Distance Interventions for Children with Sleep Problems: A Review

Sleep problems in childhood are frequent and may cause damage to the children and their families;however,parental orientation appears to be effective in its many new formats,such as the distance treatment.This study aimed to review the literature about behavioral intervention performed by distance to sleep problems in childhood and summarize the main characteristics of such interventions.Searches were performed up to November 2021 in BVS Psicologia ULAPSI Brasil,SCOPUS,and PsycINFO,using the key words:sleep problems,insomnia,nighttime fears,behavioral intervention,behavioral treatment,treatment,intervention,sleep,behavior,child,children,infant,mobile phones,smartphone,app,telephone,online,internet,bibliotherapy.We included 14 studies.The main results indicate that interventions were implemented between 2 and 12 weeks,the most reported procedure was pre-sleep routines,and semi-presential interventions that required some presential contact were the most frequent.Written educational information about sleep through bibliotherapy and telephone contacts were the most used tools to implement the remote component of interventions.Ten studies indicated improvements on children’s sleep,and secondary results(parental sleep and/or mental health)were also reported among studies.Therefore,our findings suggest that distance interventions for childhood sleep problems are promising,but future research is still needed.

Commentary regarding “on-orbit sleep problems of astronauts and countermeasures”

This commentary addresses the article by Wu et al. entitled 'On-orbit sleep problems of astronauts and countermeasures'. In this article, the authors discussed the sleep problems of astronauts. Despite its challenging topic, the paper authored by Wu et al. has at least one major shortcoming. This issue is related to the observation that the sleep pattern of astronauts can be disturbed by light flash phenomenon. Since the first report by astronaut E.E. Aldrin in 1969, many astronauts have reported light flashes. These visually perceived flashes of light occurred in different shapes but they apparently moved across the visual field of astronauts and possibly caused, at least to some extent, sleep problems. Moreover, the countermeasures proposed by the authors may improve astronauts’ sleep pattern, but they do not address the root cause of the light flashes(i.e., heavy ion interactions outside the shielding provided by the Earth’s magnetosphere). A possible approach to reducing light flashes is available using the fact that much of the galactic cosmic radiation(GCR) spectrum is composed of ions that can be diverted from the spacecraft using electromagnetic fields. Possible design parameters and the requisite electric and magnetic field strengths to successfully deflect GCR radiation are outlined.

Sleep Duration and Sleep Problems in a Representative Sample of German Children and Adolescents

Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice.

Relation between sleep quality and glycemic control among type 2 diabetic patients

Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was recruited at diabetic clinics in Zagazig University hospitals.The interview questionnaire sheet consists of 4 par ts:(1)demographic data,(2)medical history,(3)an Arabic version of the Pittsburgh sleep quality index(PSQI),and(4)glycated hemoglobin A1c(Hb A1c)analysis test.Results:The mean of sleep duration was the highest score of PSQI components,96.8%of diabetic patients had poor sleep quality,and 90.4%of diabetic patients had poor glycemic control.A highly statistically significant relationship was found between Hb A1c and sleep quality.Moreover,income,duration of disease and smoking were independent positive predictors of Hb A1c level,while the female gender was a statistically significant negative predictor.Additionally,female gender and income were statistically significant independent positive predictors of PSQI score.Conclusions:Poor sleep quality and poor glycemic control were very common among type 2 diabetic patients.There was a highly significant relation between sleep quality and glycemic control.

Psycho-cognitive behavioral problems in sleep disordered children

Sleep disturbances are common in childhood and adolescence. Sleep problems in early infants tend to be persistent and prominent in preschool and school-aged children. Chronic sleep disorders, especially in young children may lead to neurobehavioral problems and psycho-cognitive impairment. Sleep difficulties may be the result of underlying medical conditions, （breathing disorders） or psychological problems. Research studies have shown the association between sleep disorders and day time cognitive impairment, behavioral problems, poor school performance and inattention in children. Appropriate diagnosis and early management of sleep disorders in children lead to improvement of neurocognitive function and behavioral problems in these children.

大学生网络闲逛行为与睡眠问题的关系:未完成任务与情绪反刍的中介作用

目的:基于认知评价理论,探讨了大学生的网络闲逛行为如何导致睡眠问题,并进一步比较了被动型网络闲逛与主动型网络闲逛的作用差异。方法:采用在线问卷调研对341名在家自主学习的大学生进行调查。结果:①网络闲逛与睡眠问题呈显著正相关(r=0.23,P<0.01),未完成任务和情绪反刍在网络闲逛与睡眠问题中起中介作用(间接效应=0.06,95%CI[0.01,0.12]);②被动型网络闲逛通过未完成任务和情绪反刍的链式中介显著正向影响睡眠问题(间接效应=0.07,95%CI[0.02,0.15]),主动型网络闲逛则直接通过情绪反刍显著正向影响睡眠问题(间接效应=0.21,95%CI[0.06,0.39])。结论:大学生的网络闲逛行为会导致睡眠问题,干预措施需考虑网络闲逛的不同类型。

Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model

An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems.

福建省南平市延平区学龄前儿童睡眠状况调查及与情绪行为问题的相关性研究

目的了解福建省南平市延平区学龄前儿童的睡眠状况及情绪行为问题,并分析二者的相关性。方法选取500名学龄前儿童作为调查对象,通过儿童睡眠习惯问卷(CSHQ)、长处和困难问卷(SDQ)评估受试儿童的睡眠状况和情绪行为问题;同时收集儿童的一般资料,对比不同人口社会学特征儿童的睡眠状况及情绪行为问题,并分析睡眠状况与情绪行为问题的相关性。结果学龄前儿童的睡眠异常、情绪行为异常检出率分别为15.00%和14.80%。男童的情绪行为异常检出率高于女童,差异有统计学意义(P<0.05)。不同年龄、出生体质量、是否独生子女、出生方式、是否早产、母亲妊娠年龄、父亲受教育程度、睡眠环境、共睡情况儿童的睡眠异常及情绪行为异常检出率比较,差异均无统计学意义(P>0.05)。儿童的睡眠异常检出率、情绪行为异常检出率均随着母亲受教育程度的提高而降低,随着每日屏幕暴露时间的增加而升高,差异有统计学意义(P<0.05)。与SDQ各维度(品行问题、同伴问题、情感症状、活动过度、亲社会行为)得分及总分正常/边缘儿童相比,各维度得分及总分异常儿童的睡眠异常发生率更高,差异有统计学意义(P<0.05)。多因素分析显示,睡眠异常是学龄前儿童发生品行问题、同伴问题、情感症状、活动过度、亲社会行为得分及困难总分异常的危险因素(P<0.05)。结论南平市延平区学龄前儿童的睡眠状态总体较好,但仍存在不少睡眠问题。睡眠异常会增加儿童情绪行为问题的发生风险,屏幕暴露时间过长可能增加儿童睡眠异常及情绪行为异常发生风险。

父母睡眠质量和抑郁现状及其与婴幼儿睡眠问题的关联

目的了解北京市0~35月龄婴幼儿父母的睡眠和抑郁现状,探讨其与婴幼儿睡眠问题的关联。方法依托中国疾病预防控制中心妇幼保健中心睡眠调查项目,采用三阶段分层随机抽样调查方法,选取北京市经济发展处于中等水平的2个区:东城区和大兴区,每区随机选取2个街道或乡镇,按0~35月龄分组采取抽签方式随机抽取北京市常住婴幼儿,于2021年6月至7月发放问卷1344份,本研究选取答卷人为父母的1287例进行分析。应用简明婴儿睡眠问卷、匹兹堡睡眠质量指数和流调中心用抑郁量表分别评估儿童睡眠状况、父母睡眠质量和父母抑郁情绪。采用χ^(2)检验和Logistic回归分析父母睡眠不良和抑郁情绪与婴幼儿睡眠问题的关联。结果父母睡眠不良和抑郁情绪检出率分别为15.8%、7.3%。婴幼儿与父母同屋睡的比例为94.9%,需安抚入睡的比例为93.7%,入睡困难、睡眠时间不足、睡眠质量不良、睡觉有困难的发生率依次为34.0%、11.7%、19.9%、50.0%。单因素分析显示,父母睡眠不良的婴幼儿入睡困难、睡眠时间不足、睡觉有困难的比例均较高,差异均有统计学意义(P均<0.05);父母有抑郁情绪的婴幼儿睡觉困难的比例明显高于父母无抑郁情绪的婴幼儿(P<0.05)。多因素分析显示,父母睡眠不良(OR=2.23,95%CI:1.60~3.11)和抑郁情绪(OR=1.76,95%CI:1.10~2.84)均是婴幼儿睡觉有困难的危险因素。结论父母睡眠不良和抑郁情绪与婴幼儿睡眠问题有关联,婴幼儿睡眠咨询及干预应关注父母的睡眠及情绪状态。

社区居民新型冠状病毒感染与睡眠问题的关系

目的:了解新型冠状病毒感染(COVID-19)爆发期间居民的睡眠问题发生情况,分析睡眠问题发生是否与新型冠状病毒感染有直接关联。方法:选取4810名社区居民,包括1116例新型冠状病毒核酸检测阳性者(核酸检测阳性组)和3694例新型冠状病毒核酸检测阴性者(核酸检测阴性组),采用睡眠自评量表(SRSS,总分≥23阳性)、广泛性焦虑量表(GAD-7,总分≥5阳性)和病人健康问卷(PHQ-9,总分≥5阳性)进行评测。结果:SRSS量表、GAD-7量表和PHQ-9量表筛查阳性率分别为30.5%、33.7%和27.2%。Logistic回归分析显示,控制性别、年龄段、GAD筛查阳性、PHQ筛查阳性等因素后,核酸检测阳性与SRSS筛查阳性呈正向关联(OR=1.73,95%CI:1.48~2.03)。结论:核酸检测阳性组睡眠问题发生率高于核酸检测阴性组,睡眠问题发生与新型冠状病毒感染可能有关联。

青少年早期睡眠问题的发展:性别差异及正性负性情绪的作用

为探讨青少年早期睡眠问题的发展轨迹,以及性别和正性负性情绪对其变化趋势的影响。本研究对1289名七年级学生进行历时两年共四次的追踪调查,采用潜变量增长模型分析,结果发现:(1)青少年早期睡眠问题呈曲线递增趋势,递增速度逐渐减缓,在起始水平和发展速度上均表现出显著的个体差异性;(2)在睡眠问题的起始水平上,女生显著高于男生,而在发展速度和加速度上,男女之间不存在显著差异;(3)正性情绪减缓特定时间点上青少年睡眠问题的发生,而负性情绪增强特定时间点上青少年睡眠问题的发生。研究结果表明青少年早期初始的睡眠问题并不决定后期的发展速度;性别和正性负性情绪对青少年睡眠问题发展的作用不同。

The effects of exercise on self-rated sleep among adults with chronic sleep complaints

Purpose： The purpose of this study was to evaluate whether and to what extent the observed effects on self-rated sleep in a previous study using a combined treatment program with physical exercise and sleep education can be attributed by the physical activity （PA） component. Methods： The present study reports supplementary analysis of an already described and published study. Data were provided by a nonclinical sample of 98 normal-active adults with chronic initiating and the maintaining of sleep complaints. The additional analysis included sleep log, exercise log, and daily pedometer data which were collected during a baseline week and 6-week of a combined intervention. Results： The results indicate that the number of steps （p -- 0.02） and the duration of PA （p = 0.01） is significantly related to the improvement in subjective sleep measures and therefore reveal an independent effect within this combined sleep program. Sleep diary data （recuperation of sleep, number of awakenings after sleep onset, and wake time after sleep onset time） improved significant （all p 〈 0.01） over the intervention program. About 50% of the participants stated that the PA had an effect on their improvement. Conclusion： Improvements on subjective sleep quality after a combined intervention cannot be attributed to the cognitive component alone, but PA has an independent effect. Adults with chronic sleep complaints benefit from exercise. Therefore structured PA should be implemented in any sleep management programs.

家庭电子媒介文化资本如何影响儿童的行为问题?——基于8057个3~6岁儿童样本的链式中介模型分析

为探究家庭电子媒介文化资本对学前儿童行为问题的影响及其作用机制,本研究通过问卷调查8057名3~6岁学前儿童及其家长。研究结果表明:不同性别和不同年龄的儿童在行为问题的部分维度上存在显著差异,而不同胎次的儿童在家庭电子媒介文化资本、儿童媒介实践、睡眠质量以及行为问题上均存在显著差异;家长自身媒介使用习惯与儿童的媒介实践、睡眠质量以及行为问题均呈显著正相关,家长媒介干预与儿童的媒介实践呈显著正相关,与儿童睡眠质量以及行为问题中的品行问题和心身问题两个维度均呈显著负相关,与学习问题、冲动—多动以及焦虑三个维度不相关;家长自身媒介使用习惯和媒介干预通过儿童的媒介实践和睡眠质量间接影响儿童的行为问题。基于以上研究结果,家长应当重视家庭场域中电子媒介文化资本的再生产方式,充分发挥优势家庭电子媒介文化资本的力量。

孤独症谱系障碍儿童的睡眠问题及其相关因素研究

目的:研究孤独症谱系障碍(autism spectrum disorder,ASD)儿童的睡眠问题与其相关因素,为ASD共患睡眠问题的儿童提供防治依据。方法:选取2019年7月-2022年12月就诊于佛山市妇幼保健院儿童保健科的84例ASD儿童(ASD组),和同地区同时期84例年龄匹配的正常儿童进行对比。收集两组儿童的社会人口学资料调查表和儿童睡眠习惯问卷(children’s sleep habits questionnaire,CHSQ),通过t检验或卡方检验对两组儿童的基本情况及睡眠情况进行比较,再通过logistic回归分析模型对ASD儿童的睡眠情况相关因素进行分析。结果:ASD组儿童和对照组儿童存在睡眠问题的检出率分别为91.7%和81.0%,两者差异具有统计学意义(P≤0.05),说明ASD组的睡眠问题检出率更高。ASD组在CHSQ总分、异态睡眠、日间嗜睡方面评分高于对照组,且两组差异具有统计学意义(P值均≤0.05),说明ASD组儿童存在睡眠问题更多,特别是在异态睡眠和日间嗜睡方面。logistic分析结果显示,母亲孕期补充维生素D有益于改善ASD儿童的睡眠问题(OR=0.01,P≤0.05)。结论:ASD儿童相比于正常儿童更可能出现睡眠问题,母亲孕期是否补充维生素D可能与ASD儿童存在睡眠问题相关。

西安市0~2岁婴幼儿睡眠状况调查分析

目的了解西安市0~2岁婴幼儿睡眠状况,为婴幼儿睡眠问题的防治提供参考依据。方法于2022年10月1日至2023年10月1日调查在西安市人民医院(西安市第四医院)儿童保健科接受儿童保健服务的0~2岁婴幼儿13831例。按年龄分为0~3月龄组、4~11月龄组和1~2岁组。由家长现场完成婴幼儿简明睡眠问卷。采用Kruskal-wallis秩和检验和χ~2检验进行统计学分析。结果发放问卷13831份,有效问卷13565份,有效问卷率为98.1%。其中,男童6991例(51.5%),女童6574例(48.56%);0~3月龄组、4~11月龄组、1~2岁组分别为3018例、7018例、3529例。西安市0~2岁婴幼儿睡眠问题的发生率为58.1%(7882/13565),夜醒问题的发生率最高(32.9%),其次为入睡困难(31.7%)。各年龄组婴幼儿睡眠时间、睡眠问题、睡眠习惯比较差异均有统计学意义(P<0.05),0~3月龄组总睡眠时间最长[840(780,930)min],睡眠问题发生率也最高(71.6%)。不同入睡方式下的入睡花费时间、夜间睡眠时间、白天睡眠时间及总睡眠时间差异均有统计学意义(P<0.05),其中独自在床上入睡花费时间最短[10(5,10)min];不同睡眠姿势的夜间睡眠时间比较差异无统计学意义(P>0.05),不同睡眠地点的入睡时间比较差异无统计学意义(P>0.05)。结论西安市0~2岁婴幼儿睡眠问题发生率较高,需加强对照护者进行婴幼儿睡眠知识的宣教,减少婴幼儿睡眠问题的发生,促进婴幼儿睡眠健康。

青少年失眠症状相关心理因素影响研究述评

系统地检索、评估相关文献资料以全面了解可能导致青少年失眠症状的相关心理问题影响因素研究现状,发现已有研究大多关注某一心理因素或某一睡眠问题指标,更多的实证研究证据倾向认为睡眠问题(睡眠时长不足与失眠)是心理因素发展的前瞻性预测因素,部分研究并未发现睡眠时长对心理因素的预测作用,新近的一些研究发现了失眠问题与心理因素的双向预测关系。研究结果显示,不同睡眠问题指标与心理因素的发展关系模式可能不一致,这可能与性别与年龄/年级差异有关。

国内睡眠医学中心的现状及思考

目前全国数千所医院成立睡眠医学中心或睡眠实验室,对我国睡眠医学事业发展起到了积极的推动作用,但是睡眠医学中心的标准化建设、生存现状是值得关注的话题,本文梳理了目前国内睡眠医学中心普遍存在的问题,并提出相应的意见建议,以期对国内睡眠医学的发展提供参考。

湖南省常德市4894名婴幼儿睡眠状况分析

目的了解湖南省常德市婴幼儿的睡眠状况,为促进儿童睡眠健康提供科学依据。方法选取2022年5—10月在湖南省常德市8个县/市/区妇幼保健机构、武陵区4个社区卫生服务中心儿童保健门诊做健康体检的5027名0~36月龄婴幼儿为研究对象。通过对其主要带养人进行现场问卷调查,了解婴幼儿睡眠状况。结果共收集问卷5027份,其中有效问卷4894份。问卷涉及男性2498例(51.0%),女性2396例(49.0%),平均月龄10.7个月。4~11个月婴儿与父母同床的比例最高(75.6%),睡眠姿势主要为仰睡(49.5%);0~3个月和4~11个月婴儿白天睡眠时间、睡眠总时长比12~23个月和24~36个月幼儿睡眠时间长,不同月龄组比较差异均有统计学意义(均P<0.05);24~36个月幼儿睡眠潜伏期>20 min占比最高,为50.1%;昼夜节律基本形成后,4~11个月的婴儿夜醒次数多于其他月龄组的婴幼儿,平均夜醒时长为(20.7±18.5)min;不同月龄婴幼儿入睡方式不同,0~3个月和4~11个月婴儿主要是喂食入睡,12~23个月、24~36个月幼儿主要是父母陪护入睡;月龄越大,就寝时间越晚,24~36个月幼儿就寝时间晚于21∶00比例最高,为80.0%。结论湖南省常德市0~36月龄婴幼儿睡眠状况不佳,主要存在夜间睡眠潜伏期长、晚上就寝时间过晚、总睡眠时间不足等问题。需提高带养人培养婴幼儿良好睡眠习惯的意识,改善儿童睡眠质量。

睡眠如何成为一个媒介研究问题——基于对睡眠研究的历史梳理

有关睡眠的研究始终是一个悬而未决的议题,伴随着当下睡眠问题的爆发和媒介技术对日常生活影响的加剧,传播学也逐渐涉足其中。通过对睡眠研究历史的梳理,可以发现:人类社会对睡眠的态度始终伴随着社会结构而变化。当数字媒介成为一种宏观的社会环境后,有必要重新思考二者间的相互关系。而“深度无聊”的哲学讨论为此搭建了一条理论通路,基于此,媒介使用与睡眠不再是矛盾的双方,而是可以被视为一体化的连续性过程,进而获得真空的、沉思的机会。

基于成分数据分析的留守儿童24 h活动时间分布与情绪及行为问题的关系

为探讨留守儿童24 h活动时间分布(包括睡眠、久坐行为、低强度身体活动和中高强度身体活动)与其情绪及行为问题的关系,对浙江省金华市和宁波市241名4~6年级留守儿童24 h活动时间分布和情绪及行为问题进行调查,使用成分数据分析方法分析24 h活动时间分布与情绪及行为问题的剂量-效应关系.结果表明:1)睡眠(β=-0.503,P<0.01)和低强度身体活动(β=-0.269,P<0.01)时间占比与留守儿童困难总分呈显著负相关,久坐行为(β=0.638,P<0.01)时间占比与困难总分呈显著正相关;2)睡眠替代久坐行为和中高强度身体活动,低强度身体活动替代久坐行为和中高强度身体活动有助于减少留守儿童的困难总分;3)剂量-效应分析发现,睡眠、低强度身体活动与久坐行为的替代对困难总分的影响呈对称性,而中高强度身体活动与其他活动行为的相互替代对困难总分的影响具有不对称性,其他行为替代中高强度身体活动的效应更大.结论:家庭和学校应着眼于留守儿童24 h活动整体,在保证充足睡眠的基础上促进久坐行为和低强度身体活动的转换,以获得留守儿童情绪及行为问题的良性发展.