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Unobtrusive cot side sleep stage classification in preterm infants using ultra-wideband radar 超宽带雷达在早产儿床侧睡眠阶段分类中的应用
Frontiers in sleep Pub Date : 2023-06-15 DOI: 10.3389/frsle.2023.1150962
E. Arasteh, E. R. de Groot, Demi van den Ende, T. Alderliesten, X. Long, R. de Goederen, M. Benders, J. Dudink
{"title":"Unobtrusive cot side sleep stage classification in preterm infants using ultra-wideband radar","authors":"E. Arasteh, E. R. de Groot, Demi van den Ende, T. Alderliesten, X. Long, R. de Goederen, M. Benders, J. Dudink","doi":"10.3389/frsle.2023.1150962","DOIUrl":"https://doi.org/10.3389/frsle.2023.1150962","url":null,"abstract":"Background Sleep is an important driver of development in infants born preterm. However, continuous unobtrusive sleep monitoring of infants in the neonatal intensive care unit (NICU) is challenging. Objective To assess the feasibility of ultra-wideband (UWB) radar for sleep stage classification in preterm infants admitted to the NICU. Methods Active and quiet sleep were visually assessed using video recordings in 10 preterm infants (recorded between 29 and 34 weeks of postmenstrual age) admitted to the NICU. UWB radar recorded all infant's motions during the video recordings. From the baseband data measured with the UWB radar, a total of 48 features were calculated. All features were related to body and breathing movements. Six machine learning classifiers were compared regarding their ability to reliably classify active and quiet sleep using these raw signals. Results The adaptive boosting (AdaBoost) classifier achieved the highest balanced accuracy (81%) over a 10-fold cross-validation, with an area under the curve of receiver operating characteristics (AUC-ROC) of 0.82. Conclusions The UWB radar data, using the AdaBoost classifier, is a promising method for non-obtrusive sleep stage assessment in very preterm infants admitted to the NICU.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88848502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Short Report: Barriers and facilitators to parents' implementation of a transdiagnostic eHealth sleep intervention for children with neurodevelopmental disorders 简短报告:父母对神经发育障碍儿童实施跨诊断电子健康睡眠干预的障碍和促进因素
Frontiers in sleep Pub Date : 2023-06-01 DOI: 10.3389/frsle.2023.1143281
Anastasija Jemcov, Lindsay Rosenberg, Kim M. Tan-MacNeill, I. Smith, S. Weiss, P. Corkum
{"title":"Short Report: Barriers and facilitators to parents' implementation of a transdiagnostic eHealth sleep intervention for children with neurodevelopmental disorders","authors":"Anastasija Jemcov, Lindsay Rosenberg, Kim M. Tan-MacNeill, I. Smith, S. Weiss, P. Corkum","doi":"10.3389/frsle.2023.1143281","DOIUrl":"https://doi.org/10.3389/frsle.2023.1143281","url":null,"abstract":"Background Insomnia is highly prevalent in children diagnosed with neurodevelopmental disorders (NDDs) and has negative effects on physical and mental health and wellbeing. Lack of evidence-based intervention programs and barriers to treatment (e.g., time/cost) reduce treatment access. To address these problems, the possibility was explored of modifying the Better Nights, Better Days intervention for typically developing (TD) children (BNBD-TD) to make it appropriate for children with NDD. Aims The current study's aim was to examine qualitative data from exit interviews conducted during a usability study. Parents of children with NDD used BNBD-TD and reported on barriers and facilitators experienced while implementing the intervention. Methods/procedures Participants were 15 Canadian parents of children aged 4 to 10 years who were formally diagnosed with an NDD. Parents implemented the BNBD-TD intervention with their children and participated in a semi-structured exit interview to provide perspectives on their user experience. Results Based on an inductive thematic analysis, key facilitators included increased self-efficacy, positive outcomes for the family (e.g., improved sleep problems, parent validation), improved sleep related beliefs/attitudes, and increased motivation. Key barriers included time challenges, struggles when trying to improve sleep problems, and psychosocial factors with negative effects on implementation (e.g., burnout, stress, and/or exhaustion). Conclusions/implications Barriers and facilitators identified resulted in recommendations to include more program supports, including helping parents to plan for implementation success.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73329278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effects of sleep and targeted memory reactivation on the consolidation of relevant and irrelevant information 睡眠和目标记忆再激活对相关和不相关信息巩固的影响
Frontiers in sleep Pub Date : 2023-05-25 DOI: 10.3389/frsle.2023.1187170
C. Barner, Ann-Sophie Werner, Sandra Schörk, Jan Born, S. Diekelmann
{"title":"The effects of sleep and targeted memory reactivation on the consolidation of relevant and irrelevant information","authors":"C. Barner, Ann-Sophie Werner, Sandra Schörk, Jan Born, S. Diekelmann","doi":"10.3389/frsle.2023.1187170","DOIUrl":"https://doi.org/10.3389/frsle.2023.1187170","url":null,"abstract":"Introduction Sleep is assumed to facilitate the consolidation of new memories in an active process of covert reactivation of the underlying memory representations. Recent evidence suggests that this process is selective by favoring memories that are of future relevance, and can be externally triggered by learning-associated sensory cues presented during sleep [i.e., targeted memory reactivation (TMR)]. In the present study, we (1) set out to confirm the preferential sleep effect for relevant information, and then asked whether (2) simultaneous TMR of relevant and irrelevant information facilitates the advantage for relevant information, and (3) whether the preferential benefit of sleep and TMR for relevant information persists over time. Methods To test these questions, participants explicitly learned two sets of picture-location associations, of which one set was instructed (after encoding) to be relevant and the other to be irrelevant for later testing. In Experiment 1, memory was tested after ~12 h of night sleep (n = 28) or daytime wakefulness (n = 28) as well as again after ~1 week. Results Results showed overall better memory retention after sleep compared to wakefulness after 12 h as well as after 1 week. The relevant memories were overall retained better than the irrelevant memories. Interestingly, a trend toward a stronger sleep benefit for the relevant memories emerged after 1 week, although this effect failed to reach significance. In Experiment 2, learning of the relevant and irrelevant picture-location associations took place in the presence of an odor. During subsequent sleep, in the first phase of slow wave sleep (SWS), participants were either presented with the odor again (n = 23) or received an odorless vehicle (n = 20). Memory retention was assessed after the first SWS period (following awakening) as well as after ~one week. As in Experiment 1, relevant memories were overall retained better than irrelevant memories. However, TMR did not differentially affect the retention of relevant and irrelevant memories. Discussion These findings provide tentative evidence that the selective benefit of sleep for relevant memories evolves over time but is not further facilitated by TMR.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84473545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep apnea endotypes: from the physiological laboratory to scalable polysomnographic measures 睡眠呼吸暂停内窥镜:从生理实验室到可扩展的多导睡眠图测量
Frontiers in sleep Pub Date : 2023-05-24 DOI: 10.3389/frsle.2023.1188052
E. Finnsson, Eydís Arnardóttir, Wan-Ju Cheng, Raichel M. Alex, Þ. Sigmarsdóttir, Snorri Helgason, L. Hang, J. Ágústsson, A. Wellman, S. Sands
{"title":"Sleep apnea endotypes: from the physiological laboratory to scalable polysomnographic measures","authors":"E. Finnsson, Eydís Arnardóttir, Wan-Ju Cheng, Raichel M. Alex, Þ. Sigmarsdóttir, Snorri Helgason, L. Hang, J. Ágústsson, A. Wellman, S. Sands","doi":"10.3389/frsle.2023.1188052","DOIUrl":"https://doi.org/10.3389/frsle.2023.1188052","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent upper airway obstruction during sleep. Despite the availability of continuous positive airway pressure (CPAP) as the gold standard treatment, it is not well tolerated by all patients. Accordingly, research has increasingly focused on developing methods for OSA endotyping, which aims to identify underlying pathophysiological mechanisms of the disorder to help guide treatment for CPAP-intolerant individuals. Four key endotypic traits have been identified, namely: collapsibility, upper airway muscle compensation, arousal threshold and loop gain. However, most methods for extracting these traits require specialized training and equipment not available in a standard sleep clinic, which has hampered the ability to assess the full impact of these traits on OSA outcomes. This paper aims to provide an overview of current methods for OSA endotyping, focusing on the Endo-Phenotyping Using Polysomnography (PUP) method and its cloud-based extension, PUPpy, which offer scalable and accessible ways to estimate endotypic traits from standard polysomnography. We discuss the potential for these methods to facilitate precision medicine for OSA patients and the challenges that need to be addressed for their translation into clinical practice.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72951619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Comparison of non-invasive ventilation use and outcomes in children with Down syndrome and other children using this technology 唐氏综合征患儿与其他患儿无创通气使用及预后的比较
Frontiers in sleep Pub Date : 2023-05-19 DOI: 10.3389/frsle.2023.1169236
R. Valji, M. Castro-Codesal, Melanie Lewis, J. MacLean
{"title":"Comparison of non-invasive ventilation use and outcomes in children with Down syndrome and other children using this technology","authors":"R. Valji, M. Castro-Codesal, Melanie Lewis, J. MacLean","doi":"10.3389/frsle.2023.1169236","DOIUrl":"https://doi.org/10.3389/frsle.2023.1169236","url":null,"abstract":"Rationale Children with Down syndrome (DS) make up a substantial portion of long-term non-invasive ventilation (LT-NIV) users though it is unclear if their unique features alter LT-NIV efficacy or use. The aim of this study is to compare the use and outcomes of LT-NIV for children with DS and a matched comparison (MCG). Methods This is a sub-study of a 10-year retrospective review of children initiated on LT-NIV in Alberta, Canada (N = 622). Children with DS (n = 106) were matched in a 1:2 ratio with other children using LT-NIV based on age and therapy start date. Data was collected from medical and sleep laboratory records. Results Upper airway disease was the most common indication for LT-NIV in both groups, though was higher in children with DS (DS: 90% vs. MCG: 50%, OR 8.64 [95% CI 4.38–17.04]). Sleep and respiratory parameters, at the baseline diagnostic sleep study and the change from baseline to treatment study, did not differ between groups. Nasal masks were the predominant mask type in both children with DS (55%) and the MCG (66%) with more children with DS, compared to the MCG, using full face masks (DS: 45 vs. MCG: 33%, p < 0.05). Continuous positive airway pressure was used more often in children with DS (93.3% vs. 69.2%, p < 0.001) while bilevel-positive airway pressure was more common in the MCG (DS: 6.7% vs. MCG 30.8%, p < 0.001). Children with DS were followed longer than children in the MCG (DS: 2.4 [IQR 2.8] vs. MCG: 1.8 [IQR 2.7] years, p < 0.05). Adherence was lower in children with DS at both 6–12 month follow-up and most recent visit with a similar decrease in adherence in both groups over the follow-up period (0.0 [IQR 1.4] vs. −0.3 [IQR 2.0]. Despite this, 66% and 49% of children with DS used LT-NIV for more than 4 h/night at the 6–12 month and most current visit, respectively. Discontinuation of LT-NIV and mortality did not differ between groups. Conclusion LT-NIV is a common and efficacious treatment in children with DS used predominantly for upper airway obstruction. While adherence is lower, the majority of children with DS are successful at using LT-NIV.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80846262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A daily-level, within-person examination of emotion regulation as a mediator of the relationship between sleep and behavior in youth 青少年睡眠和行为之间关系的中介——情绪调节的日常水平的个人检查
Frontiers in sleep Pub Date : 2023-05-16 DOI: 10.3389/frsle.2023.1154638
Paul Féghali, Brooke K. Iwamoto, Olivia Triplett, Nicholas J. Rockwood, Timothy D. Nelson, T. V. Van Dyk
{"title":"A daily-level, within-person examination of emotion regulation as a mediator of the relationship between sleep and behavior in youth","authors":"Paul Féghali, Brooke K. Iwamoto, Olivia Triplett, Nicholas J. Rockwood, Timothy D. Nelson, T. V. Van Dyk","doi":"10.3389/frsle.2023.1154638","DOIUrl":"https://doi.org/10.3389/frsle.2023.1154638","url":null,"abstract":"Objective Youth who experience behavioral and emotional problems are at risk for sleep disturbance, while sleep disturbance also perpetuates behavioral and emotional problems. While the relationship between sleep and psychopathology in clinical mental health samples is well-established, exploration of the underlying mechanisms maintaining this relationship is limited. The purpose of this study is to explore within-person variability in emotion regulation as a mechanism of the relationship between sleep and psychopathology in a clinical youth sample. Methods Using a within-person design, 25 children (ages 6–11; 64% male; 44% non-Hispanic White) presenting to outpatient behavioral health treatment with mental health concerns were recruited to participate in a 14-day study. Daily reports of objective sleep duration via actigraphy, self-reported subjective sleepiness, and parent-reported internalizing and externalizing problems and emotion regulation were collected. Multilevel mediation analyses were used to examine the mediating effect of emotion regulation on the daily-level relationship between sleep and behavior problems. Results At the within-person level, emotion dysregulation was a significant mediator of the relationships between objective sleep duration and both externalizing [MCCI (0.0005–0.0063)] and internalizing problems [MCCI (0.0001–0.0025)]. Contrary to hypotheses, when youth slept more than usual, internalizing and externalizing problems were worse through the indirect effect of increased emotion dysregulation. Conclusions Inconsistencies in schedules and routines, even if in a positive direction, may have short-term negative consequences for youth with emotional and behavioral concerns. Future research should look to address sleep variability and how deviations in routine may impact behavior more broadly, through the indirect effects of emotion regulation.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84014785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mandibular jaw movements as a non-invasive measure of respiratory effort during sleep: application in clinical practice 下颌运动作为睡眠中呼吸努力的非侵入性测量:在临床实践中的应用
Frontiers in sleep Pub Date : 2023-05-12 DOI: 10.3389/frsle.2023.1145620
J. Martinot, J. Pépin
{"title":"Mandibular jaw movements as a non-invasive measure of respiratory effort during sleep: application in clinical practice","authors":"J. Martinot, J. Pépin","doi":"10.3389/frsle.2023.1145620","DOIUrl":"https://doi.org/10.3389/frsle.2023.1145620","url":null,"abstract":"Assessment of respiratory effort (RE) is key for characterization of respiratory events. The discrimination between central and obstructive events is important because these events are caused by different physio-pathological mechanisms and require different treatment approaches. Many of the currently available options for home sleep apnea testing either do not measure RE, or RE signal recording is not always reliable. This is due to a variety of factors, including for instance wrong placement of the respiratory inductance plethysmography (RIP) sensors leading to artifacts or signal loss. Monitoring of mandibular jaw movements (MJM) provides the ability to accurately measure RE through a single point of contact sensor placed on the patient's chin. The inertial unit included in the capturing technology and overnight positional stability of the sensor provide a robust MJM bio-signal to detect sleep-disordered breathing (SDB). Many of the pharyngeal muscles are attached to the mandible directly, or indirectly via the hyoid bone. The motor trigeminal nerve impulses to contract or relax these muscles generate discrete MJM that reflect changes in RE during sleep. Indeed, the central drive utilizes the lower jaw as a fine-tuning lever to stiffen the upper airway musculature and safeguard the patency of the pharynx. Associations between the MJM bio-signal properties and both physiological and pathological breathing patterns during sleep have been extensively studied. These show a close relationship between changes in the MJM bio-signal as a function of RE that is similar to levels of RE measured simultaneously by the reference bio-signals such as esophageal pressure or crural diaphragmatic electromyography. Specific waveforms, frequencies, and amplitudes of these discrete MJM are seen across a variety of breathing disturbances that are recommended to be scored by the American Academy of Sleep Medicine. Moreover, MJM monitoring provides information about sleep/wake states and arousals, which enables total sleep time measurement for accurate calculation of conventional hourly indices. The MJM bio-signal can be interpreted and its automatic analysis using a dedicated machine learning algorithm delivers a comprehensive and clinically informative study report that provides physicians with the necessary information to aid in the diagnosis of SDB.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85210093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Memory retention following acoustic stimulation in slow-wave sleep: a meta-analytic review of replicability and measurement quality 慢波睡眠中声刺激后的记忆保留:可重复性和测量质量的元分析回顾
Frontiers in sleep Pub Date : 2023-05-11 DOI: 10.3389/frsle.2023.1082253
Tylor J. Harlow, Matthew Jané, H. Read, J. J. Chrobak
{"title":"Memory retention following acoustic stimulation in slow-wave sleep: a meta-analytic review of replicability and measurement quality","authors":"Tylor J. Harlow, Matthew Jané, H. Read, J. J. Chrobak","doi":"10.3389/frsle.2023.1082253","DOIUrl":"https://doi.org/10.3389/frsle.2023.1082253","url":null,"abstract":"The role of slow oscillations and spindles during sleep on memory retention has become an area of great interest in the recent decade. Accordingly, there are multiple studies that examine the efficacy of acoustic stimulation during sleep to facilitate slow oscillations and associated memory retention. Here, we run meta-analyses on a current set of 14 studies that use audible noise-burst sound stimulation to modulate overnight retention of word pairs (kS = 12 studies, kES = 14 effect sizes, n = 206 subjects). Our meta-analyses demonstrate a steady, yearly decline in effect size that accounts for 91.8% of the heterogeneity between studies. We find that the predicted effect on memory retention in 2013 favored the acoustic stimulation condition at dδ = 0.99 (95% CI [0.49, 1.49]), while the predicted effect in 2021 declined to a moderate and significant effect favoring no acoustic stimulation at dδ = −0.39 (95% CI [−0.73, −0.05]). Our meta-regression model finds no coded study-level characteristics could account for the decline in effect sizes over time other than the publication date alone. Using available data, we estimate that 34% of subjects are not actually blind to the acoustic stimulation condition due to hearing acoustic stimulation during sleep. In addition, we find that the test-retest reliability of memory retention scores is nearly zero (ρd = 0.01, 95% CI [−0.18, 0.21]), and through simulation demonstrate the impact this has on statistical power and observed effect sizes. Based on our analyses, we discuss the need for larger sample sizes, true placebo controls, age range restrictions, open-data sharing, and improvements in the reliability of memory retention tasks.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88590741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Optimizing the Better Nights, Better Days for Children with Neurodevelopmental Disorders program for large scale implementation 优化“更好的夜晚,更好的白天,为患有神经发育障碍的儿童”项目的大规模实施
Frontiers in sleep Pub Date : 2023-05-04 DOI: 10.3389/frsle.2023.1158983
Alzena Ilie, M. Orr, S. Weiss, I. Smith, G. Reid, A. Hanlon-Dearman, Cary A. Brown, E. Constantin, R. Godbout, S. Shea, O. Ipsiroglu, P. Corkum
{"title":"Optimizing the Better Nights, Better Days for Children with Neurodevelopmental Disorders program for large scale implementation","authors":"Alzena Ilie, M. Orr, S. Weiss, I. Smith, G. Reid, A. Hanlon-Dearman, Cary A. Brown, E. Constantin, R. Godbout, S. Shea, O. Ipsiroglu, P. Corkum","doi":"10.3389/frsle.2023.1158983","DOIUrl":"https://doi.org/10.3389/frsle.2023.1158983","url":null,"abstract":"Objective Pediatric insomnia is one of the most commonly reported disorders, especially in children with neurodevelopmental disorders. Better Nights, Better Days for Children with Neurodevelopmental Disorders (BNBD-NDD) is a transdiagnostic, self-guided, eHealth behavioral sleep intervention developed for parents of children with NDDs ages 4–12 years with insomnia. After usability testing, a randomized controlled trial (RCT) was conducted to evaluate the effectiveness of the BNBD-NDD program. By interviewing RCT participants after their outcome measures were collected, we sought to determine the barriers and facilitators that affect the reach, effectiveness, adoption, implementation, and maintenance of the BNBD-NDD intervention, as well as to assess whether barriers and facilitators differ across levels of engagement with the program and NDD groups. Method Twenty parents who had been randomized to the treatment condition of the RCT participated in this study. These parents participated in virtual semi-structured qualitative interviews about their experiences with the BNBD-NDD program. Rapid analysis was used, in which one researcher facilitated the interview, and another simultaneously coded the interview using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Results Overall, more facilitators than barriers were identified for Reach, Effectiveness, Implementation, and Maintenance, whereas for Adoption more barriers emerged. Participants who were engaged reported more facilitators about the BNBD-NDD program design and behavior change, while unengaged participants mentioned needing more support to help facilitate their use of the program. Lastly, parents of children with ASD reported more facilitators and more barriers than did parents of children with ADHD. Conclusion With this feedback from participants, we can optimize BNBD-NDD for large-scale implementation, by modifying the program to better support parents, helping them implement the strategies effectively at home, and increasing the accessibility of this evidence-based treatment.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90937193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Circadian rhythms in pediatric craniopharyngioma 儿童颅咽管瘤的昼夜节律
Frontiers in sleep Pub Date : 2023-04-25 DOI: 10.3389/frsle.2023.1153144
Dana Kamara, S. Crowley, V. Crabtree, Donna Hancock, Yimei Li, H. Darji, J. Semko, M. Wise, T. Merchant, B. Mandrell
{"title":"Circadian rhythms in pediatric craniopharyngioma","authors":"Dana Kamara, S. Crowley, V. Crabtree, Donna Hancock, Yimei Li, H. Darji, J. Semko, M. Wise, T. Merchant, B. Mandrell","doi":"10.3389/frsle.2023.1153144","DOIUrl":"https://doi.org/10.3389/frsle.2023.1153144","url":null,"abstract":"Introduction Craniopharyngioma is a brain tumor arising in the region of the hypothalamic-pituitary axis. Children and adolescents with craniopharyngioma have high survival rates, but often experience significant morbidity, including high rates of sleep disorders. Vulnerabilities to circadian disruption are present in this population, but little is known about circadian health. Methods We present exploratory circadian findings from a prospective trial at a single center. Data presented here are from the baseline timepoint. Fifty-three patients between the ages of 7 and 20 years provided salivary melatonin samples, following surgical resection and prior to completion of proton therapy, when indicated. We estimated dim light melatonin onset (DLMO) and collected additional sleep data from actigraphy, overnight polysomnography, and the multiple sleep latency test. Results Almost half of participants did not have a valid DLMO estimate during the sampling window, with most being above the threshold at the first sample timepoint. Those with greater disease severity variables (greater hypothalamic involvement and the presence of diabetes insipidus) were significantly more likely to have missed DLMO. For those with valid estimates, DLMO timing correlated with BMI and other sleep variables, including mean sleep latency values on the MSLT. Discussion These findings suggest that a subset of those with pediatric craniopharyngioma may experience a phase advance and that this may relate to poorer prognostic indicators. Furthermore, circadian timing correlates with other sleep and health factors. Further research with earlier sampling is needed to better understand circadian rhythms in pediatric craniopharyngioma and associations with other health and disease variables.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88580180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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