Sleep and melatonin secretion abnormalities in children and adolescents with fetal alcohol spectrum disorders

Goril, Shery; Zalai, Dóra; Scott, Louise; Shapiro, Colin M.

doi:10.1016/j.sleep.2016.06.002

Cited by 41 publications

(29 citation statements)

References 42 publications

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“…According to our results every second child with FASD experiences sleep disorders. This nding is consistent with the result of the research published by Goril et al (15) who estimated the prevalence of sleep disorders among individuals with FASD to 58%. On the other hand, Chen et al (16) established a prevalence rate at 85%.…”

Section: Discussionsupporting

confidence: 93%

“…However, as the authors suggested, given the small sample size, their data should be considered exploratory. Similarly, Goril et al (15) indicated an increased sleep fragmentation and an increased predisposition to apneic/hypopneic events, interestingly, the increased AHI was only observed in the young children in their sample. Alvik et al, Troese et al and Scher et al (19)(20)(21) demonstrated that infants with prenatal alcohol exposure tend to present fragmented sleep and experience more arousals, however, these studies were performed with a different methodology.…”

Section: Discussionmentioning

confidence: 68%

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The Prevalence and Characteristic of Sleep Problems among Children with Fetal Alcohol Spectrum Disorders (FASD).

Dyląg¹,

Bańdo²,

Baran³

et al. 2020

Preprint

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BackgroundFetal alcohol spectrum disorders (FASD) is a group of conditions resulting from prenatal alcohol exposure (PAE). Patients with FASD experience a variety of neuropsychological symptoms resulting from central nervous system impairment. Little is known about sleep disorders associated with PAE. The objective of this study was to investigate the prevalence and characterize sleep problems among individuals with FASD.Methods40 patients from FASD diagnostic center (median age 8 years (6; 11)) diagnosed with one of the FASD diagnosis and 40 patients from the control group (median age 10 years (8; 13)) participated in the study. In the 1st phase, the screening of sleep problems was performed with Child Sleep Habit Questionnaire (CSHQ) filled in by a caregiver. Those who scored above 41 points were qualified to the 2nd phase of the study in which in-lab attended polysomnography (PSG) was performed. The measurements consisted of electroencephalographic channels, left and right electrooculograms, chin electromyogram, left and right tibialis electromyogram, electrocardiogram, ventilatory monitoring, breathing effort, pulse oximetry, snoring and body position.ResultsThe number of participants with sleep disturbances was markedly higher in the study group as compared to controls (55% vs. 20%). The age-adjusted odds ratio for a positive result in CSHQ was 4.31 (95% CI: 1.54-12.11; p=0.005) for FASD patients as compared to the control group. Significant differences between the study and control groups were observed in the following subscales: sleep onset delay, night wakings , parasomnias , sleep disordered breathing, and daytime sleepiness. In PSG children from the FASD group and children from the control group experienced more arousals during the sleep than the children from the laboratory control group. ). There were no significant differences in comparison of respiratory indexes between FASD and control groups although indices in both groups were higher than previously published data for a normal population.ConclusionSleep disorders are more common among individuals with FASD than among healthy children. As distorted sleep can affect daily performance and worsen neurodevelopmental issues, it is vital for the pediatricians and other FASD specialists to include the question about sleep in the anamnesis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 68%

The Prevalence and Characteristic of Sleep Problems among Children with Fetal Alcohol Spectrum Disorders (FASD).

Dyląg¹,

Bańdo²,

Baran³

et al. 2020

Preprint

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“…Study subjects were recruited among critically ill patients admitted to the ICU between February 2015 and July 2017. The inclusion criteria were: (1) patients admitted with septic shock or developed septic shock during their ICU stay [14], (2) age > 18 and < 80 years, (3) ICU stay more than 48 h. Exclusion criteria were: (1) history of neurological or psychiatric disorders [15] or recent brain injury [16], (2) history of cancer [17], autoimmune disease or immunosuppressive therapy [18, 19], (3) alcohol or drug abuse [20, 21], (4) acute kidney injury [3, 11], (5) liver dysfunction [3, 11], (6) endocrine disorders or cortisol treatment [2] and (7) pregnant or postpartum women [15], since such cases are associated with sleep–wake cycle disruption and circadian deregulation.…”

Section: Methodsmentioning

confidence: 99%

Melatonin and cortisol exhibit different circadian rhythm profiles during septic shock depending on timing of onset: a prospective observational study

Sertaridou

Chouvarda

Arvanitidis

et al. 2018

Ann. Intensive Care

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BackgroundSeptic shock has been found to disrupt circadian rhythms. Moreover, timing of onset has been associated with different circadian profiles in experimental studies.ResultsIn this prospective study, we enrolled 26 patients divided into two groups: Group A (N = 15) included subjects who had septic shock at the time of ICU admission and Group B (N = 11) included patients who developed septic shock during ICU admission. 6-Sulfatoxymelatonin (aMT6s) and cortisol levels were measured in urine samples every 4 h over a 24-h period. Two sets of samples were taken from Group A (entry/septic shock and exit) and three sets from Group B (entry, septic shock and exit). Mean, amplitude that is the difference between peak and mean values, as well as peak time, were estimated for both aMT6s and cortisol. In Group A, amplitude of aMT6s upon entry (septic shock) was reduced in relation to exit (437.2 ± 309.2 vs. 674.1 ± 657.6 ng/4 h, p < 0.05). Peak time occurred earlier (10:00 p.m. vs. 07:00 a.m, p < 0.05) and correlated with higher APACHE II score and longer ICU stay. In Group B, aMT6s mean values were significantly increased during septic shock (2492.2 ± 1709.1 ng/4 h) compared to both entry (895.4 ± 715.5 ng/4 h) and exit (1308.6 ± 1214.4 ng/4 h, p < 0.05 for all comparisons). Amplitude of aMT6s was also elevated during septic shock (794.8 ± 431.8 ng/4 h) in relation to entry (293.1 ± 275.9 ng/4 h, p < 0.05). Regarding cortisol rhythm in Group A, during septic shock amplitude was increased compared to exit (13.3 ± 31 ng/4 h vs. 8.7 ± 21.2 ng/4 h p < 0.05) and correlated with reduced hospital length of stay. In Group B, cortisol mean values and amplitude during septic shock (10 ± 5.3 and 3 ± 1.8 ng/4 h, respectively) were significantly reduced compared to both entry (30 ± 57.9 and 12.3 ± 27.3 ng/4 h) and exit (14.4 ± 20.7 and 6.6 ± 8.7 ng/4 h, p < 0.05 for all comparisons) and correlated with higher SOFA score and longer ICU and hospital stay.ConclusionsSeptic shock induced inverse changes of aMT6s and cortisol circadian rhythm profiles both within and between different groups of patients, depending on timing of onset. Reduced rhythmicity was correlated with severity of disease and longer ICU stay.

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“…More than half of children with FASD have sleep disorders [132] including impaired breathing and fragmented sleep [133]. Sleep problems may start from early childhood [133] and many (79%) have an abnormal melatonin profile, suggesting that treatment with melatonin may be beneficial [132]. Prenatal alcohol exposure is also associated with an increased risk of seizures and epilepsy.…”

Section: Fetal Alcohol Spectrum Disorder (Fasd)mentioning

confidence: 99%

“…Prenatal alcohol exposure is also associated with an increased risk of seizures and epilepsy. In animal models, alcohol increases susceptibility to NMDA‐induced generalised tonic clonic seizures [134], but in humans, this relationship could be altered by time and dose. In a Danish Birth Cohort study of 80,526 singletons born between 1996–2002, the risk of neonatal seizures (OR = 3.15, 95% CI = 1.37–7.25) and epilepsy (OR = 1.82, 95% CI = 1.13–2.90) was increased only with binge drinking between 11–16 weeks [135].…”

Section: Fetal Alcohol Spectrum Disorder (Fasd)mentioning

confidence: 99%

Alcohol use in pregnancy and its impact on the mother and child

Oei

2020

Addiction

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Aims To review the impact of prenatal alcohol exposure on the outcomes of the mother and child. Design Narrative review. Setting Review of literature. Participants Mothers and infants affected by prenatal alcohol use. Measurements Outcomes of mothers and children. Findings Prenatal alcohol exposure is one of the most important causes of preventable cognitive impairment in the world. The developing neurological system is exquisitely sensitive to harm from alcohol and there is now also substantial evidence that alcohol-related harm can extend beyond the individual person, leading to epigenetic changes and intergenerational vulnerability and disadvantage. There is no known safe level or timing of drinking for pregnant or lactating women and binge drinking (> four drinks within 2 hours for women) is the most harmful. Alcohol-exposure increases the risk of congenital problems, including Fetal Alcohol Spectrum Disorder (FASD) and its most severe form, Fetal Alcohol Syndrome (FAS). Conclusion The impact of FASD and FAS is enduring and lifelong with no current treatment or cure. Emerging therapeutic options may mitigate the worst impact of alcohol exposure but significant knowledge gaps remain. This review discusses the history, epidemiology and clinical presentations of prenatal alcohol exposure, focusing on FASD and FAS, and the impact of evidence on future research, practice and policy directions.

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Sleep and melatonin secretion abnormalities in children and adolescents with fetal alcohol spectrum disorders

Cited by 41 publications

References 42 publications

The Prevalence and Characteristic of Sleep Problems among Children with Fetal Alcohol Spectrum Disorders (FASD).

The Prevalence and Characteristic of Sleep Problems among Children with Fetal Alcohol Spectrum Disorders (FASD).

Melatonin and cortisol exhibit different circadian rhythm profiles during septic shock depending on timing of onset: a prospective observational study

Alcohol use in pregnancy and its impact on the mother and child

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