Difference of cooling use during sleep between elderly and young people

In Japan, nearly 80% of heatstroke occurrences in recent years have involved people older than 65 years old. This study surveyed the actual use of cooling by elderly people at sleep time compared to those found for younger people. Results revealed the followings. 1) Ratios of cooling use at sleep time were 30.8% for elderly people and 57.4% for younger people. The respective ratios of natural ventilation use at sleep time were 39.9% and 32.4%. 2) Average wet bulb globe temperatures (WBGTs) of bed rooms during sleep were 26.9°C for elderly people and 26.4°C for younger people. 3) Elderly people feel warmer than younger people but they feel more thermally comfortable. 4) Sleep scores were 49.7 for elderly people and 48.5 for younger people. No difference was found for the frequency of night waking or the Sleep maintenance score, but the Fatigue recovery score showed the greatest difference between elderly and younger people.

The Mother–Offspring Conflict: The Association Between Maternal Sleep, Postpartum Depression, and Interbirth Interval Length

To test the hypothesis that infant night waking is an adaptation to increase interbirth intervals (IBIs) (i.e., the time between a mother’s consecutive births) by exhausting the mother, we made an initial attempt at investigating whether maternal sleep disturbance is associated with longer IBIs. We also explored whether postpartum depression symptoms mediated the association between maternal sleep disturbance and IBI length. We used retrospective self-reports from 729 mothers living in Finland. We conducted structural regressions separately for the mother’s two first children at two different age intervals (0–1 and 1–3 years). Infant night waking was associated with maternal sleep disturbance (β = .78–.84) and maternal sleep disturbance was associated with postpartum depression symptoms (β = .69–.81). Postpartum depression symptoms were also associated with longer IBIs for the first child (β = .23–.28). This result supports the notion that postpartum depression in and of itself could be viewed as adaptive for the offspring’s fitness, and not just as an unintentional byproduct of the mother’s sleep disturbance. Contrary to our prediction, maternal sleep disturbance was, however, associated with shorter IBIs for the first child (β = −.22 to −.30) when including postpartum depression symptoms in the model. We discuss the potential role of social support as an explanation for this unexpected result.

Parent-Mediated Home Intervention for Delayed Sleep-Onset and Night Waking in a Child With Autism Spectrum Disorder

We report the case of a 10-year-old boy with autism spectrum disorder who had difficulty initiating and maintaining sleep. Through home consultation, his parents were trained to implement a multicomponent sleep intervention that included (a) faded bedtime, (b) regimented pre-bedtime routines, and (c) elimination of positive social consequences contingent on sleep problems including unwanted co-sleeping. A critical element in the case was functional assessment of the conditions associated with poor sleeping and matching intervention to parent preferences. Compared to a baseline phase, intervention reduced night waking frequency and duration as well as the time required for the boy to fall asleep. Follow-up results one and 2 months post-intervention documented sustained improvement.

Penerapan Positive Routine dan Graduated Extinction untuk Menurunkan Perilaku Co-Sleeping pada Anak Usia Dini

Co-sleeping merupakan solusi jangka pendek yang efektif terhadap anak dengan kesulitan menginisiasi tidur (sleep onset). Pada sisi lain, co-sleeping berkorelasi dengan kemungkinan lebih tinggi untuk terbangun di malam hari (night waking), durasi tidur yang lebih pendek, penolakan yang lebih tinggi untuk tidur, dan kualitas tidur yang lebih rendah. Intervensi yang paling efektif dalam mengatasi co-sleeping adalah modifikasi perilaku. Penelitian ini bertujuan menguji efektivitas penerapan teknik-teknik modifikasi perilaku yang paling banyak digunakan dalam mengatasi co-sleeping, yaitu; positive routine dan extinction. Selain teknik-teknik tersebut, edukasi orang tua, pemberian feedback, dan reinforcement juga dilakukan dalam program ini. Partisipan penelitian ini adalah seorang anak berusia 5 tahun dengan masalah co-sleeping. Hasil penelitian membuktikan bahwa penerapan teknik-teknik tersebut memiliki efektivitas yang baik untuk menurunkan perilaku co-sleeping pada anak usia dini. Anak berhasil tidur sendiri, juga menunjukkan penurunan durasi sleep onset dan night waking. Terdapat beberapa faktor yang mendukung pelaksanaan intervensi ini; positive routine yang terbangun dengan baik sejak anak masih bayi, anak yang terbiasa melakukan aktivitas fisik secara rutin, gaya pengasuhan orang tua, juga penguasaan anak terhadap teknik relaksasi. Kata Kunci: modifikasi perilaku, co-sleeping, graduated extinction, positive routine, sleep training

Postpartum Depression and Mother-offspring Conflict over Maternal Investment

Structured Abstract Background and objectives As the mother-offspring relationship is central to human reproduction, postpartum depression symptoms are difficult to explain in evolutionary terms. We proposed that postpartum depression might arise as a result of evolutionary mother-offspring conflict over maternal investment, and investigated the association between postpartum depression symptoms, infant night waking, maternal sleep disturbance and breastfeeding frequency. Methodology We conducted a cross-sectional analysis using survey responses at six months postpartum from 1598 Finnish mothers. We hypothesized that infant night waking at six months postpartum would be associated with postpartum depression symptoms, and that this association would be mediated by maternal sleep disturbance and a higher breastfeeding frequency. Results Infant night waking was moderately associated with postpartum depression symptoms, and this association was mediated by maternal sleep disturbance (R2 = .09). Contrary to our prediction, we found that increased breastfeeding was associated with less postpartum depression symptoms. Conclusions and implications We conclude that postpartum depression symptoms might partly be the result of increased maternal fatigue stemming from high offspring demands on maternal investment, but that this is not due to the metabolic strain from increased breastfeeding. Studying postpartum depression from the mother-offspring conflict perspective can potentially improve our understanding of the involved behavioral processes of both mother and offspring, and allow interventions designed to benefit the well-being of both parties.

Developmental Profile of Sleep and Its Potential Impact on Daytime Functioning from Childhood to Adulthood in Sickle Cell Anaemia

Young individuals with sickle cell anaemia (SCA) experience sleep disturbances and often experience daytime tiredness, which in turn may impact on their daytime functioning and academic attainment, but there are few longitudinal data. Methods: Data on sleep habits and behaviour were taken on the same day as an in-hospital polysomnography. This study assesses the developmental sleep profiles of children and young adults aged 4–23 years old with SCA. We examined retrospective polysomnography (PSG) and questionnaire data. Results: A total of 256 children with a median age of 10.67 years (130 male) were recruited and 179 returned for PSG 1.80–6.72 years later. Later bedtimes and a decrease in total sleep time (TST) were observed. Sleep disturbances, e.g., parasomnias and night waking, were highest in preschool children and young adults at their first visit. Participants with lower sleep quality, more movement during the night and increased night waking experienced daytime sleepiness, potentially an indicator of lower daytime functioning. Factors influencing sleep quantity included age, hydroxyurea prescription, mean overnight oxygen saturation, sleep onset latency, periodic limb movement, socioeconomic status and night waking. Conclusion: Sleep serves an important role for daytime functioning in SCA; hence, quantitative (i.e., PSG for clinical symptoms, e.g., sleep-disordered breathing, nocturnal limb movement) and qualitative (i.e., questionnaires for habitual sleep behaviour) assessments of sleep should be mutually considered to guide interventions.

The View from the Sea: The Power of a Blue Comparative Literature

This paper advocates for a blue comparative literature that uses the view from the sea to provide new axes for comparison. Roy Jacobsen’s De usynlige (The Unseen, 2013) and Sarah Moss’s Night Waking (2011) explore subsistence lives on small islands in the northern Atlantic at different moments in the past, when inhabitants were dependent on the sea for food and transport. By looking at them together, as texts linked by their engagement with the physical world of the northern Atlantic, the two novels show how marginal populations on small islands can represent a space for the imagination of the human past and future in the Anthropocene.

Postpartum Depression and Mother-offspring Conflict over Maternal Investment

Background and objectives: As the mother-offspring relationship is central to human reproduction, postpartum depression symptoms are difficult to explain in evolutionary terms. We proposed that postpartum depression might arise as a result of evolutionary mother-offspring conflict over maternal investment, and investigated the association between postpartum depression symptoms, infant night waking, maternal sleep disturbance and breastfeeding frequency. Methodology: We conducted a cross-sectional analysis using survey responses at six months postpartum from 1598 Finnish mothers. We hypothesized that infant night waking at six months postpartum would be associated with postpartum depression symptoms, and that this association would be mediated by maternal sleep disturbance and a higher breastfeeding frequency.Results: Infant night waking was moderately associated with postpartum depression symptoms, and this association was mediated by maternal sleep disturbance (R2 = .09). Contrary to our prediction, we found that increased breastfeeding was associated with less postpartum depression symptoms. Conclusions and implications: We conclude that postpartum depression symptoms might partly be the result of increased maternal fatigue stemming from high offspring demands on maternal investment, but that this is not due to the metabolic strain from increased breastfeeding. Studying postpartum depression from the mother-offspring conflict perspective can potentially improve our understanding of the involved behavioral processes of both mother and offspring, and allow interventions designed to benefit the well-being of both parties.

0874 Patients with Congenital Central Hypoventilation Syndrome Do Not Wake Up to Ventilator Alarms

Introduction Congenital Central Hypoventilation Syndrome (CCHS) requires lifelong ventilatory support during sleep. CCHS patients are vulnerable to sleep disturbances associated with treatments, monitoring alarms, and care they receive. We hypothesized that sleep would be disrupted in CCHS patient’s due to ventilatory support and other treatments at night. Methods An anonymous survey of CCHS patients aged 0-17 years was conducted through REDCAP. Patients were recruited in person, by flyer, email, and social media. Data collected included demographics, PHOX2B genotype, ventilatory support, treatments, nursing, and sleep parameters. Results We received 22 responses (27% Female, 8.1 years ± 5.7). PHOX2B genotypes were 20/27 PARM (8), 20/26 PARM (2), 20/24 PARM (2), 20/25 PARM (4), ≥ 20/28 PARM (2), and 2 NPARM (2). Two respondents did not indicate the PHOX2B genotype. 13/22 were ventilated by PPV via tracheostomy, 7/22 by BPAP, and 2/22 by diaphragm pacing. Additional treatments received at night included suctioning (8), aerosol (1), G-tube feeding (2), and none (11). Only 9 received nursing at night. 13 used pulse oximetry for monitoring, and 9 used both pulse oximetry and end tidal CO2 monitor. 16/22 rarely woke up due to ventilator or monitor alarms. 15/22 slept within 20 minutes after going to bed. Sleep latency was not affected by mode of ventilation. 11/22 reported night waking ≥ 2 nights/week and 10/22 returned to sleep without help after night waking. 6/7 BPAP dependent patients reported low frequency of night waking (0-1 time/week). Of the PPV + trach group, 7/13 reported high frequency of night wakings, mostly 5-7 times/week. Conclusion Most CCHS patients do not awaken in response to ventilator alarms. Sleep is rarely disrupted by nursing or feeding intervention. We speculate that CCHS patients contemplating to live independently should be tested to see if they awaken in response to ventilator alarms. Support None