Sleep disturbance as a predictor of anxiety in children with Fetal Alcohol Spectrum Disorders and typically developing children

Mughal, Rabya; Joyce, Anna; Hill, Catherine M.; Dimitriou, Dagmara

doi:10.1016/j.ridd.2020.103610

Cited by 12 publications

(7 citation statements)

References 52 publications

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“…Perhaps due to the small number of participants who reported nightmares such data were not found, or this may be due to the ceiling effect of high nightmare frequency and high parasomnia scores. Within previous analyses of the larger dataset [ 43 , 44 ], parasomnias were significantly associated with executive functioning and behavioural outcomes in the TD and FASD group, but less so in the ASD group. Night wakings however were associated with somatic complaints and attention in the TD group, which is comparable to the present analysis.…”

Section: Discussionmentioning

confidence: 80%

“…Around 80% of children with FASD are in the care of adults other than the biological parent, which contributes to attachment, attentional, and other pervasive neurodevelopmental problems [ 41 ]. Sleep problems are prevalent in children with FASD and are thought to have a bidirectional association with neuropsychological outcomes, such as sensory sensitivity [ 42 ], anxiety [ 43 ], and cognition [ 44 ]. Caregiver reports reveal that children with FASD present with significantly more sleep problems than TD children [ 45 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Children with Foetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD) experience significantly higher rates of sleep disturbances than their typically developing (TD) peers. Pre-sleep anxiety and waking emotional content is known to affect the content and frequency of nightmares, which can be distressing to children and caregivers. This is the first study to analyse nightmare frequency and content in FASD, and to assess its association with psychometric outcomes. Using online caregiver questionnaires, we assessed reports from 277 caregivers of children with ASD (n = 61), FASD (n = 112), and TD children (n = 104) using the Children’s Sleep Habits Questionnaire (CSHQ), the Child Behaviour Checklist (CBCL), the Spence Children’s Anxiety Scale (SCAS), and the Behaviour Rating Inventory for Executive Functioning (BRIEF). Within the ASD group, 40.3% of caregivers reported their children had nightmares. Within the FASD group, 73.62% of caregivers reported their children had nightmares, and within the TD group, 21.36% of caregivers reported their children had nightmares. Correlation analysis revealed significant associations between anxiety and nightmares, maladaptive behaviour and nightmares, and executive functioning and nightmares in the TD and FASD groups, but not ASD group. This paper adds to the emerging body of work supporting the need for sleep interventions as part of clinical practice with regard to children with ASD and FASD. As a relatively niche but important area of study, this warrants much needed further research.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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%

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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“…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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Sleep disturbance as a predictor of anxiety in children with Fetal Alcohol Spectrum Disorders and typically developing children

Cited by 12 publications

References 52 publications

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

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

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

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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