Using a Digital Meditation Application to Mitigate Anxiety and Sleep Problems in Children with ADHD

Objective: ADHD affects 11% of children in the United States and is associated with significant levels of anxiety. Although the literature supports mindfulness-based interventions as a promising strategy for managing anxiety, it falls short in the feasibility of digital mindfulness interventions. Method: This study investigated the usefulness of the pediatric version of Headspace, a digital mindfulness program, for reducing stress in 18 children with ADHD. We conducted a 4-week pilot study to evaluate the Headspace digital mindfulness application for children ages 6 to 12 with ADHD. Parents completed the Beck Anxiety Inventory and the Children’s Sleep Habits Questionnaire at baseline and endpoint. Results: Participants had an average age of 9.2 years and were 78% male. The Headspace intervention significantly reduced anxiety and sleep problems in children with ADHD. Conclusion: Children with ADHD and comorbid anxiety and/or sleep problems could benefit from a digitally based meditation application. (J. of Att. Dis. XXXX; XX(X) XX-XX)

Hábitos de sueño en el confinamiento por Covid-19 en una muestra de niños colombianos

La nueva enfermedad provocada por el virus SARS-CoV-2 ha generado en el mundo un confinamiento cuyo fin es ralentizar el número de contagios y proteger así la vida de las personas; sin embargo, tal aislamiento y el cambio de hábitos han producido considerables efectos en su salud mental. Por consiguiente, el presente estudio tuvo como objetivo determinar los problemas en los hábitos de sueño y su relación con algunas características generadas por la reclusión en una muestra de 259 niños colombianos de 5 a 12 años de edad, residentes en la ciudad de Pasto (Colombia), a través de la aplicación a sus padres del cuestionario Children’s Sleep Habits Questionnaire y de un cuestionario ad hoc para evaluar los cambios en las rutinas diarias, el uso de la tecnología y la emocionalidad en los niños. A este efecto, se hicieron análisis descriptivos de los instrumentos, una prueba de X2 para determinar la influencia de las variables de sexo y nivel socioeconómico, y pruebas de correlación rho de Spearman entre las escalas y subescalas de dichos instrumentos. Entre los resultados más relevantes se halló que 45.5% de los niños mostraban algunos problemas del sueño, siendo las parasomnias y la somnolencia diurna los de mayor prevalencia. Además, se encontraron correlaciones positivas entre los puntajes de las escalas, identificándose también relaciones entre el uso de la tecnología y los cambios emocionales con dificultades del sueño, por lo que se concluye que han ocurrido alteraciones en los hábitos de sueño debidos al confinamiento.

Measurement of Sleep Behaviors in Chromosome 15q11.2-13.1 Duplication (Dup15q Syndrome)

Duplication of chromosome 15q11.2-q13.1 (dup15q syndrome) results in hypotonia, intellectual disability (ID), and autism symptomatology. Clinical electroencephalography has shown abnormal sleep physiology, but no studies have characterized sleep behaviors. The present study used the Children's Sleep Habits Questionnaire (CSHQ) in 42 people with dup15q syndrome to examine the clinical utility of this questionnaire and quantify behavioral sleep patterns in dup15q syndrome. Individuals with fully completed forms (56%) had higher cognitive abilities than those with partially completed forms. Overall, caregivers indicated a high rate of sleep disturbance, though ratings differed by epilepsy status. Results suggest that clinicians should use caution when using standardized questionnaires and consider epilepsy status when screening for sleep problems in dup15q syndrome.

Sleep Abnormalities in the Synaptopathies—SYNGAP1-Related Intellectual Disability and Phelan–McDermid Syndrome

Neurodevelopmental disorders are frequently associated with sleep disturbances. One class of neurodevelopmental disorders, the genetic synaptopathies, is caused by mutations in genes encoding proteins found at the synapse. Mutations in these genes cause derangement of synapse development and function. We utilized a validated sleep instrument, Children’s Sleep Habits Questionnaire (CSHQ) to examine the nature of sleep abnormalities occurring in individuals with two synaptopathies—Phelan–McDermid syndrome (PMD) (N = 47, male = 23, female = 24, age 1–46 years) and SYNGAP1-related intellectual disability (SYNGAP1-ID) (N = 64, male = 31, female = 33, age 1–64 years), when compared with unaffected siblings (N = 61, male = 25, female = 36, age 1–17 years). We found that both PMD and SYNGAP1-ID have significant sleep abnormalities with SYNGAP1-ID having greater severity of sleep disturbance than PMD. In addition, sleep disturbances were more severe for PMD in individuals 11 years and older compared with those less than 11 years old. Individuals with either disorder were more likely to use sleep aids than unaffected siblings. In conclusion, sleep disturbances are a significant phenotype in the synaptopathies PMD and SYNGAP1-ID. Improved sleep is a viable endpoint for future clinical trials for these neurodevelopmental disorders.

Linguistic adaptation and psychometric evaluation of Italian version of children’s sleep habits questionnaire

Background The Children’s Sleep Habits Questionnaire (CSHQ) is a parent-report questionnaire used to examine sleep behavior in children. Linguistic adaptation of CSHQ into several languages and/or psychometric analysis of reliability have been published. Main text Our aim was to translate the original 33-items CSHQ from English to Italian and to examine its reliability for use in 4–10 years-old children of Italy. After translation and back-translation procedure of the original CSHQ, the Italian CSHQ (CSHQ-IT) was administered to 69 mothers of healthy children. Reliability of CSHQ-IT was examined by the internal consistency of the scale (using the Cronbach’s alpha coefficient), and by the test-retest analysis obtained by asking mothers who had completed the CSHQ-IT at baseline to re-complete it after a two-week interval (measured with the Lin’s Concordance Correlation Coefficient, CCC). The CSHQ-IT showed adequate internal consistency (Cronbach’s alpha = 0.81 for the total scale). The total CSHQ-IT score showed a strong correlation in retests (CCC 0.87; 95% Confidence Interval, 0.80; 0.92). Conclusion CSHQ-IT is a valuable tool for evaluating sleep behavior in children 4–10 years-old in Italy. Future research should be implemented to provide definitive validity of CSHQ-IT in children with sleep-disordered breathing.

AB0753 ASSESSMENT OF SLEEP PROBLEMS IN PATIENTS WITH KAWASAKI DISEASE: A SURVEY-BASED STUDY

Background:Kawasaki disease (KD) is a type of vasculitis that affects mainly medium and small arteries,especially the coronary arteries (1).It mainly affects children under the age of five (2).Sleep disturbances are more prevalent among medically ill children and adults and may have a negative impact on their health related quality of life (3, 4).To the best of our knowledge,sleep problems have not previously studied in KD patients.Objectives:This study aimed to investigate sleep problems, sleep disturbances and the relation between sleep problems and clinical manifestations among patients with KD.Methods:A cross-sectional study was performed using a written survey. Participants were invited through social media groups including patients and parents of children with KD. The survey included questions about demographic data, KD manifestations, disease duration and treatment received for management of the disease. Children’s Sleep Habits Questionnaire (33-item version) was also included in the survey (5).Results:There was a total of 262 survey participants (130 KD and 132 age- and sex matched healthy controls). There was no significant difference in the frequency of clinically significant sleep disturbance between patients with KD and healthy controls. However, the total sleep score was significantly higher in KD patients than health controls (p<.001).Total sleep duration was significantly higher in patients with KD (4.94±1.88 vs 3.74 ±1.14 hr, p<.001).Additionally KD patients had significantly higher scores regarding sleep onset delay (p=.001),night wakings (p<.001),parasomnias (p<.001) and sleep disordered breathing (p<.001) when compared to healthy controls.KD Patients who manifested with chronic heart disease or lethargy had significantly higher sleep score than patients without (p=.015,.039 respectively).Conclusion:This study showed that patients with KD had more sleep disturbance than their healthy peers. The presence of either chronic heart disease or lethargy is associated with poor sleep quality.This study highlights the need for assessment of sleep disorders in KD patients.References:[1]Hedrich CM, Schnabel A, Hospach T. Kawasaki Disease. Front Pediatr. 2018;6:198-.[2]Singh S, Gupta MK, Bansal A, Kumar RM, Mittal BR. A comparison of the clinical profile of Kawasaki disease in children from Northern India above and below 5 years of age. Clinical and experimental rheumatology. 2007;25(4):654-7.[3]van Golde EG, Gutter T, de Weerd AW. Sleep disturbances in people with epilepsy; prevalence, impact and treatment. Sleep medicine reviews. 2011;15(6):357-68.[4]Roehrs T, Diederichs C, Gillis M, Burger AJ, Stout RA, Lumley MA, et al. Nocturnal sleep, daytime sleepiness and fatigue in fibromyalgia patients compared to rheumatoid arthritis patients and healthy controls: a preliminary study. Sleep medicine. 2013;14(1):109-15.[5]Silva FG, Silva CR, Braga LB, Serrão Neto A. Portuguese Children’s Sleep Habits Questionnaire-validation and cross-cultural comparison. Jornal de pediatria. 2014;90(1):78-84.Disclosure of Interests:None declared

Assessment of preschool children's sleep habits in relation to the time spent watching television

Aims To assess preschool children's sleep habits and television viewing habits, parents' perceptions about TV viewing and any correlation between the two. Methods The study was conducted between March and June 2018 in randomly selected kindergartens of a large city in Greece. A total of 100 pre-school children and their parents participated in the study. Two questionnaires, the Children's Sleep Habits Questionnaire (CSHQ) and the Children's Television-Viewing Habits Questionnaire (CTVQ), were validated in Greek and used for this study. Results Children's age (P=0.001), parents' educational level (P<0.001) and number of siblings (P<0.001) were found to significantly affect the time children spent watching TV daily. Fathers' age (P=0.004), number of siblings (P=0.001) and time children spent watching TV daily (P=0.007) were negatively correlated with CSHQ score. Conclusions Pre-school aged children spend a large amount of time watching TV, which results in altered sleep patterns, despite parents encouraging them to participate in other activities. Healthcare professionals should provide parents, teachers and children with evidence-based information and advice in order to lower the incidence of sleep disorders resulting from excessive time spent watching TV.