Sleepless in America: Inadequate Sleep and Relationships to Health and Well-being of Our Nation's Children

Smaldone, Arlene; Honig, Judy; Byrne, Mary

doi:10.1542/peds.2006-2089f

Cited by 389 publications

(284 citation statements)

References 47 publications

(55 reference statements)

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“…We conducted analyses both with and without adjustment for potential confounders chosen a priori through review of the current literature. These potential confounders included child gender, 17,33 parent marital status, 34 and family socioeconomic status. 35 The unadjusted and adjusted analyses of the binary outcomes provided similar results, and we summarized the intervention effect as the difference between the 2 proportions and the unadjusted risk ratio.…”

Section: Discussionmentioning

confidence: 99%

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Sleep problems are common in school-aged children and might compromise the function of children and parents and contribute to a poor transition to school, which can result in later academic difficulties. Improvement of child sleep through brief behavioral strategies might improve the school transition. WHAT THIS STUDY ADDS:Large-scale screening of new school entrants for sleep problems, followed by a targeted behavioral intervention, was demonstrated to be feasible and was beneficial for short-to medium-term child psychosocial outcomes. Larger effectiveness trials are needed to confirm the public health benefits of these interventions. abstract OBJECTIVE: To determine the feasibility of screening for child sleep problems and the efficacy of a behavioral sleep intervention in improving child and parent outcomes in the first year of schooling. METHODS:A randomized controlled trial was nested in a population survey performed at 22 elementary schools in Melbourne, Australia. Intervention involved 2 to 3 consultations that covered behavioral sleep strategies for children whose screening results were positive for a moderate/severe sleep problem. Outcomes were parent-reported child sleep problem (primary outcome), sleep habits, psychosocial health-related quality of life, behavior, and parent mental health (all at 3, 6, and 12 months) and blinded, face-to-face learning assessment (at 6 months). RESULTS:The screening survey was completed by 1512 parents; 161 (10.8%) reported a moderate/severe child sleep problem, and 108 of 136 (79.2% of those eligible) entered the trial. Sleep problems tended to resolve more rapidly in intervention children. Sleep problems affected 33% of 54 intervention children versus 43% of 54 control children at 3 months (P ϭ .3), 25.5% vs 46.8% at 6 months (P ϭ .03), and 32% vs 33% at 12 months (P ϭ .8). Sustained sleep-habit improvements were evident at 3, 6, and 12 months (effect sizes: 0.33 [P ϭ .03]; 0.51 [P ϭ .003]; and 0.40 [P ϭ .02]; respectively), and there were initial marked improvements in psychosocial scores that diminished over time (effect sizes: 0.47 [P ϭ .02]; 0.41 [P ϭ .09]; and 0.26 [P ϭ .3]; respectively). Better prosocial behavior was evident at 12 months (effect size: 0.35; P ϭ .03), and learning and parent outcomes were similar between groups.CONCLUSIONS: School-based screening for sleep problems followed by a targeted, brief behavioral sleep intervention is feasible and has benefits relevant to school transition. Pediatrics 2011;128:692-701

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Section: Discussionmentioning

confidence: 99%

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

et al. 2011

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“…Agreement rates in the current study differed little between the asthma/non-asthma groups and thus implications specific to asthma are unclear especially since it is unknown if all the child awakenings were caused by respiratory symptoms. But, with estimates that over 25%, or 19 million, of our nation's children obtain inadequate sleep (Mindell, Owens, & Carskadon, 1999;Smaldone, Honig, & Byrne, 2007) and 76% of parents saying they would change something about their child's sleep habits if possible (National Sleep Foundation, 2004), there is a clear need to further explore parent and child ability to similarly and accurately report number of awakenings and overall quality of sleep and the potential consequences of inadequate or poor sleep. The need for greater knowledge is imperative in children with asthma since decisions to 'step up' or 'step down' treatment will continue to depend on report of adequate sleep to support daytime function as well as the presence or absence of respiratory symptoms (EPR-3, 2007;Global Initiative for Asthma, 2006.)…”

Section: Discussionmentioning

confidence: 99%

Parent-Child Agreement in Report of Nighttime Respiratory Symptoms and Sleep Disruptions and Quality

Kieckhefer

Lentz²,

Tsai³

et al. 2009

Journal of Pediatric Health Care

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Introduction-Asthma control requires assessment of nighttime symptoms and sleep disruption. Cognitive and emotional development enables most school age children to report nocturnal problems but providers often rely only on parental report potentially limiting the comprehensiveness of their assessments and their ability to support the child's emerging efforts at shared management of their illness. This study investigated parent-child concordance in report of nighttime respiratory symptoms, sleep disruption and quality of sleep in a sample of 9-11 year old children with asthma. Secondarily, similar concordance patterns in an equal number of dyads where the child was asthma free were examined, to illustrate the potential influence of asthma.

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“…29 In adolescents, disrupted or insufficient sleep has been associated with violent behavioral problems such as fighting, bullying, and shoplifting, 33 as well as aggression, anger, and impulsivity. 27,34 A recent report from the 2003 National Survey of Children's Health 35 found that inadequate sleep in teens (N=21,641, age 12-17 years) was associated with "parental reports of family disagreements involving heated arguing" and "concern that the child was not always safe at home, at school or in their neighborhood." Teens with inadequate sleep were "more likely to be perceived as a difficult child" and the "object of parental anger."…”

Section: Sleep Disturbance and Risk Behaviors In African-american Adomentioning

confidence: 99%

Sleep Disturbance and Risk Behaviors among Inner-City African-American Adolescents

2011

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Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, whereas teens from impoverished urban areas are likely to witness neighborhood violence and/or engage in risk behaviors that may affect sleep. Data from the Mobile Youth Survey, a longitudinal study of impoverished inner-city African-American adolescents (1998-2005; N=20,716; age range=9.75-19.25 years), were used to compare paired years of annual surveys elicited by questions about how sleep was affected when bad things happen to friends or family. Using a cross-lagged panel multivariate approach comparing reports for two sequential years and controlling for age/gender plus exposure to traumatic stress and violence, prior sleep disturbance was associated with carrying a knife/gun, brandishing a knife/gun, using a knife/gun, quick temperedness, warmth toward mother, worry, and belief in the neighborhood street code in the latter year. Conversely, seeing someone cut, stabbed, or shot, using alcohol, worry, and internalized anger were associated with sleep disturbance in a latter year. Although a limited measure of sleep disturbance was used, these findings support further research to examine sleep disturbance and risk behaviors among low-income adolescents.

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Sleepless in America: Inadequate Sleep and Relationships to Health and Well-being of Our Nation's Children

Cited by 389 publications

References 47 publications

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

Parent-Child Agreement in Report of Nighttime Respiratory Symptoms and Sleep Disruptions and Quality

Sleep Disturbance and Risk Behaviors among Inner-City African-American Adolescents

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