bluuebunny/crossref_metadata_2025_split huggingface dataset:
0485 Verbal Hostility Moderates Parental and Child Sleep Onset Latency in Children with Autism Spectrum Disorder
Authors: Stearns Melanie , Sparrow Emilie , Nair Neetu , Mazurek Micah , Curtis Ashley , Beversdorf David , Sohl Kristin , Davis Beth Ellen , Takahashi Nicole , McCrae Christina 
Published: May 2022

Abstract

Introduction
Research indicates parent and child sleep onset latency (SOL) are positively correlated. In addition, parents who have difficulty sleeping may be more tired and report using negative parenting behaviors, such as verbal hostility. Experiencing verbal hostility may increase child anxiety and make it harder for them to fall asleep. Given that up to 80% of children with ASD experience sleep problems, it is important to understand potential relations among sleep and parenting behavior in this population. The current study examined whether verbal hostility moderated the relationship between parent and child SOL.

Methods
The sample (N=56) consisted of parents (90% female) reporting on their children aged 6-12 (M=8.63, SD = 2.00; 77% male) who expressed interest in a study exploring behavioral treatments for sleep. All children were diagnosed with ASD and had parent reported sleep complaints (e.g., difficulty falling asleep, waking up in the night). Baseline data were examined in the current analyses. Measures included an average of parent and child SOL on daily sleep diaries over 14 days of baseline. Verbal hostility was measured using the verbal hostility subscale on the Parenting Styles and Dimensions Questionnaire – Short Version. Covariates included child and parent age.

Results
Moderation analyses were conducted using SPSS PROCESS. Parent and child SOL were significantly correlated (r(55)=.28, p=.04). Parent nor child SOL were correlated with verbal hostility. The interaction between parent SOL and verbal hostility t (1, 55) = 5.34, p = .02 was significantly associated with child SOL, such that higher levels of verbal hostility exacerbated the association between greater parent and child SOL.

Conclusion
These results suggest that the association between parent and child SOL depends in part on the level of verbal hostility a parent uses to discipline their child with ASD. Future research should utilize longitudinal and experimental methodology to determine the causality of these relationships. In addition, teaching positive parenting techniques to parents of children with ASD may be an important component to behavioral sleep treatment so that both child sleep and disciplinary strategies are targeted.

Support (If Any)
United States Department of Defense USAMRAA Autism Research Program (McCrae, PI; CTA W81XWH2010399).
0494 The Associations Between Insomnia Symptoms and Emotional Regulation Among Typically Developing Adolescents during the COVID-19 Pandemic
Authors: Scholes Samantha , Somerville Gail , Saha Sujata , Tobia Jessica , Piccireli Mikaela , Barnard Sophia , Patel Krupali , Gruber Reut 
Published: May 2022

Abstract

Introduction
A high prevalence of sleep disturbances was observed in adolescents during the coronavirus disease (COVID-19) pandemic. This has been interpreted as being related to disruptions in daily routines and social life caused by pandemic-related societal restrictions. Although the COVID-19 pandemic interrupted the routines of all adolescents, not all adolescents developed insomnia in response to pandemic-related changes. A reduced ability to regulate negative emotions is associated with a higher risk of developing insomnia, yet it is not known if it is associated with higher levels of insomnia in adolescents. Cognitive reappraisal, which consists of changing the way one thinks about potentially emotion-inducing events, is effective in downregulating negative emotion. Expressive suppression, which is changing the way one behaviorally responds to emotion-eliciting events, can decrease a positive emotional experience but does not alter the experience of negative emotion. The objective of this study was to examine the associations between insomnia symptoms in typically developing adolescents during the COVID-19 pandemic and the tendency to use cognitive reappraisal or expressive suppression to regulate emotions. It was hypothesized that high levels of insomnia symptoms among adolescents during the COVID-19 pandemic would be associated with more frequent use of expressive suppression and less frequent use of cognitive reappraisal when regulating emotions.

Methods
49 adolescents aged 11-16 (M= 13.43, SD= 1.67) participated in the study during the first wave of the COVID-19 pandemic in Canada (May 15 to June 30, 2020). The Insomnia Severity Index (ISI) was used to assess the severity of nighttime and daytime components of insomnia. The Emotion Regulation Questionnaire was used to assess respondents' tendencies to regulate their emotions using cognitive reappraisal or expressive suppression.

Results
Higher ISI total scores were significantly associated with lower reappraisal scores on the Emotion Regulation Questionnaire.

Conclusion
A higher level of insomnia symptoms among typically developing adolescents during the COVID-19 pandemic was associated with less frequent use of emotional regulation strategy that is effective in downregulating negative emotion. Limitations: Given the cross-sectional design of the study, it is not possible to determine causality.

Support (If Any)
CIHR 418638 to Reut GruberRGPIN-2015-04467 to Reut Gruber
0506 Clinical efficacy of intravenous ferric carboxymaltose for restless legs symptoms and low serum ferritin in children with autism spectrum disorder
Authors: DelRosso Lourdes , Cho Yeilim , Ferri Raffaele , Krell Melissa , Reuter-Yuill Lilith , Mogavero Maria , Picchietti Daniel 
Published: May 2022

Abstract

Introduction
Restless legs syndrome (RLS) may be underdiagnosed in children with autism spectrum disorder (ASD) due to difficulty expressing the symptoms in their own words. In addition, administration of oral iron may be particularly difficult in ASD children.

Methods
Retrospective case series of children with ASD, restless legs (RL) symptoms, and serum ferritin &lt;30 μg/L treated with intravenous (IV) ferric carboxymaltose (FCM). Patients received a single dose of IV FCM, 15 mg/kg if weighting &lt;50 kg or 750 mg if weighting &gt;50 kg. Data collected included presenting symptoms, serum ferritin, iron profile, and Clinical Global Impression Scale (CGI-Severity pre-infusion and CGI-Improvement post-infusion).

Results
Nineteen subjects, 4-11 years old (12 male, median age 6, interquartile range (IQR) were included. Thirteen children took melatonin, median dose 3 mg (IQR 1-6). Full RLS diagnostic criteria were identified in 6 verbal children (31.6%). RL symptoms in the 13 other children occurred at night and began or worsened during periods of rest or inactivity and included: need for a parent to rub or massage legs (5), fidgeting (2), wiggling (2), kicking (2), pacing (1), and discomfort (1), but improvement of symptoms with movement was difficult to determine. Baseline median values were ferritin 10 µg/L (IQR 10-16), iron 66.5 μg/dL (IQR 57-96), TIBC 382 μg/dL (IQR 360-411) and transferrin 19 mg/dL (IQR 14-28). Median CGI-S was 4 (moderate symptoms) (IQR 3-4). After IV FCM all measures improved and were statistically significant at the Wilcoxon test for paired datasets. Median ferritin was 68 µg/L (IQR 62.5-109, p&lt;0.00045). The median CGI-I was 1 (very much improved) (IQR 1-2). All children meeting full RLS criteria improved. Three children in the RL symptom group did not improve. Children meeting the full RLS criteria had lower baseline ferritin levels than those with a suspected diagnosis (9 µg/L, IQR 9-10 vs. 13 µg/L, IQR 10-16, Mann-Whitney test p&lt;0.045).

Conclusion
The majority of children (84.2%) with ASD and RL symptoms had clinical improvement after IV FCM. All serum iron parameters improved significantly after a single IV infusion.

Support (If Any)
None
0507 Prevalence and Components of Naptime vs. Bedtime Routines in Young Children
Authors: Mindell Jodi , Leichman Erin , Rotella Katie 
Published: May 2022

Abstract

Introduction
Bedtime routines are a well-established sleep-promoting practice for young children; however, little is known about the prevalence or components of naptime routines. Thus, the aim of this study was to explore the prevalence and activities (e.g., feeding, hygiene components) of home-based naptime routines for infants and toddlers.

Methods
Mothers of 465 infants and toddlers (4-36mos; M=18.5mos) completed an online questionnaire addressing questions about naptime routines and behaviors, as well as the Brief Infant Sleep Questionnaire–Revised (BISQ-R). The sample included infants (4-11.9m; n=147), younger 1-year-olds (12-17.9m; n=87), older 1-year-olds (18-23.9m; n=75), and 2-year-olds (24-36m; n=156).

Results
Overall, 95% (n=440) reported that their child naps at home, and 65% (n=301) indicated having a naptime routine lasting approximately half an hour (M=29.0 minutes; SD=31.0). As compared to 54% reporting a consistent naptime routine (³5 times per week), ranging from 50% in 2yos to 62% in younger-1yos, 81% had a consistent bedtime routine. Overall, mothers reported a mean 69.0% (SD=24.4) similarity between naptime and bedtime routine steps. A bath (18% at naptime vs. 90% at bedtime), washing-up (30% vs. 56%), lotion use (23% vs. 80%), breastfeeding/breastmilk (21% vs. 37%), and feeding to sleep (44.% vs. 47%) were less prevalent at naptime than bedtime.Prevalence ranges by age group were: bath 12% (2yos) to 23% (infants) at naptime and 84% (infants) to 93% (2yos) at bedtime; washing-up, 28% (infants) to 34% (older-1yos) at naptime and 54% (younger-1yos) to 58% (infants) at bedtime; lotion application, 19% (2yos) to 29% (younger-1yos) at naptime and 78% (2yos) to 83% (younger-1yos) at bedtime; breastfeeding, 8% (2yos) to 35% (infants) at naptime and 13% (2yos) to 65% (infants) at bedtime; and feeding to sleep, 31% (2yos) to 57% (infants) at naptime and 35% (2yos) to 58% (infants) at bedtime.

Conclusion
Overall, nearly all infants and toddlers napped, and just over half reported having a naptime routine. Naptime routines were much less prevalent than bedtime routines, but overall contained similar activities. Feeding behaviors across naptime and bedtime routines were more similar than hygiene components (e.g., bath), with slight variation by age. Psychoeducation about a naptime routine’s potential benefit may be warranted.

Support (If Any)
Johnson & Johnson Consumer Inc., Skillman, NJ, USA
0512 Concurrent and longitudinal linkages between bedtime routines and social-emotional development in toddlers
Authors: Lam Joey , Heere Megan , Williamson Ariel , Mindell Jodi 
Published: May 2022

Abstract

Introduction
Sleep is important for optimal development in early childhood. Instituting a consistent bedtime routine is an empirically supported behavioral intervention to promote early childhood sleep health. However, prior work has focused on the benefits of a bedtime routine for sleep outcomes, with little research on its potential benefits to social-emotional development. Thus, the current study examined concurrent and longitudinal associations between a consistent bedtime routine (defined as 5 or more nights per week) and social-emotional development in toddlers (ages 12.0 to 19.9 months).

Methods
Caregivers of 32 infants (M = 12.5mos, 59.4% female) completed baseline questionnaires about the frequency of their child’s bedtime routine and other evening activities at their scheduled 12-month well-child visit. At their child’s 15-month well visit, caregivers completed questionnaires including items on bedtime routine frequency, the communication and personal-social subscales of the Ages and Stages Questionnaire (ASQ), and the Brief Infant-Toddler Social and Emotional Assessment (BITSEA).

Results
Over half (59.4%) of caregivers reported a consistent child bedtime routine at 12 months and nearly three quarters (71.9%) reported a consistent bedtime routine at 15 months. Linear regression showed that having a consistent bedtime routine at 15 months was significantly associated with fewer concurrent social-emotional problems on the BITSEA, B = -2.40, p = .009, 95% CI [-3.86, -.94]. Toddlers who scored above the BITSEA cutoff for social-emotional concerns (31.3%) were engaged in a consistent bedtime routine less frequently (M = 4.50 nights/week) than those below the cutoff (M = 6.18 nights/week), p = .004, η2 = .24. However, bedtime routine frequency at 12 months did not predict 15-month BITSEA concerns, p&gt;.05. No associations emerged between bedtime routine frequency at 12 or 15 months and the communication and personal-social ASQ scores.

Conclusion
A consistent bedtime routine is concurrently, but not longitudinally, associated with positive social-emotional development, including less frequent clinically significant concerns, in toddlers at 15 months of age. Bedtime routine frequency was not linked to communication or personal-social interactions. Implementing a consistent bedtime routine may be a feasible method to promote toddlers’ social-emotional development within the context of concerns.

Support (If Any)
This study was partially funded by the Simms/Mann Institute
0513 Sleep in Children in Need of a Bed and Living in Poverty
Authors: Carson Mikalya , Lamanna Erin , Dunnewald Majalisa , Fay Kate , Kyck Fiona , Mindell Jodi , Williamson Ariel 
Published: May 2022

Abstract

Introduction
Healthy sleep is important for child development, with youth living in poverty and especially those who do not have a bed at greater risk for sleep issues. This study assessed sleep in school-aged children identified by social services as needing a bed and living in poverty.

Methods
Fifty-two families (100% living ≤ 100% of the US poverty line) of children ages 8-12 years (M= 9.65; 55.8% girls; 61.5% non-Latinx Black) referred to a non-profit bed provision program completed Patient-Reported Outcomes Measurement Information System (PROMIS) measures of child sleep disturbances, sleep-related impairment, and sleep practices prior to bed provision. Comparisons were made to normative data for each measure based on converted T-scores/means.

Results
T-scores (M = 50; SD = 10) for caregiver and child reported child sleep disturbances (M= 46.81 and 47.22, respectively) and sleep-related impairment (M= 56.82 and 53.33, respectively) fell within the normal range. Although few caregiver-child dyads reported clinically significant (&gt; 1 SD above the mean) child sleep disturbances (7.7% and 10.8%, respectively), 30.7% of caregivers and 27.4% of children reported clinically significant child sleep impairment scores compared to an expected rate of 15.9% from normative data. Regarding sleep practices, few caregiver (11.5%) and child (9.8%) reports of problematic sleep timing and caregiver-rated child bedtime routine inconsistency (13.5%) were &gt; 1 SD above the normative mean. However, 25.5% of youth reported inconsistent bedtime routine scores &gt; 1 SD above the normative mean, while 25.0% of caregivers and 31.4% of youth reported scores &gt; 1 SD above the normative mean for child difficulty falling asleep without caregiver presence at bedtime. The prevalence of these elevated scores were greater than the expected prevalence of 15.9% in normative data.

Conclusion
Overall, children living in poverty and without an individual bed score similar to normative samples on sleep measures. However, a greater proportion of youth in this sample showed clinically significant sleep impairments and poor sleep practices compared to normative data. Future studies are needed to understand and promote healthy sleep among youth living in poverty.

Support (If Any)
American Academy of Sleep Medicine Foundation
0532 Defining Sleep Architecture in Pediatric Patients with Prader Willi Syndrome
Authors: Patel Neha , Lew Jenny , Nino Gustavo , Weiss Miriam , Aziz Julia 
Published: May 2022

Abstract

Introduction
Prader Willi Syndrome (PWS) is a rare genetic disorder characterized by infantile hypotonia, hyperphagia leading to early childhood obesity, and short stature. PWS patients are at risk for multiple sleep abnormalities including increased risk of obstructive sleep apnea, central sleep apnea, and excessive daytime sleepiness. The limited studies reviewing PSGs in pediatric PWS patients showed varying results. Our study aim is to characterize sleep characteristics in pediatric patients with PWS.

Methods
We conducted a retrospective chart review of pediatric patients with a genetically confirmed diagnosis of Prader Willi Syndrome from 2007 to 2015. In lab polysomnograms were scored using the AASM criteria for pediatric sleep studies. Data was collected on sleep architecture parameters and compared to normative data available for pediatric polysomnography. Given large variability in sleep architecture during infancy, subjects were divided into two age groups (&lt; 1 years old, 1-19 years old).

Results
Fifty-one PSGs were reviewed of which 31 (60.7%) belong to males and 20 (39.3%) belong to females. Forty-one PSGs were initial studies and 11 were repeat studies. Age at the time of sleep study ranged from 11 days to 19 years old. 8 (15%) subjects were less than 1 years old and 44 (84%) were 1 year and older. For subjects less than one year old, mean sleep onset latency (min) was 21±33.4, REM onset latency (min) 35±27.2, SWS(%) 43.3±10.2, REM(%) 35.3±7.35, arousal index 9.7±11.9, wake after sleep onset (WASO) (min) 59.5±11.4 and sleep efficiency 82.4±9.4. For the 1-19 year age group, mean sleep onset latency (min) was 24.5±23.1, REM onset latency (min) 104± 59.9, SWS (%) 21.4±7.11, REM (%) 21.3±6.9, arousal index 7.3±5.4, WASO (min) 46.5±36.10 and sleep efficiency was 85.7±9.0.

Conclusion
In our population of PWS patients, REM onset latency was not decreased as shown in previous studies. Sleep efficiency was decreased. Other sleep parameters fell within normal range. Additional data on signs of excessive daytime sleepiness and sleep disordered breathing in this population is needed to understand if EDS persists with decreased sleep efficiency and otherwise normal sleep parameters and/or with OSA.

Support (If Any)
0541 Auto PAP adherence determinants of children during the pandemic: A single center experience
Authors: Rao Harish , Harrison Jessica , Slaven James , Bandyopadhyay Anuja , Jalou Hasnaa 
Published: May 2022

Abstract

Introduction
Obstructive sleep apnea (OSA) is characterized by episodes of partial or complete upper airway obstruction, associated with gas exchange abnormalities, and sleep disruption resulting in OSA syndrome. OSA in majority of children improves after adenotonsillectomy, but with comorbidities or severe OSA, there is a high risk of residual OSA. Positive airway pressure (PAP) is a more definitive therapy for residual OSA when well tolerated. Reported CPAP adherence in children varies from 11-78%, but data on AutoPAP (APAP) acceptability and adherence has not been described.

Methods
Due to the limitations placed on PAP titration during the SARS-COV-2 pandemic, children (range 2-18 years) diagnosed with OSA at our institution were placed on APAP therapy (Auto CPAP or Auto BiPAP). We performed a retrospective analysis of APAP download data of children who met the criteria (adherence at 90 days&gt;4 hours). Adherent (usage&gt;70%) and non-adherent children were compared using Wilcoxon rank sum test. Logistic regression analyses were performed the effect of covariates including age, PSG AHI, Day 1-7 usage, Day 1-7 residual AHI, Day 1-14 usage, Day 1-14 residual AHI, Day 1-30 usage, Day 1-30 residual AHI or mean pressure at 90 day on compliance at 90 days.

Results
On day 90, 73 out of 90 children (40 boys) were using APAP &gt;4 hours. Age, diagnostic PSG AHI, residual AHI (days 1-7; 1-14, 1-30), APAP median pressure, pressure (95% centile), and pressure (maximum) had no effect on adherence. Adherence at days (1-7; 1-14; 1-30) and day 1-90 residual AHI had a positive effect on adherence at day 90. There was no statistically significant difference in BMI z-score, age, PSG AHI, median pressure between the two groups. However, residual AHI was lower in the compliant group.

Conclusion
APAP was fairly well accepted in our study with the majority of children with usage &gt; 4 hours at day 90. Adherence on (days 1-7 and 1-30) predicted APAP usage at day 90. This mirrors adherence data from adult OSA patients. APAP was effective in the compliant group with lower residual AHI. Further analysis of adherence characteristics such as; family history of PAP, PAP mode, mask, surgery and comorbidities is planned.

Support (If Any)
0562 Associations of Insomnia Symptoms and Unhealthy Alcohol Use with Post-Operative Healthcare Utilization in Veterans Undergoing Decompressive Laminectomy for Lumbar Spinal Stenosis
Authors: Tighe Caitlan , Bachrach Rachel , Perera Subashan , Weiner Debra 
Published: May 2022

Abstract

Introduction
Lumbar spinal stenosis (LSS) affects 11-39% of adults and contributes to significant pain and disability. Decompressive laminectomy (DL) is a common surgical intervention for LSS but many with medical and psychosocial comorbidities may not improve. Insomnia and unhealthy alcohol use, for example, are common among people living with chronic pain and may affect key laminectomy outcomes, such as healthcare utilization rates. We examined associations of self-reported rates of post-DL healthcare utilization in Veterans with insomnia symptoms and alcohol use.

Methods
We analyzed data from a multi-site prospective cohort study of Veterans with LSS undergoing DL. Participants (N=200) self-reported prior 12-month alcohol use behavior (Short Michigan Alcohol Screening Test; SMAST) and prior two-week insomnia symptoms (Insomnia Severity Index; ISI) prior to surgery; 12-months of post DL healthcare office visits, ER visits, hospitalizations, and mental health visits were reported over the telephone monthly. Negative binomial regression models via incident rate ratios (IRR) compared healthcare utilization rates between individuals reporting alcohol-related problems only (SMAST &gt;2), insomnia symptoms only (ISI ≥ 8), and both to those reporting neither.

Results
Approximately 52% of participants reported insomnia symptoms, 75% unhealthy alcohol use, and 39% both. Rates of office, ER, and hospital visits were descriptively highest in those reporting insomnia only; mental health visits were highest in those with both insomnia and unhealthy alcohol use. Those with insomnia only had more ER (IRR=2.39, p=.04) and mental health visits (IRR=4.32, p=.03) than those with neither insomnia nor unhealthy alcohol use; individuals with both insomnia and unhealthy alcohol use also had more mental health visits (IRR=4.22, p=.01). Adjusting for covariates rendered IRRs attenuated and statistically nonsignificant, but magnitudes remained high.

Conclusion
Most Veterans with LSS reported insomnia symptoms and/or unhealthy alcohol use. Those with insomnia symptoms reported the highest rates of healthcare utilization, including higher rates of ER and mental health visits. Insomnia symptoms may contribute to post-operative healthcare utilization, lending support for assessment and intervention of sleep-related problems pre-laminectomy.

Support (If Any)
This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, grant # RX000798. Dr. Tighe is supported by Career Development/Capacity Building Award Number IK2 RX003393 from the United States (U.S.) Department of Veterans Affairs Rehabilitation R&D (Rehab RD) Service. Dr. Bachrach is supported by a U.S. Department of Veterans Affairs Health Services Research and Development Service (HSR&D) Career Development Award (CDA 20-057).