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Sex differences and the interaction of age and sleep issues in neuropsychological testing performance across the lifespan in an ADD/ADHD sample from the years 1989 to 2009.

Sex differences and the interaction of age and sleep issues in neuropsychological testing performance across the lifespan in an ADD/ADHD sample from the years 1989 to 2009.

Psychol Rep. 2014 Apr;114(2):404-38

Authors: Fisher BC, Garges DM, Yoon SY, Maguire K, Zipay D, Gambino M

Abstract
Chart review of population (9 to 80 years) neuropsychological test battery for ADHD diagnosis, questionnaires with multiple responders were evaluated in outpatient setting from 1989-2009. The focus was gender differences across age, diagnostic group (ADHD-Inattentive/ADHD plus), neuropsychological test performance, and reported sleep symptoms over the lifespan. Individuals were assigned to ADHD-I group or ADHD plus group (based upon secondary diagnosis of sleep, behavioral, emotional disturbance); ADHD not primary was excluded (brain insult, psychosis). Among these were 1,828 children (ages 9 to 14), adolescents (ages 15 to 17), and adults (ages 18 and above); 446 children (312 diagnosed ADHD-I), 218 adolescents (163 diagnosed ADHD-I), and 1,163 adults (877 ADHD-I). Sleep was problematic regardless of age, ADHD subtype, and gender. The type and number of sleep problems and fatigue were age dependent. ADHD subtype, gender, fatigue, age, and sleep (sleep onset, unrefreshing sleep, sleep maintenance) were significant variables affecting neuropsychological test performance (sequencing, cognitive flexibility, slow- and fast-paced input, divided attention, whole brain functioning). Findings suggest that ADHD involves numerous factors and symptoms beyond attention, such as sleep which interacts differently dependent upon age.

PMID: 24897898 [PubMed - indexed for MEDLINE]

Chronic sleep curtailment and adiposity.

Chronic sleep curtailment and adiposity.

Pediatrics. 2014 Jun;133(6):1013-22

Authors: Taveras EM, Gillman MW, Peña MM, Redline S, Rifas-Shiman SL

Abstract
OBJECTIVES: To examine the extent to which chronic sleep curtailment from infancy to mid-childhood is associated with total and central adiposity.
METHODS: We studied 1046 children participating in a prospective cohort study. At age 6 months and yearly from age 1 to 7 years, mothers reported their children's sleep duration in a usual 24-hour period. The main exposure was a sleep curtailment score from age 6 months to 7 years. The range of the total score was 0 to 13, where 0 indicated the maximal sleep curtailment and 13 indicated never having curtailed sleep. Outcomes in mid-childhood were BMI z score, dual X-ray absorptiometry total and trunk fat mass index (kg/m(2)), and waist and hip circumferences (cm).
RESULTS: The mean (SD) sleep score was 10.2 (2.7); 4.4% scored a 0 to 4, indicating multiple exposures to sleep curtailment between age 6 months to 7 years, 12.3% scored 5 to 7, 14.1% scored 8 to 9, 28.8% scored 10 to 11, and 40.3% scored 12 to 13. In multivariable models, children who had a sleep score of 0 to 4 had a BMI z score that was 0.48 U (95% confidence interval, 0.13 to 0.83) higher than those who had a sleep score of 12 to 13. We observed similar associations of higher total and trunk fat mass index and waist and hip circumferences, and higher odds of obesity (odds ratio, 2.62; 95% confidence interval, 0.99 to 6.97) among children who had a score of 0 to 4 vs 12 to 13.
CONCLUSIONS: Chronic sleep curtailment from infancy to school age was associated with higher overall and central adiposity in mid-childhood.

PMID: 24843068 [PubMed - indexed for MEDLINE]

Distinct developmental trends in sleep duration during early childhood.

Distinct developmental trends in sleep duration during early childhood.

Pediatrics. 2014 Jun;133(6):e1561-7

Authors: Magee CA, Gordon R, Caputi P

Abstract
BACKGROUND AND OBJECTIVES: Sleep is important to child development, but there is limited understanding of individual developmental patterns of sleep, their underlying determinants, and how these influence health and well-being. This article explores the presence of various sleep patterns in children and their implications for health-related quality of life.
METHODS: Data were collected from the Longitudinal Study of Australian Children. Participants included 2926 young children followed from age 0 to 1 years to age 6 to 7 years. Data on sleep duration were collected every 2 years, and covariates (eg, child sleep problems, maternal education) were assessed at baseline. Growth mixture modeling was used to identify distinct longitudinal patterns of sleep duration and significant covariates. Linear regression examined whether the distinct sleep patterns were significantly associated with health-related quality of life.
RESULTS: The results identified 4 distinct sleep duration patterns: typical sleepers (40.6%), initially short sleepers (45.2%), poor sleepers (2.5%), and persistent short sleepers (11.6%). Factors such as child sleep problems, child irritability, maternal employment, household financial hardship, and household size distinguished between the trajectories. The results demonstrated that the trajectories had different implications for health-related quality of life. For instance, persistent short sleepers had poorer physical, emotional, and social health than typical sleepers.
CONCLUSIONS: The results provide a novel insight into the nature of child sleep and the implications of differing sleep patterns for health-related quality of life. The findings could inform the development of effective interventions to promote healthful sleep patterns in children.

PMID: 24843067 [PubMed - indexed for MEDLINE]

Duration and course of post-concussive symptoms.

Duration and course of post-concussive symptoms.

Pediatrics. 2014 Jun;133(6):999-1006

Authors: Eisenberg MA, Meehan WP, Mannix R

Abstract
OBJECTIVES: To examine the incidence, duration, and clinical course of individual post-concussive symptoms in patients presenting to a pediatric emergency department (ED) with a concussion.
METHODS: We conducted secondary analysis of a prospective cohort study of patients 11 to 22 years old presenting to the ED of a children's hospital with an acute concussion. The main outcome measure was duration of symptoms, assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPSQ). Patients initially completed a questionnaire describing mechanism of injury, associated symptoms, past medical history, and the RPSQ, then were serially administered the RPSQ for 3 months after the concussion or until all symptoms resolved.
RESULTS: Headache, fatigue, dizziness, and taking longer to think were the most common symptoms encountered at presentation, whereas sleep disturbance, frustration, forgetfulness, and fatigue were the symptoms most likely to develop during the follow-up period that had not initially been present. Median duration of symptoms was the longest for irritability (16 days), sleep disturbance (16 days), frustration (14 days), and poor concentration (14 days), whereas nausea, depression, dizziness, and double-vision abated most quickly. One month after injury, nearly a quarter of children still complained of headache, >20% suffered from fatigue, and nearly 20% reported taking longer to think.
CONCLUSIONS: Among patients presenting to a pediatric ED after a concussion, physical symptoms such as headache predominate immediately after the injury, emotional symptoms tend to develop later in the recovery period, and cognitive symptoms may be present throughout.

PMID: 24819569 [PubMed - indexed for MEDLINE]

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