First name
Jodi
Middle name
A
Last name
Mindell

Title

Differences in Sleep Patterns and Problems by Race in a Clinical Sample of Black and White Preschoolers.

Year of Publication

2017

Number of Pages

1281-1288

Date Published

2017 Nov 15

ISSN Number

1550-9397

Abstract

<p><strong>STUDY OBJECTIVES: </strong>Community-based research indicates that Black preschoolers tend to have more bedtime difficulties and are at higher risk for obstructive sleep apnea (OSA) compared to White preschoolers. This study examined differences in sleep patterns and problems by race among a clinical sample of Black and White preschoolers at an outpatient sleep clinic.</p>

<p><strong>METHODS: </strong>Data were collected from electronic medical records for 125 children ages 2-5 years (mean = 3.37 years, 64.0% White, 36.0% Black; 59.2% male) presenting at a pediatric sleep clinic in an academic medical center. Neighborhood income data were based on ZIP codes entered into the United States Census Bureau's American Fact Finder.</p>

<p><strong>RESULTS: </strong>Black patients (51.1%) were significantly more likely than White patients (20.0%) to bed-share with a caregiver (χ = 12.99, ≤ .001). There were no other significant differences in presenting sleep patterns (bed/wake times, sleep onset latency, naps, night awakenings, or sleep opportunity). Logistic regressions showed that White patients were more likely to present with difficulty falling/staying asleep and receive an insomnia diagnosis, and Black patients were more likely to present with OSA-related concerns and receive a diagnosis of suspected OSA, even when controlling for relevant sociodemographic covariates.</p>

<p><strong>CONCLUSIONS: </strong>In contrast to community-based research, Black and White children showed similar sleep patterns. However, there were differences by race in referral questions and diagnoses. Findings suggest the need to consider caregiver perceptions and other sociocultural factors that may contribute to differential rates of presentation for sleep services, as well as potential health disparities in this regard.</p>

DOI

10.5664/jcsm.6798

Alternate Title

J Clin Sleep Med

PMID

28992828

Title

Benefits of a bedtime routine in young children: Sleep, development, and beyond.

Year of Publication

2018

Number of Pages

93-108

Date Published

2018 08

ISSN Number

1532-2955

Abstract

<p>This paper presents a conceptual model and reviews the empirical evidence to support a nightly bedtime routine as a key factor in the promotion of not only healthy sleep, but also of broad development and wellbeing in early childhood. A bedtime routine embodies the characteristics of nurturing care and early child stimulation, which are deemed to be essential for positive outcomes, especially for at-risk children. Furthermore, common, adaptive components of a bedtime routine can contribute to an array of positive developmental outcomes beyond improved sleep, inclusive of language development, literacy, child emotional and behavioral regulation, parent-child attachment, and family functioning, among other outcomes. These bedtime routine components include activities in the broad domains of nutrition (e.g., feeding, healthy snack), hygiene (e.g., bathing, oral care), communication (e.g., reading, singing/lullabies) and physical contact (e.g., massage, cuddling/rocking). A bedtime routine can provide multiple benefits to child and family functioning at a time of day that many parents are present with their children. Although additional research on hypothesized routine-related child outcomes and mechanisms of action are needed, promoting a bedtime routine may be a feasible and cost-effective method to promote positive early childhood development worldwide, particularly for socioeconomically disadvantaged and other at-risk young children.</p>

DOI

10.1016/j.smrv.2017.10.007

Alternate Title

Sleep Med Rev

PMID

29195725

Title

Caregiver-perceived sleep outcomes in toddlers sleeping in cribs versus beds.

Year of Publication

2019

Number of Pages

16-21

Date Published

2019 02

ISSN Number

1878-5506

Abstract

<p><strong>OBJECTIVE: </strong>Little is known about whether sleep space impacts toddler sleep outcomes. We examined the prevalence of crib-sleeping and its association with caregiver-reported sleep patterns and problems in a large sample of toddlers from Western countries.</p>

<p><strong>METHODS: </strong>Participants were caregivers of 1983 toddlers ages 18.0-35.9 months (51.7% male; mean age 25.3 months) from Australia, Canada, New Zealand, the United Kingdom, and the United States sleeping in a crib or bed in a separate room from caregivers. Caregiver-reported sleep patterns and problems were collected via a free, publicly available child sleep smartphone application.</p>

<p><strong>RESULTS: </strong>Across countries/regions, rates of crib-sleeping decreased linearly with age, with 63.4% of toddlers ages 18.0-23.9 months, 34.3% of toddlers ages 24.0-29.9 months, and 12.6% of toddlers ages 30.0-35.9 months sleeping in a crib. Across age groups and countries, crib sleeping was significantly associated with an earlier bedtime, shorter sleep onset latency, fewer night awakenings, longer stretches of time asleep, increased nighttime sleep duration, and decreased bedtime resistance and sleep problems. The duration of night awakenings did not significantly differ by sleep space.</p>

<p><strong>CONCLUSION: </strong>Sleeping in a crib instead of a bed is associated with enhanced caregiver-reported sleep quantity and quality for toddlers in Western countries. Consistent with practice recommendations, deferring the crib-to-bed transition until age 3 years may benefit toddlers' sleep in Western contexts. Additional research is needed to identify the impact of sleep space on child sleep in other countries/regions.</p>

DOI

10.1016/j.sleep.2018.10.012

Alternate Title

Sleep Med.

PMID

30529772

Title

Child sleep behaviors and sleep problems from infancy to school-age.

Year of Publication

2019

Number of Pages

5-8

Date Published

2019 Nov

ISSN Number

1878-5506

Abstract

<p><strong>OBJECTIVE: </strong>Few studies have examined the sleep behaviors associated with a caregiver-reported sleep problem beyond early childhood and across different age groups. This study examined sleep behaviors associated with a caregiver-reported sleep problem from birth to middle childhood.</p>

<p><strong>METHODS: </strong>Participants were 5107 children from the Longitudinal Study of Australian Children-Birth Cohort. Caregiver-reported child sleep problems and sleep behaviors were assessed biennially from ages 0-1 to 10-11 years. Logistic regressions were used to examine associations between three child sleep behaviors (waking overnight, difficulty falling asleep, and difficulty sleeping alone) and the odds of having a caregiver-reported sleep problem at each age.</p>

<p><strong>RESULTS: </strong>Caregiver-reported child sleep problems were most prevalent in infancy (17.1%) and decreased through middle childhood (7.7%). All three sleep behaviors were associated with a sleep problem at each age. Whereas waking overnight was the most common sleep behavior and was associated with the highest odds of having a sleep problem from infancy to age 6-7 years (ORs&nbsp;=&nbsp;5.78-8.29), difficulty falling asleep was the most common sleep behavior and was associated with the highest odds of having a sleep problem at ages 8-9 and 10-11 years (ORs&nbsp;=&nbsp;10.65 and 17.78, respectively).</p>

<p><strong>CONCLUSION: </strong>Caregivers' endorsement of a child sleep problem was associated with developmentally-relevant sleep behaviors, with night awakenings most relevant during infancy and difficulty falling asleep most relevant in middle childhood. Study findings have implications for targeted and developmentally-focused sleep problem screening questions in child healthcare settings. Future research examining additional indicators of caregiver-defined sleep problems is required.</p>

DOI

10.1016/j.sleep.2019.05.003

Alternate Title

Sleep Med.

PMID

31600659

Title

Sleep Problem Trajectories and Cumulative Socio-Ecological Risks: Birth to School-Age.

Year of Publication

2019

Number of Pages

229-237.e4

Date Published

2019 Dec

ISSN Number

1097-6833

Abstract

<p><strong>OBJECTIVES: </strong>To evaluate whether there are distinct childhood sleep problem trajectories from birth to 10-11&nbsp;years and to assess associations with cumulative socio-ecological risks (child, family, context).</p>

<p><strong>STUDY DESIGN: </strong>Participants were 5107 children from the Longitudinal Study of Australian Children-Birth Cohort. At birth, cumulative risk indexes were generated for birth, parenting, family, socioeconomic, and neighborhood risks. Parent-reported child sleep problems were assessed biennially from ages 0-1 to 10-11&nbsp;years. Sleep problem trajectories were derived using latent class&nbsp;analysis. Multivariable logistic regression was used to examine associations with risk indexes.</p>

<p><strong>RESULTS: </strong>Five distinct trajectories emerged: persistent sleep problems through middle childhood (7.7%), limited infant/preschool sleep problems (9.0%), increased middle childhood sleep problems (17.0%), mild sleep problems over time (14.4%), and no sleep problems (51.9%). Cumulative mother- and father-reported family risks (distress; marital/relational hostility) were linked to nearly all of the trajectories, whereas father- and mother-reported parenting risks were associated with fewer trajectories. Birth risks were associated with increased middle childhood sleep problems. Neighborhood risks were not associated with any trajectories. Socioeconomic risks were linked to mild and persistent sleep problem trajectories. Cumulative risk indexes were most associated with increased middle childhood sleep problems.</p>

<p><strong>CONCLUSIONS: </strong>This study identified distinct longitudinal sleep problem trajectories, suggesting the need for continuous sleep screening over development. Cumulative risks assessed at birth-primarily maternal and paternal family risks-predicted these trajectories, especially for the sleep problems in middle childhood trajectory. Preventive interventions targeting modifiable factors, particularly caregiver distress and marital/relational hostility, could benefit child sleep.</p>

DOI

10.1016/j.jpeds.2019.07.055

Alternate Title

J. Pediatr.

PMID

31564429

Title

Cumulative Socio-Demographic Risk Factors and Sleep Outcomes in Early Childhood.

Year of Publication

2019

Date Published

2019 Sep 26

ISSN Number

1550-9109

Abstract

<p><strong>STUDY OBJECTIVES: </strong>To examine associations between cumulative socio-demographic risk factors, sleep health habits, and sleep disorder symptoms in young children.</p>

<p><strong>METHODS: </strong>205 caregiver-child dyads (child mean age ± SD: 3.3 ± 1.1 years; 53.7% girls; 62.9% Black, 22.4% non-Hispanic/Latino White, 4.4% Hispanic/Latino; 85.4% maternal caregiver reporter) completed caregiver-rated sleep measures (Brief Child Sleep Questionnaire [BCSQ]; Pediatric Sleep Questionnaire [PSQ] snoring subscale), which were used to generate indexes of poor sleep health habits, pediatric insomnia symptoms, and obstructive sleep apnea (OSA) symptoms. A cumulative risk index was created reflecting caregiver, family, and neighborhood risks.</p>

<p><strong>RESULTS: </strong>Overall, 84.5% of children had ≥ 1 poor sleep health habits, 62.9% had ≥ 1 insomnia symptom, and 40.0% had ≥ 1 OSA symptom. Poisson regression indicated that each increase in the number of cumulative risk factors was associated with a 10% increase in poor sleep health habits, a 9% increase in insomnia symptoms, and an 18% increase in OSA symptoms. Specific caregiver risks (depressive symptoms, lower educational attainment) and family risks (single caregiver, crowded home) were most predictive of poor sleep outcomes.</p>

<p><strong>CONCLUSIONS: </strong>Poor sleep health habits and sleep disorder symptoms are highly prevalent in early childhood, particularly among families experiencing cumulative socio-demographic risks. Findings underscore the need for targeted screening and prevention for modifiable sleep behaviors and efforts to tailor such strategies for at-risk children and families, especially those living in crowded conditions, or with caregivers who are single or have a lower educational attainment or depressive symptoms.</p>

DOI

10.1093/sleep/zsz233

Alternate Title

Sleep

PMID

31555826

Title

Initial Validation of the Sleep Disturbances in Pediatric Cancer Model.

Year of Publication

2016

Date Published

2016 Mar 18

ISSN Number

1465-735X

Abstract

<p>OBJECTIVE : The current study evaluates content validity of the Sleep Disturbance in Pediatric Cancer (SDPC) model using qualitative and quantitative stakeholder input.  METHODS : Parents of children (aged: 3-12 years) with acute lymphoblastic leukemia (n = 20) and medical providers (n = 6) participated in semi-structured interviews about child sleep during cancer treatment. They also rated SDPC model component importance on a 0-4 scale and selected the most relevant sleep-related intervention targets.  RESULTS : Qualitatively, parents and providers endorsed that changes in the child's psychosocial, environmental, and biological processes affect sleep. Stakeholders rated most model components (parent: 32 of 40; provider: 39 of 41) as important (&gt;2) to child sleep. Parents were most interested in interventions targeting difficulty falling asleep and providers selected irregular sleep habits/scheduling, though groups did not differ significantly. CONCLUSIONS : Stakeholders supported SDPC content validity. The model will inform subsequent measure and intervention development focusing on biological and behavioral factors most salient to sleep disturbances in pediatric cancer.</p>

DOI

10.1093/jpepsy/jsw008

Alternate Title

J Pediatr Psychol

PMID

26994058

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