Nightmares in Children with Foetal Alcohol Spectrum Disorders, Autism Spectrum Disorders, and Their Typically Developing Peers

Mughal, Rabya; Wong, Siu Sing; Dimitriou, Dagmara; Halstead, Elizabeth

doi:10.3390/clockssleep3030033

Cited by 5 publications

(4 citation statements)

References 57 publications

(81 reference statements)

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“…Persistent sleep problems were common in children with PAE/FASD (55%–85%; Alvik et al, 2011; Chandler‐Mather et al, 2021; Chen et al, 2012; Dylag et al, 2021; Goril et al, 2016; Hayes et al, 2020; Ipsiroglu et al, 2013; Mughal, Hill, et al, 2020; Mughal, Joyce, et al, 2020; Rosett et al, 1979; Scher et al, 2000). Disrupted sleep patterns were attributed to challenging night behaviors (Chen et al, 2012; Dylag et al, 2021; Hayes et al, 2020; Ipsiroglu et al, 2013; Mughal et al, 2021; Mughal, Joyce, et al, 2020; Spruyt et al, 2016; Wengel et al, 2011), in addition to behavioral, emotional and cognitive functioning difficulties (Alvik et al, 2011; Hayes et al, 2020; Mughal et al, 2021; Mughal, Hill, et al, 2020; Spruyt et al, 2016; Troese et al, 2008). Differences in processing auditory and multisensory stimuli during sleep may impact the ability to fall asleep and increase the incidence of night wakings (Wengel et al, 2011).…”

Section: Resultsmentioning

confidence: 99%

“…Finally, several studies identified disrupted sleep and challenging nighttime behaviors in children with FASD (Alvik et al, 2011; Chandler‐Mather et al, 2021; Chen et al, 2012; Dylag et al, 2021; Goril et al, 2016; Hayes et al, 2020; Mughal et al, 2021; Mughal, Hill, et al, 2020; Mughal, Joyce, et al, 2020; Skorka et al, 2022; Spruyt et al, 2016; Troese et al, 2008; Wengel et al, 2011). As behavioral concerns are associated with sleep problems (Hayes et al, 2020), early interventions targeted toward improving sleep outcomes should be a therapeutic priority as it may lead to improvements in cognitive outcomes (Mughal, Hill, et al, 2020; Mughal, Joyce, et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

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Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Reid,

Kent,

Hewlett

et al. 2023

Alcohol: Clinical and Experimental Research

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BackgroundA scoping review was undertaken to identify factors outside of current fetal alcohol spectrum disorder (FASD) diagnostic criteria that could be considered as part of a holistic assessment process to enable targeted recommendations and supports to improve outcomes. Evidence will be used to inform the revision of the Australian Guide to the Diagnosis of FASD.MethodsSix electronic databases were searched. Studies were eligible if they included factors outside of the diagnostic criteria that clinicians might need to consider as part of a holistic (i.e., physical, social, mental health and wellbeing) assessment process. Data charting and content analysis was performed for synthesis of results.Results121 studies were included that spanned 12 key areas. This included physical health, sleep, adverse postnatal experiences, substance use/other risk‐taking behaviors, contact with the criminal justice system, mental health, First Nations cultural considerations, transition to adult roles, involvement with the out‐of‐home care system, feeding and eating, strengths/interests/external resources and incontinence.ConclusionsAreas to be considered as part of a holistic assessment and diagnostic process spanned individual, family, and system level factors. The results of the current review provide guidance for clinicians regarding the wide range of factors that may influence long‐term health, development, and wellbeing for individuals with prenatal alcohol exposure and FASD. In practice this guidance can be used to inform an individualized assessment process to facilitate tailored recommendations and supports to best meet the complex needs of those living with FASD and their families.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Reid,

Kent,

Hewlett

et al. 2023

Alcohol: Clinical and Experimental Research

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“…Although data are limited, caregivers of children with FASD also report sleep problems beyond infancy (Wengel et al., 2011), including problems with falling asleep, sleep duration, night wakings, nightmares, bedtime resistance, sleep anxiety, and parasomnias (i.e., bedwetting, sleep talking, night terrors; Rzepecka et al., 2011), compared to controls (Chen et al., 2012; Gerstner et al., 2023; Mughal et al., 2021; Wengel et al., 2011). Objective data obtained from limited ( n = 5, n = 19, and n = 36, respectively; Chen et al., 2012, Dylag et al., 2021, Goril et al., 2016) polysomnography studies indicate children with FASD have increased sleep fragmentation, mild sleep disordered breathing and greater frequency of central apneic events, and abnormal melatonin secretion.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of sleep in children with heavy prenatal alcohol exposure

Inkelis,

Soja,

Mattson

et al. 2024

Alcohol, Clinical and Experimental Research

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BackgroundSleep plays an important role in neurodevelopment. However, the effects of prenatal alcohol exposure on sleep quality have been understudied, despite reports of sleep disturbance in infants prenatally exposed to alcohol and elevated levels of sleep problems reported by caregivers of children with fetal alcohol spectrum disorders. The current study characterizes sleep in children with prenatal alcohol exposure using both objective (actigraphy) and subjective (questionnaires, sleep diaries) methods.MethodsParticipants aged 6–10 years, with and without prenatal alcohol exposure, were included in the study (alcohol‐exposed [AE]: n = 35; control [CON]: n = 39). Objective sleep was measured via 24‐h actigraphy for 2 weeks. Parents completed sleep diaries and sleep questionnaires (Children's Sleep Habits Questionnaire, Pediatric Sleep Questionnaire). Multivariate analysis of variance was used to characterize the sleep profile (objective, subjective) and examine group differences.ResultsThere were no group differences on actigraphy metrics averaged across 2 weeks. However, the AE group showed significantly greater intraindividual variability on most actigraphy measures, particularly total sleep time, percent sleep, wake after sleep onset, and number of wake bouts. Parents reported significantly more sleep problems in the AE group than in the CON group, primarily driven by night wakings, parasomnias (e.g., sleepwalking), snoring, and daytime sleepiness. These effects were more severe in children >8.5 years of age.ConclusionsDespite similar 2‐week average sleep outcomes, children with prenatal alcohol exposure showed greater intraindividual sleep variability and parents reported more sleep problems related to sleep behavior and snoring. These difficulties with sleep may be related to other cognitive and behavioral outcomes. Importantly, sleep is a modifiable behavior, and interventions that focus on variability in sleep, particularly in sleep duration, can impact the quality of life in children with prenatal alcohol exposure and their families.

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“…Caregivers report high rates of insomnia symptoms in children with FASD, with 56.4% reporting that their child has difficulty falling asleep, 44.8% reporting that their child experiences difficulties with waking during the night, and 29.4% reporting that waking early in the morning is problematic for their child (Hayes et al, 2020). Children with FASD have also been reported to have more frequent nightmares than typically developing children (Mughal et al, 2021), and consistently score higher than controls on measures of nightmares and other parasomnias and difficulties with sleep onset, duration, and waking (Chen et al, 2012; Dylag et al, 2021; Mughal et al, 2020, 2021).…”

Section: Introductionmentioning

confidence: 99%

Understanding the impacts of childhood adversity on sleep problems in children with fetal alcohol spectrum disorder: A comparison of cumulative and dimensional approaches

Chandler‐Mather

Betts

Donovan

et al. 2023

Alcohol: Clinical and Experimental Research

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BackgroundThe developmental impacts of prenatal alcohol exposure (PAE) and postnatal exposure to adversity are typically considered in isolation. However, both contribute independently to sleep problems. Children with fetal alcohol spectrum disorder (FASD) have PAE and significant sleep disturbances. What is not clear is the relative contribution to these disturbances of exposure to early life adversity. This study examined how exposure to such adversity impacts frequent insomnia symptoms and nightmares in children with FASD and “At Risk” designations.MethodsWe compared two approaches to modeling adversity in children who had undergone a diagnostic assessment for FASD: a cumulative risk approach that sums adversities to create a total score and an approach that treats exposure to threat and deprivation as independent dimensions. Data on caregiver‐reported exposure to adversity and sleep problems for 63 children (aged 3 years 4 months to 7 years 8 months) were extracted from clinical archives. Cumulative risk, threat exposure, and deprivation exposure scores were computed and were tested as predictors of insomnia symptoms and nightmares. All analyses controlled for age and gender.ResultsThere were high rates of caregiver‐reported sleep problems with 60.3% (n = 38) of children having nightmares and 44.4% (n = 28) having a frequent insomnia symptom. The cumulative risk analysis showed that for every additional exposure to adversity, the odds of having a caregiver‐reported insomnia symptom increased by 38%. The dimensional analysis showed no relationship between deprivation and sleep problems. However, every additional exposure to threat increased the odds of nightmares by 93%.ConclusionsExposure to postnatal adversity contributes to sleep disturbances in children with FASD, with unique roles for cumulative risk and the threat dimension of adversity. The implications of these findings for the etiology and treatment of sleep disturbances in children with FASD are discussed.

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Nightmares in Children with Foetal Alcohol Spectrum Disorders, Autism Spectrum Disorders, and Their Typically Developing Peers

Cited by 5 publications

References 57 publications

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Characteristics of sleep in children with heavy prenatal alcohol exposure

Understanding the impacts of childhood adversity on sleep problems in children with fetal alcohol spectrum disorder: A comparison of cumulative and dimensional approaches

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