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Signs and Symptoms of Non-restorative Sleep

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Sleep Disorders in Pediatric Dentistry
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Abstract

Through my daily clinical work in developmental paediatrics and child and adolescent psychiatry, I have seen an increasing number of children and youth with neurodevelopmental and/or neuropsychiatric conditions, who suffer from undiagnosed and/or untreated sleep problems. I came to the realization that the lack of attention given to these problems by medical care providers came from the scarcity of explanatory models for reported symptoms. All patients had received various developmental paediatrics and mental health diagnoses, based on their daytime presentations (e.g. attention deficit hyperactivity disorder, ADHD; autism spectrum disorder, autism). However, the possible effect that chronic sleep deprivation had on daytime symptoms was either recognized but not investigated further or remained unrecognized and was therefore taken as given or even considered to be part of the condition. This article gives an overview of how, during clinical encounters, the description of behaviours and clinical features as clinical best practice can change our understanding of sleep problems in children with neurodevelopmental and/or neuropsychiatric conditions.

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References

  1. Ipsiroglu OS, McKellin WH, Carey N, Loock C. “They silently live in terror …” Why sleep problems and night-time related quality-of-life are missed in children with a fetal alcohol spectrum disorder. Soc Sci Med. 2013;79:76–83. https://doi.org/10.1016/j.socscimed.2012.10.027.

    Article  PubMed  Google Scholar 

  2. Ethnography [Def. 1]. (n.d.). In Oxford Dictionaries. Accessed on July 4, 2015, from http://www.oxforddictionaries.com/definition/english/ethnography.

  3. Kleinman A. The illness narratives: suffering, healing, and the human condition. New York, NY: Basic Books; 1988.

    Google Scholar 

  4. Kleinman A. Catastrophe and caregiving: the failure of medicine as an art. Lancet. 2008;371(9606):22–3.

    Article  PubMed  Google Scholar 

  5. Ecology [Def. 1]. (n.d.). In Oxford Dictionaries. Accessed on July 14, 2015, from http://www.oxforddictionaries.com/definition/english/ecology.

  6. Lucyshyn J, Albin R. Comprehensive support to families of children with disabilities and problem behaviors: keeping it “friendly”. In: Singer G, Powers L, editors. Families, disabilities, and empowerment: active coping skills and strategies for family interventions. Baltimore, MD: Paul H Brookes; 1993. p. 365–407.

    Google Scholar 

  7. Lucyshyn J, Albin R, Nixon C. Embedding comprehensive behavioural support in family ecology: an experimental single-case analysis. J Consult Clin Pyschol. 1997;65:241–51.

    Article  Google Scholar 

  8. McKellin W. Hearing impaired families: the social ecology of hearing loss. Soc Sci Med. 1995;40(11):1469–80.

    Article  PubMed  Google Scholar 

  9. Dickens C. The pickwick papers. London: Chapman & Hall; 1837.

    Google Scholar 

  10. American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;1(22):667–89.

    Google Scholar 

  11. Epstein L, Kristo D, Strollo P, Friedman N, Malhotra A, Patil S, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263–76.

    Article  PubMed  Google Scholar 

  12. Mindell JA, Owens JA. A clinical guide to pediatric sleep: diagnosis and management of sleep problems. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009.

    Google Scholar 

  13. Jan JE, Owens JA, Weiss M, Johnson K, Wasdell M, Freeman R, Ipsiroglu OS. Sleep hygiene for children with neurodevelopmental disabilities. Paediatrics. 2008;122(6):1343–50. https://doi.org/10.1542/peds.2007-3308.

    Article  Google Scholar 

  14. Jan JE, Asante KO, Conry JL, Fast DK, Bax MC, Ipsiroglu OS, et al. Sleep health issues for children with FASD: Clinical considerations. Int J Pediatr. 2010;2010:639048. https://doi.org/10.1155/2010/639048.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Malow BA, Byars K, Johnson K, Weiss S, Bernal P, Goldman S, et al. A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders. Pediatrics. 2012;130(Suppl. 2):S106–24. https://doi.org/10.1542/peds.2012-0900I.

    Article  PubMed  Google Scholar 

  16. Wiggs L, Stores G. Severe sleep disturbance and daytime challenging behaviour in children with severe learning disabilities. J Intellect Disabil Res. 1996;40(6):518–28.

    Article  PubMed  Google Scholar 

  17. Zucconi M, Bruni O. Sleep disorders in children with neurologic diseases. Semin Pediatr Neurol. 2001;8(4):258–75.

    Article  PubMed  Google Scholar 

  18. Chervin RD. Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea. Chest. 2000;118(2):372–9. https://doi.org/10.1378/chest.118.2.372.

    Article  PubMed  Google Scholar 

  19. Gottlieb DJ, Vezina RM, Chase C, Lesko SM, Heeren TC, Weese-Mayer DE, et al. Symptoms of sleep-disordered breathing in 5-year-old children are associated with sleepiness and problem behaviors. Pediatrics. 2003;112(4):870–7.

    Article  PubMed  Google Scholar 

  20. Johnson K, Malow BA. Sleep in children with autism spectrum disorders. Curr Treat Options Neurol. 2008;10(5):350–9. https://doi.org/10.1007/s11940-008-0038-5.

    Article  PubMed  Google Scholar 

  21. Ferber R. Solve your child’s sleep problems: new, revised, and expanded edition. New York, NY: Touchstone; 2006.

    Google Scholar 

  22. Jan JE, Bax M, Owens JA, Ipsiroglu OS, Wasdell M. Neurophysiology of circadian rhythm sleep disorders of children with neurodevelopmental disabilities. Eur J Pediatr Neurol. 2012;16(5):403–12. https://doi.org/10.1016/j.ejpn.2012.01.002.

    Article  Google Scholar 

  23. Picchietti DL, Bruni O, de Weerd A, Durmer JS, Kotagal S, Owens JA, et al. Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group. Sleep Med. 2013;14(12):1253–9. https://doi.org/10.1016/j.sleep.2013.08.778.

    Article  PubMed  Google Scholar 

  24. Coccagna G, Vetrugno R, Lombardi C, Provini F. Restless legs syndrome: an historical note. Sleep Med. 2004;5(3):27–283. https://doi.org/10.1016/j.sleep.2004.01.002.

    Article  Google Scholar 

  25. Ipsiroglu OS, Beyzaei N, Berger M, Wagner A, Dhalla S, Garden J, Stockler S. “Emplotted narratives” and structured “behavioral observations” supporting the diagnosis of Willis‐Ekbom disease/restless legs syndrome in children with neurodevelopmental conditions. CNS Neurosci Ther. 2016;22(11):894–905. https://doi.org/10.1111/cns.12564.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Wiggs L, Stores G. Sleep disturbance in children and adolescents with disorders of development: its significance and management. Oxford: Cambridge University Press; 2001.

    Google Scholar 

  27. Wiggs L, Stores G. Sleep patterns and sleep disorders in children with autistic spectrum disorders: insights using parent report and actigraphy. Dev Med Child Neurol. 2004;46(6):372–80. https://doi.org/10.1017/S0012162204000611.

    Article  PubMed  Google Scholar 

  28. Gruber R, Wise MS, Frenette S, Knäauper B, Boom A, Fontil L, Carrier J. The association between sleep spindles and IQ in healthy school-age children. Int J Psychophysiol. 2013;89(2):229–40. https://doi.org/10.1016/j.ijpsycho.2013.03.018.

    Article  PubMed  Google Scholar 

  29. Sivertsen B, Posserud M, Gillberg C, Lundervold A, Hysing M. Sleep problems in children with autism spectrum problems: a longitudinal population-based study. Autism. 2012;16(2):139–50. https://doi.org/10.1177/1362361311404255.

    Article  PubMed  Google Scholar 

  30. Wolfson AR, Montgomery-Downs H, editors. The Oxford handbook of infant, child, and adolescent sleep and behaviour. New York, NY: Oxford University Press; 2013.

    Google Scholar 

  31. Sloper T, Beresford B. Families with disabled children - social and economic needs are high but remain largely unmet. BMJ. 2006;333(7575):928–9. https://doi.org/10.1136/bmj.39017.633310.BE.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Krakowiak P, Goodlin-Jones B, Hertz-Picciotto I, Croen L, Hansen R. Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: A population-based study. J Sleep Res. 2008;17:197–206. https://doi.org/10.1111/j.1365-2869.2008.00650.x.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Ipsiroglu OS. Applying ethnographic methodologies & ecology to unveil dimensions of sleep problems in children & youth with neurodevelopmental conditions (Doctoral dissertation). Vancouver, BC: University of British Columbia; 2016.

    Google Scholar 

  34. Owens JA, Dalzell V. Use of the BEARS sleep screening tool in a pediatric residents continuity clinic: a pilot study. Sleep Med. 2005;6:63–9. https://doi.org/10.1016/j.sleep.2004.07.015.

    Article  PubMed  Google Scholar 

  35. Ipsiroglu OS, Carey N, Collet J, Fast D, Garden J, Jan JE, et al. De- medicalizing sleep: sleep assessment tools in the community setting for clients (patients) with FASD & prenatal substance exposure. National Organisation for Fetal Alcohol Syndrome – UK (NOFAS-UK): Fetal Alcohol Forum. 2012. Accessed on May 1, 2015, from http://www.nofas-uk.org/PDF/FETAL%20ALCOHOL%20FORUM%20Issue%207%20June%202012.pdf.

  36. Stockler S, Moeslinger D, Herle M, Wimmer B, Ipsiroglu OS. Cultural aspects in the management of inborn errors of metabolism. J Inherit Metab Dis. 2012;35(6):1147–53. https://doi.org/10.1007/s10545-012-9455-4.

    Article  PubMed  Google Scholar 

  37. Bruni O, Fabrizi P, Ottaviano S, Cortesi F, Giannotti F, Guidetti V. Prevalence of sleep disorders in childhood and adolescence with headache: a case-control study. Cephalalgia. 1997;17(4):492–8.

    Article  PubMed  Google Scholar 

  38. Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): Validity and reliability of scales for sleep‐disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med. 2000;1(1):21–32.

    Article  PubMed  Google Scholar 

  39. Cicourel A. Hearing is not believing: language and the structure of belief in medical communication. In: Fisher S, Todd AD, editors. The social organization of doctor-patient communication. Washington, DC: Center for Applied Linguistics; 1983. p. 221–39.

    Google Scholar 

  40. Fontana A, Frey J. The interview. From structured questions to negotiated text. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. 2nd ed. Thousand Oaks, CA: Sage Publications; 2000. p. 645–72.

    Google Scholar 

  41. Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, Giannotti F. The Sleep Disturbance Scale for Children (SDSC) - construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251–61.

    Article  PubMed  Google Scholar 

  42. Owens JA, Spirito A, McGuinn M. The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school aged children. Sleep. 2000;23(8):1043–51.

    Article  PubMed  Google Scholar 

  43. Ipsiroglu OS, Berger M, Lin T, Elbe D, Stockler S, Carleton B. Pathways to overmedication and polypharmacy: case examples from adolescents with fetal alcohol spectrum disorders. In: Di Pietro N, Illes J, editors. The science and ethics of antipsychotic use in children. Waltham, MA: Elsevier; 2015a. p. 125–48.

    Chapter  Google Scholar 

  44. Ipsiroglu OS. Autismus-Spektrum-Störungen und Willis-Ekbom-Erkrankung. Ein Plädoyer für explorative Anamnesen [Autism spectrum disorders and Willis Ekbom disease. A plea for explorative histories]. In: Paditz E, Sauseng W, editors. Schlafmedizin Kompendium [Sleep Medicine Compendium]. Dresden: Kleanthes; 2015.

    Google Scholar 

  45. Malow BA, Connolly HV, Weiss SK, Halbower A, Goldman S, Hyman SL, et al. The pediatric sleep clinical global impressions scale-a new tool to measure pediatric insomnia in autism spectrum disorders. J Dev Behav Pediatr. 2016;37(5):370–6. https://doi.org/10.1097/DBP.0000000000000307.

    Article  PubMed  Google Scholar 

  46. Robinson A, Malow B. Gabapentin shows promise in treating pediatric insomnia. Sleep. 2012;35:A394. https://doi.org/10.1177/0883073812463069.

    Article  Google Scholar 

  47. American Academy of Sleep Medicine. International classification of sleep disorders, revised: Diagnostic and coding manual. Chicago, IL: American Academy of Sleep Medicine; 2001.

    Google Scholar 

  48. Picchietti M, Picchietti D. Advances in pediatric restless legs syndrome: iron, genetics, diagnosis and treatment. Sleep Med. 2010;11:643–51. https://doi.org/10.1016/j.sleep.2009.11.014.

    Article  PubMed  Google Scholar 

  49. Todd A, Fisher S. The social organization of doctor-patient communication. Norwood, NJ: Ablex Publishing; 1993.

    Google Scholar 

  50. Ipsiroglu OS, Andrew G, Carmichael-Olson H, Chen M, Collet J, Pei J, et al. How to approach sleep problems in children with FASD: the 1st Canadian FASD & SLEEP consensus paper. J Populat Ther Clin Pharmacol. 2011;18(3):422–3.

    Google Scholar 

  51. Ipsiroglu OS, Wind K, Hung Y-H, Berger M, Chan F, Yu W, et al. Prenatal alcohol exposure and sleep-wake behaviors: exploratory and naturalistic observations in the clinical setting and in an animal model. Sleep Med. 2019;54:101–12. https://doi.org/10.1016/j.sleep.2018.10.006. Epub 2018 Oct 25. PMID: 30530254.

    Article  PubMed  Google Scholar 

  52. Ipsiroglu OS, Jan JE, Freeman RD, Laswick A, Milner R, Mitton C, et al. How to approach pediatric sleep in British Columbia: a consensus paper. B C Med J. 2009;50(9):512–6.

    Google Scholar 

  53. Ipsiroglu OS, Beyzaei N, Tse E, Marwaha A. [BC Down syndrome survey results – sleep/wake behaviours: sleep diagnoses]. Unpublished raw data presented at the Sleep Summit Meeting at the Down Syndrome Research Foundation, Vancouver, BC. 2015b, June. Accessed on August 17, 2015, from http://www.dsrf.org/media/BCDSS%20%20Focus%20Group%20Discussion%20(Final)%20-%20June%205,%202015.pdf.

  54. Stores G, Stores R. Sleep disorders and their clinical significance in children with Down syndrome. Dev Med Child Neurol. 2013;55(2):126–30. https://doi.org/10.1111/j.1469-8749.2012.04422.x.

    Article  PubMed  Google Scholar 

  55. Lal C, White DR, Joseph JE, van Bakergem K, LaRose A. Sleep-disordered breathing in Down syndrome. Chest. 2015;147(2):570–9. https://doi.org/10.1378/chest.14-0266.

    Article  PubMed  Google Scholar 

  56. Mattingly C. The concept of therapeutic ‘emplotment’. Soc Sci Med. 1994;38(6):811–22.

    Article  PubMed  Google Scholar 

  57. Mattingly C. Healing dramas and clinical plots: the narrative structure of experience. Cambridge: Cambridge University Press; 1998.

    Book  Google Scholar 

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Ipsiroglu, O.S. (2019). Signs and Symptoms of Non-restorative Sleep. In: Liem, E. (eds) Sleep Disorders in Pediatric Dentistry . Springer, Cham. https://doi.org/10.1007/978-3-030-13269-9_2

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  • DOI: https://doi.org/10.1007/978-3-030-13269-9_2

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