Sleep Medication in Older Adults: Identifying the Need for Support by a Community Pharmacist

Many older adults take benzodiazepines and sedative-hypnotics for the treatment of sleep disorders. With a view to considering the possible discontinuation of hypnotics, the objectives of the present study were to describe bedtime habits and sleep patterns in older adults and to identify the sleep medications taken. An expert group developed a structured interview guide for assessing the patients’ bedtime habits, sleep patterns, and medications. During an internship in a community pharmacy, 103 sixth-year pharmacy students conducted around 10 interviews each with older adults (aged 65 or over) complaining of sleep disorders and taking at least one of the following medications: benzodiazepines, benzodiazepine derivatives (“Z-drugs”), antihistamines, and melatonin. A prospective, observational study was carried out from 4 January to 30 June 2016. The pharmacy students performed 960 interviews (with 330 men and 630 women; mean ± standard deviation age: 75.1 ± 8.8). The most commonly taken hypnotics were the Z-drugs zolpidem (n = 465, 48%) and zopiclone (n = 259, 27%). The vast majority of patients (n = 768, 80%) had only ever taken a single hypnotic medication. The median [interquartile range] prescription duration was 120 (48–180) months. About 75% (n = 696) of the patients had at least 1 poor sleep habit, and over 41% (n = 374) had 2 or more poor sleep habits. A total of 742 of the patients (77%) reported getting up at night—mainly due to nycturia (n = 481, 51%). Further, 330 of the patients (35%) stated that they were keen to discontinue their medication, of which 96 (29%) authorized the pharmacist to contact their family physician and discuss discontinuation. In France, pharmacy students and supervising community pharmacists can identify problems related to sleep disorders by asking simple questions about the patient’s sleep patterns. Together with family physicians, community pharmacists can encourage patients to discuss their hypnotic medications.

To Assess the Parental Perception on Sleep Habit among the Children in Pediatric Ward and OPD of Jubilee Mission Medical College and Research Institute, Thrissur

Children are the worlds precious resources and the best hope for future. During clinical experiences, observation and rapport with mothers, investigators assess many children show difference in sleep patterns and irritated with daily life. The present study was aimed to assess the parental perception on sleep habit of children in the paediatric ward. Objectives: assess the parental perception on sleep habit among children and to find relationship between sleep habit and selected socio demographic variables. Methodology: Quantitative experimental approach was used with descriptive design. The data were collected from 50 children by using random sampling technique. Data were analysed using descriptive and inferential statistics. Result and interpretation: The findings of the study had shown that majority of subjects 24(48%) of the children belongs to age group of 2 to 3 years, 27(54%) were females, 25(50) of children were moderately nourished.39(78%) of children has a meal pattern of more than one hour before sleep, 60% like outdoor play, 35(70%) does not need toys for sleep. Majority of the parents 22(44%) belongs to 26-30 age group, 25(50%) belongs to females, 17(34%) were graduates, 40(80%) were healthy. we found that there is a relationship between clinical data variables such as nutritional status(p=0.041) with sleep habit of children. By using parental perception questionnaire, we found that parents have good perception on sleep habit among children as out of 50 samples 35(70%) secure good score, 14 (28%) secure satisfactory score and only 1(2%) secure poor score.

The Development and Application of a Resilience-Promoting Program Using Changes in Sleep-Related Habits in Korean Adolescents

Objective: Resilience-promoting program which covers strategies to improve sleep health through modulation of sleep-related habits has been lacking. The authors aimed to develop a resilience-promoting program that incorporates the encouragement of healthy sleep habits. Methods: Fifty-eight adolescents (27 female, 46.6%; aged 13.78±0.82 years) were recruited to test the effectiveness of the program. Dur- ing the first and final sessions, several self-reported questionnaires, including the Connor-Davidson Resilience Scale (CD-RISC), the Smart- phone Addiction Scale–short version (SAS-SV), Hospital Anxiety and Depression Scale (HADS), Composite Scale of Morningness (CSM), In- somnia Severity Index (ISI), and a sleep habit-related questionnaires were administered to the adolescents. After the first session, adolescents were provided with an Actiwatch and were asked to wear the watch to the last session date. Multiple linear regression analyses were used to identify predictors of resilience and sleep quality.Results: The participants’ resilience, morningness, sleep quality, wake after sleep onset (WASO), and wakening frequency during the night changed significantly. Resilience at the last session was related to sleep quality (β=-0.394, p=0.005) at the last session when controlling for age, sex, and morningness. Sleep quality at the last session was related to the mean sun- light exposure time (β=-0.363, p=0.037) at the last session when controlling for age, sex, and WASO during the third week.Conclusion: This study found that four weekly sessions of resilience-promoting program improved resilience, sleep quality including objective actigraphic measures, and morningness. Improved resilience was related to better sleep quality.

Sleep disorders and associated factors in children with cerebral palsy

Background Sleep disorders are a condition affecting quality and quantity of sleep. Children with cerebral palsy (CP) have higher risk of sleep disorders than those with no chronic disease. Objective To determine the prevalence and factors associated with sleep disorders in children with CP. Methods We conducted an analytic, observational study with cross-sectional design in children aged 4-10 years with CP. Subjects were recruited consecutively; children with chronic diseases (cardiovascular, malignancy, chronic obstructive pulmonary disease, and diabetes mellitus) were excluded from the study. Primary data including sociodemographics, intensity of physiotherapy outside Sardjito General Hospital (SGH), sleep hygiene, and sleep disorders were collected from the Children’s Sleep Habit Questionnaire (CSHQ). Secondary data were acquired from medical records, such as type of CP, severity of motor function impairment, presence of epilepsy, intensity of physiotherapy performed at SGH, as well as anti-epileptic, anti-spastic, and sleep-affecting medicines. Results We found sleep disorders in 64 of 75 (85%) subjects, mostly bedtime resistance (66%). Spastic quadriplegia (OR=3.63; 95%CI 1.82 to15.94) and presence of epilepsy (OR=7.82; 95%CI 1.53 to 39.84) were significantly associated with sleep disorders in children with CP aged 4-10 years. Conclusion Sleep disorders are common in children with CP, with the majority experiencing bedtime resistance. Sleep disorders are more prevalent in subjects with spastic quadriplegia and epilepsy.

The effect of continuous care model on infant sleep habits in Bint Al-Huda educational and medical center in Bojnourd in 2019

Background: Sleep is one of the essential and vital needs of human and a factor that affects the growth and development of children. The basic learning of sleep habit is formed in childhood and the person tries to maintain it throughout life. Therefore, considering the importance of childhood in the formation of appropriate sleep habit, this study was conducted to investigate the effect of continuous care model on infant sleep habits in Bint Al-Huda medical center in Bojnourd. Methods: This interventional study was performed on 66 mothers attending the Bint Al-Huda Hospital in Bojnourd in 2019. Sampling was done by available method and the samples were randomly assigned to the intervention and control groups. The intervention group received a continuous care model program in 4 sessions. Each session lasted for of 45-60 minutes. Data collection tools included the demographic characteristics questionnaire and the Infant Sleep Habit Scale (ISQ). The collected data were analyzed by SPSS software version 16 using Fisher and Rapid Major statistical tests at the significance level of p <0.05. Results: The results of Rapid Major test showed a significant difference (P = 0.01) between the intervention and control groups at 1, 2 and 3 months after the intervention, so that sleep habits did changed in the intervention group at different times after the intervention, but in the control group, sleep habit disorders were observed. Conclusion: According to the obtained results, it is suggested that teaching mothers proper sleep habits in the long run can improve their knowledge and performance in improving sleep habits of their infants. Key words: Continuous Care Model, Sleep Habits, Infant

Assessment of sleep quality in school children of 6-12 years in COVID-19 pandemic

Background: Sleep disorders in children are one of the common disorders and their frequency has increased during the COVID-19 pandemic. The study aims to assess the quality of sleep and study the parameters of sleep in school children aged 6-12 years in pandemic with the help of children’s sleep habit questionnaire (CSHQ).Methods: A survey-based study was conducted from December 2020 to March 2021 using the data obtained from CSHQ. The study involved 498 school children, among which 244 were male participants and 254 were female participants. It involved students from schools of Rahata and Mumbai, Maharashtra.Results: The results of the study were withdrawn. Bedtime Resistance had mean value of 11.79±4.56, sleep onset delay had mean of 1.56±0.71. Average of sleep duration was 4.56±2.09. Sleep anxiety had mean of 7.48±3.1, night wakings had mean of 4.27±1.91. Mean of parasomnias was 10.1±4.46. Average of sleep disordered breathing was 4.09±1.86, for daytime sleepiness mean was 13.04±5.44 with significance of p˂0.0001.Conclusions: The study concluded that sleep time became lesser and bedtime became later in present scenario of COVID-19. The subscale items of CSHQ scale have increased values indicating towards altered sleep pattern. The total scoring of CSHQ for age group 6-9 years on average is higher than age group 10-12 years except “sleep onset delay” and “sleep duration”. Also, the total scores of female participants are higher as compared to male participants.

GADGET ADDICTION AND THE EFFECT OF SLEEP HABIT, STRESS, PHYSICAL ACTIVITY TO OBESITY

Obesity become worrying problem among adolescents, they who are obesed are 80% have the opportunity to experience obesity as adults and have higher risk of serious diseases such as cardiovascular disease, stroke, diabetes, asthma, and some types of cancer. According to the health profile of Yogyakarta Special Province in 2017 the prevalence of obesity was 19.1% occurs in adolescents. The main purpose of the research is to analyze the direct and indirect effects of gadget usage, sleep habit, stress, and physical activity on obesity. The population in this research was obese junior and senior high school adolescents, totaling 150 persons. Determination of samples is taken by simple random sampling. Independent variables consist of gadget usage, stress level, sleep habit, and physical activity. While the dependent variable is obesity. Bivariate analysis with chi-square test is applied for cathegorical data and independent T-test for numerical data. Multivariate analysis is carried out with path analysis, using the Amos version 22.0 software program. The results of this research found that the conclusions of the path diagram generated are as follow: 1) Gadget usage variable path coefficient value has a positive effect on physical activity. 2) Physical activity variable path coefficient value has a positive in effect on obesity. 3) Sleep habit and stress variable path coefficient value has a positive effect on gadget usage. It can be concluded that gadget addiction is directly related to sleep habits, stress, physical activity, and indirectly with obesity.

Sleep Disturbances and Patterns in Children With Neurodevelopmental Conditions

Background: Children with neurodevelopmental conditions (NDC) often experience sleep problems which are long-lasting and more complex than typically developing children. These sleep problems impact their families and there is little guidance for management specifically for sleep for families of children with neurodevelopmental conditions. The present study aims to use parental report to evaluate sleep disturbances and sleep patterns in a large sample of children with NDC. We aim to identify associations with age, diagnosis, and medication groups.Methods: Data on 601 children aged between 2 and 17 years was analyzed from a UK non-profit service for sleep for families of children with NDC. Parents/carers completed the children's sleep habit questionnaire, a 7 day sleep diary, and information on child age, diagnosis, and medication. Parents also reported previous sleep management techniques they had tried.Results: Overall, we found differences between age, diagnosis, and medication use groups for sleep disturbances and sleep diary parameters in these populations. Sensory conditions were associated with high night time waking duration. Parents reported their child's short sleep duration was the most common problem for them.Conclusions: Key areas for further research are outlined including the long term considerations for parental presence at bedtime for sleep anxiety, melatonin use and efficacy, and consideration for interventions to reduce daytime fatigue in children aged 7–11 years old.

Sleeping Habits Amongst Riyadh Children: A Cross-Sectional and Validation Study

Background: To validate the Arabic translation of the Children’s Sleep Habit Questionnaire and determine the behavioral prevalence of sleep habits amongst school aged children in Riyadh, Saudi Arabia. Methods: This prospective cross sectional study involved a Linguistic validation involving 50 bilingual parent participants in each of the Arabic and English Surveys, with a cross sectional pilot involving 1546 parent participants regarding their children’s Sleeping Habits. The Children’s Sleep Habit Questionnaire was distributed via Survey Monkey and subjected to IBM-SPSS statistics. Parents of 1546 school aged children ranging from 3 years to 12 years of age completed the survey.Results: The Total score of all domains ranged between 11 and 70. Mean Score of 35-37 in 11 % of this population. The Children’s Sleep Habit Questionnaire scores were High in comparison to the Owen’s article; greater research is needed to determine the underlying causes of the increased likelihood of sleep disorders.Conclusion: Our findings, especially in sleep anxiety are alarming and warrant for more research to determine underlying causes of the more prevalent sleep disorders (Sleep Anxiety) and any other apparent or possible causes for sleep disturbances amongst children.

Sleep Disorder in Children Suffering from Autism Spectrum Disorder in the Hilly Area of Uttarakhand

Background: Autism Spectrum Disorder (ASD) includes neurodevelopmental problems throughout life that affect all areas of child development such as abnormal and impaired social interaction, problems in communication, restricted interest, repetitive and stereotypical behaviors. Sleep problems are most commonly complained by parents of children suffering from ASD. About 20-30% of children less than 5 years with normal development give complaints of sleep problems mainly of bedtime resistance, sleep onset delay and night awakening. Less commonly reported sleep disturbance by parents is nightmares or night terrors repetitive and stereotypical behavior. Less frequently reported complain is of breathing sleep disorder. It has already been proved by many studies that ASD children have more complaints about sleep problems than in normal children. But the data of children with ASD having sleep problems in the Indian population is less, so with our study we want to know the prevalence of ASD children with sleep problems in children of the hilly area of Uttarakhand. Objective: The study aims to know the different problems related to sleep faced by children suffering from ASD ( Age range from 4 to 10 years ) with autistic spectrum disorders using the Children’s Sleep Habit Questionnaire (Preschool and school-age, abbreviated version). Subjects and Method s: All patients of ASD presenting to the Psychiatry and Pediatric Outpatient department of Government Medical College and Susheela Tiwari trust Hospital, Haldwani, Uttarakhand from in February 2019 to January 2020. It’s a cross-sectional study of children with different problems related to sleep faced by children suffering from ASD ( Age range from 4 to 10 years ) with autistic spectrum disorders using the Children’s Sleep Habit Questionnaire (CSHQ) (Preschool and school-age, abbreviated version). Results: Demographic and clinical characteristics: The sample consisted of 30 children of ASD with sleep problems ( Mean Age 8.06 years, SD 3.25, Male 21 and Female 9 Children) age range from 4 Years to 10 Years and is compare from 30 normal children (mean age 9.06 Years, SD 3.15, Male 21 and Female 9) for the control group. Both groups were analysed using CSHQ tools. There were no statistically significant differences in age and gender (P value more than 0.05). About 60% (n=18) of the children suffering from ASD had an intellectual disability and 40% (n=12) children with ASD had normal Intellectual. Comparison of Total CSHQ score, bedtime resistance and sleep anxiety showed a statistically significant difference in children suffering from ASD with sleep disorder when compared from normal children. Using CSHQ tools sleep onset delay, night waking, day time sleepiness, parasomnias and sleep –disorder breathing does not show any statistical difference between children with ASD and normal children used as Control. Conclusion: This study compared sleep problems between children with ASD and typically developing children (4-10 Years of age) and examined associated factors of sleep problems in ASD from a different point of view.