These findings demonstrate that parents' emotional availability at bedtimes may be as important, if not more important, than bedtime practices in predicting infant sleep quality. Results support the theoretical premise that parents' emotional availability to children in sleep contexts promotes feelings of safety and security and, as a result, better-regulated child sleep. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do our methods lead to insomniacs' madness?: Daytime testing after laboratory and home-based polysomnographic studies

Complaints of daytime dysfunction are common among chronic insomniacs, but laboratory comparisons of insomniacs and age-matched and gender-matched normal controls have generally failed to document these complaints. However, a few studies, which allowed subjects to sleep in their homes on the nights before daytime testing, have shown some relative diurnal deficits among insomniacs. The current study compared the effects of nocturnal laboratory and home polysomnogram (PSG) studies on subsequent daytime test results among older insomniacs and normal sleepers. Insomniacs (n = 32) and normal sleepers (n = 32) were randomly assigned to first undergo three nights of nocturnal PSG monitoring either in the sleep laboratory (16 insomniacs, 16 normal sleepers) or in their homes (16 insomniacs, 16 normal sleepers). Following the third night of PSG monitoring, subjects spent 1 day in the sleep laboratory, where they completed a four-trial multiple sleep latency test along with four trials of a computer-administered performance test battery. Results showed that insomniacs, as a group, were slightly, albeit consistently, sleepier than were normal sleepers following nights of home sleep monitoring, but a reverse of this trend was found among subjects who underwent nocturnal laboratory PSG before daytime testing. Furthermore, normal sleepers showed faster reaction times on a signal detection task than did insomniacs within the subgroup who underwent home PSGs prior to such testing. However, within the subgroup that underwent nocturnal laboratory PSGs, insomniacs' signal detection reaction times were significantly faster than those shown by normal sleepers. Results provide some support for the speculation that the nocturnal PSG monitoring site, used as a precursor to daytime testing, may systematically affect daytime comparisons between insomniacs and matched controls. Moreover, these results suggest that the use of home-based nocturnal PSG monitoring prior to daytime testing may provide an enhanced understanding of insomniacs' diurnal complaints.     

Child sleep disorders: Associations with parental sleep duration and daytime sleepiness.

This study examined the associations between childhood sleep disorders and mothers' and fathers' sleep duration and daytime sleepiness. One hundred seven families of children (ages 2-12 years) presenting to a pediatric sleep disorders clinic completed questionnaires assessing the sleep symptoms of the mother, father, and child. Parents of children with more than 1 type of sleep disorder experienced more daytime sleepiness than parents of children with a single sleep disorder. The pattern of results suggested more associations between maternal and child sleep than between paternal and child sleep. Within families, mothers reported significantly more daytime sleepiness than fathers, although there were no parental differences in sleep duration. Results provide preliminary evidence for an association between child sleep problems and parental daytime sleepiness, which may, in turn, extend previous research linking young children's sleep problems and parental functioning. Implications for treatment of both children and adults with sleep problems are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep patterns and sleep disruptions in school-age children.

This study assessed the sleep patterns, sleep disruptions, and sleepiness of school-age children. Sleep patterns of 140 children (72 boys and 68 girls; 2nd-, 4th-, and 6th-grade students) were evaluated with activity monitors (actigraphs). In addition, the children and their parents completed complementary sleep questionnaires and daily reports. The findings reflected significant age differences, indicating that older children have more delayed sleep onset times and increased reported daytime sleepiness. Girls were found to spend more time in sleep and to have an increased percentage of motionless sleep. Fragmented sleep was found in 18% of the children. No age differences were found in any of the sleep quality measures. Scores on objective sleep measures were associated with subjective reports of sleepiness. Family stress, parental age, and parental education were related to the child's sleep–wake measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

基于一维卷积神经网络的儿童睡眠分期

高质量睡眠与儿童的身体发育、认知功能、学习和注意力密切相关,由于儿童睡眠障碍的早期症状不明显,需要进行长期监测,因此急需找到一种适用于儿童睡眠监测,且能够提前预防和诊断此类疾病的方法。多导睡眠图(Polysomnography,PSG)是临床指南推荐的睡眠障碍基本检测方法,通过观察PSG各睡眠期间的变化和规律,对睡眠质量评估和睡眠障碍识别具有基础作用。本文对儿童睡眠分期进行了研究,利用多导睡眠图记录的单通道脑电信号,在Alexnet的基础上,用一维卷积代替二维卷积,提出一种1D-CNN结构,由5个卷积层、3个池化层和3个全连接层组成,并在1D-CNN中添加了批量归一化层（Batch normalization layer）,保持卷积核的大小保持不变。针对数据集少的情况,采用了重叠的方法对数据集进行了扩充。实验结果表明,该模型儿童睡眠分期的准确率为84.3%。通过北京市儿童医院的PSG数据获得的归一化混淆矩阵,可以看出,Wake、N2、N3和REM期睡眠的分类性能很好。对于N1期睡眠,存在将N1期睡眠被误分类为Wake、N2和REM期睡眠的情况,因此以后的工作应重点提升N1期睡眠的准确性。总体而言,对于基于带有睡眠阶段标记的单通道EEG的自动睡眠分期,本文提出的1D-CNN模型可以实现针对于儿童的自动睡眠分期。在未来的工作中,仍需要研究开发更适合于儿童的睡眠分期策略,在更大数据量的基础上进行实验。      

Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures?

STUDY OBJECTIVES: This study provides estimates of reliability for aggregated values from 1 to 7 recording nights for five commonly used actigraphic measures of sleep patterns, reliability as a function of night type (weeknight or weekend night), and stability of measures over several months. DESIGN AND SETTING: Data are from three studies that obtained 7 nights of actigraph data (using Mini Motionlogger actigraphs and associated validated algorithms [ASA]) on children and adolescents living at home on self-selected sleep-wake schedules. PARTICIPANTS: Participants were 169 children aged 12-60 months, and 55 adolescents aged 11-16 years. MEASUREMENTS AND RESULTS: Up to 28% of weekly recordings may be unacceptable for analysis in young participants because of illness, technical problems, and participant noncompliance; studies aiming to collect 5 nights of actigraph data should record for at least 1 full week. Reliability estimates for values aggregated over any 5 nights were adequate (> or = .70) for sleep start time, wake minutes, and sleep efficiency. Measures of sleep minutes and sleep period were less reliable and may require 7 or more nights for estimates of stable individual differences. Reliability for 1- or 2-night aggregates were poor for all measures. We found significant and high correlations between summer and fall session measures for all five variables when weekend nights were included. CONCLUSIONS: Five or more nights of usable recordings are required to obtain reliable actigraph measures of sleep for children and adolescents.     

Effects of antipsychotic treatment on polysomnographic measures in schizophrenia: a replication and extension

OBJECTIVE: The authors sought to replicate and extend previous observations of improvement in some EEG sleep measures during the course of antipsychotic treatment in schizophrenia patients. METHOD: Fourteen medication-free patients with schizophrenia underwent 2 nights of sleep EEG monitoring before and after 3-4 weeks of treatment with clinically determined doses of haloperidol or thiothixene. RESULTS: Measures of sleep continuity improved consistently. REM latency increased, although five of 14 patients continued to exhibit short REM latencies (less than 60 minutes). Stage 3 sleep increased during neuroleptic treatment, while stage 4 sleep did not change. CONCLUSIONS: These data demonstrate partial improvement of some but not all EEG sleep measures in schizophrenic patients through the course of neuroleptic treatment. They suggest that shortened REM latency and disturbed sleep continuity might represent reversible state abnormalities, while reduced slow-wave sleep may represent a more persistent trait abnormality in schizophrenia.