scholarly journals BEHAVIORAL SLEEP PROBLEMS IN CHILDREN (BEHAVIORAL INSOMNIA) AND EFFECTIVE METHODS OF THEIR MANAGEMENT

2021 ◽  
Author(s):  
GVANTSA ARVELADZE ◽  
TEIMURAZ MIKELADZE
Keyword(s):  
Children And Adolescents ◽  
Behavioral Interventions ◽  
Sleep Problems ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Pharmacologic Therapy ◽  
Poor Sleep ◽  
Older Children ◽  
Falling Asleep ◽  
Sleep Schedule

Sleep problems with behavioral origins occur in 20 to 30 percent of children and are especially common in children with medical, neurodevelopmental, or psychiatric disorders. Insomnia related to learned sleep onset associations is most common in infants and toddlers and is characterized by prolonged night waking, requiring parental intervention to restore sleep. It occurs when the child learns to associate falling asleep with specific experiences, such as being rocked or fed. Insomnia related to inadequate limit-setting is a disorder most common in children who are preschool-aged and older and is characterized by active resistance, verbal protests, and repeated demands at bedtime. Guidance to parents about healthy sleep practices helps to prevent sleep problems and is also an important first step in treatment. An integral part of the bedtime routine is the institution of a bedtime and sleep schedule that ensures a developmentally appropriate amount of sleep. A consistent nightly bedtime will help to set the circadian clock and enable the child to fall asleep more easily. Treatment of primary insomnia in older children and adolescents usually involves behavioral interventions that resemble those used in adults. Establishing a consistent sleep schedule is also important for older children and adolescents for whom poor sleep hygiene is a common cause of sleep problems. Pharmacologic therapy for the treatment of childhood insomnia is not a first-line treatment and should always be combined with behavioral therapy.

The Effect of Uncoupled Sleep and Dysfunctional Sleep Beliefs on Sleep Outcomes in Older Adults following Online Cognitive Behavioral Therapy for Insomnia: A Single-Group Non-randomized Trial (Preprint)

2021 ◽  
Author(s):  
Yvonne Kutzer ◽  
Lisa Whitehead ◽  
Eimear Quigley ◽  
Shih Ching Fu ◽  
Mandy Stanley
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Sleep Quality ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705

Behavioral Interventions for Irritability in Children and Adolescents

2019 ◽  
pp. 255-274
Author(s):  
Denis G. Sukhodolsky ◽  
Theresa R. Gladstone ◽  
Carolyn L. Marsh ◽  
Kimberly R. Cimino
Keyword(s):  
Children And Adolescents ◽  
Dialectical Behavior Therapy ◽  
Social Information Processing ◽  
Behavioral Interventions ◽  
Emotion Dysregulation ◽  
Behavioral Therapy ◽  
Management Training ◽  
Parent Management Training ◽  
Childhood Disorders ◽  
Antecedents And Consequences

Irritability is a common and impairing problem in children and adolescents that can be viewed as a dimension of psychopathology, as well as a core or co-occurring symptom in many childhood disorders. Two forms of interventions for irritability, parent management training (PMT) and cognitive-behavioral therapy (CBT), share common behavioral principles and social information-processing theoretical underpinnings. PMT aims to ameliorate aversive patterns of family interaction that produce the antecedents and consequences that maintain a child’s noncompliance and aggression. During CBT, children learn to regulate frustration and improve social problem-solving skills to reduce the frequency and intensity of anger outbursts and aggressive behavior. Dialectical behavior therapy (DBT) combines training in behavioral skills for reducing interpersonal conflicts with mindfulness and acceptance techniques for emotion regulation. Treatment studies of these approaches in children with various forms of behavioral and emotion dysregulation are reviewed and implications for children with disruptive mood dysregulation disorder are discussed.

scholarly journals Sleep problems in 0-36 months old Indonesian children with atopic dermatitis

2019 ◽  
Author(s):  
I. Irwanto ◽  
Hapsari W. Ningtiar ◽  
Taufiq Hidayat ◽  
Azwin M. Putera ◽  
Zahrah Hikmah ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Onset Time ◽  
Skin Condition ◽  
Chi Square ◽  
Falling Asleep ◽  
Chi Square Test ◽  
And Behavior ◽  
And Control

Atopic dermatitis (AD) is a chronic, relapsing, highly pruritic skin condition that develops in early childhood. Sleep problems are common in AD children and lead to impaired quality of life, disturbance of neurocognitive function and behavior. The aim of this study was to assess the prevalence of sleep problems in 0-36 months old Indonesian children with AD. Children aged 0-36 months were enrolled, divided into two groups, AD and control. Sleep problems and AD were assessed using Brief Infant Sleep Questionnaire (BISQ) and Severity Scoring of Atopic Dermatitis Index (SCORAD). Chi-square test was performed to compare the outcome. There were 35 children participating in each group. In children with sleep problems, 85.7% were diagnosed with AD and 11.4% were non-AD. Nocturnal sleep duration, night waking, nocturnal wakefulness, sleep onset time, method of falling asleep and parental consideration of sleep problems occur more often within AD group. Severity of AD also significantly contributes to sleep problems in AD group. In conclusion, this study showed that sleep problems are more prevalent in children with AD.

scholarly journals Enuresis: modern aspects of etiology, pathogenesis, psycho-, pharmaco-, physical therapy and phytotherapy (part 1)

2020 ◽  
Keyword(s):  
Physical Therapy ◽  
Sleep Problems ◽  
Behavioral Therapy ◽  
Poor Sleep ◽  
Patient Centered ◽  
Water Excretion ◽  
Critical Areas ◽  
Icd 10 ◽  
Therapeutic Measures ◽  
Single Approach

The review (part 1) discusses modern views on the etiology, pathogenesis and clinical course of bedwetting in children. Enuresis is a common condition that causes significant disruption in critical areas of a child's life. Despite the existence of an international standard and clinical guidelines for the treatment of bedwetting, specialists do not have a single approach to the management of patients with enuresis. In order to systematize modern views on these issues, 73 sources were analyzed. The criteria for enuresis according to ICD-10 and DSM-5.0 and various approaches to classifying the types of enuresis are present in the review. The characteristics of simple, neurotic, endocrinopathic, epileptic, neuropathic and dysplastic forms of enuresis are given. The modern concepts of the pathophysiology of enuresis are analyzed. Connection between bedwetting and sleep problems, high levels of arousal in the cerebral cortex, fragmentation, and poor sleep quality are accentuated in the several analyzed studies. The changes in the autonomic nervous system and hemodynamics arising in connection with these disorders contribute to the excessive formation of urine and an increase in the activity of the bladder. Some patients have nocturia associated with circadian fluctuations in the level of vasopressin, which, however, does not always explain the occurrence of bedwetting. A number of analyzed studies have established a relationship between polyuria and changes in salt and water excretion. Other mechanisms of the pathogenesis of enuresis, concerning violations of the reservoir function of the urinary bladder during sleep, are also highlighted. Knowledge of the etiology and pathogenesis of enuresis helps doctors better understand the nature of a particular child's condition and, personalize treatment, based on modern protocols. The patient-centered approach to the treatment of enuresis is discussed in article, as well as sequence of therapeutic measures, including behavioral therapy, alarm-therapy and pharmacotherapy, and if indicated, also physical therapy and herbal medicine, a detailed analysis of which is presented in part 2 of the review.

Impact of Digital Monitoring, Assessment and Cognitive Behavioral Therapy on Subjective Sleep Quality, Workplace Productivity and Health Related Quality of Life: Observational Study (Preprint)

2018 ◽  
Author(s):  
Yuval Altman ◽  
Shuli Eyal ◽  
Anda Baharav ◽  
Kyle Niejadlik
Keyword(s):  
Sleep Problems ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Work Productivity ◽  
Average Amount ◽  
Subjective Sleep ◽  
Sleep Parameters ◽  
Smart Mobile

BACKGROUND Sleep difficulties negatively impact health, performance and quality of life, as about a third of the general population suffers from at least one insomnia symptom. Recent studies link insomnia with reduced work productivity, resulting in extensive losses for employees, employers and insurers. Cognitive behavioral therapy for insomnia (CBTi) is recommended as first-line treatment for insomnia and the ubiquity of smart mobile devices allows for promising approaches to overcome some of the limitations surrounding it. OBJECTIVE Our aim was to propose a comprehensive sleep solution for smart mobile devices, and to characterize the effects of this solution, while using adequate sample sizes. METHODS Employees of a Fortune-50 company were randomly selected, all with a Pittsburgh Sleep Quality Index (PSQI) larger than 8. Subjects were randomly assigned to either an intervention group (IG, n=247) or a control group (CG, n=249), and were asked to fill several questionnaires, in addition to the PSQI. Questionnaires were completed pre-treatment, post-treatment at six weeks and a follow-up after two months. People in the IG were provided with a sleep assessment and therapy service via a mobile app (SleepRate). De-identified objective and subjective sleep data were acquired on a nightly basis, along with a digital sleep diary. Sleep parameters included sleep onset (SO), wake after sleep onset (WASO), sleep efficiency (SE) and sleep satisfaction (SS). Sleep problems, such as symptoms of insomnia, were detected based on the sleep data and several questionnaires. Subjects in the IG were then offered treatment to address the detected sleep problems. For subjects with symptoms of insomnia, average sleep parameters during the assessment week (AW) were compared to those during the last week in treatment (LW). RESULTS Post-treatment average PSQI was lower for the IG (8.5), compared to that of the CG (10.9, p=.005), as were absenteeism (IG: 0.39%, CG: 1.0%, p=.06) and presenteeism (IG: 15.6%, CG: 21.4%, p=.02). The average amount of healthy days was significantly higher for the IG (22.5 days) compared to that of the CG (18.6 days, p=.005). At follow-up, average PSQI of the IG was significantly lower (7.1) than that of the CG (10.4, p=.005), as well as absenteeism (IG: 0.15%, CG: 0.84%, p=.03) and presenteeism (IG: 11.9%, CG: 23.5%, p=.005), while the average amount of healthy days was significantly higher (IG: 23.8, CG: 19.0, p=.005). For subjects in the IG, subjective SE was significantly higher at LW (89.1±12.3%, mean±SD) compared to that at the AW (87.5±9.8%, p=.025), WASO significantly shortened (AW: 25.7±27minutes, LW: 19.8±18.4minutes, p=.011), as SS increased significantly (AW: 49.2±11.5, LW: 53±15.4, p=.003). CONCLUSIONS The use of a mobile sleep solution improved the subjective sleep perception in the IG and facilitated a substantial increase in work productivity.

Searching for a Good Night's Sleep: What Mental Health Counselors Can Do About the Epidemic of Poor Sleep

2011 ◽  
Vol 33 (4) ◽  
pp. 312-326 ◽  
Author(s):  
Dolores Puterbaugh
Keyword(s):  
Mental Health ◽  
United States ◽  
Sleep Problems ◽  
Behavioral Therapy ◽  
The United States ◽  
Mental Health Counseling ◽  
Mental Health Counselors ◽  
Poor Sleep ◽  
Health Counseling ◽  
Behavioral Counseling

Sleep problems are epidemic in the United States. Many adults complain of poor sleep yet engage in behaviors that are counterproductive to sleep. This article briefly reviews recent research on the treatment of insomnia and discusses application of mental health counseling strategies for treatment. Case studies illustrate the application of current research within counselor areas of expertise in cognitive behavioral therapy and behavioral counseling.

Does Cigarette Smoking Increase Sleep Problems?

1993 ◽  
Vol 77 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Frances J. Lexcen ◽  
Robert A. Hicks
Keyword(s):  
Cigarette Smoking ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Caffeine Consumption ◽  
Daily Diaries ◽  
Delayed Sleep ◽  
And Gender ◽  
Ethnicity And Gender

Cigarette smoking has been associated with delayed sleep onset and diminished sleep duration, primarily on the bases of responses to one-shot questionnaires. This study used a survey format of daily diaries to observe sleep quality. 29 smokers were matched for age, ethnicity, and gender with 29 nonsmokers. Both groups recorded information on cigarette, alcohol, caffeine consumption, daily stress, and sleep quality. While the results showed that smokers were more likely to experience poor sleep than nonsmokers, these data are difficult to interpret because smokers also used significantly greater amounts of alcohol and caffeine.

Sleep Related Beliefs and their Association with Alcohol Relapse Following Residential Alcohol Detoxification Treatment

2013 ◽  
Vol 42 (5) ◽  
pp. 593-604 ◽  
Author(s):  
Neil Smith ◽  
Robert Hill ◽  
Jane Marshall ◽  
Francis Keaney ◽  
Shamil Wanigaratne
Keyword(s):  
Alcohol Dependence ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Inpatient Setting ◽  
Sleep Onset Latency ◽  
Dysfunctional Beliefs ◽  
Sleep Diaries ◽  
Relapse Rates ◽  
Dysfunctional Beliefs About Sleep

Background: Alcohol dependence is known to impact upon sleep, and poor sleep has been shown to affect relapse rates following treatment for alcohol dependence. Aims: The aim of this study was to investigate the association between sleep problems and relapse in dependent drinkers in an inpatient setting. This was done by studying sleep related cognitions in individuals undergoing medically assisted alcohol withdrawal. Method: Sleep and sleep-related cognitions data were collected for 71 individuals undergoing detoxification treatment. Sleep was measured using sleep diaries and actigraph motion monitors. Participants completed sleep-related cognition questionnaires and were subject to telephone follow-up interviews. The results were then used to predict relapse rates 4 weeks after discharge. Results: Longer sleep onset latency recorded on the unit predicted relapse at 4 weeks. Higher dysfunctional beliefs about sleep were found to be associated with lower relapse rates. Conclusions: This study suggests that some dysfunctional beliefs about sleep may support recovery following discharge from treatment. The study further supports the need for tailored cognitive-behavioural treatments for sleep difficulties in this population to reduce relapse rates.

Sleep in family caregivers of patients admitted to hospice: A pilot study

2013 ◽  
Vol 12 (6) ◽  
pp. 439-444 ◽  
Author(s):  
Anners Lerdal ◽  
Caryl L. Gay ◽  
Elisabeth Saghaug ◽  
Kaare Gautvik ◽  
Ellen Karine Grov ◽  
...  
Keyword(s):  
Pilot Study ◽  
Family Caregivers ◽  
Study Protocol ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Sleep Disruption ◽  
Cross Sectional ◽  
Falling Asleep ◽  
Wrist Actigraphy ◽  
Clinically Significant

AbstractObjectives:Caring for a dying family member is known to interfere with sleep, yet little is known about caregiver sleep once the patient is admitted to hospice. The aim of this pilot study was to describe the sleep of partners and other family caregivers of patients in hospice.Methods:The pilot study used a cross-sectional, descriptive, and comparative design. Participants included the primary family caregivers of patients recently admitted to a hospice in Norway. Caregiver sleep during the prior month was measured with the Pittsburgh Sleep Quality Index (PSQI). During the patient's hospice stay, caregiver sleep was measured using wrist actigraphy for four nights and three days.Results:Twenty family caregivers (12 partners and 8 other relatives) completed the study protocol without difficulty. On the PSQI, most caregivers (n = 13) reported clinically significant sleep problems during the prior month. Once the patient was admitted to hospice, actigraphy indicated that 10 caregivers had clinically significant sleep disruption (≥15% wake after sleep onset) and six averaged <7 hours of sleep per night. Partner caregivers reported more trouble falling asleep, and less sleep medication use, in the prior month than other types of family caregivers. However, once the patient was admitted to hospice, and after adjusting for caregiver age, partner caregivers experienced less sleep disruption than other caregivers.Significance of results:Findings demonstrate feasibility of the study protocol and indicate that sleep problems are common for caregivers of dying patients, even after the patient is admitted to hospice. The caregiver's relationship to the patient may be an important factor to consider in future studies.

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