Behavioral treatment of pediatric sleep disturbance: Ethical considerations for pediatric psychology practice.

Abstract Hoarding disorder in late life has been associated with increased risk for medical conditions and decreased ability to perform activities of daily living in the home; however, no studies have yet examined the relationship between geriatric hoarding and sleep. This study represents a secondary data analysis of older adults who received 26 sessions of group behavioral treatment for hoarding disorder (n = 41; mean age 64, range 55-85). Baseline sleep disturbance was significantly associated with hoarding severity, even when controlling for inability to sleep in a bed due to household clutter level. However, no significant change in sleep disturbance was reported following completion of treatment and baseline sleep disturbance was not significantly predictive of change in hoarding symptom severity. Findings suggest that disturbed sleep quality is associated with greater hoarding symptom severity but does not preclude positive symptom change in treatment.

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(A109) Systematic Literature Review on Pediatric Sleep Disturbance Management Post-Disaster: Implications of Post-Disaster Pediatric Clinical Management in Developing Countries

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11001269 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s38-s38

Author(s):

E.Y.Y. Chan ◽

S.D. Koo

Keyword(s):

Developing Countries ◽

Sleep Disturbance ◽

Clinical Management ◽

Sleep Disturbances ◽

Pediatric Patients ◽

Pediatric Population ◽

Traumatic Events ◽

Clinical Effectiveness ◽

Post Disaster ◽

Pediatric Sleep

IntroductionSleep disturbances are common symptoms during the immediate and long-term aftermath of exposure of traumatic events. While stress affects sleep in all age groups, due to differences in physiological, psychological, and socio-behavorial risk factors, the clinical management of pediatric patients with sleep disturbances post-disaster might be different. This study aims to systematically review scientific literature on the clinical management of pediatric sleep disturbances post-disaster and its clinical implication in developing countries. Methods: A keyword-based, systematic review was conducted for scientific publication in academic and disaster literature databases (Medline, PUBMED, Academic Search Premier, Google Scholar, ELDIS, PsycINFO, PILOTS and RELIEFWEB) until October 2010. Abstracts of all the hits were inspected to remove non-relevant articles, and all relevant articles were reviewed and scored by two reviewers to determine relevancy before being included in the final study database. Quality, relevance, and applicability of the reported literature were examined critically with the EBM level of evidence and EPPHPPQ (2003) assessment tool.Results and DiscussionThe literature disproportionally emphasized the clinical effects and psychological impacts of traumatic events on pediatric patients, and most reported studies were reported as a subset within PTSD study literature. Management of younger children, gender differences, clinical effectiveness of cross-disciplinary management modalities, and experiences in middle- and low-income countries were extremely limited. While principles of sleep hygiene and clinical guidelines for management of adult sleep disturbance are available, the application of clinical effectiveness and appropriateness of these guidelines in pediatric population must be examined further.Conclusion and ImplicationsCurrently, there is limited literature on the acute management of pediatric sleep disturbances post-disaster in developing countries. Evidence-based studies are needed to identify the appropriate clinical approaches to support the pediatric population with sleep disturbances post-disaster.

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