SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science XI. Pediatrics
0781
THE SUSTAINED IMPACT OF A HEALTHY MEDIA USE
INTERVENTION ON PRESCHOOL CHILD SLEEP
Garrison MM 1 , Christakis D 1,2
1
Center for Child Health, Behavior, and Development, Seattle
Children’s Hospital, Seattle, WA, USA, 2 Pediatrics, University of
Washington, Seattle, WA, USA
Introduction: While there are many causes of childhood sleep problems,
recent research has highlighted the role of media use. We examined
whether an intervention promoting healthy media use could impact
preschool sleep problems.
Methods: We are conducting a randomized, controlled trial of an intervention
aiming to improve the media diet (TV, movies, computer and
video games) of children ages 3-5 by decreasing violent or age-inappropriate
content, and replacing it with prosocial, developmentally positive
content. Parent-report surveys were collected at baseline, 6 and 12
months. Sleep questions were drawn from the Child Sleep Habits Questionnaire,
a validated measure assessing the frequency of problems with
sleep onset latency, night awakenings, nightmares, difficulty waking in
the morning, and daytime tiredness. Total sleep problem scores could
range from 5-15. Linear and multinomial logistic regressions were used
to test the impact of the intervention on the trajectory of sleep problem
scores after controlling for baseline sleep and behavior problem scores.
Results: The study enrolled 615 children, of which 404 have completed
all three timepoints; 13% have a trajectory of improvement, 5%
of worsening, and 82% of stability. Children in the intervention group
had significantly greater improvement in sleep problem scores between
baseline and six months, with a difference in score change of 0.29 between
groups (95%CI 0.05-0.54). The effect was sustained to month 12,
where the difference between groups was 0.30 (95%CI 0.06-0.54). The
intervention group was also significantly more likely to have a trajectory
of improvement (OR=2.86, 95%CI 1.25-6.53). The intervention effect
was significantly greater for boys (OR=9.00, 95%CI 2.38-33.93) than
girls (OR=0.97, 95%CI 0.29-3.24).
Conclusion: A healthy media use intervention had a significant and sustained
impact on child sleep, despite not directly targeting sleep habits.
More research is needed on the mediators involved to explore why these
effects were observed largely in boys.
0782
PRELIMINARY VALIDATION OF THE INSOMNIA SEVERITY
INDEX FOR CHILDREN (ISI-C)
Moreau V, Morin CM
École de psychologie, Université Laval, Québec, QC, Canada
Introduction: Most questionnaires assessing pediatric sleep disturbances
are relatively long and address the whole spectrum of sleep disorders.
There is a need for brief questionnaires targeting more specific conditions
such as insomnia. The objective of this study was to validate a
pediatric version of the Insomnia Severity Index (ISI).
Methods: The ISI for Children (ISI-C) was adapted from the adult
version. The original version assesses, for the past month, insomnia
symptoms, sleep satisfaction, noticeability of difficulties, distress, and
daytime consequences. The wording of items was modified so that parents
could answer for sleep difficulties experienced by the child. The
noticeability item was dropped and the daytime consequences and satisfaction
items were duplicated to assess these dimensions in both the
parent and the child. The final version contained eight items rated on
five-point scales (total score ranged from 0-32). It was administered to
62 healthy school-age children (32M/30F, mean age = 9.9 years old, SD
= 1,75, range = 6-12), along with the Children Sleep Habits Questionnaire
(CSHQ), sleep diaries, and actigraphy.
Results: Good internal reliability was suggested by a Cronbach’s alpha
coefficient of .79. Convergent validity was supported by a significant
correlation with the CSHQ total score (r = .53, p < .001), as well as with
the Bedtime Resistance (r = .43, p < .01), Sleep Duration (r = .37, p <
.01), and Night Wakings (r = .36, p < .01) subscales. The total ISI-C
score did not correlate with actigraphic data, but its sleep onset insomnia
item was correlated with sleep latency measured with actigraphy (r =
.34, p < .01).
Conclusion: The ISI-C shows adequate psychometric properties and
could be a useful assessment questionnaire of insomnia in children. Testretest
reliability remains to be documented, as well as its validation with
clinical samples of children with sleep disorders.
Support (If Any): This research was supported by a student scholarship
awarded to Vincent Moreau from the Canadian Institutes of Health
Research.
0783
AGE-RELATED GENDER DIFFERENCES IN THE
PREVALENCE OF INSOMNIA IN A COMMUNITY SAMPLE
OF YOUNG CHILDREN
Bixler EO, Fernandez-Mendoza J, Calhoun S, Singareddy R,
Tsaoussoglou M, Vgontzas AN
Psychiatry, Penn State College of Medicine, Hershey, PA, USA
Introduction: Few population-based studies have examined the prevalence
of insomnia and its association with sociodemographic factors in
children.
Methods: A sample of 700 children (6-12 yr) from The Penn State Child
Cohort underwent a 9-hour polysomnogram, a physical examination
and a parent completed sleep questionnaire. Insomnia was defined as
a parent-reported difficulty falling (DFA) and/or staying (DSA) asleep.
Results: The prevalence of insomnia was 19.2%, with 44.7% reporting
DFA, 26.0% DSA, and 29.3% both. There were no significant differences
between girls (20.0%) and boys (18.3%) or between age groups
of 5-7, 8-10, and ≥ 11 yr (21.2%, 16.5%, and 24.3%, respectively) in
the prevalence of insomnia. However, significant age differences were
found within girls so that those ≥ 11 yr showed a higher prevalence of
insomnia (30.1%) as compared to those 5-7 (21.4%) or 8-10 yr (15.9%).
Furthermore, similar findings were found in terms of insomnia subtypes:
girls ≥ 11 yr had the highest prevalence of DFA (21.3%) as compared to
those with 5-7 (8.2%) or 8-10 yr (7.1%) , followed by those with both
DFA and DSA (with a prevalence of 9.4%, 4.8%, and 11.5% for those
with 5-7, 8-10, and ≥ 11 yr, respectively). Consistently, within girls,
those ≥ 11 yr had a higher prevalence of insomnia with “long” (≥ 21
minutes) sleep latency (26%) as compared to insomnia with normal (<
21 minutes) sleep latency (4.1%). In contrast, the prevalence of insomnia
within boys was similar across the 5-7, 8-10, and ≥ 11 yr age groups
(21.1%, 17.6%, and 17.5%, respectively) and did not change significantly
when examined across insomnia subtypes, either based on subjective
complaints or objective sleep latency.
Conclusion: These data suggest that gender differences in insomnia
may start during the peripubertal period. These gender differences are
most likely explained by hormonal and psychological changes associated
with puberty, presented earlier in girls.
0784
CIRCADIAN MISALIGNMENT IN CHILDREN PRESENTING
WITH INSOMNIA SYMPTOMS TO THE PEDIATRIC SLEEP
DISORDERS CLINIC: DETECTION AND PREVALENCE
Price GG 1 , Rosen CL 2
1
Sleep Medicine, University Hospitals, Case Western Reserve
Univeristy, Cleveland, OH, USA, 2 Pediatric Pulmonology, Sleep
Medicine, University Hospitals, Case Western Reserve University,
Cleveland, OH, USA
Introduction: Evaluation and management of pediatric insomnia complaints
often overwhelms the busy clinician. Circadian rhythm disturbances
may play a significantly under recognized role in pediatric
insomnia complaints. The purpose of this study was to estimate the prev-
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SLEEP, Volume 34, Abstract Supplement, 2011