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Pediatric Insomnia

Oliviero Bruni, Stefania Sette, Marco Angriman, Emma Baumgartner, Lara Selvaggini, Cristina Belli, Raffaele Ferri
OBJECTIVES: To identify different profiles of pediatric insomnia, based on the most frequent clinical presentations (nocturnal awakenings, difficulty in falling asleep, nocturnal restlessness, early morning awakenings). STUDY DESIGN: A structured parent interview was conducted in 338 children (mean age 21.29 months, SD 10.56) referred by pediatricians because of insomnia resistant to behavioral approaches and common drug treatments. The aim was to assess the characteristics of insomnia in children, together with family sleep-related history...
March 15, 2018: Journal of Pediatrics
Kiran Maski, Judith Owens
PURPOSE OF REVIEW: This article provides an overview of the clinical features, diagnosis, and treatment of insomnia, restless legs syndrome, periodic limb movements of sleep, parasomnias, narcolepsy, and sleep-related breathing disorders among children and adolescents. RECENT FINDINGS: Pediatric presentations of sleep disorders differ from adult presentations, making diagnosis challenging. Specific clinical syndromes, such as cataplexy in children with narcolepsy type 1, can have an altogether different presentation compared to adult-onset symptoms, contributing to diagnostic delays and potential misdiagnoses...
February 2018: Continuum: Lifelong Learning in Neurology
Xianchen Liu, Hua Chen, Zhen-Zhen Liu, Cun-Xian Jia
OBJECTIVE: Little is known about psychopathological features associated with restless legs syndrome (RLS) in pediatric populations. This study examined sleep duration, insomnia, and psychopathological profile associated with RLS in a large community sample of adolescents. Methods: Participants included 11,831 adolescents from 3 counties of Shandong, China. Mean age of the participants was 15.0 (SD = 1.5) years, and 51% were boys. In November and December 2015, participants completed a structured questionnaire to assess sleep duration, sleep problems, behavioral/emotional problems, and hopelessness...
January 2018: Journal of Clinical Psychiatry
Paul Gringras, Tali Nir, John Breddy, Anat Frydman-Marom, Robert L Findling
OBJECTIVE: To assess the efficacy and safety of novel pediatric-appropriate, prolonged-release melatonin minitablets (PedPRM) versus placebo for insomnia in children and adolescents with autism spectrum disorder (ASD), with or without attention-deficit/hyperactivity disorder (ADHD) comorbidity, and neurogenetic disorders (NGD). METHOD: A total of 125 children and adolescents (2-17.5 years of age; 96.8% ASD, 3.2% Smith-Magenis syndrome [SMS]) whose sleep failed to improve on behavioral intervention alone were randomized (1:1 ratio), double-blind, to receive PedPRM (2 mg escalated to 5 mg) or placebo for 13 weeks...
November 2017: Journal of the American Academy of Child and Adolescent Psychiatry
Ariel A Williamson, Sonia L Rubens, Kristina E Patrick, Melisa Moore, Jodi A Mindell
STUDY OBJECTIVES: Community-based research indicates that Black preschoolers tend to have more bedtime difficulties and are at higher risk for obstructive sleep apnea (OSA) compared to White preschoolers. This study examined differences in sleep patterns and problems by race among a clinical sample of Black and White preschoolers at an outpatient sleep clinic. METHODS: Data were collected from electronic medical records for 125 children ages 2-5 years (mean = 3...
November 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Antonio Clavenna, Maurizio Bonati
Attention-deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder in children and adolescents that comprises core symptoms of developmentally inappropriate levels of inattention and/or hyperactivity and impulsivity. Stimulant (methylphenidate, amphetamines) and non stimulant (atomoxetine, clonidine and guanfacine) are the treatment usually prescribed for ADHD. Area covered: This review covers the safety of ADHD medications in children and adolescents. MEDLINE, EMBASE and PsycINFO databases were searched with the aim to retrieve prospective studies that monitored the incidence of adverse events (AEs) in children receiving drug therapy for ADHD...
December 2017: Expert Opinion on Drug Safety
Oliviero Bruni, Marco Angriman, Fabrizio Calisti, Alessandro Comandini, Giovanna Esposito, Samuele Cortese, Raffaele Ferri
BACKGROUND: Sleep disturbances, in particular insomnia, represent a common problem in children with neurodevelopmental disabilities (NDDs). Currently, there are no approved medications for insomnia in children by the US Food and Drug Administration or European Medicines Agency and therefore they are prescribed off-label. We critically reviewed pediatric literature on drugs as well as nonpharmacological (behavioral) interventions used for sleep disturbances in children with NDDs. METHODS: PubMed, Ovid (including PsycINFO, Ovid MEDLINE® , and Embase), and Web of Knowledge databases were searched through February 12, 2017, with no language restrictions...
September 18, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Judith A Owens, Maile Moore
Sleep problems in infants and young children are common and often underdiagnosed. The potential negative outcomes that chronic disrupted sleep can have on a child's daytime functioning, as well as the adverse impact it can have on the family, are well known. There is considerable evidence to support the use of behavioral interventions to treat childhood insomnia. These strategies not only produce reliable and durable positive changes in sleep in most young children, but may also improve child and family well-being without negative effects on a child's social-emotional development...
September 1, 2017: Pediatric Annals
Tamar N Goldberg, Michael F Cellucci
Anti-NMDAR encephalitis is becoming more widely recognized as a cause of encephalopathy in both adults and children. Certain clinical features such as mood lability, movement disorders, speech dysfunction, seizures, and autonomic instability in a pediatric patient should prompt immediate concern and evaluation for autoimmune encephalitis among providers. We present the case of a pediatric patient with anti-NMDAR encephalitis in which the symptom prompting medical evaluation was insomnia. Insomnia has not previously been emphasized in the literature as a presenting feature of this disease in children and has a broad differential...
2017: Case Reports in Pediatrics
Yu-Shu Huang, Christian Guilleminault
Pediatric obstructive sleep apnea (OSA) was initially described in 1976. In 1981, Dr. Guilleminault emphasized that pediatric OSA was different from the clinical presentation reported in adults. It was characterized by more disturbed nocturnal sleep than excessive daytime sleepiness, and presented more behavioral problems, particularly school problems, hyperactivity, nocturnal enuresis, sleep terrors, depression, insomnia, and psychiatric problems. The underlying causes of pediatric OSA are complex. Such factors as adenotonsillar hypertrophy, obesity, anatomical and neuromuscular factors, and hypotonic neuromuscular disease are also involved...
2017: Advances in Oto-rhino-laryngology
Peter C Rowe, Rosemary A Underhill, Kenneth J Friedman, Alan Gurwitt, Marvin S Medow, Malcolm S Schwartz, Nigel Speight, Julian M Stewart, Rosamund Vallings, Katherine S Rowe
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease that affects children and adolescents as well as adults. The etiology has not been established. While many pediatricians and other health-care providers are aware of ME/CFS, they often lack essential knowledge that is necessary for diagnosis and treatment. Many young patients experience symptoms for years before receiving a diagnosis. This primer, written by the International Writing Group for Pediatric ME/CFS, provides information necessary to understand, diagnose, and manage the symptoms of ME/CFS in children and adolescents...
2017: Frontiers in Pediatrics
Ian H Steele, Natasha Thrower, Paul Noroian, Fabian M Saleh
Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States...
June 21, 2017: Journal of Forensic Sciences
Dong Soon Kim, Cho Long Lee, Young Min Ahn
PURPOSE: To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. METHODS: Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. RESULTS: Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0-18 years)...
May 2017: Korean Journal of Pediatrics
Timothy Culbert
It has been well-established that a variety of mind-body (MB) techniques, including yoga, mental imagery, hypnosis, biofeedback, and meditation, are effective at addressing symptoms such as pain, anxiety, nausea, and insomnia, as well as helping with a wide variety of medical, emotional, and behavioral issues in pediatric populations. In addition, MB skills can also be health promoting in the long-term, and with regular practice, could potentially contribute to longer attention spans, social skills, emotional regulation, and enhanced immune system functioning...
April 4, 2017: Children
Danielle K Sandsmark, Jonathan E Elliott, Miranda M Lim
Sleep-wake disturbances following traumatic brain injury (TBI) are increasingly recognized as a serious consequence following injury and as a barrier to recovery. Injury-induced sleep-wake disturbances can persist for years, often impairing quality of life. Recently, there has been a nearly exponential increase in the number of primary research articles published on the pathophysiology and mechanisms underlying sleep-wake disturbances after TBI, both in animal models and in humans, including in the pediatric population...
May 1, 2017: Sleep
Neepa Gurbani, Stijn L Verhulst, Chee Tan, Narong Simakajornboon
STUDY OBJECTIVES: Idiopathic central sleep apnea (ICSA) is categorized as a type of nonhypercapnic central sleep apnea (CSA). Recurrent cessation and resumption of respiration leads to sleep fragmentation, which causes excessive daytime sleepiness, frequent nocturnal awakenings, or both. ICSA has been described in the adult population but there is limited information in children. The purpose of this study was to describe clinical manifestations and polysomnographic findings in children with ICSA...
June 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Stephanie G Craig, Margaret D Weiss, Kristen L Hudec, Christopher Gibbons
OBJECTIVE: Children with ADHD display higher rates of sleep problems, and both sleep disorders and ADHD have been shown to affect functioning in childhood. The current study examines the frequency and relationship between sleep problems and ADHD, and their impact on quality of life (QoL) and functional impairment. METHOD: Parents of 192 children with ADHD ( M = 10.23 years) completed measures regarding their child's ADHD symptoms (Swanson, Nolan and Pelham [SNAP]), sleep disorders (Pediatric Sleep Questionnaire [PSQ]), QoL (Child Health Illness Profile [CHIP-PE]), and functioning (Weiss Functional Impairment Rating Scale-Parent Report [WFIRS-P])...
January 1, 2017: Journal of Attention Disorders
Jeffrey R Strawn, Eric T Dobson, Lisa L Giles
The evidence base for psychopharmacologic interventions in youth with depressive and anxiety disorders as well as attention/deficit hyperactivity disorder (ADHD) has dramatically increased over the past two decades. Psychopharmacologic interventions commonly utilized in the pediatric primary care setting-selective serotonin (norepinephrine) reuptake inhibitors (SSRIs/SSNRIs), stimulants and α2 agonists-are reviewed. General pharmacologic principles are summarized along with class-related side effects and tolerability concerns (e...
January 2017: Current Problems in Pediatric and Adolescent Health Care
Julio Fernandez-Mendoza, Susan L Calhoun, Alexandros N Vgontzas, Yun Li, Jordan Gaines, Duanping Liao, Edward O Bixler
Based on previous studies on the role of objective sleep duration in predicting morbidity in individuals with insomnia, we examined the role of objective sleep duration in differentiating behavioral profiles in adolescents with insomnia symptoms. Adolescents from the Penn State Child Cohort (n = 397, ages 12-23, 54.7% male) underwent a nine-hour polysomnography (PSG), clinical history, physical examination and psychometric testing, including the Child or Adult Behavior Checklist and Pediatric Behavior Scale...
December 13, 2016: Brain Sciences
Sonia L Rubens, Kristina E Patrick, Ariel A Williamson, Melisa Moore, Jodi A Mindell
OBJECTIVE: Individual and socio-demographic factors have been found to be associated with sleep disturbances in children. Few studies have examined these factors among children presenting for care at pediatric sleep clinics. This study examined individual and socio-demographic factors in association with presenting problems and diagnostic impressions for new patients at an interdisciplinary pediatric sleep clinic. METHODS: Data were collected from electronic medical records of 207 consecutive patients (54% male, 59% White, Meanage  = 7...
September 2016: Sleep Medicine
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