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EPILEPSY AND SLEEP IN CHILDHOOD AND ADOLESCENCE
No full textThere is a reciprocal relationship between sleep and epilepsy: sleep affects epilepsy as well as epilepsy affects sleep. Since the onset of epilepsy most commonly occur during childhood, from infancy through adolescence, as well as many sleep disorders this chapters covers the complex relationship between sleep and epilepsy in children from the following point of view: effect of sleep on epilepsy, effect of epilepsy on sleep, effect of antiepileptic drugs on sleep and effect of sleep deprivation on epilepsy
Controlled-release melatonin, singly and combined with cognitive behavioural therapy, for persistent insomnia in children with autism spectrum disorders: a randomized placebo-controlled trial
No full textAlthough melatonin and cognitivebehavioural therapy have shown efficacy in treating sleep disorders in children with autism spectrum disorders, little is known about their relative or combined efficacy. One hundred and sixty children with autism spectrum disorders, aged 410 years, suffering from sleep onset insomnia and impaired sleep maintenance, were assigned randomly to either (1) combination of controlled-release melatonin and cognitivebehavioural therapy; (2) controlled-release melatonin; (3) four sessions of cognitivebehavioural therapy; or (4) placebo drug treatment condition for 12 weeks in a 1 : 1 : 1 : 1 ratio. Children were studied at baseline and after 12 weeks of treatment. Treatment response was assessed with 1-week actigraphic monitoring, sleep diary and sleep questionnaire. Main outcome measures, derived actigraphically, were sleep latency, total sleep time, wake after sleep onset and number of awakenings. The active treatment groups all resulted in improvements across all outcome measures, with moderate-to-large effect sizes from baseline to a 12-week assessment. Melatonin treatment was mainly effective in reducing insomnia symptoms, while cognitivebehavioural therapy had a light positive impact mainly on sleep latency, suggesting that some behavioural aspects might play a role in determining initial insomnia. The combination treatment group showed a trend to outperform other active treatment groups, with fewer dropouts and a greater proportion of treatment responders achieving clinically significant changes (63.38% normative sleep efficiency criterion of >85% and 84.62%, sleep onset latency <30 min). This study demonstrates that adding behavioural intervention to melatonin treatment seems to result in a better treatment response, at least in the short term
Long-term effect of behavioral intervention in cosleepers with primary sleep-disorders: eighteen-month follow-up study
No full textSleep practices and habits in children across different cultures
No full textSleep characteristics in children vary not only with age but also with ethnic and socio-cultural influences. In fact, lifestyle issues, as well as cultural beliefs and family values, might influence sleep too. Cultural differences are not random events, they occur because cultures with different geographies, climates, economies, religious, and histories exerting unique influences.Most works looking at influences on children sleep development have tended to focus on individual factors in children and their parents, family interactions and the impact of socio-demographic factors. Nevertheless, cultural factors are vitally important in creating the context within which different, more proximal factors interact to affect a child’s health, development, and well-being. Thus, child sleep development is the result of complex interrelationship of biological, psychological, environmental and social influences, the relative contributions of which are often difficult to separate. Variability among cultures concerning sleep-patterning expectations and interpretations is enormous and it can be found for almost any preference or norm its opposite in some other cultural settingsFurthermore, in recent years, we have witnessed to dramatic demographic changes in many countries, consequently health professionals and pediatricians have been confronted with family of widely differing cultural origins. A growing literature is documenting differences between ethnic groups in child-rearing values, beliefs and goals (7). Thus, it becomes more important in evaluating etiologic factors and planning interventions for the individual child and the family to incorporate the pediatric sleep disorders in the specific cultural context.
This chapter will try to provide an overview of some specific sleep issues that are highly influenced by the cultural context based on the review of previous epidemiological surveys carried out in different sociocultural contexts
MANAGEMENT OF COSLEEPING IN CHILDREN AND PREADOLESCENT WITH PSYCHIATRIC DISORDERS - ONE YEAR FOLLOW-UP STUDY
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