bluuebunny/crossref_metadata_2025_split huggingface dataset:
0819 Cultural Adaptation and Preliminary Efficacy Testing of a Sleep Intervention (SIESTA) for Urban Latino Children
Authors: Koinis-Mitchell Daphne , Yeo Anna , Boergers Julie , Chavez Ligia , Canino Glorisa 
Published: April 2024

Abstract

Introduction
Latino children living in urban areas face disproportionate exposure to contextual and cultural stressors that can challenge optimal sleep. School Intervention to Enhance Latino Students’ Time Asleep (SIESTA) is a tailored intervention to improve sleep hygiene and duration in Latino middle school students in the U.S. and Puerto Rico.

Methods
Using Barrera and colleagues’ five stages of cultural adaptation, we identified intervention elements to retain, set refinement goals, and gathered information (literature review, focus groups/interviews, school feedback). Stage 2 involved expert review and integrating information from Stage 1. Stage 3 included an open trial to assess the content and acceptability of the adaptation. Stage 4 involved integration of feedback from the open trial. In Stage 5 (pilot RCT), Latino children (ages 11-13, n=34) and their caregivers were recruited from urban middle schools in Greater Providence and San Juan. Children were randomized to the SIESTA or control condition. SIESTA participants received a virtual group intervention (four sessions about sleep hygiene, duration, environment) and two caregiver-child sessions (sleep environment assessment, goal setting, feedback from daily sleep monitoring). Control participants received basic sleep and health education (equivalent contact time). All participants completed baseline, end-of-treatment (EOT), and 4-month follow-up assessments.

Results
We identified themes about sleep values and beliefs, urban stressors disrupting sleep (e.g., noise, crowding), and barriers to engagement. Each component was tailored based on experiences relevant to many urban Latino families. SIESTA participants reported high acceptability. Sleep duration measured via actigraphy increased by 13.3% (M=45min; d=0.16) in SIESTA participants vs. 7.2% (M=25min; d=0.14) in controls from baseline to EOT, p=.04. Differences were greater at 4-months (15% increase in SIESTA, 1% in controls). Caregiver- and child-reported sleep disturbances significantly decreased from baseline to EOT and to follow-up for SIESTA vs. controls (p’s&lt;.04). Caregiver- and child-reported sleep hygiene improved significantly for SIESTA vs. controls from baseline to EOT and to follow-up (p’s&lt;.05).

Conclusion
A rigorous, multi-method approach allowed for tailoring of an innovative intervention to address the sleep needs of urban Latino children. SIESTA shows potential to improve sleep duration and hygiene in this population. A large-scale RCT will evaluate effectiveness and implementation.

Support (if any)
1R34HL135073
0823 Associations Between Parental Anxiety, Psychological Distress, and Infant Sleep Difficulties
Authors: Narcisse Marie-Rachelle , Sharkey Katherine , Mason Gina , Barker David 
Published: April 2024

Abstract

Introduction
Insufficient sleep in infancy is linked with deleterious health outcomes, encompassing compromised brain development, learning, mental functioning, and emotional states. Whether parents' emotional symptoms influence infant sleep has not been examined at the national level comprehensively. To explore this question observationally, we investigated associations between parental emotional symptoms and disturbances in infant sleep patterns.

Methods
This study utilized data from the National Health Interview Survey encompassing 447 mothers and 304 fathers and their infants (0-1 year; n=751) to examine associations among maternal and paternal anxiety, psychological distress, and infant sleep disturbances. Parents used the Baby Pediatric Symptom Checklist to report their infant sleep symptoms (troubles falling asleep: "Is it hard to put your child to sleep?” and staying asleep: "Does your child have trouble staying asleep?", with responses “not at all” (N), “somewhat” (S), “very much” (V). Predictors included maternal and paternal anxiety levels, gauged by frequency of feelings of worry, nervousness, or anxiety. Psychological distress was measured using the Kessler-6 scale. Multi-group generalized structural equation modeling was employed. Covariates were: age, sex, race/ethnicity (parent/infant), marital status, education, employment, nativity, poverty level, number of children and adults in household, and chronic health conditions (parent).

Results
Endorsement rates for trouble falling asleep were: N=79.6%, S=17.6%, and V=3.4%, and for trouble staying asleep: N=84.5%, S=13.4%, and V=2.1%. Compared with mothers who never experienced anxiety, mothers who reported anxiety a few times a year or weekly were 3.0 and 4.0 times as likely to report their infant having trouble falling asleep. Mothers experiencing anxiety a few times a year, monthly, or weekly, were 3.5, 5.0, and 5.2 times as likely to report their infant having trouble staying asleep. These associations were not evident among fathers. No associations were identified between maternal or paternal psychological distress and difficulties in infant sleep initiation or maintenance.

Conclusion
Results from this study align with previous clinical research showing differential associations between infant sleep and maternal and paternal mental health symptoms. Future work is needed to better understand why these differences exist in anxiety and to elucidate why psychological distress was not linked with infant sleep.

Support (if any)
COBRE Award P20GM139743
0827 Sleep-related Impairment and Cognitive Function Among Hispanic and Non-Hispanic Children in Rhode Island
Authors: Romero-Ramos Yaideliz , Acevedo Aliana Rodriguez , Katz Abby , Evans Gabrielle , Johnson Azia , Kemball-Cook William , Maxwell Zoe , Nwanaji-Enwerem Ugoji , Story Diane , Ury Brooke , Yang Jue , Cheol-Shin Jong , Barker David , McGeary John , Dunsiger Shira , Grigsby-Toussaint Diana 
Published: April 2024

Abstract

Introduction
Racially minoritized groups disproportionately experience poor sleep health profiles that increase the risk of long-term cognitive decline. Notably, disparities in sleep health are observed in childhood, where unfavorable sleep-wake patterns have been linked to cognitive impairments such as deficits in memory and attention. Nonetheless, limited studies exist examining sleep-related impairment on cognitive function among racially minoritized children in the United States. We aim to explore the association between sleep-related impairment (e.g., perception of waking alertness, sleepiness, and function) and cognitive function among a diverse sample of Rhode Island children.

Methods
A sample of elementary school children in grades 1-3 was taken from the ongoing Project Greenspace, Sleep, and Mental Health (G-SPACE) study in Rhode Island. Sleep-related impairment and cognitive function were assessed using PROMIS® Parent Proxy Scales. Multiple linear regression models were used to estimate associations between sleep-related impairment and cognitive function in the aggregate sample and then stratified by ethnicity (i.e., Hispanic and non-Hispanic) while controlling for actigraphy-derived sleep duration, age, gender, and income.

Results
The final sample (N=76) included 43 (57%) non-Hispanic and 33 (43%) Hispanic children. Seventy-four percent of the non-Hispanic children identified as White. Girls accounted for 60% (N=46) of the sample, with 26 (34%) and 20 (26%) being non-Hispanic and Hispanic females, respectively. The mean ages were 7.58 (SD=1.03) and 7.66 (SD=0.89) for non-Hispanic and Hispanic children. Adjusted analysis showed a negative association between sleep-related impairment and cognitive function in non-Hispanic children (β= - 0.52, 95% CI= -0.84, -0.21, p&lt; 0.01), but no significant association was found in the Hispanic subgroup (β= - 0.06, 95% CI= -0.60, -0.47, p= 0.82).

Conclusion
Our findings suggest a negative relationship between sleep-related impairment and cognitive function among non-Hispanic children. However, no significant association was observed among Hispanics, suggesting ethnicity may serve as a moderator of the association between sleep-related impairment and cognitive performance. Limitations include a small sample size and less diversity in the Hispanic subgroup. Future analyses will include a larger and more diverse sample size and other factors, including sleep-related breathing disorders, and access to greenspace.

Support (if any)
Project G-SPACE is supported by the NIH/NIMHD (R01MD016241) and NIGMS 5P20GM139743.
0830 Polysomnography Differences in Children with and Without Hypertension in the Absence of OSA
Authors: Rani Seema , Cohen Alexandra , Martinez Diana , Exarchakis Alyssa , Harper Christine , Strang Abigail , Baker-Smith Carissa , Chidekel Aaron 
Published: April 2024

Abstract

Introduction
There is growing evidence linking hypertension and sleep disturbances in adults, even in the absence of OSA. Even though hypertension is associated with OSA in children, there is a lack of data on influence of the non-respiratory parameters of sleep on hypertension. The objective of this study is to compare respiratory and non-respiratory sleep parameters in children with and without hypertension, among those without OSA based on PSG.

Methods
IRB approved retrospective chart review of patients ages 8-17 years, who underwent PSG at Nemours Children’s Hospital, DE, between January 2020 and May 2023. Data was collected on demographics, anthropometrics, comorbid medical conditions, and PSG findings from EMR. Hypertension was defined as an average systolic (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for gender, age, and height based on AAP Clinical Practice Guidelines. An average of 5 BP measurements from clinic visits within year prior to the date of the PSG were analyzed. Height percentiles were calculated using CDC guidelines. Descriptive and comparative statistics were performed to compare PSG findings between non-hypertensive and hypertensive youth.

Results
We collected data on 228 children. The cohort (n=228) was split into non-OSA and OSA groups based on PSG results. Among the non-OSA group (n=108), 22 individuals were categorized as hypertensive (20.3%). Mean age was 11.4 years and mean BMI z-score was 2.7 (1.83) among the hypertensive group and 12.6 years and 1.12 (2.04) respectively among the non-hypertensive group, with a significant difference in BMI z-score (p&lt; 0.001). Respiratory and non-respiratory sleep parameters were similar, except average heart rate during sleep was significantly higher in the hypertensive group; 79.3 BPM (±11.34) vs 70.9 BPM (±10.07) for the non-hypertensive group (p = 0.002).

Conclusion
In children without OSA, there were no observed differences in respiratory or non-respiratory parameters between the hypertensive and non-hypertensive groups. Children in hypertensive group had a significantly higher BMI Z-score and average heart rate during sleep. This may suggest that obesity and sympathetic activation are important in the pathogenesis of pediatric hypertension even in the absence of detectable sleep disorders. Future studies with larger cohorts are necessary to further explore these relationships.

Support (if any)
0831 Grand Connections: Inter- and Intraindividual Sleep Between Grandparents Raising Grandchildren and Grandchildren
Authors: Stearns Melanie , McGovney Kevin , Meltzer Lisa , McHale James , Littlewood Kerry , Szalacha Laura , McCrae Christina 
Published: April 2024

Abstract

Introduction
Grandparents raising grandchildren (GRG) report greater global sleep problems and sleep disturbances than non-caregiving grandparents. Moreover, 70% of grandchildren being raised by their grandparents sleep shorter or longer than recommended. However, no studies examined the daily relationship (intraindividual) or average (interindividual) relationship between GRG/grandchild sleep. We examined daily and average GRG and grandchild sleep associations.

Methods
Co-residing GRG (N=24, Mage=58.41, 66.7% female; 63% primary grandchild caregiver) completed daily sleep diaries for themselves/their grandchildren (Mage=8.19, 33.4% female). Grandparent/grandchild variables included sleep onset latency-SOL, wake after sleep onset-WASO, and total sleep time-TST. Multi-level models (Rv4.2.2) examined grandchild and grandparent sleep associations, controlling for grandparent and grandchild age.

Results
Daily grandchild sleep was positively associated with daily grandparent sleep for SOL (t(276)=5.75, p&lt;.001), WASO (t(276)=7.71, p&lt;.001), and TST (t(276)=5.68, p&lt;.001). Daily grandparent sleep was positively associated with daily grandchild sleep for SOL (t(276)=5.74, p&lt;.001), WASO (t(276)=7.71, p&lt;.001), and TST (t(276)=5.68, p&lt;.001). Average grandchild sleep was positively associated with average grandparent sleep for SOL (t(23)=2.31, p=.030) and WASO, (t(23)=8.31, p&lt;.001). Average grandparent sleep was positively associated with average grandchild sleep for SOL (t(23)=2.36, p=.027) and WASO (t(23)=8.26, p&lt;.001).

Conclusion
Analyses suggest a bidirectional relationship between GRG and grandchild sleep. Because over half of all GRGs coparent children with one or more family members, family-level analyses may help clarify sleep associations. Given that grandparents in this study reported on both their own and the child's sleep, longitudinal/multi-method studies are needed to determine causality. It remains to be determined whether improving grandchild sleep may improve grandparent sleep (and vice versa), or if dyadic intervention is needed.

Support (if any)
Sleep Research Society Small Research Grant (Stearns, PI)
0832 Hypertension in Pediatric Patients Without Obstructive Sleep Apnea (OSA)
Authors: Exarchakis Alyssa , Cohen Alexandra , Harper Christine M , Strang Abigail , Chidekel Aaron , Baker-Smith Carissa , Rani Seema , Martinez Diana 
Published: April 2024

Abstract

Introduction
Studies show that sleep disturbances are associated with adult hypertension. The relationship between OSA and hypertension has been extensively studied, however, is understudied in pediatric patients without OSA. The aim of this study was to identify socioeconomic factors, social determinants, and medical co-morbidities associated with hypertension in pediatric patients without OSA based on polysomnography (PSG).

Methods
IRB-approved retrospective chart review of patients who underwent PSG at Nemours Children's Hospital, DE between January 2020 and July 2023. Eligibility criteria included children 8-17 years, completed PSG, and office visit blood pressure (BP) recordings. Anthropometrics, demographics, and socioeconomic, social determinants, and medical history obtained from EMR. Those without OSA based on PSG were divided into hypertensive and non-hypertensive groups. Hypertension was defined as the average (5 BP measurements from clinic visits within a year from PSG) systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) that is ≥95th percentile for gender, age, and height based on AAP Clinical Practice Guidelines. Height percentiles were calculated using CDC guidelines. Descriptive and comparative statistics were performed to compare the two groups. Data is reported as mean ± SD, non-hypertensive vs. hypertensive. Frequency of categorical data is reported in parentheses for the hypertensive group.

Results
Of the 228 patients, 108 did not meet criteria for OSA based on AHI&gt;2 and were excluded from the analysis (47.3%). Of the 108 without OSA, 22 were hypertensive (20.3%). All 22 had SBP ≥95th percentile; two had both SBP and DBP ≥95th percentile. Significant differences between hypertensives and non-hypertensives were in race (p=0.037, higher frequency of blacks), parents in household (p=0.042, lower frequency in those with both parents in the household), diabetes (p= 0.047, higher frequency of type 2 diabetes), and mental illness (p=0.027, higher frequency of autism and mood disorders). Daytime HR (96.2 ±12.4 vs 87.1±12.2, p=0.003), and BMI (2.7± 2.0 vs 1.1±1.8, (p&lt; 0.001) were both significantly higher in the hypertensive group.

Conclusion
In pediatric patients without OSA, there are multiple factors and co-morbidities associated with hypertension. Future larger studies are necessary to establish these associations and relationships in non-OSA patients.

Support (if any)
0833 Identifying Clinical Determinants of Obstructive Sleep Apnea in Children with Sickle Cell Disease
Authors: Larrain Diana , Jon Cindy , Ahlstrom Katie , Yadav Aravind 
Published: April 2024

Abstract

Introduction
Children with sickle cell disease (SCD) are at increased risk for obstructive sleep apnea (OSA). Guidelines recommend screening for OSA in this population based on clinical assessment. Several aspects of OSA in children with SCD remain poorly understood, such as clinical characteristics and the optimal approach for screening. Although polysomnography (PSG) proves valuable for diagnosing individuals who exhibit signs and symptoms of OSA, its cost-effectiveness as a screening tool for asymptomatic children with SCD remains uncertain. There is a need for an effective clinical screening approach for OSA in this population. The objective is to compare the clinical characteristics of children with SCD who had OSA (AHI &gt;1) against those who did not on PSG.

Methods
All SCD patients aged 2 to 18 between March 2016 to May 2023 attending the Comprehensive Sickle Cell Center who underwent PSG were retrospectively compared with sleep apnea symptoms during clinic visits. Symptoms criteria were retrieved from clinical encounters for snoring, apnea, mouth breathing, gasping, enuresis in children older than ten, morning headache, hyperactivity, daytime sleepiness, and daytime naps.

Results
From 180 children with SCD who attended the clinic, 56 patients (31.1%) had a PSG performed, whereby 37.5% (n=21) were diagnosed with OSA, and 62.5% (n=35) did not have OSA. In children with OSA, 80.9% (n=17) reported snoring, 23% (n=5) mouth breathing, and 4.7% (n=1) witnessed apnea. From the group without OSA, 40% (n=14) had no symptoms, 42% (n=14) reported snoring, 20% (n=7) mouth breathing, 17.1% (n=6) reported taking naps, 14.2% (n=5) gasping. Despite being the most frequent symptom to occur in those with and without OSA, habitual snoring was significantly higher in the OSA group (p= 0.02). Conversely, in the absence of symptoms, patients were unlikely to have OSA (p=0.003).

Conclusion
In children with SCD, the absence of symptoms suggests OSA is not present; therefore, PSG may not be warranted. However, the presence of habitual snoring may be an indicator for OSA requiring PSG confirmation.

Support (if any)
0836 Similarities and Differences in Maternal and Paternal Bed-sharing Beliefs in Mexican American Couples with Toddlers
Authors: Munoz-Gauna Anthony , Meltzer Lisa , Fineman Melissa , Gallegos Maria Flores , Martinez Suzanna , Ringwood Haley , Tschann Jeanne , Williamson Ariel , Thompson Darcy 
Published: April 2024

Abstract

Introduction
Room-sharing, but not bed-sharing is recommended for safe sleep, and pediatric behavioral sleep interventions commonly recommend a separate child sleep space, even when room-sharing. However, bed-sharing is more common globally and across cultural groups than in U.S.-based non-Latino White families. Further, most research has focused on maternal beliefs about bed-sharing, with little consideration of paternal beliefs. This exploratory study describes similarities and differences in maternal and paternal beliefs about bed-sharing in Mexican American couples with toddlers.

Methods
Fourteen Mexican American couples (mothers [27-41 years, mean education 12.8 + 3.7 years] and fathers [27-45 years, mean education 11.1 + 3.4 years]) with toddlers (78.6% boys; 12-15 months) completed the 17-item Bed-sharing Beliefs measure in Spanish (50%) or English. Half of families reported bed-sharing with their toddler. Although data collection is ongoing, we describe dyadic concordance (dyads both agree or disagree) or discordance (one person agrees, the other disagrees) in the current sample.

Results
The most dyadic concordant responses were parent sleep/privacy items: “bed-sharing interferes with the parents privacy” (100% concordance: 93% agree), “bed-sharing makes the parents sleep poorly” (86% concordance: 64% agree), and “bed-sharing helps the parent sleep well” (79% concordance, 36% agree). Teaching the child to sleep independently items also had strong dyadic concordant responses: “bed-sharing makes the transition to their own bed harder” (79% concordance, 64% agree), “bed-sharing makes it harder for the child to sleep on their own” (79% concordance, 64% agree), and “bed-sharing makes the child dependent on the parent to sleep” (77% concordance, 62% agree). The greatest dyadic discordant responses were related to the child’s sleep quality: 62% discordance for both “bed-sharing keeps the child from sleeping comfortably” and “bed-sharing interferes with the child’s sleep.” No differences between bed-sharing and non-bedsharing dyads were found.

Conclusion
Early findings from our ongoing study of sleep beliefs in Mexican American families with toddlers suggest greater parental concordance about the impact of bed-sharing on parental privacy/sleep and toddlers learning to sleep independently, with discordant beliefs about the impact of bed-sharing on child sleep quality. Further exploration of dyadic parental beliefs about bed-sharing and the relationship with sleep location is needed in a larger sample.

Support (if any)
R01HL163859