Abstract
This study examined the nature and prevalence of diagnostically defined sleep disorders, including Sleep Onset Insomnia (SOI) and Night Waking Insomnia (NWI), in a sample of 183 young children admitted to an early childhood psychiatric day treatment program. A semi-structured diagnostic interview, the Diagnostic Infant and Preschool Assessment, was used to assess for sleep and other psychiatric disorders. Daily sleep diaries and the Child Behavior Checklist were also examined. 41 % of children met criteria for a sleep disorder; 23 % met diagnostic criteria for SOI and 4 % met criteria for NWI, with an additional 14 % meeting criteria for both (SOI + NWI). Sleep-disordered children demonstrated longer latency to sleep onset, longer and more frequent night awakenings, less total sleep, and lower sleep efficiency than non-sleep disordered participants. Diagnosable sleep disorders, particularly SOI, were quite common in this acute clinical sample, exceeding previous estimates obtained in community and pediatric practice samples.
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Notes
Percentages do not sum to 100 % because diagnoses were not mutually exclusive and many children met criteria for multiple diagnoses. For example, 17.4 % of children met criteria for two diagnoses and 43.2 % of children met criteria for three or more diagnoses.
We appreciated the comments of an anonymous reviewer who suggested ideas about a continuum of severity and shared arousal processes.
References
Mindell JA, Emslie G, Blumer J, Genel M, Glaze D, Ivanenko A et al (2006) Pharmacologic management of insomnia in children and adolescents: consensus statement. Pediatrics 117:e1223–e1232
Anders TE, Dahl R (2007) Classifying sleep disorders in infants and toddlers. In: Nafrrow WE, First MB, Sirovatka PJ, Regier DA (eds) Age and gender considerations in psychiatric diagnosis: a research agenda for DSM-V. American Psychiatric Publishing, Arlington, pp 215–226
Ferber R, Kryger M (1995) Principles and practice of sleep medicine in the child. W.B. Saunders, Philadelphia
Lam P, Hiscock H, Wake M (2003) Outcomes of infant sleep problems: a longitudinal study of sleep, behavior, and maternal well-being. Pediatrics 111:E203–E207
Lozoff B, Askew GL, Wolf AW (1996) Cosleeping and early childhood sleep problems: effects of ethnicity and socioeconomic status. J Dev Behav Pediatr 17:9–15
Ottaviano S, Giannotti F, Cortesi F, Bruni O, Ottaviano C (1996) Sleep characteristics in healthy children from birth to 6 years in the urban area of Rome. Sleep 19:1–3
Sadeh A, Gruber R, Raviv A (2002) Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Dev 73:405–417
Smedje H, Broman JE, Hetta J (2001) Associations between disturbed sleep and behavioural difficulties in 635 children aged six to eight years: a study based on parents’ perceptions. Eur Child Adolesc Psychiatry 10:1–9
Kateria S, Swanson M, Trevarthin G (1987) Persistence of sleep disturbances in preschool children. J Pediatr 110:642–646
Goodlin-Jones BL, Tang K, Liu J, Anders TF (2008) Sleep patterns in preschool-age children with autism, developmental delay, and typical development. J Am Acad Child Adolesc Psychiatry 47:930–938
Wiggs L, Stores G (1996) Severe sleep disturbance and daytime challenging behaviour in children with severe learning disabilities. J Intellect Disabil Res 40:518–528
Willoughby MT, Angold A, Egger HL (2008) Parent-reported attention-deficit/hyperactivity disorder symptomatology and sleep problems in a preschool-age pediatric clinic sample. J Am Acad Child Adolesc Psychiatry 47:1086–1094
Bates JE, Viken RJ, Alexander DB, Beyers J, Stockton L (2002) Sleep and adjustment in preschool children: sleep diary reports by mothers relate to behavior reports by teachers. Child Dev 73:62–74
Lavigne JV, Arend R, Rosenbaum D, Smith A, Weissbluth M, Binns HJ et al (1999) Sleep and behavior problems among preschoolers. J Dev Behav Pediatr 20:164–169
Marcotte AC, Thacher PV, Butters M, Bortz J, Acebo C, Carskadon MA (1998) Parental report of sleep problems in children with attentional and learning disorders. J Dev Behav Pediatr 19:178–186
Dahl RE (1996) The impact of inadequate sleep on children’s daytime cognitive function. Semin Pediatr Neurol 3:44–50
Alfano CA, Gamble AL (2009) The Role of sleep in childhood psychiatric disorders. Child Youth Care Forum 38:327–340
Lavigne JV, Arend R, Rosenbaum D, Smith A, Weissbluth M, Binns HJ, Christofell KK (1999) Sleep and behavior problems among preschoolers. J Dev Behav Pediatr 20:164–169
Steinsbekk S, Berg-Nielsen TS, Wichstrom L (2013) Sleep disorders in preschoolers: prevalence and comorbidity with psychiatric symptoms. J Dev Behav Pediatr 34:633–641
Ivanenko A, Johnson K (2008) Sleep disturbances in children with psychiatric disorders. Semin Pediatr Neurol 15:70–78
Gregory AM, Sadeh A (2012) Sleep, emotional and behavioral difficulties in children and adolescents. Sleep Med Rev 16:129–136
Lavigne JV, LeBailly SA, Hopkins J, Gouze KR, Binns HJ (2009) The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. J Clin Child Adolesc Psychol 38:315–328
Luby JL (2012) About 7% of 4-year-olds in Norway meet criteria for a psychiatric diagnosis. Evid Based Ment Health 15:108
ICSD-DCM2 (2005) The international classification of sleep disorders, diagnostic and coding manual. American Academy of Sleep Medicine, Minneapolis
Scheeringa MS, Haslett N (2010) The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: a new diagnostic instrument for young children. Child Psychiatry Hum Dev 41:299–312
Egger HL, Angold A (2006) Common emotional and behavioral disorders in preschool children: presenation, nosology, and epidemiology. J Child Psychol Psychiatry 47:313–337
Gregory AM, Cousins JC, Forbes EE, Trubnik L, Ryan ND, Axelson DA et al (2011) Sleep items in the child behavior checklist: a comparison with sleep diaries, actigraphy, and polysomnography. J Am Acad Child Adolesc Psychiatry 50:499–507
Achenbach TM, Rescorla LA (2000) Manual for the ASEBA school-age forms & profiles. University of Vermont Research Center for Children, Youth & Families, Burlington
Dunn LM, Dunn DM (2007) PPVT-4: peabody picture vocabulary test. NCS Pearson Inc, Bloomington
Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Pyschol Meas 1:385–401
Abidin RR (1995) Parenting Stress Index, 3rd edn. Psychological Assessment Resources, Odessa
Martin SE, McConville DM, Williamson LR, Feldman G, Boekamp JR (2013) Partial hospital treatment for preschoolers with severe behavior problems: child age and maternal functioning as predictors of outcome. Child Adol Ment Health 18:24–32
Task Force on Research Diagnostic Criteria: Infancy and Preschool (2003) Research diagnostic criteria for infants and preschool children: the process and empirical support. J Am Acad Child Adolesc Psychiatry 42:1504–1512
Polimeni MA, Richdale AL, Francis AJ (2005) A survey of sleep problems in autism, Asperger’s disorder and typically developing children. J Intellect Disabil Res 49:260–268
Minde K, Faucon A, Falkner S (1994) Sleep problems in toddlers: effects of treatment on their daytime behavior. J Am Acad Child Adolesc Psychiatry 33:1114–1121
Acknowledgments
We are grateful to the children and parents who participated in this study. We also thank Mia DeMarco for her helpful assistance with this research project.
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Boekamp, J.R., Williamson, L.R., Martin, S.E. et al. Sleep Onset and Night Waking Insomnias in Preschoolers with Psychiatric Disorders. Child Psychiatry Hum Dev 46, 622–631 (2015). https://doi.org/10.1007/s10578-014-0505-z
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DOI: https://doi.org/10.1007/s10578-014-0505-z