Polysomnography and Self-reported Sleep, Pain, Fatigue, and Anxiety in Children with Active and Inactive Juvenile Rheumatoid Arthritis

Ward, Teresa M.; Brandt, Patricia; Archbold, Kristen Hedger; Lentz, Martha J.; Ringold, Sarah; Wallace, Carol A.; Landis, Clark R.

doi:10.1093/jpepsy/jsm121

Cited by 51 publications

(59 citation statements)

References 25 publications

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“…In the present sample, 68% of children with JIA scored above the CSHQ clinical cutoff score for disordered sleep, a finding that is similar to those of previous studies (Bloom et al, 2002;Butbul Aviel et al, 2011;Ruperto et al, 2010;Ward et al, 2008). Average nighttime sleep duration was well below 8.5-10 hr the National Sleep Foundation recommends for youth.…”

Section: Discussionsupporting

confidence: 90%

“…In the few studies that have objectively measured sleep in JIA, authors have reported both sleep-disordered breathing and periodic limb movements (Passarelli et al, 2006;Ward et al, 2008Ward et al, , 2010Zamir et al, 1998). In children with chronic conditions like JIA, sleep disturbances may be a sign of an unrecognized sleep disorder that manifests as sleep fragmentation.…”

Section: Discussionmentioning

confidence: 99%

“…A total sleep disturbance score >41 is a clinical indicator of disturbed sleep. Investigators have used the CSHQ in previous studies involving children with JIA and typically developing school-age children (Bloom et al, 2002;Butbul Aviel et al, 2011;Ruperto et al, 2010;Ward et al, 2008). Reliability of the total sleep disturbance score in this sample was a ¼ .81.…”

Section: Sleepmentioning

confidence: 91%

“…Given our previous findings regarding sleep in JIA (Ward et al, 2008(Ward et al, , 2010, we hypothesized that children with JIA would show decreased nighttime sleep duration, decreased sleep efficiency, increased movement and fragmentation index score, and increased fatigue, regardless of JIA category or disease state (active vs. inactive). Based on the previous studies of S100A12 and MRP8/14 serum protein concentrations and sleep fragmentation Kim et al, 2010), we hypothesized that the movement and fragmentation index score would be positively associated with S100A12 and MRP8/14 serum protein concentrations.…”

mentioning

confidence: 98%

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Sleep Fragmentation and Biomarkers in Juvenile Idiopathic Arthritis

Ward

Yuwen

Voss

et al. 2015

Biological Research For Nursing

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Objectives: (1) To compare sleep (nighttime sleep duration and sleep efficiency) and sleep fragmentation (movement and fragmentation index), as measured by actigraphy, and symptoms (pain and fatigue) in 8-to 14-year-old children with polyarticular and extended oligoarticular juvenile idiopathic arthritis (JIA) and (2) to examine the associations between sleep fragmentation (movement and fragmentation index) and the calcium-binding protein biomarkers S100A12 and myeloid-related protein (MRP8/14). Method: Participants included 40 children with extended oligoarticular (n ¼ 15) or polyarticular (n ¼ 25) JIA and their parents. Serum protein samples were obtained during routine rheumatology clinic visits. Children completed the PedsQL Multidimensional Fatigue Scale and daily pain and sleep diaries and wore actigraphy monitors for 9 consecutive days. Parents completed the Children's Sleep Habits Questionnaire (CSHQ). Results: Of the 40 children, 68% scored above the CSHQ clinical cutoff score for sleep disturbances. Mean nighttime sleep duration was 7.5 hr, and mean sleep efficiency was 85.3%. Group differences were not found for nighttime sleep duration, sleep efficiency, movement and fragmentation index, or S100A12 and MRP8/14 protein concentrations. In a stepwise regression, medications, joint count, and movement and fragmentation index explained 21% of the variance in MRP8/14 concentration. Conclusion: Decreased nighttime sleep duration, poor sleep efficiency, and fragmented sleep were observed in our sample, regardless of JIA category. Sleep fragmentation was a significant predictor of MRP8/14 protein concentration. Additional research is needed to understand the interrelations among sleep fragmentation, effects of medication, and S100A12 and MRP8/14 protein biomarkers in JIA.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Sleepmentioning

confidence: 91%

mentioning

confidence: 98%

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Sleep Fragmentation and Biomarkers in Juvenile Idiopathic Arthritis

Ward

Yuwen

Voss

et al. 2015

Biological Research For Nursing

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“…Evidence from a variety of patient populations and studies of healthy children suggest that children, much like adults, show improvements in sleep quality from the first to second night in the sleep laboratory, 3,[5][6][7][8][9][10]19 with some measures of sleep quality continuing to improve when data from subsequent nights are collected. 3 The most consistently reported changes are in TST, SE, WASO, and REM parameters.…”

Section: Discussion and Limitationsmentioning

confidence: 99%

First Night Effect Analysis in a Cohort of Young Children with Autism Spectrum Disorder

Buckley

Wingert

Swedo

et al. 2013

Journal of Clinical Sleep Medicine

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Study Objectives: To evaluate for the fi rst night effect (FNE) in a group of young children with autism. Design: Analysis of polysomnographic data from a 2-night sleep laboratory study. Setting: Clinical Center of the National Institutes of Health. Patients or Participants: 15 children (aged 2-10 years) with a diagnosis of an ASD. Interventions: None. Measurements and Results: Polysomnographic analysis showed the presence of a FNE for wake after sleep onset minutes, stage 2, and sleep effi ciency, but not for REM sleep parameters or TST. Conclusions S C I E N T I F I C I N V E S T I G A T I O N ST he fi rst night effect (FNE) refers to the well-accepted phenomenon of a poorer quality of sleep on the fi rst night when subjects undergo two or more consecutive nights in the sleep lab. Typically, FNE effects include lower sleep effi ciency, less total sleep time, less REM sleep, longer latency to REM sleep, and more intermittent awake time on night one.1,2 While this phenomenon is well recognized among adult populations, there are few exclusively pediatric studies that have examined FNE, and fewer still that have included young children with disorders affecting development.The largest pediatric study examining the FNE was performed in 1984. It was a laboratory-based evaluation of 87 healthy children between the ages of 6 and 15 years. This experiment reported an increase in TST and a decrease in sleep latency for night two. It also revealed similar second night fi ndings as had been seen in adult cohorts, namely, better sleep effi ciency, fewer wake after sleep onset (WASO) minutes, decreased REM latency, and increased REM percentage.3 Palm et al. conducted a 2-night at home study in 1989 on 18 healthy children between 8 and 12 years and did not fi nd such an effect. 4 Instead, there was an increase in sleep latency, an increase in percentage of stage 1 sleep, and an increase in REM latency, all on the second night.The majority of FNE data in children have come from studies using patient populations that frequently undergo overnight polysomnography (PSG) as part of a routine diagnostic assessment. Several studies have examined the FNE among children with suspected sleep disordered breathing (SDB) and obese children who are at risk for developing SDB. Scholle et al. evaluated 131 children between the ages of 2 and 17 years with suspected SDB for 2 nights in the laboratory. 5 The work concluded that while there was a FNE effect for WASO and REM percentage, a second night was not needed for pertinent respiratory parameters. Similarly, Verhulst et al. examined 70 children between the ages of 2 and 17 years, also referred for SDB, and found a FNE for REM sleep parameters but not for respiratory measures.6 Li et al. compared 46 obese children to 44 normal weight children between the ages of 7 and 15 years. 7 The groups were later further broken down for the presence or absence of SDB, and sleep architecture was examined using a 2-night, laboratory-based study. Children with and without SDB had increased TST and greater ...

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Sleep disturbances and neurobehavioral functioning in children with and without juvenile idiopathic arthritis

Ward¹,

Ringold²,

Metz³

et al. 2011

Arthritis Care Res

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Objective To compare sleep disturbances and neurobehavioral function in children with juvenile idiopathic arthritis (JIA) to age-sex matched control children. Methods Parents of and children (N = 116) 6–11 years of age with (n = 70) and without (n = 46) JIA participated. Parents completed questionnaires on sleep habits, sleep behavior and school competence of their children; children completed computerized neurobehavioral performance tests. Results Compared to control children, children with JIA had a statistically significant (p < .001) greater mean overall sleep disturbance score and higher scores on 6 of 8 subscales (all p < .03) on the children’s sleep habits questionnaire (CSHQ). There were no group differences on neurobehavioral performance test scores. However, children, regardless of group, with an overall CSHQ score above an established cut off for clinically significant sleep disturbances had slower mean simple reaction time (t = −2.2, p<.03) and mean 5-choice reaction time (t = −2.3, p<.02) compared to those below the cutoff score. The CHSQ overall sleep disturbance score predicted reaction time (p <0.009), after controlling for age, IQ, medication, and group. Conclusion Children with JIA have more parent reported sleep disturbances, but performed as well as control children on a series of standardized computer tests of neurobehavioral performance. Children with more disturbed sleep had slower reaction times.

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Polysomnography and Self-reported Sleep, Pain, Fatigue, and Anxiety in Children with Active and Inactive Juvenile Rheumatoid Arthritis

Abstract: Sleep was not altered in children with active JRA, however, the "first night effect" suggests that valid laboratory sleep assessments require an adaptation night.

Cited by 51 publications

References 25 publications

Sleep Fragmentation and Biomarkers in Juvenile Idiopathic Arthritis

Sleep Fragmentation and Biomarkers in Juvenile Idiopathic Arthritis

First Night Effect Analysis in a Cohort of Young Children with Autism Spectrum Disorder

Sleep disturbances and neurobehavioral functioning in children with and without juvenile idiopathic arthritis

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