Pediatric sleep difficulties after moderate–severe traumatic brain injury

The objective of this study is to systematically investigate sleep following moderate–severe pediatric traumatic brain injury (TBI). School-aged children with moderate–severe TBI identified via hospital records were invited to participate, along with a school-age sibling. Subjective reports and objective actigraphy correlates of sleep were recorded: Children's Sleep Habits Questionnaire (CSHQ), Sleep Self-Report questionnaire (SSR), and 5-night actigraphy. TBI participants (n = 15) and their siblings (n = 15) participated. Significantly more sleep problems were parent-reported (CSHQ: p = 0.003; d = 1.57), self-reported (SSR: p = 0.003; d = 1.40), and actigraph-recorded in the TBI group (sleep efficiency: p = 0.003; d = 1.23; sleep latency: p = 0.018; d = 0.94). There was no evidence of circadian rhythm disorders, and daytime napping was not prevalent. Moderate–severe pediatric TBI was associated with sleep inefficiency in the form of sleep onset and maintenance problems. This preliminary study indicates that clinicians should be aware of sleep difficulties following pediatric TBI, and their potential associations with cognitive and behavioral problems in a group already at educational and psychosocial risk

Intense physical activity is associated with cognitive performance in the elderly

Numerous studies have reported positive impacts of physical activity on cognitive function. However, the majority of these studies have utilised physical activity questionnaires or surveys, thus results may have been influenced by reporting biases. Through the objective measurement of routine levels of physical activity via actigraphy, we report a significant association between intensity, but not volume, of physical activity and cognitive functioning. A cohort of 217 participants (aged 60–89 years) wore an actigraphy unit for 7 consecutive days and underwent comprehensive neuropsychological assessment. The cohort was stratified into tertiles based on physical activity intensity. Compared with individuals in the lowest tertile of physical activity intensity, those in the highest tertile scored 9%, 9%, 6% and 21% higher on the digit span, digit symbol, Rey Complex Figure Test (RCFT) copy and Rey Figure Test 30-min recall test, respectively. Statistically, participants in the highest tertile of physical activity intensity performed significantly better on the following cognitive tasks: digit symbol, RCFT copy and verbal fluency test (all P<0.05). The results indicate that intensity rather than quantity of physical activity may be more important in the association between physical activity and cognitive function

Factors affecting the sleep of one-year-olds : a pilot study using objective monitoring of New Zealand infants : a thesis presented in partial fulfilment of the requirements of the degree of Master of Science in Psychology at Massey University, Wellington, New Zealand

Sleep takes time to mature and in infancy the structure and cycle of sleep differs greatly to that of adults. Data concerning normative sleep of infants is lacking due to few studies using objective measures. Factors affecting infants' sleep are both intrinsic and extrinsic in nature. The causes of problematic sleep are not well understood. This study aimed to pilot a methodology involving 1 week of actigraphy monitoring of 1-year-olds, as well as collecting normative data concerning sleep and sleep ecology through questionnaires and diaries. Potential factors contributing to sleep quantity, quality and maturation were investigated. Sleeping problems were reported in 35% of the sample of 52 Wellington infants. Current breastfeeding, time awake at night, and poor evening mood were all associated with problem sleep. Short sleep duration and more instances of being put to bed were also significant predictors of reporting problem sleep. Infants were typically rated in a poorer mood and exhibited more bedtime problems at the weekend. Longer sleep onset latencies and poorer sleep efficiency were identified by actigraphy on weekend evenings. The timing of sleep did not differ between genders or between week days and weekends, or childcare and non-childcare days. Mixed model analysis of variance indicated that the maturation and quality of sleep were significantly correlated with age and stages of cognitive and motor development. Sleep duration did not correlate with ponderal index, possibly due to the young age group as well as underrepresentation of short sleeping or overweight infants. Results support previous studies in western societies and autonomous sleeping is common. Potential mechanisms behind relationships between sleep and feeding, temperament and development are discussed. Strengths and limitations of methods and procedures are assessed. Actigraphic recording of 1-year-olds is demonstrated to be a useful and reliable tool for studying sleep of infants and the results contribute to normative data. Future studies in NZ should consider recruiting a more representative sample and incorporate a longitudinal design to further assess the relationships highlighted here and in previous research

Activity monitoring in patients with depression : A systematic review

Copyright © 2012 Elsevier B.V. All rights reserved.Peer reviewedPreprin

On multifractals: a non-linear study of actigraphy data

This work aimed, to determine the characteristics of activity series from fractal geometry concepts application, in addition to evaluate the possibility of identifying individuals with fibromyalgia. Activity level data were collected from 27 healthy subjects and 27 fibromyalgia patients, with the use of clock-like devices equipped with accelerometers, for about four weeks, all day long. The activity series were evaluated through fractal and multifractal methods. Hurst exponent analysis exhibited values according to other studies ($H>0.5$) for both groups ($H=0.98\pm0.04$ for healthy subjects and $H=0.97\pm0.03$ for fibromyalgia patients), however, it is not possible to distinguish between the two groups by such analysis. Activity time series also exhibited a multifractal pattern. A paired analysis of the spectra indices for the sleep and awake states revealed differences between healthy subjects and fibromyalgia patients. The individuals feature differences between awake and sleep states, having statistically significant differences for $\alpha_{q-} - \alpha_{0}$ in healthy subjects ($p = 0.014$) and $D_{0}$ for patients with fibromyalgia ($p = 0.013$). The approach has proven to be an option on the characterisation of such kind of signals and was able to differ between both healthy and fibromyalgia groups. This outcome suggests changes in the physiologic mechanisms of movement control.Comment: Preprint accepted for publication at Physica A: Statistical Mechanics and its Application

Relationship Between Sleep and Behavior in Autism Spectrum Disorder: Exploring the Impact of Sleep Variability.

Objective:The relationship between sleep (caregiver-reported and actigraphy-measured) and other caregiver-reported behaviors in children and adults with autism spectrum disorder (ASD) was examined, including the use of machine learning to identify sleep variables important in predicting anxiety in ASD. Methods:Caregivers of ASD (n = 144) and typically developing (TD) (n = 41) participants reported on sleep and other behaviors. ASD participants wore an actigraphy device at nighttime during an 8 or 10-week non-interventional study. Mean and variability of actigraphy measures for ASD participants in the week preceding midpoint and endpoint were calculated and compared with caregiver-reported and clinician-reported symptoms using a mixed effects model. An elastic-net model was developed to examine which sleep measures may drive prediction of anxiety. Results:Prevalence of caregiver-reported sleep difficulties in ASD was approximately 70% and correlated significantly (p &lt; 0.05) with sleep efficiency measured by actigraphy. Mean and variability of actigraphy measures like sleep efficiency and number of awakenings were related significantly (p &lt; 0.05) to ASD symptom severity, hyperactivity and anxiety. In the elastic net model, caregiver-reported sleep, and variability of sleep efficiency and awakenings were amongst the important predictors of anxiety. Conclusion:Caregivers report problems with sleep in the majority of children and adults with ASD. Reported problems and actigraphy measures of sleep, particularly variability, are related to parent reported behaviors. Measuring variability in sleep may prove useful in understanding the relationship between sleep problems and behavior in individuals with ASD. These findings may have implications for both intervention and monitoring outcomes in ASD

Sleep During Pregnancy: The nuMoM2b Pregnancy and Sleep Duration and Continuity Study

Study Objectives: To characterize sleep duration, timing and continuity measures in pregnancy and their association with key demographic variables. Methods: Multisite prospective cohort study. Women enrolled in the nuMoM2b study (nulliparous women with a singleton gestation) were recruited at the second study visit (16-21 weeks of gestation) to participate in the Sleep Duration and Continuity substudy. Women <18 years of age or with pregestational diabetes or chronic hypertension were excluded from participation. Women wore a wrist activity monitor and completed a sleep log for 7 consecutive days. Time in bed, sleep duration, fragmentation index, sleep efficiency, wake after sleep onset, and sleep midpoint were averaged across valid primary sleep periods for each participant. Results: Valid data were available from 782 women with mean age of 27.3 (5.5) years. Median sleep duration was 7.4 hours. Approximately 27.9% of women had a sleep duration of 9 hours. In multivariable models including age, race/ethnicity, body mass index, insurance status, and recent smoking history, sleep duration was significantly associated with race/ethnicity and insurance status, while time in bed was only associated with insurance status. Sleep continuity measures and sleep midpoint were significantly associated with all covariates in the model, with the exception of age for fragmentation index and smoking for wake after sleep onset. Conclusions: Our results demonstrate the relationship between sleep and important demographic characteristics during pregnancy