SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science XI. Pediatrics
Methods: To elicit an understanding of mother-child sleep patterns during
ALL maintenance chemotherapy, a qualitative descriptive approach
was chosen. This approach allows for the discovery of themes that are
not identified in the literature, or may not be revealed through quantitative
methods. The sample, obtained through The Children’s Hospital
Denver (TCH) hematology practice included 23 dyads of mothers and
children with ALL. The typical maternal participants were mid-thirties,
married (76.9%), white (65%), 42% had a college education or higher,
and 35% were employed. To the extent possible, patients from diverse
cultural and socioeconomic backgrounds were included to provide
broad perspectives. Participants shared audio recorded narratives (30-60
minutes) pertaining to their sleep (e.g., quality, quantity) relative to their
child’s ALL diagnosis.
Results: Interviews were transcribed and independently analyzed by co-
PIs and compared. Themes emerging from the data included:“ A Whole
New Cancer World” and “I don’t remember what it is like to sleep.”
Facets of the sleep theme included “sick at night,” “coping with exhaustion,”
and “moving toward sleep.” Participants described the best and
worst nights, and shared a wide variety of strategies to improve sleep.
Conclusion: Even during maintenance chemotherapy, the quality and
quantity of the child’s sleep had a major negative impact on maternal
sleep and family sleeping arrangements. This study has implications
for clinicians in assessing and implementing interventions for impaired
sleep in parents, and children with ALL.
Support (If Any): UC Denver Colorado Clinical Translational Science
Institute (CCTSI) Pilot Award (1UL1RR014780)
0881
THE PREVALENCE AND PATTERNS OF SLEEP DISORDERS
AND CIRCADIAN RHYTHM DISRUPTIONS IN CHILDREN
WITH FETAL ALCOHOL SPECTRUMS DISORDERS (FASD)
Goril S 2,3 , Shapiro CM 1,2
1
Psychiatry, Toronto Western Hospital, UHN, Toronto, ON, Canada,
2
Youthdale Child and Adolescent Sleep Centre, , Toronto, ON, Canada,
3
Collaborative Program in Neurosciences, University of Toronto,
Toronto, ON, Canada
Introduction: Sleep disorders have been poorly described in children
and adolescents diagnosed with FASD. The objective of this study is
to describe the sleep and circadian rhythm characteristics of children
with FASD using 2 nights of overnight polysomnography, sleep questionnaires,
and the Dim Light Melatonin Onset (DLMO) test. To our
knowledge, no comprehensive study of this nature has been conducted.
Methods: Children aged 5-18 years diagnosed with Fetal Alcohol Spectrum
Disorder (FASD) were recruited from various FASD clinics to the
Youthdale Child and Adolescent Sleep Centre in Toronto. After a medical
consultation, each participant had 2 nights of overnight polysomnography,
as well as an additional night of DLMO. Participants completed
various sleep, alertness, and mood questionnaires. To date, objective
sleep parameters, subjective questionnaire data were analyzed using
SPSS for 9 study patients.
Results: Descriptive pilot data shows the mean percentage values for
stage 4 slow wave sleep (SWS) were slightly elevated compared to
the normative values. The mean percentage values of REM sleep was
slightly decreased. Mean percentage values of wakefulness were also increased,
suggesting increased sleep fragmentation during the night. The
DLMO results obtained to date in this group are all abnormal.
Conclusion: Polysomnographic analysis supports disrupted sleep patterns
in children with FASD including increased night awakenings, increased
sleep fragmentation, and decreased REM sleep. The increased
prevalence of sleep and circadian disturbances in this population suggests
the need for a more proactive approach to sleep.
0882
POLYSOMNOGRAPHY AND ACTIGRAPHY CONCORDANCE
IN JUVENILE IDIOPATHIC ARTHRITIS AND ASTHMA
COMPARED TO HEALTHY CHILDREN
Ward TM 1 , Lentz M 2 , Kieckhefer G 1 , Landis CA 2
1
Family & Child Nursing, University of Washington, Seattle, WA,
USA, 2 Biobehavioral Nursing and Health Sciences, University of
Washington, Seattle, WA, USA
Introduction: Agreement between actigraphy and polysomnography
(PSG) have been reported in healthy school-age children < 9 years old,
but to our knowledge studies have not been reported in children with
chronic illnesses such as arthritis or asthma. The purpose of this study
was to evaluate sensitivity, specificity, and accuracy with an epoch-byepoch
comparison between PSG and actigraphy, and to compare PSG
derived sleep parameters to those derived from actigraphy in 9-to-11
year-old children with juvenile idiopathic arthritis (JIA), asthma, and
healthy children.
Methods: Seventy-one children 9-11 years of age. Two consecutive
nights of PSG and actigraphy were recorded and sensitivity, specificity,
and accuracy were evaluated in an epoch-by-epoch comparison of PSG
and actigraphy.
Results: Overall, mean sensitivity and accuracy were higher than specificity
but sensitivity was significantly higher for JIA on night 1, while
specificity was significantly lower for JIA compared to asthma and controls
for both nights at all three activity count thresholds evaluated. Total
sleep time (TST), wake after sleep onset (WASO), and sleep efficiency
(SE) derived from PSG were not different among the 3 groups, but TST
and SE were higher and WASO was lower in JIA. Based on the Bland-
Altman technique, actigraphy was more accurate in estimating TST and
WASO at the medium sensitivity threshold.
Conclusion: Compared to PSG, actigraphy was reasonably accurate in
identifying sleep from wake in 9 to 11 year old children with JIA and
asthma. However, actigraphy was less accurate in the identification of
nocturnal wakefulness at all activity count thresholds tested in JIA. It
is important for clinicians and researchers to understand the strengths
and limitations of the various actigraphy devices, as actigraphy is not as
sensitive for measuring nocturnal wakefulness in children with certain
chronic illnesses.
Support (If Any): National Institute of Nursing Research, T32
NR00710, NR08136, NR08238, the Center for Women’s Health and
Gender Research, NR04011, the National Center for Research Resources
(NCRR), M01-RR-00037, the Center for Research on Management
of Sleep Disturbances, NR011400, and Pulmonary Center Training
grant, T72 MC 0007
A301
SLEEP, Volume 34, Abstract Supplement, 2011