bluuebunny/crossref_metadata_2025_split huggingface dataset:
0488 Trajectories of Insomnia Symptoms since Childhood Associated with Treatment of Internalizing Disorders in Adulthood
Authors: Singh Rupsha , Lenker Kristina , Calhoun Susan , Ricci Anna , Liao Jason , He Fan , Vgontzas Alexandros , Liao Duanping , Bixler Edward , Fernandez-Mendoza Julio 
Published: May 2022

Abstract

Introduction
Internalizing disorders (ID) are the most common form of psychopathology, with a large proportion of individuals seeking treatment in young adulthood. Childhood insomnia symptoms, i.e., difficulties initiating or maintaining sleep (DIMS), have been shown to be associated with ID, however, little is known about the developmental trajectories of insomnia symptoms and their associated risk of receiving pharmacotherapy for ID. The present study examined the longitudinal association between trajectories of childhood insomnia symptoms and risk of receiving treatment for ID in young adulthood.

Methods
We analyzed data from the Penn State Child Cohort, a population-based sample of 505 children (Mdn=9y), who were followed-up 8 years later as adolescents (Mdn=16y) and 15 years later as young adults (Mdn=24y). Insomnia symptoms were defined as parent-reported (childhood) or self-reported (adolescence and young adulthood) moderate-to-severe DIMS. The trajectories of insomnia symptoms across the three time-points were identified as never, remitted, waxing-and-waning, incident and persistent. The presence of ID was defined as a self-report of a diagnosis of mood and/or anxiety disorders, whether they had received treatment or not and whether treatment consisted of prescription psychotropic medication (i.e., antidepressants, anxiolytics). Logistic regression models were adjusted for sex, race/ethnicity, age, and any childhood or adolescent history of a psychiatric diagnosis or psychotropic medication use.

Results
Persistent (OR=3.0) and incident (OR=3.3) trajectories, but not waxing-and-waning (OR=1.1) or remitted (OR=0.8) trajectories, were associated with increased odds of ID that did not receive treatment in adulthood. Additionally, the odds of receiving treatment for ID with prescription psychotropic medication in adulthood were increased in those with persistent (OR=3.4), incident (OR=3.5) and waxing-and-waning (OR=2.1) trajectories, but not in those with a remitted trajectory (OR=0.7).

Conclusion
Childhood-onset persistent insomnia symptoms as well as adult-onset incident insomnia symptoms are strong risk factors for receiving treatment for mood/anxiety disorders in adulthood, while childhood insomnia symptoms that fully remit over time are not. Treatment of insomnia in youth should be an essential target as to decrease the risk of developing severe forms of mood/anxiety disorders requiring psychotropic treatment in adulthood.

Support (If Any)
National Institutes of Health (R01HL136587, R01MH118308, UL1TR000127)
0496 Sleep and Behavior Problems in Children with Overweight and Obesity
Authors: Tsai Shao-Yu , Tung Yi-Ching , Huang Chuen-Min , Lee Chien-Chang 
Published: May 2022

Abstract

Introduction
Limited studies have examined sleep variability in children with overweight and obesity, nor do studies focused on its relation with behavior outcomes in this high risk pediatric population. The purpose of this study was to examine sleep duration and its variability in relation to behavior outcomes in school-age children with overweight and obesity.

Methods
Sleep in 246 children aged 6-9 years with overweight and obesity was assessed using actigraphy for 7 days and through the parent-report Children’s Sleep Habits Questionnaire (CSHQ). Children’s behaviors were assessed using parental responses on the Behavior Assessment for Children. Children were categorized into 4 groups based on the median split of the average daily sleep duration and its variability: sufficient-stable, sufficient-variable, insufficient-stable, and insufficient-variable. General linear model (GLM) analyses were performed with the 4 sleep groups as the primary predictor variable and child behavior outcomes as the dependent variable.

Results
Average daily sleep duration by actigraphy was 7.52 hours, with 84.6% of the children having clinically significant CSHQ sleep disturbance scores and 68.3% having a total behavior problem score in the clinical range. In the unadjusted and adjusted GLM analysis, children in the insufficient-stable sleep duration category had significantly higher emotion problem (p &lt; 0.05), self-control problem (p &lt; 0.01), and total behavior problem scores (p &lt; 0.01) when compared with those in the sufficient-stable sleep duration (reference) category. Children in the insufficient-variable sleep duration category had significantly higher self-control problem scores when compared with those in the reference category (p &lt; 0.05).

Conclusion
School-age children with overweight and obesity coexist with sleep and behavior problems, with those who have persistent short sleep at the greatest risk for the worst behavior outcomes.

Support (If Any)
This work was supported by Ministry of Science and Technology, Taiwan, MOST 107 - 2314 - B - 002 - 025 - MY3.
0499 Sleep and Neurocognition in Adolescents with ADHD: A Polysomnographic Study
Authors: Lunsford-Avery Jessica , Kollins Scott , Jackson Leah , Tominaga-Brown Noyuri , Thalasila Venkata Ramana , Krystal Andrew 
Published: May 2022

Abstract

Introduction
Sleep disturbances are common among adolescents with ADHD; however, few studies have characterized the nature of ADHD-related sleep problems using the gold-standard sleep measure, polysomnography (PSG), in adolescence. Additionally, although similar cognitive deficits are common across ADHD and sleep-disordered populations, the potential role of sleep in contributing to cognitive impairment in adolescent ADHD is unknown. This study investigates differences in PSG-measured sleep among adolescents with ADHD versus healthy controls without psychiatric disorders (HC) and associations with cognition.

Methods
Sixty-two adolescents aged 13-17 (31 ADHD, mean age=15.3, 50% female) completed a psychiatric evaluation and 3 nights of ambulatory PSG. Following the third night, participants completed the Cambridge Neuropsychological Test Automated Battery (CANTAB). Sleep variables were averaged over 3 nights. Linear regressions controlling for age and sex examined group differences in a range of traditional PSG and spectral EEG indices as well as relationships between PSG/spectral indices and cognition (two summary scores derived from CANTAB: response accuracy and response time) within the ADHD group.

Results
Adolescents with ADHD displayed reduced SWS% (F(3,51)=9.67, p=.003), increased N2% (F(3,51)=10.35, p=.002), increased relative sigma (F(3,47)=6.55, p=.01) and beta (F(3,47)=4.10, p&lt;.05) power, and a trend toward reduced relative delta power (F(3,47)=2.95, p=.09) compared to HC. Within the ADHD group, greater REM% (r=.43), reduced N2% (r=-.55), greater relative delta power (r=.52), higher delta power peak (r=.56), steeper delta decline overnight (r=-.56), and reduced relative theta (r=-.53), beta (r=-.74), and gamma (r=-.67) power were associated with better response accuracy (p’s&lt;.05). Greater relative delta (r=-.51), and reduced relative theta (r=.55) and beta (r=.63), power were associated with faster response times.

Conclusion
Although adolescents with ADHD did not differ from HC on traditional PSG measures (TST, WASO), they exhibited abnormalities in sleep stage distribution and non-REM EEG frequency spectral indices, including reduced SWS and low frequency power and increased stage 2 sleep and high frequency power overnight. Notably, similar parameters were associated with impaired cognition, suggesting sleep may contribute to cognitive deficits in ADHD. Future studies may clarify whether sleep plays a causal role in cognitive impairments in adolescent ADHD and if sleep treatments result in improved cognition in this population.

Support (If Any)
K23MH108704
0500 Increased adherence to light therapy and psychosocial outcomes in adolescents and young adults with cancer
Authors: MacArthur Erin , Semko Joshua , Kamara Dana , Wang Fang , Pan Haitao , Brigden Jane , Pappo Alberto , Wilson Matthew , Crabtree Valerie 
Published: May 2022

Abstract

Introduction
Adolescent/young adult (AYA) oncology patients consistently report fatigue as one of the most distressing symptoms during treatment. Bright white light (BWL) has been demonstrated to improve the symptoms of cancer-related fatigue in adults, and our prior research demonstrated feasibility, acceptability, and preliminary efficacy of BWL in AYA with cancer. As part of the trial examining the feasibility and acceptability of BWL in AYA, we explored whether adherence affected patient outcomes in the BWL group.

Methods
Twenty-seven participants were randomized to receive BWL using LiteBook® (retrofitted with adherence monitors) for 30 minutes upon waking daily for eight weeks. Study team members met with patients weekly for the duration of the intervention to download adherence data from the monitors, administer questionnaires, and discuss barriers to adherence if necessary. Participants completed mood, quality of life, and fatigue measures at every other research visit (5 times over the duration of the study).

Results
Adherence was characterized by total number of days that participants used the light device while on study. Multivariate regression was used to examine the predictive relationship between adherence and patient outcomes. Adherence significantly predicted parent-reported physical functioning [β=1.45, p= 0.0079], emotional functioning [β=0.87, p=0.0137], and total health-related quality of life [β= 0.76, p= 0.0218]. Adherence did not predict any of the self-reported patient outcomes.

Conclusion
BWL is a promising treatment to improve cancer-related fatigue in AYA, and adherence is essential to treatment success. Although adherence did not predict any participant self-reported outcomes, participants with better adherence had improved parent-reported emotional and physical functioning and overall quality of life. Individually tailored interventions, including sleep hygiene psychoeducation and motivational interviewing, may be used to increase adherence to light therapy to improve patient outcomes. Measures to monitor and foster adherence should be included in future light therapy trials.

Support (If Any)
This research was funded and supported by ALSAC.
0501 Sleep pattern changes two years after participating in the Makos sleep study: The effect of extending total sleep time and weighted blankets on teenage swimmers performance
Authors: Zarrouf Lily 
Published: May 2022

Abstract

Introduction
The initial Makos study was conducted in 2019, studying the effect of extending total sleep time and the use of weighted blankets (ETST+WB) on teenage swimmers’ performance. In it, we found a significant improvement of 100-free style race time in teenage swimmers after ETST+WB. The aim of the current follow-up study is to evaluate the sleep pattern of the same swimmers after 2 years.

Methods
Using an open-label prospective approach, the study investigated swimmer’s event time changes, total sleep time, daytime sleepiness, and other sleep measures after 2 years of the initial changes during the first study. 8 healthy swimmers on the Makos swim team filled follow-up questionnaires and participated in a 100-yard freestyle race. Descriptive statistics, frequency distributions, and correlation using SPSS 14.

Results
Eight (6F; 2M) of the initial nine seasonal teen swimmers participated (age 13-17). Four swimmers reported headaches and one reported sore throat in the morning. Three (37.5%) reported feeling sleepy during the day and 3 reported falling asleep when riding in a car. Two reported leg movements during the night. In two years after the initial study, 100-free race time significantly improved (65.01*5.38 vs 59.32*5.43 p=0.003), but the positive effect of ETST+WB on recorded sleep time was lost and returned to baseline. There was a clear trend, but no significant difference in total sleep time among the 3 groups: (initial 8:45 *0:32; after ETST+WB 9:17*0:32; after 2 years 8:08*0:30).

Conclusion
The improvement of total sleep time with weighted blankets and encouragement during the initial study correlated with improvement of 100 free race time in seasonal teen swimmers. This improvement in total sleep time was lost and returned back to baseline after 2 years follow up.

Support (If Any)
The authors report no financial relationship with any company whose products are mentioned in this manuscript, or with companies of competing products. Participants will be able to keep SKY Grand activity trackers at the end of their participation.
0508 Maternal Perceptions of Naps in Young Children
Authors: Leichman Erin , Rotella Katie , Mindell Jodi 
Published: May 2022

Abstract

Introduction
Sleep in young children affects both family functioning and maternal mental health and well-being. However, little is known about parental perceptions about daytime sleep. Thus, the aims of this study were to determine maternal perceptions of (1) naps overall, and (2) how naps impact child and maternal functioning.

Methods
Mothers of 465 infants and toddlers (4-36mos; M=18.5mos) completed an online questionnaire addressing questions about maternal nap perceptions, as well as the Brief Infant Sleep Questionnaire–Revised (BISQ-R). Global nap perceptions were categorized as positive or negative. Perceived impact on mother and child was also assessed.

Results
Overall, 95% (n=440) reported that their child napped. The majority of mothers agreed that naps were important (98.2%). Over one third (38.9%) wanted to change something about their child’s naps and 28% reported that naps are a problem. Furthermore, the majority of mothers believed that naps were an important part of their child’s day (94.6%), and that when they nap well their child is in a better mood (97.3%), more easy-going (95.7%), has fewer tantrums (88.7%), and is a better listener (84.4%, toddlers). Fewer mothers reported that their child’s nap is frustrating (21.8%) or are more trouble than they are worth (4.1%). Just under half wished their child fell asleep faster/easier for naps (49.0%), and one third wished they napped longer (35.5%).Finally, the majority of mothers believe that their child’s naps are an important part of their own day (94.1%), improve their own mood (87.1%) and make them feel more calm (89.9%). When their children nap, mothers can nap themselves (51.0%), get more done in the house (91.5%), get more work done (87.4%), spend more time with others (77.9%), and spend more time doing things for themselves (79.5%).

Conclusion
Overall, the vast majority of mothers believe that their child’s naps are important for their child, as well as for themselves. However, one third report that their child’s nap is problematic, almost one half want to change something (e.g., that their child fell asleep faster/more easily and napped longer). Future studies are needed focusing on interventions for daytime sleep issues to improve both child and family functioning.

Support (If Any)
Johnson & Johnson Consumer Inc., Skillman, NJ, USA
0510 Parent and Child Perception of Sleep for Children with Sensory Processing Difficulties
Authors: Hartman Amy , Soehner Adriane , Smagula Stephen , McKendry Sarah , Bendixen Roxanna 
Published: May 2022

Abstract

Introduction
Roughly 5.3 million elementary children in the United States experience sensory processing (SP) difficulties, like sensitivity to touch and overstimulation with movement. These difficulties cause high levels of daytime stress and daytime dysfunction (e.g., difficulties with attention, academics, and emotional regulation). In typically developing children (without SP difficulties), high levels of daytime stress impact sleep; however, research has yet to explore sleep health in children with SP difficulties. Our study aims to use validated self- and parent-reported questionnaires to characterize differences in sleep health for children with and without SP difficulties.

Methods
Children (ages 6-10) with (n=22) and without (n=33) SP difficulties (per parent report; Autism and ADHD diagnosis excluded) were recruited for this convergent mixed-methods study. Sleep was assessed using validated self- and parent-report questionnaires, the Sleep Self-Report (SSR) and Children’s Sleep Habits Questionnaire (CSHQ), and through qualitative interviews with parents. Groups were compared using t-test and Mann-Whitney U tests, with significance set a priori at α=0.05. A rapid qualitative analysis produced themes and were integrated with the quantitative data.

Results
Parents of children with SP report significantly worse sleep quality on the CSHQ difficulties (MedianSP= 50.5, SDSP= 11.45) than parents of children without SP difficulties (MedianCON=43.0, SDCON=7.27, U= -2.92, p=.004). Children with SP deficits also report significantly worse sleep on the SSR (MSPD=42.18, SDSPD=8.26) compared to their peers (MCON=33.55, SDCON=6.71, t(53)= -4.26, p&lt;.001). Qualitative themes highlight the higher prevalence of rigid, lengthy bedtime routines and adaptations within the sleep environment (e.g. specific pajamas, special bedding) to support sleep for children with SP difficulties. Parents of children with SP difficulties also report higher frequencies of an adult being in the room while the child falls asleep and co-sleeping in the middle of the night.

Conclusion
Parents and children both report poorer sleep in children with SP difficulties when compared to peers. Future studies should incorporate other sleep health measurement tools (e.g. actigraphy) to further understand areas to target for intervention.

Support (If Any)
Sensory Integration Education Network PhD Grant (PI: Hartman, 2021); University of Pittsburgh’s School of Health and Rehabilitation Science’s PhD Student Award (PI: Hartman, 2021).
0514 Risk Factors for Symptoms and Signs of Sleep Apnea Impacting Quality of Life in an Urban Pediatric Community-Based Sample
Authors: Gueye-Ndiaye Seyni , Hauptman Marissa , Yu Xinting , Rueschman Michael , Castro-Diehl Olga Cecilia , Owens Judith , Gold Diane , Adamkiewicz Gary , Phipatanakul Wanda , Redline Susan 
Published: May 2022

Abstract

Introduction
Pediatric obstructive sleep apnea (OSA) disproportionately affects children from minority groups and children living in disadvantaged neighborhoods, but the risk factors that drive this risk are not well understood. We investigated the relationship between minority race/ethnicity, household risk factors (smoking, socio-economic status [SES]), and neighborhood disadvantage with OSA-related quality of life (QOL) scores in participants in the Environmental Assessment of Sleep Youth (EASY) observational study.

Methods
Families of children 5-12 years old recruited from largely low-income Boston-area neighborhoods participated in an extensive in-home evaluation of OSA risk factors. OSA-related QOL was assessed with parent-reported OSA-18 questionnaire (values &gt;37 indicative of negative impact of symptoms and signs of OSA on QOL). Secondhand smoking (SHS) was defined by parent-report of smoking in the home. Neighborhood disadvantage was characterized using geocoded addresses, calculating the Neighborhood Socioeconomic (NSES) index. We performed logistic regression with OSA-18 &gt;37 as the dependent variable and age, gender, race/ethnicity, BMI, household smoking, household measures of SES and NSES index as independent variables.

Results
The sample included 256 children (40%-Hispanic ethnicity, 31%-Black, 20%-White, 9%-Other; 56% were female), with a mean age 9.1±1.9 and BMI percentile 69.9±29.8. 33% and 40% of children were from households with income &lt;$25,000 and $25,000-$75,000, respectively, and 10% had SHS exposure. Mean NSES index was 47.9±15.4 (national average of 50). An elevated OSA-18 was reported for 35% of participants and significantly associated with Hispanic ethnicity and smoking exposure (OR=2.16, CI 1.01-4.62 and OR=2.71, CI 1.2-6.3) after adjusting for age, gender, and BMI percentile. Further adjustment for family income attenuated the association of OSA-18 with Hispanic ethnicity, but a significant association with household smoking persisted. NSES index and BMI percentile were not associated with OSA-18.

Conclusion
High symptoms and signs of OSA impacting QOL were associated with Hispanic ethnicity, household smoking and SES in this diverse cohort of children living in urban and predominantly low-income communities. The study points to the need for strategies to reduce household smoking as one strategy for decreasing sleep health disparities, and the further need to understand other factors associated with low SES that increase risk for poor sleep health.

Support (If Any)
NIH-NHLBI/T32HL007901, R35HL1358181, P30ES000002, K24AI106822, R01Hl137192, K23ES031663
0519 Sleep Dysfunction in Rett Syndrome
Authors: Bricker Katelyn , Vaughn Bradley , Roth Heidi , Walker Nathan , Fan Zheng (Jane) 
Published: May 2022

Abstract

Introduction
Rett syndrome (RTT) is an X-linked neurodevelopmental disorder affecting females and is linked to mutations in the methyl-CpG-binding protein 2 (MeCP2) gene. Typical comorbidities in RTT include poor growth, feeding difficulties, hyperventilation and breath-holding, seizures, scoliosis, and disrupted sleep. A few studies indicate sleep disruption in patients with RTT yet there is minimal data on polysomnographic findings in this population. We reviewed our cohort of Rett syndrome patients who underwent polysomnography.

Methods
This retrospective case control of 10 RTT subjects (mean age, 11.19 years; ranged from 1 to 33 years) underwent standard polysomnography (PSG) recording. Subjects were compared to 10 age and gender matched controls with an AHI &lt;5 and no chronic medical problems using a student paired t test. All studies were scored using the AASM criteria.

Results
We found our cohort to have increased N3% sleep, decreased N2%, and shorter sleep onset latency (p&lt; 0.05). Trends of lower BMI, lower oxygen saturation, and shorter REM latency (p &lt; 0.10 but &gt; 0.05). Review of PSGs shows the slow wave have morphological of typical slow waves and not that of the slowing seen on wake EEG nor the epileptiform activity. 4 of the 10 PSGs are notable for frequent interictal epileptiform discharges. 2 of the 10 subjects had a central apnea index &gt;5, 2 had an AHI &gt;5 and 1 demonstrated hypoventilation. There were central apneas associated with hyperventilation during awake and sleep-awake transition.

Conclusion
Our cohort of RTT patients demonstrates differences in sleep architecture, manifested most notably by a high percentage of SWS. This population has high amplitude rhythmic slow (theta) activity on wake EEG, primarily in the frontal-central regions. This slowing was distinct from the epileptiform activity seen in 40% of our cohort. Central apnea also appeared in older patients and the very young. Larger population studies are needed for future research.

Support (If Any)