scholarly journals Predictors and Correlates of Pediatric Postburn Pruritus in Preschool Children of Ages 0 to 4

2019 ◽  
Vol 40 (6) ◽  
pp. 930-935 ◽  
Author(s):  
Dylan Stewart ◽  
Jill Caradec ◽  
Susan Ziegfeld ◽  
Elizabeth Reynolds ◽  
Rick Ostrander ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Pediatric Patients ◽  
Sleep Onset ◽  
Adult Survivors ◽  
Common Type ◽  
Burn Injuries ◽  
Self Report ◽  
Burn Patients ◽  
Minority Status ◽  
Delayed Sleep

Abstract Pruritus is a common problem following burn injuries; however, the literature to date has focused on adult survivors and/or pediatric survivors of large burns. The current study examines acute postburn pruritus in children under the age of 4 years (N = 256) with smaller burns (mean TBSA = 3.99%), which represents the most common type of patient typically treated in pediatric burn centers. Parents rated their child for pruritus, irritability, and sleep disturbances; additionally, parents completed a self-report of distress. Nearly half (47.3%) were rated by parents as displayed some level of pruritus, with the greatest proportion rated as mild. Regression analysis indicated that child minority status, greater burn TBSA, and more days elapsed since burn predicted higher levels of pruritus. In turn, pruritus was positively correlated with child irritability, delayed sleep onset, sleep disturbance, and parent distress. Thus, our results indicate that parent-rated pruritus in young pediatric burn patients is important to evaluate, as itch is significantly associated with other important clinical outcomes as early as the first month of the burn for pediatric patients and their parents.

scholarly journals 727 Impact of Washington State COVID-19 Lockdown on Sleep

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A283-A284
Author(s):  
Mary Peterson ◽  
Kirsie Lundholm ◽  
Lillian Skeiky ◽  
Hans Van Dongen ◽  
Devon Hansen
Keyword(s):  
Sleep Disturbances ◽  
Sleep Onset ◽  
Washington State ◽  
Self Report ◽  
Sleep Disruption ◽  
Before And After ◽  
Report Data ◽  
Delayed Sleep ◽  
Self Report Data ◽  
At Home

Abstract Introduction The COVID-19 pandemic caused a global disruption to daily routines. Studies using surveys and sleep-related applications on mobile devices suggest that the pandemic has contributed to increases in sleep disruption or onset of new sleep disturbances. We present results from a naturalistic at-home study in which objective sleep measurements were made using both a wrist actigraph (Actiwatch-2, Philips Respironics) and a non-contact monitoring device (SleepScore Max, SleepScore Labs), comparing sleep measurements obtained immediately before and after the start of the first mandatory COVID-19 stay-at-home order in Washington State. Methods As part of a larger study, nine Washington State residents (ages 22–48, 5 female, 4 male; 6 insomniacs, 3 normal sleeper) were enrolled in a 10-week at-home sleep monitoring study, which involved 1 week of actigraphy, 8 weeks of non-contact monitoring (data available for 6 subjects), and 1 week of actigraphy. During the study, the Washington State governor issued a stay-at-home order, effective March 15, 2020. We compared sleep measurements obtained before this date (mean ± SD: 25.0 ± 15.0 nights) and after this date (25.2 ± 13.9 nights) using mixed-effects ANOVA. Results Non-contact monitoring measurements indicated that after the start of the lockdown, participants woke up later by 63.2 ± 12.1 min (mean ± SE; F[1,299]=27.40, p<0.001) without significant change in bedtime (F[1,299]=0.29, p=0.59). Sleep latency lengthened by 4.0 ± 2.3 min (F[1,295]=4.92, p=0.027), and there were increases in number of awakenings (F[1,295]=6.22, p=0.013) and wake after sleep onset (F[1,295]=12.58, p<0.001). Actigraphy data complemented these results, showing delayed sleep onset by 53.4 ± 15.1 min (F[1,101]=12.46, p<0.001) and delayed final awakening by 104.3 ± 19.6 min (F[1,101]=28.43, p<0.001), with longer sleep duration (F[1,101]=6.06, p=0.016), increased number of awakenings (F[1,101]=13.00, p<0.001), and a trend for increased intermittent wakefulness (F[1,101]=3.88, p=0.052) post-lockdown. Conclusion In this sample, we found evidence of increased sleep disruption following the first Washington State stay-at-home order related to COVID-19. Our findings are consistent with previous studies based on self-report data, which observed later wake times and decreases in sleep quality post-lockdown. Support (if any) NIH grant KL2TR002317. Non-contact monitoring devices provided by SleepScore Labs.

scholarly journals 1109 Broadly Assessing Sleep Complaints In A Sample Of Patients With ADHD

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A422-A422
Author(s):  
M Seewald ◽  
C Alio ◽  
B Rosenfield ◽  
R DiTomasso ◽  
A L Muench ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disturbances ◽  
A Priori ◽  
Sleep Onset ◽  
Sleep Complaints ◽  
Insomnia Disorder ◽  
Delayed Sleep Phase Disorder ◽  
Delayed Sleep Phase ◽  
Delayed Sleep ◽  
Age Range

Abstract Introduction It is commonly observed in clinical settings that patients with ADHD regularly present with comorbid “sleep disturbances”. In the absence of broad based sleep disorders assessments, it is thought that this represents Delayed Sleep Phase Disorder (DSPD). Recently, a surveillance study was undertaken in a university-based, outpatient specialty clinic for adults with ADHD, by adding a comprehensive sleep disorders screener (SDS-CL-25) to the clinical intake procedures. These data were used to ascertain which sleep disorders symptoms are common in this clinical cohort. Methods SDS-CL-25 data were collected in 150 subjects (93/57 male/female, mean age 32.8, age range 18-79). The SDS-CL-25 is a 25 item instrument developed to screen for 13 sleep disorders at one time (Sleep Dx symptoms are endorsed on Likert-scales; 0 [never] 4 [>5x/week]). For the purposes of this study, the percentage of subjects endorsing frequent symptomatology (sum of the percent of endorsements for columns 3 & 4)was calculated per symptom. Sums of >20% were considered, a priori, to be of clinical significance. Results Patients endorsed: increased fatigue (59%); SL or WASO or EMA’s >30 minutes (40%; 26%; 21%, respectively); late preferred time to bed (31%); work & school limits sleep opportunity (30%); variable time to and out of bed (27%); and snoring (21%). The average percent endorsement was 15% (range 0-59%). Conclusion These results suggest that, consistent with clinical observations, adult patients diagnosed with ADHD frequently endorse late preferred time to bed, variable sleep wake schedules, work/school limitations on sleep opportunity, and sleep onset problems that are accompanied by daytime fatigue. This constellation of symptoms is consistent with the notion that patients with ADHD tend to have comorbid DSPD. The high prevalence of middle and late insomnia was unexpected and suggests that Insomnia Disorder (proper) may also be a feature of ADHD. Support No support was provided for this abstract.

745 Pediatric Burn Transfers: A 10 Year Analysis of Adherence to ABA Transfer Criteria

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S205-S206
Author(s):  
Janine Roller ◽  
Rebecca Courtemanche ◽  
Marija Bucevska ◽  
Sally Hynes
Keyword(s):  
Pediatric Patients ◽  
Burn Injuries ◽  
Physician Education ◽  
Accurate Estimation ◽  
Burn Patients ◽  
Burn Care ◽  
The Past ◽  
Medical Disorders ◽  
Referral Criteria ◽  
Burn Depth

Abstract Introduction Severe burn injuries require complex care at certified burn centres to minimize morbidity and mortality. The ABA Burn Centre Referral Criteria was developed to aid clinicians in determining which patients warrant transfer as physician comfort with the management of pediatric burns, accurate estimation of TBSA, and burn depth varies. We hypothesize that pediatric patients are often transferred despite not meeting referral criteria. The aim of this study was to review pediatric patients with burn injuries that were transferred to the provincial burn centre over the past 10 years to better understand the reasons for the transfer. Methods A 10-year retrospective review from January 2008 to December 2018 was performed using the provincial Burn Registry. Pediatric burn patients under 18 years old who were transferred for burn care were identified and their demographics, burn characteristics, and the basis for transfer was analyzed against the ABA Burn Referral Criteria. Results A total of 130 pediatric burn patients were transferred from 42 different hospitals of varying trauma levels. Patients on average were 5 years old, predominantly male (59%), and scalds were the most common etiology (53%). Most patients were transferred by a fixed-wing ambulance (54%) and the average transport time was 1.5 days after the initial injury. All children met 1 or more ABA Referral Criteria for transfer. The most common reasons for transfer were for a TBSA greater than 10% (42.2%), burn to the hand (27.7%) or perineum (11.5%), 3° burn depth (12.3%), or significant pre-existing medical disorders (9.2%). Conclusions Over the past 10 years, all pediatric burn patients met ABA Burn Centre Referral Criteria based on TBSA, burn depth and burn location alone. This study is limited in that we were not able to capture all pediatric burn patients to identify those that warranted a referral but were not transferred. Applicability of Research to Practice The results indicate that burn-related transfers to the provincial burn centre were appropriate. The dissemination of this information to the referring centres may serve to reinforce these positive referral patterns. Furthermore, this audit provides insight into the geographic origins of pediatric burn referrals in the province to help direct burn prevention and physician education efforts, as well as resources for initial burn care and post-discharge rehabilitation services.

scholarly journals Neural correlates of sleep recovery following melatonin treatment for pediatric concussion: a randomized control trial

2020 ◽  
Author(s):  
Kartik K Iyer ◽  
Andrew Zalesky ◽  
Luca Cocchi ◽  
Karen M Barlow
Keyword(s):  
Sleep Disturbances ◽  
Functional Neuroimaging ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Neural Correlates ◽  
Self Report ◽  
Symptom Improvement ◽  
Melatonin Treatment ◽  
Link Type ◽  
Over Time

Evidence-based treatments for children with persistent post-concussion symptoms (PPCS) are few and limited. Common PPCS complaints such as sleep disturbance and fatigue could be ameliorated via the supplementation of melatonin, which has significant neuroprotective and anti-inflammatory properties. This study aims to identify neural correlates of melatonin treatment with changes in sleep disturbances and clinical recovery in a pediatric cohort with PPCS. We examined structural and functional neuroimaging (MRI) in 62 children with PPCS in a randomized, double-blind, placebo-controlled trial of 3mg or 10mg of melatonin (NCT01874847). The primary outcome was the total youth self-report Post-Concussion Symptom Inventory (PCSI) score after 28 days of treatment. Secondary outcomes included the change in the sleep domain PCSI score and sleep-wake behavior (assessed using wrist-worn actigraphy). Whole-brain analyses of (i) functional connectivity (FC) of resting-state fMRI, and (ii) structural grey matter (GM) volumes via voxel-based morphometry were assessed immediately before and after melatonin treatment and compared to placebo in order to identify neural effects of melatonin treatment. Increased FC of posterior default mode network (DMN) regions with visual, somatosensory and dorsal networks was detected in the melatonin groups over time. FC increases also corresponded with reduced wake periods (r=-0.27, p=0.01). Children who did not recover (n=39) demonstrated significant FC increases within anterior DMN and limbic regions compared to those that did recover (i.e. PCSI scores returned to pre-injury level n=23) over time, (p=0.026). Increases in GM volume within the posterior cingulate cortex were found to correlate with reduced wakefulness after sleep onset (r=-0.32, p=0.001) and sleep symptom improvement (r=0.29, p=0.02). Although the melatonin treatment trial was negative and did not result in PPCS recovery (with or without sleep problems), the relationship between melatonin and improvement in sleep parameters were linked to changes in function-structure within and between brain regions interacting with the DMN. Clinical Trial Registration ID#NCT01874847.

scholarly journals The Monday Effect Revisited: A Diary and Sleep Actigraphy Study

2020 ◽  
Vol 4 (2) ◽  
pp. 167-176
Author(s):  
Achim Elfering ◽  
Christin Gerhardt ◽  
Diana Pereira ◽  
Anna Schenker ◽  
Maria U. Kottwitz
Keyword(s):  
Sleep Duration ◽  
Sleep Onset ◽  
Monday Morning ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Social Stressors ◽  
Monday Effect ◽  
Work Related ◽  
Cognitive Failure ◽  
Delayed Sleep

Abstract Purpose Accidents are more likely to occur during the morning hours of Mondays (Monday effect). This might be due to a higher level of cognitive failure on Monday morning at work. Methods In a pilot actigraphy study across one working week, we explored this Monday effect and regressed daily self-reported workplace cognitive failure on weekdays (Monday versus other days), background social stressors at work, delayed sleep onset and sleep duration. Diary data were gathered from 40 full-time employees. Results Confirming our assumptions, results revealed work-related cognitive failure and sleep-onset latency on the previous night to be higher on Mondays compared to other workdays. Work-related cognitive failure correlated positively with delayed sleep-onset latency and background social stressors. In multilevel regression analysis, Monday significantly explained variations in workplace cognitive failure. The addition of background social stressors at work and sleep-onset latency to the regression model showed unique contributions to the prediction of workplace cognitive failure. No significant two-way or three-way interactions between working days, sleep-onset latency or sleep duration, and background social stressors were found. Conclusion Peak levels of cognitive failure on Monday morning and the association of cognitive failure with social stressors at work contribute to understanding the mechanisms involved in the increased prevalence of occupational accidents on Monday morning. Occupational safety interventions should address both social stressors at work and individual sleep hygiene.

scholarly journals 229 Sleep-wake behavior, meal timings and digital media duration of Indians during COVID-19 Lockdown

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A91-A92
Author(s):  
Babita Pande ◽  
Meenakshi Sinha ◽  
Ramanjan Sinha
Keyword(s):  
Digital Media ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Therapeutic Management ◽  
Daily Routine ◽  
Age Group ◽  
Younger Age ◽  
Gender And Age ◽  
Delayed Sleep ◽  
The Impact

Abstract Introduction Lockdown and stay home order has been imposed on people in many countries including India to prevent the community transmission of COVID-19 pandemic. However this social restriction led to disturbed daily routine and lifestyle behaviour that is needed to be attended for proper therapeutic management of overall health during such crisis. The impact of lockdown on the most apparent behavioral changes viz. sleep-wake behaviour, major meal timings, and digital screen duration of Indians were investigated. In addition the effects of gender and age were explored. Methods After seeking permission from Ethical Institution, an online questionnaire based survey was circulated within India in the first week of May, 2020 for which total 1511 male and female (age ≥18 years) subjects participated. The sleep-wake behavior observed were sleep-wake timings, sleep duration, mid sleep time (MST) as function of lockdown, and social (lockdown) jetlag (SJL = MST before lockdown-MST during lockdown). Results The sleep onset-wakeup and meal times were significantly delayed during lockdown, which was more pronounced in younger age group. The sleep duration increased, specifically in young individuals during lockdown. Females showed more delayed sleep onset-waking times and first meal timing with longer sleep duration during lockdown. Increased digital media duration was observed in all age groups, primarily in males. The younger age group and specifically female reported higher SJL and delayed MST. A positive association was obtained between sleep duration & first meal time, and SJL & major meal timings/screen duration, and a significant negative relationship of sleep duration and SJL with age. Conclusion The study shows delayed sleep-wake schedule, meal timings and increased digital media duration among Indians during COVID-19 lockdown compared to before lockdown. Also, gender and age emerged as important mediating factors for this alteration. The pandemic has given opportunity to sleep more and compensate for the sleep. In spite of that, the higher social jetlag in young age group and female showed the compromised sleep and maladaption with societal timing. These findings have applied implications in sleep health during longer social isolation conditions and for proper therapeutic management. Support (if any) No

scholarly journals Activity Impairment, Work Status, and Work Productivity Loss in Adults 5–7 Years After Burn Injuries

2021 ◽  
Author(s):  
Inge Spronk ◽  
Nancy EE Van Loey ◽  
Cornelis H van der Vlies ◽  
Juanita A Haagsma ◽  
Suzanne Polinder ◽  
...  
Keyword(s):  
Productivity Loss ◽  
Total Body Surface Area ◽  
Work Productivity ◽  
Burn Injuries ◽  
Work Status ◽  
Burn Patients ◽  
Work Situation ◽  
Activity Impairment ◽  
Severe Burns ◽  
Specific Health

Abstract An important aspect of the rehabilitation of burn patients is social participation, including daily activities and work. Detailed information on long-term activity impairment and employment is scarce. Therefore, we investigated activity impairment, work status, and work productivity loss in adults 5–7 years following burn injuries, and investigated associations with burn-specific health-related quality of life (HRQL) domains. Adult participants completed the Work Productivity and Activity Impairment General Health questionnaire and the Burn Specific Health Scale-brief (BSHS-B) 5–7 years post-burn. Outcomes were compared between participants with mild/intermediate and severe burns (>20% total body surface area burned). Seventy-six (36%) of the 213 participants experienced some degree of activity impairment due to burn-related problems 5–7 years post-burn. Seventy percent of the population was employed; 12% of them experienced work productivity loss due to burn-related problems. Nineteen percent reported changes in their work situation (partly) because of the burn injury. A higher proportion of participants with severe burns had activity impairments (56% vs 29%; P = .001) and work productivity loss (26% vs 8%; P < .001) compared to participants with mild/intermediate burns. Activity impairment and work productivity loss were both associated with burn-related work problems and lower mood, measured with the BSHS-B. In conclusion, a substantial part of the study population experienced activity impairment and work productivity loss, was unemployed, and/or reported changes in their work situation due to their injury. Particularly patients with severe burns reported productivity loss and had lower employment rates. This subscribes the importance of addressing work-related functioning in the rehabilitation of burn patients.

352 Feasibility of Hypnosis as Adjunctive Treatment for Subjective Sleep Disturbance: A Pilot Study and Proof of Concept

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A140-A141
Author(s):  
Emma Zhao ◽  
Afik Faerman ◽  
David Spiegel
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Positive Impact ◽  
Self Report ◽  
Adjunctive Treatment ◽  
Current Evidence ◽  
Data Set ◽  
Sleep Complaints ◽  
Subjective Sleep ◽  
Before And After

Abstract Introduction Hypnosis-based interventions have been shown to have a positive impact on several dimensions of sleep health. However, current evidence is limited as only a paucity of studies included populations with sleep complaints. Here we present a pilot data set to demonstrate the feasibility of developing a hypnosis-based adjunctive treatment for subjective sleep complaints. Methods Eleven adults (42% female; mean age 45±16.87 years) who sought treatment at the Stanford Sleep Medicine Center or Center for Integrative Medicine for subjective sleep complaints received hypnosis as adjunctive treatment. Self-report questionnaires were used to assess the weekly frequency of subjective sleep disturbances experienced before and after treatment, as well as 5-point Likert scale ratings of perceived qualitative improvement in symptom severity and overall sleep quality. Results Five participants (45%) reported a reduction in symptom frequency and severity after hypnosis treatment. All five participants attributed at least some of the improvement to hypnosis treatment. Most participants (63%) observed post-treatment improvements in their overall sleep quality. No participants reported adverse effects of hypnosis. Conclusion Results suggest hypnosis-based adjunctive treatment may be effective for alleviating subjective sleep disturbances. The findings serve as preliminary support for further randomly controlled trials in larger samples. Support (if any):

scholarly journals Demographic, psychological, chronobiological, and work-related predictors of sleep disturbances during the COVID-19 lockdown in Italy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Federico Salfi ◽  
Marco Lauriola ◽  
Aurora D’Atri ◽  
Giulia Amicucci ◽  
Lorenzo Viselli ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Negative Impact ◽  
Female Gender ◽  
Protective Role ◽  
Depression Symptoms ◽  
Work Related ◽  
Working From Home ◽  
Delayed Sleep Phase ◽  
Delayed Sleep ◽  
Morning Type

AbstractThe first COVID-19 contagion wave caused unprecedented restraining measures worldwide. In Italy, a period of generalized lockdown involving home confinement of the entire population was imposed for almost two months (9 March–3 May 2020). The present is the most extensive investigation aimed to unravel the demographic, psychological, chronobiological, and work-related predictors of sleep disturbances throughout the pandemic emergency. A total of 13,989 Italians completed a web-based survey during the confinement period (25 March–3 May). We collected demographic and lockdown-related work changes information, and we evaluated sleep quality, insomnia and depression symptoms, chronotype, perceived stress, and anxiety using validated questionnaires. The majority of the respondents reported a negative impact of confinement on their sleep and a delayed sleep phase. We highlighted an alarming prevalence of sleep disturbances during the lockdown. Main predictors of sleep disturbances identified by regression models were: female gender, advanced age, being a healthcare worker, living in southern Italy, confinement duration, and a higher level of depression, stress, and anxiety. The evening chronotype emerged as a vulnerability factor, while morning-type individuals showed a lower predisposition to sleep and psychological problems. Finally, working from home was associated with less severe sleep disturbances. Besides confirming the role of specific demographic and psychological factors in developing sleep disorders during the COVID-19 pandemic, we propose that circadian typologies could react differently to a particular period of reduced social jetlag. Moreover, our results suggest that working from home could play a protective role against the development of sleep disturbances during the current pandemic emergency.

scholarly journals The Cycle of Daily Stress and Sleep: Sleep Measurement Matters

2020 ◽  
Author(s):  
Danica C Slavish ◽  
Justin Asbee ◽  
Kirti Veeramachaneni ◽  
Brett A Messman ◽  
Bella Scott ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Multilevel Models ◽  
Single Channel ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Daily Stress ◽  
Sleep Diaries ◽  
Sleep Measurement

Abstract Background Disturbed sleep can be a cause and a consequence of elevated stress. Yet intensive longitudinal studies have revealed that sleep assessed via diaries and actigraphy is inconsistently associated with daily stress. Purpose We expanded this research by examining daily associations between sleep and stress using a threefold approach to assess sleep: sleep diaries, actigraphy, and ambulatory single-channel electroencephalography (EEG). Methods Participants were 80 adults (mean age = 32.65 years, 63% female) who completed 7 days of stressor and sleep assessments. Multilevel models were used to examine bidirectional associations between occurrence and severity of daily stress with diary-, actigraphy-, and EEG-determined sleep parameters (e.g., total sleep time [TST], sleep efficiency, and sleep onset latency, and wake after sleep onset [WASO]). Results Participants reported at least one stressor 37% of days. Days with a stressor were associated with a 14.4-min reduction in actigraphy-determined TST (β = −0.24, p = 0.030), but not with other actigraphy, diary, or EEG sleep measures. Nights with greater sleep diary-determined WASO were associated with greater next-day stressor severity (β = 0.01, p = 0.026); no other diary, actigraphy, or EEG sleep measures were associated with next-day stressor occurrence or severity. Conclusions Daily stress and sleep disturbances occurred in a bidirectional fashion, though specific results varied by sleep measurement technique and sleep parameter. Together, our results highlight that the type of sleep measurement matters for examining associations with daily stress. We urge future researchers to treat sleep diaries, actigraphy, and EEG as complementary—not redundant—sleep measurement approaches.

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