Help them make it through the night: The behavioural treatment of infant sleep disturbance

1995 ◽  
Vol 20 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Carolyn Lawton ◽  
Neville M. Blampied ◽  
Karyn G. France
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Significant Degree ◽  
Infant Sleep ◽  
Behavioural Treatment ◽  
Onset Delay ◽  
Regular Time ◽  
Clinically Significant ◽  
Night Waking

Sleep disturbances such as bed refusal and resistance, sleep-onset delay, night waking with crying, and unwanted co-sleeping with parents affect 15% to 25% of families during their infant's first two years. A program is described that involves structured pre-bedtime activities, putting the child into his or her own bed awake at a regular time, and responding to subsequent waking and crying with planned ignoring and minimally-arousing checks when necessary. This programme was demonstrated in four families and shown to resolve infant sleep disturbances to a clinically significant degree and to the satisfaction of the parents.

Sleep disturbance and quality of life in Rheumatoid Arthritis: a prospective mobile health study (Preprint)

2021 ◽  
Author(s):  
John McBeth ◽  
William G Dixon ◽  
Susan Mary Moore ◽  
Bruce Hellman ◽  
Ben James ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Sleep Disturbance ◽  
Mobile Health ◽  
Sleep Disturbances ◽  
Total Sleep Time ◽  
Sleep Onset ◽  
Sleep Time ◽  
Domain Scores

BACKGROUND Sleep disturbance and poor health related quality of life (HRQoL) are common in people with rheumatoid arthritis (RA). Sleep disturbances, such as less total sleep time, more waking periods after sleep onset, and higher levels of non-restorative sleep, may be a driver of HRQoL. However, understanding if these sleep disturbances reduce HRQoL has, to date, been challenging due to the need to collect complex time-varying data in high resolution. Such data collection has now been made possible by the widespread availability and use of mobile health (mHealth) technologies. OBJECTIVE In a mobile health (mHealth) study we tested whether sleep disturbance (both absolute values and variability) caused poor HRQoL. METHODS The Quality of life, sleep and rheumatoid arthritis (QUASAR) study was a prospective mHealth study of adults with RA. Participants completed a baseline questionnaire, and for 30 days wore a triaxial accelerometer to objectively assess sleep, and provided daily reports via a smartphone app of sleep (Consensus Sleep Diary (CSD)), pain, fatigue, mood, and other symptoms. Participants completed the World Health Organization Quality of Life-Brief (WHOQoL-BREF) questionnaire every 10 days. Multi-level modelling tested the relationship between sleep variables and WHOQoL-BREF domains (physical, psychological, environment and social). RESULTS Of 268 recruited participants, 254 were included in this analysis. Across all WHOQoL-BREF domains, participant’s scores were lower than the population average. CSD sleep parameters predicted WHOQoL-BREF domain scores. For example, for each hour increase in the total time asleep physical domain scores increased by 1.11 points (β = 1.11 (0.07, 2.15)) and social domain scores increased by 1.65 points. These associations were not explained by sociodemographic and lifestyle factors, disease activity, medication use, levels of anxiety, sleep quality, or clinical sleep disorders. They were, however, attenuated and no longer significant when pain, fatigue and mood were included in the model. Increased variability in the total time asleep, was associated with poorer physical and psychological domain scores independently of all covariates. There were no patterns of association between actigraphy measured sleep and WHOQoL-BREF. CONCLUSIONS Optimising total sleep time, increasing sleep efficiency, decreasing sleep onset latency, and reducing the variability in total sleep time could improve HRQoL in people with RA.

scholarly journals 0275 Exposure to Experimentally Induced Sleep Disturbance Affects the Inflammatory Resolution Pathways in Healthy Humans

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A104-A105
Author(s):  
L C Engert ◽  
M Dubourdeau ◽  
J M Mullington ◽  
M Haack
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Experimental Studies ◽  
Low Grade ◽  
Omega 3 ◽  
Science Center ◽  
Healthy Humans ◽  
Recovery Sleep ◽  
Experimentally Induced

Abstract Introduction Sleep disturbances are assumed to impair health through induction of low-grade systemic inflammation. Experimental studies have shown that such inflammatory upregulation does not normalize even after a couple of nights of recovery sleep. We hypothesized that sleep disturbances do not only affect inflammatory pathways, but also the recently detected inflammatory resolution pathways, which actively terminate inflammation. Mediators of inflammatory resolution mainly derive from omega-3 fatty acids converted to specialized pro-resolving mediators (SPMs), such as resolvins. We investigated SPMs in healthy humans exposed to a novel model of experimental insomnia. Methods Twenty-four individuals (age 18–42 years, 12 women) participated in a study consisting of two 19-day in-hospital protocols (insomnia/control). After three nights of baseline sleep (8h/night, 23:00-07:00), participants in the experimental insomnia condition were exposed to three cycles of three nights of disturbed sleep (delayed sleep-onset, hourly sleep disruption, advanced sleep-offset) followed by one night of 8h-recovery sleep. The protocol ended with three additional nights of recovery sleep. In the control condition, participants had an uninterrupted sleep opportunity (8h/night) across the 19-day protocol. Blood samples were taken at 11:00 at baseline, during experimental insomnia exposure, and after recovery sleep. Several SPMs were measured in plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Data were analyzed using linear mixed models. Results Exposure to experimental insomnia affected several SPMs compared to control sleep, including a decrease of resolvin D4 and E2 concentrations, which was still evident after the third recovery night (p<.05). Conclusion This is the first investigation on the effects of experimentally induced sleep disturbance on inflammatory resolution pathways. The results support that SPMs, particularly resolvin D4 and E2, are decreased by sleep disturbances, and do not normalize after a couple of nights of recovery sleep. Targeting these pathways by pharmacologically increasing SPMs may help to limit inflammatory consequences of sleep disturbances. Support NIH/NINDS R01-NS091177; NIH/National Center for Research Resources UL1-RR02758 and M01-RR01032 to the Harvard Clinical and Translational Science Center.

Anxiety, Obsessive-Compulsive, and Related Disorders

2020 ◽  
pp. 318-336
Author(s):  
Bruce Rohrs ◽  
Benjamen Gangewere ◽  
Alicia Kaplan ◽  
Amit Chopra
Keyword(s):  
Anxiety Disorders ◽  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Onset Latency ◽  
Limited Evidence ◽  
Obsessive Compulsive ◽  
Psychotherapeutic Interventions

Despite its common comorbidity, sleep disturbance is often underrecognized and undertreated in individuals with anxiety disorders. Compared to mood disorders, sleep disturbance in this population is less well studied except for panic disorder and generalized anxiety disorder. Some evidence suggests a bidirectional link between anxiety disorders and sleep disturbance. Polysomnography findings point to some commonalities across anxiety disorders, including longer sleep onset latency, reduced total sleep time, and reduced sleep efficiency. The underlying biological mechanisms linking anxiety disorders and sleep disturbance are still unclear. However, there is limited evidence suggesting a connection between impaired executive functioning due to sleep problems and failure to inhibit anxiety related thoughts and feelings. Cortisol irregularities and disruption in the serotonergic system may also play a role. Evidence suggests that anxiety sensitivity is a transdiagnostic factor that contributes to both anxiety disorders and sleep disturbance. Further research is warranted to elucidate common biological and psychological factors underlying sleep disturbances and anxiety disorders. There is an imminent need to systematically assess the impact of sleep disturbance on symptom severity and treatment outcomes in anxiety, obsessive-compulsive, and related disorders. Limited evidence is available for medications and targeted psychotherapeutic interventions for management of sleep disturbance thus warranting the development of robust sleep interventions to achieve optimal clinical outcomes in this patient population.

scholarly journals Basal Ganglia Local Field Potentials as a Potential Biomarker for Sleep Disturbance in Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexander J. Baumgartner ◽  
Clete A. Kushida ◽  
Michael O. Summers ◽  
Drew S. Kern ◽  
Aviva Abosch ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Sleep Disturbance ◽  
Local Field ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Local Field Potentials ◽  
Motor Symptoms ◽  
Field Potentials ◽  
Potential Biomarker ◽  
Non Motor Symptoms

Sleep disturbances, specifically decreases in total sleep time and sleep efficiency as well as increased sleep onset latency and wakefulness after sleep onset, are highly prevalent in patients with Parkinson's disease (PD). Impairment of sleep significantly and adversely impacts several comorbidities in this patient population, including cognition, mood, and quality of life. Sleep disturbances and other non-motor symptoms of PD have come to the fore as the effectiveness of advanced therapies such as deep brain stimulation (DBS) optimally manage the motor symptoms. Although some studies have suggested that DBS provides benefit for sleep disturbances in PD, the mechanisms by which this might occur, as well as the optimal stimulation parameters for treating sleep dysfunction, remain unknown. In patients treated with DBS, electrophysiologic recording from the stimulating electrode, in the form of local field potentials (LFPs), has led to the identification of several findings associated with both motor and non-motor symptoms including sleep. For example, beta frequency (13–30 Hz) oscillations are associated with worsened bradykinesia while awake and decrease during non-rapid eye movement sleep. LFP investigation of sleep has largely focused on the subthalamic nucleus (STN), though corresponding oscillatory activity has been found in the globus pallidus internus (GPi) and thalamus as well. LFPs are increasingly being recognized as a potential biomarker for sleep states in PD, which may allow for closed-loop optimization of DBS parameters to treat sleep disturbances in this population. In this review, we discuss the relationship between LFP oscillations in STN and the sleep architecture of PD patients, current trends in utilizing DBS to treat sleep disturbance, and future directions for research. In particular, we highlight the capability of novel technologies to capture and record LFP data in vivo, while patients continue therapeutic stimulation for motor symptoms. These technological advances may soon allow for real-time adaptive stimulation to treat sleep disturbances.

scholarly journals Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis

SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
Lucy Webster ◽  
Sergi Costafreda Gonzalez ◽  
Aisling Stringer ◽  
Amy Lineham ◽  
Jessica Budgett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Disturbance ◽  
Associated Factors ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Care Home ◽  
Care Homes ◽  
People With Dementia ◽  
Falling Asleep ◽  
Clinically Significant

Abstract Study Objectives Sleep disturbances are a feature in people living with dementia, including getting up during the night, difficulty falling asleep, and excessive daytime sleepiness and may precipitate a person with dementia moving into residential care. There are varying estimates of the frequency of sleep disturbances, and it is unknown whether they are a problem for the individual. We conducted the first systematic review and meta-analysis on the prevalence and associated factors of sleep disturbances in the care home population with dementia. Methods We searched Embase, MEDLINE, and PsycINFO (29/04/2019) for studies of the prevalence or associated factors of sleep disturbances in people with dementia living in care homes. We computed meta-analytical estimates of the prevalence of sleep disturbances and used meta-regression to investigate the effects of measurement methods, demographics, and study characteristics. Results We included 55 studies of 22,780 participants. The pooled prevalence on validated questionnaires of clinically significant sleep disturbances was 20% (95% confidence interval, CI 16% to 24%) and of any symptom of sleep disturbance was 38% (95% CI 33% to 44%). On actigraphy using a cutoff sleep efficiency of <85% prevalence was 70% (95% CI 55% to 85%). Staff distress, resident agitation, and prescription of psychotropic medications were associated with sleep disturbances. Studies with a higher percentage of males had a higher prevalence of sleep disturbance. Conclusions Clinically significant sleep disturbances are less common than those measured on actigraphy and are associated with residents and staff distress and the increased prescription of psychotropics. Actigraphy appears to offer no benefit over proxy reports in this population.

Handling Parents' Concerns Regarding the Behavioural Treatment of Infant Sleep Disturbance

1994 ◽  
Vol 11 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Karyn G. France
Keyword(s):  
Sleep Disturbance ◽  
Professional Practice ◽  
Cultural Practices ◽  
Infant Sleep ◽  
Effective Management ◽  
Professional Relationship ◽  
Behavioural Treatment ◽  
Professional Advice ◽  
Management Techniques

Infant sleep disturbance (ISD) is widespread and troublesome. Although effective management techniques have been established, some lay and professional authors have expressed concern about these interventions. These concerns are sometimes shared by parents who seek professional advice while feeling ambivalent about undertaking treatment. These concerns include (a) that ISD is normal and inevitable, (b) that it results from unnatural or artificial cultural practices, (c) the belief that ISD expresses a need state, and (d) the belief that the use of extinction is harmful. These concerns are examined and the management of ISD by extinction and its alternatives are considered in the light of the ethics of professional practice. It is concluded that these concerns are best answered within the context of a professional relationship based on a partnership and the sharing of expertise with parents.

scholarly journals FAAH and CNR1 Polymorphisms in the Endocannabinoid System and Alcohol-Related Sleep Quality

2021 ◽  
Vol 12 ◽  
Author(s):  
Soundarya Soundararajan ◽  
Narjis Kazmi ◽  
Alyssa T. Brooks ◽  
Michael Krumlauf ◽  
Melanie L. Schwandt ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Acid Amide ◽  
Sleep Onset ◽  
Endocannabinoid System ◽  
Sleep Efficiency ◽  
Subjective Sleep Quality

Sleep disturbances are common among individuals with alcohol use disorder (AUD) and may not resolve completely with short-term abstinence from alcohol, potentially contributing to relapse to drinking. The endocannabinoid system (ECS) is associated with both sleep and alcohol consumption, and genetic variation in the ECS may underlie sleep-related phenotypes among individuals with AUD. In this study, we explored the influence of genetic variants in the ECS (Cannabinoid receptor 1/CNR1: rs806368, rs1049353, rs6454674, rs2180619, and Fatty Acid Amide Hydrolase/FAAH rs324420) on sleep quality in individuals with AUD (N = 497) and controls without AUD (N = 389). We assessed subjective sleep quality (from the Pittsburgh Sleep Quality Index/PSQI) for both groups at baseline and objective sleep efficiency and duration (using actigraphy) in a subset of individuals with AUD at baseline and after 4 weeks of inpatient treatment. We observed a dose-dependent relationship between alcohol consumption and sleep quality in both AUD and control groups. Sleep disturbance, a subscale measure in PSQI, differed significantly among CNR1 rs6454674 genotypes in both AUD (p = 0.015) and controls (p = 0.016). Only among controls, neuroticism personality scores mediated the relationship between genotype and sleep disturbance. Objective sleep measures (sleep efficiency, wake bouts and wake after sleep onset), differed significantly by CNR1 rs806368 genotype, both at baseline (p = 0.023, 0.029, 0.015, respectively) and at follow-up (p = 0.004, p = 0.006, p = 0.007, respectively), and by FAAH genotype for actigraphy recorded sleep duration at follow-up (p = 0.018). These relationships suggest a significant role of the ECS in alcohol-related sleep phenotypes.

scholarly journals Development and Validation of Sleep Disturbance Questionnaire in Patients with Acute Coronary Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-8
Author(s):  
Elham Sepahvand ◽  
Rostam Jalali ◽  
Behnam Khaledi Paveh ◽  
Mansour Rezaei
Keyword(s):  
Acute Coronary Syndrome ◽  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Face Validity ◽  
Validity And Reliability ◽  
Coronary Syndrome ◽  
Coronary Patients ◽  
Development And Validation

Background and Objectives. Severe sleep disturbance is a common problem among patients in cardiac care units (CCUs). There are questionnaires to measure sleep disturbances. Therefore, the present study seeks to design a valid and reliable questionnaire to assess sleep disturbance in patients with acute coronary syndrome (ACS) hospitalized in CCUs. Materials and Methods. In the present methodological research, items of the questionnaire were extracted through a systematic review. The validity and reliability of the questionnaires was assessed by face validity, content validity, construct validity, Cronbach’s alpha coefficient, and test-retest methods. Results. Factor analysis provided a questionnaire of 23 items on 5 dimensions of sleep disturbance in coronary patients: “sleep onset and continuity disorder,” “disorder in daytime functioning,” “sleep disturbance caused by environmental factors,” “sleep disturbance as a result of cardiac diseases,” and “respiratory disorders during sleep.” Furthermore, test-retest analysis showed a reliability correlation coefficient of r=0.766 and α Cronbach’s reliability (α=0.855). Conclusion. Sleep disturbance questionnaire for patients with ACS hospitalized in coronary care unit (CCU) was identified in 5 dimensions and assessed for validity and reliability. To control and improve the sleep quality of CCU hospitalized patients, we need to identify and remove predisposing factors.

129 Greater NREM Sleep Rebound in Response to Experimental Sleep Disturbance Associated with Higher Inflammatory Resolution in Humans

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A52-A53
Author(s):  
Larissa Engert ◽  
Marc Dubourdeau ◽  
Rammy Dang ◽  
Janet Mullington ◽  
Monika Haack
Keyword(s):  
Sleep Disturbance ◽  
Slow Wave ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Slow Wave Sleep ◽  
Sleep Onset ◽  
Nrem Sleep ◽  
Low Grade ◽  
German Research Foundation ◽  
Recovery Sleep

Abstract Introduction Sleep disturbances deteriorate immune function by not only affecting pro-inflammatory pathways, but also inflammatory resolution pathways, which actively terminate inflammation. It is assumed that slow wave sleep (SWS) amount and slow wave activity (SWA) convey the immune-supportive functions of sleep. We investigated whether changes in SWS induced by experimental sleep disturbance followed by recovery sleep predict changes in inflammatory resolution mediators. Methods The randomized controlled within-subjects trial (N=24, 20-42 years, 12 women) consisted of two 19-day in-hospital protocols (experimental sleep disturbance/control). After three nights of baseline sleep (8h/night), participants in the experimental sleep disturbance condition were exposed to three cycles of three nights of disturbed sleep (delayed sleep-onset, hourly sleep disruption, advanced sleep-offset) followed by one night of 8h-recovery sleep. The protocol ended with three nights of recovery sleep. In the control condition, participants had uninterrupted sleep (8h/night). Sleep (PSG) and resolvin lipid mediators in plasma (1100h, LC-MS/MS) were assessed at baseline, during the last cycle of sleep disturbance, and during/after the first and third night of final recovery sleep. Data were analyzed using generalized linear mixed models and Pearson/Spearman correlations. Results As expected, SWS amount decreased during experimental sleep disturbance and increased during the first recovery sleep night (p<.001). Similarly, resolvin (Rv) D2 and RvD3 decreased during sleep disturbance and RvD2 increased with subsequent recovery sleep (p<.001). The SWS response did not correlate with the resolvin response to sleep disturbance or to recovery sleep. However, the NREM sleep response correlated with the resolvin response during the third recovery sleep night, i.e., a greater NREM response was associated with a greater RvD2 and RvD3 response (r=.68, p=.002; r=.58, p=.012). In contrast, a greater REM sleep response was associated with a lower resolvin response (r=−.63, p=.005; r=−.66, p=.003). Conclusion These data suggest that during recovery from sleep disturbance, NREM rather than REM sleep promotes inflammatory resolution, thereby acting as the sleep state that protects against low-grade systemic inflammation, which has been frequently observed as a consequence of sleep disturbances. Analysis whether SWA is related to inflammatory resolution is in progress. Support (if any) NIH/NINDS R01-NS091177; NIH/NCRR UL1-RR02758, M01-RR01032; German Research Foundation (DFG) EN1291/1-1.

Gambling-like video game practices: A cross-sectional study of links with problem gambling and disordered gaming

2019 ◽  
Author(s):  
David Zendle
Keyword(s):  
Video Games ◽  
Problem Gambling ◽  
Video Game ◽  
Large Scale ◽  
Significant Degree ◽  
Cross Sectional Study ◽  
Video Gaming ◽  
Cross Sectional ◽  
Streaming Services ◽  
Clinically Significant

A variety of practices have recently emerged which are related to both video games and gambling. Most prominent of these are loot boxes. However, a broad range of other activities have recently emerged which are also related to both gambling and video games: esports betting, real-money video gaming, token wagering, social casino play, and watching videos of both loot box opening and gambling on game streaming services like Twitch.Whilst a nascent body of research has established the robust existence of a relationship between loot box spending and both problem gambling and disordered gaming, little research exists which examines whether similar links may exist for the diverse practices outlined above. Furthermore, no research has thus far attempted to estimate the prevalence of these activities.A large-scale survey of a representative sample of UK adults (n=1081) was therefore conducted in order to investigate these issues. Engagement in all measured forms of gambling-like video game practices were significantly associated with both problem gambling and disordered gaming. An aggregate measure of engagement was associated with both these outcomes to a clinically significant degree (r=0.23 and r=0.43). Engagement in gambling-like video game practices appeared widespread, with a 95% confidence interval estimating that 16.3% – 20.9% of the population engaged in these activities at least once in the last year. Engagement in these practices was highly inter-correlated: Individuals who engaged in one practice were likely to engage in several more.Overall, these results suggest that the potential effects of the blurring of lines between video games and gambling should not primarily be understood to be due to the presence of loot boxes in video games. They suggest the existence of a convergent ecosystem of gambling-like video game practices, whose causal relationships with problem gambling and disordered gaming are currently unclear but must urgently be investigated.

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