Valid methods for estimating children's sleep problems in clinical practice

Werner, Helene; Hunkeler, Peter; Benz, Caroline; Molinari, Luciano; Huber, Reto; Jenni, Oskar G.

doi:10.1111/apa.12782

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…16,17 Periods of daytime and nighttime sleep were recorded in 15-min intervals, indicated by a continuous line, sleep onset time by the beginning and sleep end time by the ending of the continuous line (see example 16 ). Parents were also asked to indicate periods when the child was sick, when the actigraph was taken off, or when unusual external motion occurred that could mask sleep (e.g., sleeping in the buggy).…”

Section: Sleep-wake Variablesmentioning

confidence: 99%

The Zurich 3-Step Concept for the Management of Behavioral Sleep Disorders in Children: A Before-and-After Study

Werner

Hunkeler

Benz

et al. 2015

Journal of Clinical Sleep Medicine

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Objectives: Several strategies have been found to be effective for the treatment of childhood behavioral sleep disorders. One which has yet to be evaluated is the Zurich 3-step concept, which combines basic notions of the two-process model of sleep regulation (introducing a regular rhythm and adjusting bedtime to sleep need) with behavioral strategies. This uncontrolled before-and-after study describes our concept and its step-wise approach, assesses changes in sleep-wake variables and behavior problems, and also examines associations between changes in sleep-wake variables and behavior problems. Methods: A total of 79 children with sleep problems (age range 6-47 months, 42% females) were included. Sleep problems were assessed by the Infant Sleep Questionnaire, sleep-wake variables by diary and actigraphy, and behavior problems of children ≥ 18 months by the Child Behavior Checklist. Results: A signifi cant decrease in nocturnal wake duration (Cohen's d = −0.34) and a signifi cant increase in the duration of the longest continuous nocturnal sleep period (Cohen's d = 0.19) were found from before to after intervention (on average 2.7 months, SD 1.5). The variability for sleep onset and end time decreased, and actigraphically measured circadian rest-activity cycle measures improved. Parent-reported internalizing and total behavior problems also decreased (Cohen's d = 0.66). Conclusions:The fi ndings of both objective and subjective assessment techniques suggest that the Zurich 3-step concept is effective. Thus, the intervention concept may be useful in clinical practice with sleep-disordered children.

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Section: Sleep-wake Variablesmentioning

confidence: 99%

The Zurich 3-Step Concept for the Management of Behavioral Sleep Disorders in Children: A Before-and-After Study

Werner

Hunkeler

Benz

et al. 2015

Journal of Clinical Sleep Medicine

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“…Actigraphy has become a widely used method to objectively measure sleep over the past 20 years and has proven to be useful in assessing habitual sleep pattern in children with and without sleep problems. 18,24 In clinical research, actigraphy is used to investigate sleep and the relationship between sleep and behavioral functions in different clinical populations, for example, children with ADHD 25 or children with Down syndrome or Williams syndrome. 26 In children and adolescents with neurodevelopmental disorders the method allows to detect effects of medication on sleep.…”

Section: Actigraphymentioning

confidence: 99%

Methods in Pediatric Sleep Research and Sleep Medicine

Mouthon

Huber

2015

Neuropediatrics

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Several methods are used to evaluate sleep in infants, children, and adolescents including: Questionnaires and diaries, actigraphy, polysomnography, and electroencephalography which are well established. Novel approaches such as high-density electroencephalography, simultaneous electroencephalography?functional magnetic resonance imaging and nonpharmacological methods aiming for a modulation of sleep are currently only used for research. These approaches might become valuable methods for clinical application in the future. The purpose of this review is to present an overview of current methods and their respective fields of application and to report available rules and recommendations for their use.

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“…Screening measures, including sleep-related questions, are used routinely within these clinics, such as the Child Behavior Check List (CBCL). Although some authors have argued that parents may have a biased perception of sleep patterns in childhood [23], specific sleep items of the CBCL are associated with other validated sleep measures such as sleep diaries, actigraphy, and polysomnography in school-aged children [24]. Consequently, there is a need to evaluate the CBCL’s discriminating power with various clinical populations.…”

Section: Introductionmentioning

confidence: 99%

Sleep Difficulties in Preschoolers with Psychiatric Diagnoses

Chénier-Leduc

Béliveau

Dubois‐Comtois

et al. 2019

IJERPH

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Background: Sleep problems among preschoolers are highly prevalent. Given the impact of poor sleep quality on development, this relationship is particularly relevant in vulnerable populations but is less documented. This study aims to document parental perception of sleep problems in preschoolers assessed in a psychiatric clinic, as a function of diagnosis type. Methods: Children (14–71 months, n = 228) were evaluated by a psychiatrist, and diagnoses were pooled into four categories: behavioral disorders, relational disorders/psychosocial problems, developmental coordination disorder (DCD), and communication disorders. Sleep problems were measured using the Child Behavior Checklist (CBCL). Results: In this clinical sample of preschoolers, 21.6% of children were identified as having a sleep problem by their parents. Behavioral disorders and communication disorders were associated with increased parental report of sleep problems (respectively, trouble falling asleep and nighttime awakenings), while DCD was associated with lower parental report of sleep problems (fewer nighttime awakenings and less difficulty falling asleep) (p < 0.05). Relational disorders were not associated with parental reports of sleep difficulties (p > 0.05). Moreover, some psychiatric categories were associated with specific sleep symptoms (such as difficulty falling asleep and night awakenings). Conclusion: Parents of preschoolers with behavioral disorders and communication disorders are more likely to report sleep problems in their children than parents of preschoolers with DCD and relational disorders. Since different categories of psychiatric disorders are associated with specific types of sleep complaints, screening, and treatment should be adapted accordingly.

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Valid methods for estimating children's sleep problems in clinical practice

Cited by 7 publications

References 11 publications

The Zurich 3-Step Concept for the Management of Behavioral Sleep Disorders in Children: A Before-and-After Study

The Zurich 3-Step Concept for the Management of Behavioral Sleep Disorders in Children: A Before-and-After Study

Methods in Pediatric Sleep Research and Sleep Medicine

Sleep Difficulties in Preschoolers with Psychiatric Diagnoses

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