bluuebunny/crossref_metadata_2025_split huggingface dataset:
0910 Prevalence And Risk Factors Of Obstructive Sleep Apnea Syndrome In 3-14 Yearsold Children In Beijing: A Cross-sectional Surveyabstract
Authors: Wei W 
Published: May 2020

Abstract

Introduction
To explore the prevalence and risk factors of obstructive sleep apnea syndrome (OSAS) in 3-14 years old children in Beijing.

Methods
A cross-sectional study of random stratified cluster sampling was conducted on 3-14 years old children and adolescents in Beijing. The preliminary screening was completed through Pediatric Sleep Questionnaire (PSQ) investigation and the diagnosis of OSAS was conducted by polysomnography.

Results
After random sampling, a total of 11 kindergartens, 7 primary schools and 8 junior high schools from 7 districts of Beijing were involved in the survey. A total of 11420 questionnaires were sent out, and 10743 (94.07%) were recovered. The final effective data were 9198 (effective response rate 85.62%). The age of the investigated children was 8.8±3.8 years. PSQ positive rate was 8.86% (95CI 8.28-9.44%). With diagnostic criteria AHI≥5, the estimated prevalence of OSAS in Beijing children was 5.90% (95%CI 3.72-8.28%); with ICSD-3 diagnostic criteria (OAHI&gt;1), the estimated prevalence was 8.08% (95% CI 5.74-10.62%). Overweight (OR=3.13), frequent allergic rhinitis (OR=6.80) and family snoring history (OR=6.14) were important risk factors for children’s OSAS.

Conclusion
PSQ was used in Beijing children’s OSAS epidemiological survey with good reliability and validity. The positive rate of the PSQ screening was 8.86% (95CI 8.28-9.44%);the estimated prevalence of OSAS in children aged 3-14 years in Beijing was 5.90% (95%CI 3.72-8.28%) with criteria AHI≥5 and 8.08% (95%CI 5.74-10.62%) with criteria OAHI&gt;1, respectively. Gender, BMI, history of ENT and family history of snoring were important risk factors for children’s OSAS.

Support
This work was supported by Beijing Municipal Science and Technology Project grant (Z161100000116050 and Z161100003216212) and Beijing Municipal Administration of Hospitals Clinical Technology Innovation Project grant (XMLX201701).
0921 Insomnia in Adolescents: Patient-Centered Outcomes and Perspectives
Authors: Honaker S M , Simon S L , Byars K C , Graef D M , Williamson A A , Meltzer L 
Published: May 2020

Abstract

Introduction
An estimated 25-40% of adolescents endorse symptoms of insomnia. While research has demonstrated that insomnia is associated with impaired functioning, little is known regarding which insomnia symptoms or outcomes are most burdensome for adolescents. Patient-centered outcomes (PCO) are clinical and research questions and outcomes that are meaningful to patients. This study is the first to evaluate PCOs in adolescents with insomnia.

Methods
We conducted an online survey of adolescents in the USA, UK, Canada, Australia, and New Zealand who were 13 - 18 years old and reported experiencing one or more insomnia symptoms. Participants were recruited using targeted advertising on Facebook. Participants reported on insomnia symptom severity, frequency, and duration, help-seeking behavior, areas of insomnia-related impairment, and research priorities.

Results
Of the N=3034 respondents, 99.3% (n=3014) met inclusion criteria. Participants were predominantly female (77.0%) and white non-Hispanic (70.8%), with a mean age of 16.1 years (SD=1.3). Most (87.5%) met DSM-V diagnostic criteria for insomnia, yet only 29.3% reported seeking professional help. Over half (52.1%) reported a symptom duration of three or more years. Insomnia symptoms reported were sleep initiation difficulties (94.4%), sleep fragmentation (65.3%), premature awakening (54.5%), and difficulty sleeping independently (22.3%). The most burdensome areas of insomnia-related impairment were reported to be mood (72.2%), attentional focus (61.0%), pain (49.7%), worry (46.3%) and sleepiness (38.7%). Adolescents with insomnia most frequently endorsed the following research priorities: causes of insomnia (66.4%), early detection (66.1%), public education about sleep (49.1%) and non-pharmacological treatments (48.3%).

Conclusion
Adolescents with insomnia report significant insomnia-related distress and impairment, with symptoms often persisting for three or more years. However, adolescents with insomnia often do not seek professional help. Areas perceived as most problematic to adolescents living with insomnia (e.g., mood, focus, pain) should be considered as important outcomes for insomnia researchers.

Support
This publication was made possible with support from Grant Number UL1TR002529 (A Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award and the Indiana University School of Medicine.
0924 Adolescent Perceptions of Insomnia Treatment
Authors: Simon S L , Meltzer L J , Williamson A A , Graef D M , Byars K C , Honaker S M 
Published: May 2020

Abstract

Introduction
Approximately 10% of adolescents meet diagnostic criteria for insomnia, which is associated with increased health problems, academic difficulties, and psychological morbidity. Empirical evidence supports cognitive-behavioral treatments for insomnia, yet research suggests adolescent insomnia is undertreated. Thus, the goal of this study was to evaluate adolescent perceptions about insomnia treatment seeking and strategies.

Methods
Adolescents ages 13-18 years with self-reported insomnia symptoms completed an online survey assessing treatment-seeking behaviors and management strategies. English-speaking participants were recruited using targeted Facebook advertising. Descriptive statistics were used to summarize results.

Results
Of the 3,014 survey respondents, participants were predominantly female (77%) and white non-Hispanic (71%), with a mean age of 16±1.3 years. Most (87%) met DSM-V diagnostic criteria for insomnia, but only 29% reported seeking professional help for insomnia. Of these, participants reported waiting an average of 1-2 years after symptom onset to seek treatment. Participants most often sought help from a mental health professional (18%) or primary care provider (13%), while &lt;2% saw a sleep specialist. Across adolescents, the most commonly endorsed strategies to manage insomnia symptoms were daytime caffeine consumption (48%), staying out of bed except when trying to sleep (38%), and daily exercise (28%). Nearly half of participants endorsed currently using medications to help with sleep, most commonly melatonin (18%) and antihistamine-based sleep aids (10%). Participants reported greatest preference to take medication (64%), meet individually with a sleep specialist (48%), or use a phone or tablet application (40%) to help with sleep. While 30% of participants felt that sleep researchers should prioritize increasing access to insomnia treatment, 20% encouraged developing new modes for treatment delivery (e.g., online).

Conclusion
Adolescents with insomnia reported using behavioral and pharmacological strategies to help with sleep, with very few receiving treatment from a sleep specialist. Further research is needed to increase accessibility and acceptability of interventions for adolescent insomnia.

Support
N/A
0952 Parent-Child Perceptions About Healthy Sleep Promotion in a Mobile Health Sleep Extension Intervention
Authors: Mitchell J A , Eck C , Hickey J , Huffnagle N , Fiks A G , Zemel B S , Dinges D F , Williamson A A 
Published: May 2020

Abstract

Introduction
Over half of school-aged children sleep insufficiently and sleep promoting interventions are urgently needed. To effectively promote pediatric sleep health, it is critical to obtain feedback from youth and their families about acceptable intervention strategies. This qualitative study examined perceptions about healthy sleep promotion in parent-child dyads participating in a mobile health sleep extension intervention.

Methods
A total of 26 parent-child dyads (child mean age 11 years, SD = 0.67; 46% non-Latinx White; 19% Black) participated in a mobile intervention to extend child sleep duration over 11 weeks (2-week baseline; 7-week intervention; 2-week follow-up). Participants wore a FitBit during the study, were provided with a sleep duration goal, and received general sleep health-promoting electronic messages using the University of Pennsylvania’s Way to Health platform. Following the intervention, parents and their children separately completed a semi-structured telephone interview to capture perceptions of the intervention strategies. Three coders developed a codebook using an inductive approach to identify emergent themes and conducted coding in NVivo.

Results
Emergent themes fell into domains of intervention acceptability/feasibility and barriers. Mobile messaging about the child’s sleep duration goal was well-received, although child participants in particular desired more personalized messaging, with sleep promotion targeted to their specific sleep habits. Parents and children both discussed ancillary benefits to intervention participation, including an enhanced focus on sleep. Barriers to sleep extension during the intervention and maintenance of any gains post-intervention were related to: competing child academic, social, and extracurricular demands; family factors (work schedules; family rules and norms); and the challenges of limiting ubiquitous electronic devices.

Conclusion
Despite high parent-child acceptability of a mobile child sleep extension intervention, individual and contextual barriers may limit long-term adherence. Tailoring healthy sleep messages to target these factors could improve sustained benefits to child sleep.

Support
Sleep Research Society Foundation and K23HD094905 (AAW); NIH/NCATS UL1TR001878 (JAM and DFD) and K01HL123612 (JAM).
0955 Does Primary Caregiver Influence Sleep in Preschoolers? Evidence from a Large-Scale Longitudinal Study in China
Authors: Li W , Wang G , Zhang Y , Zhao J , Jiang F 
Published: May 2020

Abstract

Introduction
The aim of the study is to characterize sleep disturbances and sleep patterns in preschoolers, and to examine the potential role of primary caregivers and particularly its transition on children’s sleep in a large-scale cohort study in China.

Methods
A representative sample of 20324 newly enrolled preschoolers(age 3-4 years) were recruited in Shanghai,China at 2016.11. Sleep disturbances were examined at 3 timepoints from age 3-4 years to 5-6 years by the Children’s Sleep Habits Questionnaire(CSHQ). Data on bedtime, onset time and offset time were included, along with primary caregivers derived from each follow-up. Prevalence and trend estimates of sleep disturbances and sleep patterns were presented. Multivariable logistic regression and propensity score-adjusted models for sleep disturbances at wave3 on different caregiving models were analysed adjusting for demographics, socioeconomic status, family characteristics, maternal mental health and CSHQ total score at baseline.

Results
Prevalence of global sleep disturbances (CSHQ total score&gt;41) steadily fell from 84.2% to 73.8%. Specifically, behavioral sleep problem domains of “Bedtime besistance”and “Sleep anxiety” decreased from 66.4% to 47.3% and 53.4% to 37.8%, respectively. Meanwhile, Bedtime gradually delayed from 21:04(SD=0:37) to 21:20(SD=0:33) while offset time changed slightly from 7:13(SD=0:29) to 7:17(SD=0:27). Compared with counterparts in western countries, children slept for a shorter nocturnal sleep duration (NSD) with 9.51(SD=0.57) hours at wave1, 9.42(SD=0.57) hours at wave2 and 9.42(SD=0.52) hours at wave3. Different caregiving models were independently associated with sleep disturbances at wave3. Taking “Predominant parental care” as reference, “Predominant grandparental care” and “Transition from parental to grandparental care” were associated with higher odds of sleep disturbances (OR=1.32, 95% CI [1.17, 1.48], p&lt;0.001 and OR=1.25, 95% CI [1.03, 1.52], p=0.020, respectively). While “Transition from grandparental to parental care” has no significant effect(OR=1.04, 95%CI [0.94, 1.15], p=0.436).

Conclusion
Grandparental care is associated with increased risk of sleep disturbances among preschoolers in China. Parenting and Grandparenting factors should be considered when assessing and treating sleep disturbances and optimizeing sleep health in preschoolers.

Support
Supported by the Chinese National Natural Science Foundation of China (81773443, 81728017, 81728017); Ministry of Science and Technology (2016YFC1305203); Shanghai Science and Technology Commission (17XD1402800, 18695840200, 2018SHZDZX05, 18JC1420305);
0965 The Association Between Liquid Consumption and Sleep Patterns in School Children
Authors: Raine P , Wang J , Pitt S 
Published: May 2020

Abstract

Introduction
Liquid consumption is essential for daily function and may also play a role in sleep regulation. The aim of this study was to assess 1) the association between the frequency of liquid consumption and sleep patterns; and 2) the different types of liquids on the association between liquid consumption and sleep.

Methods
Participants included 597 children ages 9-13 years old from the China Jintan Child Cohort Study. To assess child liquid intake, children self-reported the types of liquids consumed and the frequency these liquids were consumed. To assess sleep patterns, both parents and children reported sleep patterns using the parent-reported Child Sleep Habit Questionnaire (CSHQ) and a child self-reported questionnaire. Descriptive statistics and independent sample t-tests analyses were performed to examine the differential effects of liquid consumption frequency and sleeping habits.

Results
Overall, a slight dose-dependent relationship between liquid consumption and sleep quality was observed. Less sleep problems and improved sleep quality were observed for water (bedtime resistance, sleep anxiety, night awakenings, parasomnias, sleep-disordered breathing, daytime sleepiness; p&lt;0.05) and milk (parasomnias, sleep-disordered breathing, p&lt;0.05) consumption. Caffeinated soda tended to increase sleep problems (sleep-disordered breathing, p&lt;0.05). Sleep onset delay had a different pattern from that of other subscales, in which water increased sleep problems and caffeinated soda decreased sleep problems. There was some discrepancy between parent- and self-reported parasomnias, but sleep disordered breathing showed consistent patterns.

Conclusion
Children who consumed more liquid, especially water and milk, were more likely to experience less sleep problems. However, caffeinated soda consumption may be linked to increased sleep problems. Findings suggest that school children may need consume more healthy liquids for better sleep patterns. Future randomized-controlled trial studies are needed to verify these findings.

Support
This study was funded by the National Institutes of Environmental Health Sciences and the National Institutes of Health (R01-ES-018858, K02-ES-019878, and K01-ES015877).
0966 Sleep-Wake Patterns in Mothers and Children in a Rural Community With Limited Access to Electricity: Results from the Ghana Randomized Air Pollution and Health Study
Authors: Kundel V , Darko P , Taweesedt P , Parekh A , Ayappa I , Lee A , Darby J , Kaali S , Asante K 
Published: May 2020

Abstract

Introduction
Studies measuring objective sleep duration in rural/indigenous populations are limited, showing sleep duration similar to that of industrialized countries. Little is known about sleep duration in women of reproductive age, and children within these populations. Our study is the first to objectively characterize sleep in mothers and children in an agrarian community with limited access to electricity, utilizing data from the Ghana Randomized Air Pollution and Heath Study (GRAPHS).

Methods
The GRAPHS cohort, a cluster-randomized trial, evaluated the efficacy of clean fuels on birthweight and infant pneumonia incidence in central Ghana. The study initially recruited pregnant women and newborns in 2013. This study is now utilizing wrist-actigraphy to analyze sleep-wake patterns among mothers and children of GRAPHS. We have thus far analyzed actigraphy in 39 mothers and 49 children (including 25 mother-child pairs), using the Motionlogger-MicroWatch with the Cole-Kripke algorithm to assess total sleep time (TST). We report baseline characteristics and sleep-wake patterns of our sample.

Results
Mean age of mothers was 33.5 years, (range 22-48), and mean age of children was 3.9 years (3-4). Average nights recorded were 4 (standard deviation [SD] 2.1). For mothers, average median time-in-bed was 7.9 (SD 1.2) hours, TST was 6.4 (SD .9) hours, and sleep efficiency was 82% (SD 7.9). Median bedtime was 9:33pm (SD 1.5 hours), and median wake-time was 5:56am (SD 1.4 hours). For children, average median time-in-bed was 9.9 (SD 1.0) hours, TST was 8.2 (SD 0.9) hours, and sleep efficiency was 83% (SD 6). Median bedtime was 8:03pm (SD 0.8 hours), and median wake-time was 6:06am (SD 0.6 hours). There was no correlation between sleep measures in mother-child pairs.

Conclusion
In an agrarian Ghanaian community with limited access to electricity, objective sleep measures in women were similar to prior studies conducted in indigenous/rural populations of developing African countries (Ndiaye et.al.2007, Samson et.al.2016), though data in children is lacking for comparison. When compared with post-industrialized countries, objective sleep measures for this age group of non-gravid women are sparse. In toddlers however, TST was lower in our cohort when compared with objective sleep amongst toddlers in industrialized nations.

Support
2K24HL109156-06A1
0999 Predictors Of Natural Resolution Of Behavioral Sleep Problems In Early Childhood
Authors: Garrison M M 
Published: May 2020

Abstract

Introduction
Primary care providers are often unsure which patients require treatment for behavioral sleep problems of early childhood vs. which are likely to improve without intervention. Given limited treatment resources as well as the time and cost burden that intervention can pose for families, it may be helpful to identify the predictors of children whose behavioral sleep problems are likely to resolve -- and stay resolved -- without active intervention.

Methods
Here, we use the control arm of a randomized trial of 2.5 to 5 year-old community-recruited children with behavioral sleep problems to examine the natural history of behavioral sleep problems and the predictors of resolution. Of 217 families in the control arm, 146 had inadequate mean sleep duration at baseline (&lt; 10.5 hours/night per diary) and were eligible for inclusion in the analysis. Data were drawn from sleep diaries and parent report surveys conducted at baseline, 3 and 12 months. Improvement was defined as increased duration by either at least 60 min from baseline or by 30 min to at least 10.5 hours/night. We conducted an exploratory logistic regression to identify predictors of natural resolution.

Results
Of the 146 eligible families, 130 had follow-up data at both 3 and 12 months and were included in this analysis. Of those 130, only 22 (17%) had substantially improved sleep by 3 months follow-up, and 10 of these continued to have improved sleep duration at 12 months. The strongest predictors of natural improvement both at 3 and 12 months were female child sex, having either infant or school-aged siblings, CBQ low-intensity pleasure score (i.e., children who tend to respond positively to cuddling, reading, and other gentle activities), mean duration of sleep onset latency per diary, parent-reported parasomnias on the CSHQ, and age under 4 years.

Conclusion
These findings suggest that contrary to common beliefs of both primary care providers and parents, relatively few children will experience a clinically meaningful improvement in sleep duration without intervention.

Support
This work is supported by a grant from the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD): 5R01HD071937.
Estimating daytime sleepiness with previous night electroencephalography, electrooculography, and electromyography spectrograms in patients with suspected sleep apnea using a convolutional neural network
Authors: Nikkonen Sami , Korkalainen Henri , Kainulainen Samu , Myllymaa Sami , Leino Akseli , Kalevo Laura , Oksenberg Arie , Leppänen Timo , Töyräs Juha 
Published: May 2020

AbstractA common symptom of obstructive sleep apnea (OSA) is excessive daytime sleepiness (EDS). The gold standard test for EDS is the multiple sleep latency test (MSLT). However, due to its high cost, MSLT is not routinely conducted for OSA patients and EDS is instead evaluated using sleep questionnaires. This is problematic however, since sleep questionnaires are subjective and correlate poorly with the MSLT. Therefore, new objective tools are needed for reliable evaluation of EDS. The aim of this study was to test our hypothesis that EDS can be estimated with neural network analysis of previous night polysomnographic signals. We trained a convolutional neural network (CNN) classifier using electroencephalography, electrooculography, and chin electromyography signals from 2,014 patients with suspected OSA. The CNN was trained to classify the patients into four sleepiness categories based on their mean sleep latency (MSL); severe (MSL &lt; 5min), moderate (5 ≤ MSL &lt; 10), mild (10 ≤ MSL &lt; 15), and normal (MSL ≥ 15). The CNN classified patients to the four sleepiness categories with an overall accuracy of 60.6% and Cohen’s kappa value of 0.464. In two-group classification scheme with sleepy (MSL &lt; 10 min) and non-sleepy (MSL ≥ 10) patients, the CNN achieved an accuracy of 77.2%, with sensitivity of 76.5%, and specificity of 77.9%. Our results show that previous night’s polysomnographic signals can be used for objective estimation of EDS with at least moderate accuracy. Since the diagnosis of OSA is currently confirmed by polysomnography, the classifier could be used simultaneously to get an objective estimate of the daytime sleepiness with minimal extra workload.
Lymphovenous Anastomosis for Morbidly Obese Patients with Lymphedema
Authors: Yoshida Shuhei , Koshima Isao , Imai Hirofumi , Uchiki Toshio , Sasaki Ayano , Fujioka Yumio , Nagamatsu Shogo , Yokota Kazunori , Yamashita Shuji 
Published: May 2020

Background:
Although patients with obesity-induced lymphedema can be treated by weight loss therapy, they find it difficult to lose the required amount of weight. The aims of this study were to clarify the characteristics of the lymphatic vessels in patients with obesity-induced lymphedema and to determine the feasibility and efficacy of lymphovenous anastomosis (LVA) in these patients.

Methods:
Twenty-two patients (44 edematous lower limbs) with a body mass index (BMI) >35 kg/m2 (obese group) and 91 patients with lymphedema (141 edematous lower limbs) and BMI <25 kg/m2 were enrolled as a control group (nonobese group) and underwent LVA. The diameter and depth of lymphatics and the effect of LVA were compared.

Results:
Lymphatics were detectable within 10-mm depth in the nonobese group and the obese group (3.0 ± 1.4 mm versus 3.5 ± 2.1 mm; P < 0.01). The lymphatic diameter was significantly greater in the obese group than in the nonobese group (0.79 ± 0.30 mm versus 0.54 ± 0.22 mm; P < 0.01). There was no significant difference in the rate of improvement in lymphedema after LVA between the nonobese group (9.1% ± 9.2%) and the obese group (8.9% ± 7.3%; P = 0.84). There was no correlation between the improvement rate of lymphedema and that of BMI in the obese group (P = 0.57).

Conclusions:
LVA is a feasible procedure even in morbidly obese patients. Considering that substantial weight loss is a difficult and time-consuming task for patients, LVA combined with not gaining weight is a good option for these patients.