Search PubMed⌕ Search

Biomedical subjects

Judith A Owens

Publications and source records attributed to Judith A Owens.

15 recordsLinked to original sources
PubMed2006

Sleep practices, attitudes, and beliefs in inner city middle school children: a mixed-methods study.

The objective of this study was to utilize both semi-quantitative and qualitative data to examine the sociodemographic, social environmental, and behavioral context of sleep practices in a group of 64 middle school students enrolled in a summer camp program. Participants completed the Sleep Habits Survey; semi-structured interviews were used to collect data regarding sleep knowledge, perceived barriers to healthy sleep, consequences of inadequate sleep, sources of sleep information, and suggestions for improved sleep. Environmental and social factors figured prominently as perceived barriers to healthy sleep. Many of the respondents mentioned adult guidance regarding sleep habits as potentially helpful. Identification of predictive factors for insufficient sleep may be helpful in developing interventions to change sleep health risk behaviors in middle school populations.

Adolescent↗
PubMed2005

Use of the 'BEARS' sleep screening tool in a pediatric residents' continuity clinic: a pilot study.

OBJECTIVE: To assess the effectiveness of a simple, 5-item pediatric sleep screening instrument, the BEARS (B=Bedtime Issues, E=Excessive Daytime Sleepiness, A=Night Awakenings, R=Regularity and Duration of Sleep, S=Snoring) in obtaining sleep-related information and identifying sleep problems in the primary care setting. SETTING: Pediatric residents' continuity clinic in a tertiary care children's hospital. METHODS: BEARS forms were placed in the medical records of a convenience sample of 2 to 12 year old children presenting for well child visits over the 5 month study period. Sleep-related information recorded in the BEARS visit and in the pre-BEARS visit, which was the subject's most recent previous well child check (WCC), was coded with respect to whether or not a sleep problem was indicated, and whether sleep issues were addressed. RESULTS: A total of 195 children had both a documented pre-BEARS and BEARS WCC visit. BEARS visits were significantly more likely than the pre-BEARS visits to have any sleep information recorded (98.5% vs. 87.7%, p<0.001), and to have information recorded about bedtime issues (93.3% vs. 7.7%, p<0.001), excessive daytime sleepiness (93.9% vs. 5.6%, p<0.001), snoring (92.8% vs. 7.2%, p<0.001), nighttime awakenings (91.3% vs. 29.2%, p<0.001), and regularity and duration of sleep (65.3% vs. 31.5%, p<0.001). Significantly more sleep problems were identified during the BEARS visits in the domains of bedtime issues (16.3% vs. 4.1%, p<0.001), nighttime awakenings (18.4% vs. 6.8%, p<0.001) and snoring (10.7% vs. 4.6%, p=0.012). Finally, almost twice as many BEARS charts had sleep mentioned in the Impression and Plan (13.1% vs. 7.3%), which approached significance (p=0.07). CONCLUSIONS: The BEARS appears to be a user-friendly pediatric sleep screening tool which significantly increases the amount of sleep information recorded as well as the likelihood of identifying sleep problems in the primary care setting.

Ambulatory Care Facilities↗
PubMed2005

The ADHD and sleep conundrum: a review.

The relationship between attention-deficit hyperactivity disorder (ADHD) and sleep is a complex one that poses many challenges in clinical practice. Recent studies have helped to elucidate the nature of the brain mechanisms and neuromodulator systems underlying the theoretical associations among sleepiness, arousal, and attention. Studies of sleep disturbances in children with academic and behavioral problems have also underscored the role that primary sleep disorders such as obstructive sleep apnea hypopnea syndrome play in the clinical presentation of symptoms of inattention and behavioral dysregulation. In addition, new methodologies used in examining sleep and sleep patterns in children diagnosed with ADHD have shed further light on the prevalence, type, risk factors for, and impact of sleep disturbances in these children. The following discussion of the multilevel relationships among sleep quality and quantity, neurobehavioral functioning, and the clinical syndrome of ADHD expands on previous reviews of the literature and synthesizes what is currently known about the interaction of sleep and attention/arousal in children to propose possible underlying mechanisms, integrate more recent findings, and highlight important areas for future study. In addition, guidelines are provided for a clinical approach to evaluation and management of children with ADHD and sleep problems.

Anxiety↗
PubMed2005

Sleep disturbance and injury risk in young children.

The objective of this study was to investigate the relationship between sleep disturbance and both injury rates and injury-prone behaviors in preschool-age and early school-age children, using cross-sectional surveys of sleep disturbance (Children's Sleep Habits Questionnaire) and injury-related behaviors (Injury Behavior Checklist), and chart review of injuries. Participants were 71 patients enrolled in a pediatric clinic in a children's teaching hospital, ages 3 through 7 years, coming either for well-child care in a pediatric primary care clinic or for pediatric emergency room treatment of minor injuries. Results suggest that children with more frequent injuries had significantly more sleep problems overall, particularly anxiety around sleep, than did children with low injury rates. Children with more parent-reported injury-prone behaviors also had significantly more sleep disturbance. Daytime sleepiness-related items did not differ between injury history or injury behavior groups. Results of this study support an increased prevalence of sleep disturbances in young children with higher injury rates and more injury-prone behavior. Sleep disturbance may be a potential risk factor for increased injuries in this age group.

Accident Proneness↗
PubMed2005

Sleep patterns and sleep problems among schoolchildren in the United States and China.

OBJECTIVES: Sleep patterns and sleep problems in children are not only influenced by a large number of biological and psychologic factors but also by cultural and social factors. Little is known about similarities and differences in sleep patterns and sleep problems among children across countries. We attempted to compare sleep patterns and sleep problems among schoolchildren from 2 countries with distinctive cultural contexts: the United States and China. METHODS: The data come from 2 cross-sectional surveys in 3 elementary schools of Jinan City, People's Republic of China, and 3 elementary schools from a suburban school district in southeastern New England, United States. The Chinese sample consisted of 517 elementary school children (grades 1 to 5), and the US sample consisted of 494 elementary school children (grades kindergarten through 4). We used the Children's Sleep Habits Questionnaire (CSHQ) to assess children's sleep patterns and sleep problems as reported by parents. Parents of the Chinese sample completed a Chinese version of the CSHQ. RESULTS: For children in both the US and Chinese samples, reported bedtime was delayed and sleep duration decreased with increasing age. Compared with the US children (grades 1-4), Chinese children went to bed approximately half an hour later (9:02 vs 8:27 pm) and woke up half an hour earlier (6:28 vs 6:55 am), resulting in an average sleep duration that was 1 hour less (9.25 vs 10.15 hours). Chinese children were rated significantly higher than the US children on almost all CSHQ scales, indicating more sleep problems in Chinese children. Common sleep problems observed for all children were difficulty falling asleep, having a fear of sleeping in the dark, sleep talking, restless sleep, teeth grinding during sleep, and daytime sleepiness. Shorter daily sleep duration was associated with difficulty falling asleep, struggling at bedtime, and trouble sleeping away for the US children, and with going to bed at different times and having a fear of sleeping alone for Chinese children. Short sleep duration was a main predictor of daytime sleepiness for Chinese children, whereas restless sleep and snoring predicted daytime sleepiness for the US children. CONCLUSIONS: As reported by parents, children in China went to bed later and woke up earlier and their sleep duration was 1 hour shorter than the US children. Chinese children were reported to have more sleep problems than their US counterparts. Daytime sleepiness was determined by sleep duration only for those who slept insufficiently. Unique school schedules and sleep practices may contribute to the differences in the sleep patterns and sleep problems of children from the United States and China.

Adolescent↗
PubMed2005

Patients with attention-deficit/hyperactivity disorder without observed apneic episodes in sleep or daytime sleepiness have normal sleep on polysomnography.

STUDY OBJECTIVE: There is continuing speculation about the relationship between attention-deficit/hyperactivity disorder (ADHD) and obstructive sleep apnea (OSA) or periodic limb movement disorder (PLMD)/restless legs syndrome. The objective was to determine if a significant portion of children with ADHD diagnosed using DSM-IV criteria have OSA or PLMD. SETTING: Sleep disorders centers in a private practice setting and a hospital setting. PARTICIPANTS: Children aged 6 to 14 years with ADHD were enrolled. Patients with snoring were not excluded. Although patients with snoring plus either observed apneic episodes in sleep or excessive daytime sleepiness were to be excluded, as were patients with restless legs at night, only 1 subject actually had to be excluded because of these criteria. MEASUREMENTS AND RESULTS: Forty children were evaluated with a polysomnogram. A respiratory disturbance index cut-off of more than 5 per hour of sleep was used to diagnose OSA, and a periodic limb movement (with arousal) index cut-off of 5 or more per hour of sleep was used to diagnose PLMD. The Attention-Deficit/Hyperactivity Disorder Rating Scale-IV-Parent Version: Investigator Administered and Scored was used to determine severity of inattentive, hyperactive, and total ADHD symptoms. Except for a somewhat longer rapid eye movement sleep latency and decreased percentage of rapid eye movement sleep, polysomnography was essentially normal. No patient had OSA or PLMD on polysomnography. CONCLUSIONS: OSA or PLMD is not a common underlying disorder or etiologic factor in patients who meet the criteria for ADHD. In the absence of symptoms suggesting a primary sleep disorder, such as snoring with observed apneic episodes in sleep or daytime sleepiness or restless legs, polysomnographic evaluation does not seem indicated in patients with ADHD.

Adolescent↗
PubMed2004

Sleep problems.

Explore the source record for details and available documents.

Adolescent↗
PubMed2003

Medication use in the treatment of pediatric insomnia: results of a survey of community-based pediatricians.

OBJECTIVES: To examine clinical practice patterns, beliefs, and attitudes regarding the use of both nonprescription and prescription medications by community-based pediatricians for children with significant difficulties in initiating and/or maintaining sleep. METHODS: A survey was mailed to 3424 American Academy of Pediatrics members in 6 US cities. RESULTS: The final sample (n = 671) consisted of practitioners who identified themselves as primary care pediatricians. Three percent +/- 7% of visits in the respondents' practices were for pediatric insomnia, although there was a wide range in the numbers of children identified during a typical 6-month practice period. More than 75% of practitioners had recommended nonprescription medications, and >50% had prescribed a sleep medication. Specific clinical circumstances in which medications were most commonly used were acute pain and travel, followed by children with special needs (mental retardation, autism, and attention-deficit/hyperactivity disorder). Antihistamines were the most commonly reported nonprescription medications for sleep. Melatonin or herbal remedies had been recommended by approximately 15% of the respondents. alpha-agonists were the most frequently prescribed sleep medications (31%). The likelihood of prescribing medication for sleep was 2- to 4-fold greater in respondents who treated children with attention-deficit/hyperactivity disorder for daytime behavioral problems or nocturnal sleep problems, respectively. Practitioners expressed a range of concerns about sleep medication appropriateness, safety, tolerance, and side effects in children. CONCLUSIONS: The practice of prescribing or recommending sedatives and hypnotics for pediatric insomnia is common among community-based pediatricians, especially among special needs patients. An empirically based approach to the use of these medications is needed.

Adolescent↗
PubMed2002

Sleepiness in children and adolescents: clinical implications.

Over the past decade, excessive sleepiness among children and adolescents has been identified as a major societal concern. Professionals working with pediatric groups must increasingly factor sleepiness into assessments of waking function. We define and discuss excessive sleepiness in children and adolescents and review available evidence regarding effects on behavior, mood, and performance. Findings for daytime sleepiness and subsequent impairment in these domains are classified as robust to unknown. Empirical evidence clearly indicates that children and adolescents experience significant daytime sleepiness as a result of inadequate or disturbed sleep. The specific effect of sleepiness on functional domains in pediatric groups are less well-studied, but existing data suggests that children are likely to experience impairment in behavioral, mood, and performance domains. However, such variables as developmental differences in the type and degree of impairment, the degree of sleep disturbance required to produce impairments, and potential risk and protective factors for the effects of sleepiness in children have yet to be described. Further research is clearly warranted, and we discuss important questions and methodological concerns to encourage inquiry in both clinical and experimental settings. Advice is offered with regard to screening for sleep problems and associated sleepiness with children and adolescents.

Achievement↗
PubMed2002

Cosleeping.

Explore the source record for details and available documents.

Adult↗
PubMed2002

Sleep and its relationship to pain, dysfunction, and disease activity in juvenile rheumatoid arthritis.

OBJECTIVE: To determine what sleep abnormalities may exist in children with juvenile rheumatoid arthritis (JRA). and their relationship to pain, dysfunction. and disease activity. METHODS: Twenty-five children with active JRA (11 pauciarticular, 9 polyarticular, 5 systemic) had their sleep assessed by parallel, validated patient and parent questionnaires (Sleep Self-Report, SSR, and Children's Sleep Habits Questionnaire, CSHQ). Disease activity was assessed by parent and physician global assessments (on a 5 point scale: 0 = no disease activity to 4 = very severe disease), erythrocyte sedimentation rate (ESR), and numbers of swollen and limited joints. Functional assessment was based on parental completion of the Juvenile Arthritis Functional Assessment Report (JAFAR). Pain was assessed by the average pain visual analog scale of the Varni Pediatric Pain Questionnaire. Results were compared to those from 45 healthy age and sex matched controls by Mann-Whitney U tests, and correlated with variables of JRA disease activity, function, and pain using Spearman correlations. RESULTS: Patients with JRA had higher total score on the CSHQ (p < 0.0001), as well as subscales assessing night wakings, parasomnias. sleep anxiety, sleep-disordered breathing, and morning wakening/daytime sleepiness (p < 0.0001-0.05). There were no correlations between CSHQ scores and JRA disease activity or pain variables, but the total score on the SSR did correlate with pain (r = 0.56, p = 0.005). CONCLUSION: We conclude that sleep abnormalities are common in children with JRA, and are multi-dimensional.

Anxiety↗
PubMedDate not supplied

Sleep problems in pediatric practice: clinical issues for the pediatric nurse practitioner.

Sleep problems are highly prevalent in children and adolescents, but often go unrecognized and untreated in clinical settings. The purposes of this paper are to provide pediatric nurse practitioners with an understanding of the impact of sleep problems on children, their families, and on clinical pediatric practice; examine clinical practice issues that pediatric nurse practitioners identify as important regarding pediatric sleep; and provide practical information on current resources available for pediatric nurse practitioners and their patients on the prevention and treatment of pediatric sleep problems. The discussion of these issues incorporates results from a needs assessment survey on pediatric sleep completed by 317 pediatric nurse practitioners who attended the April 2003 Annual Conference of the National Association of Pediatric Nurse Practitioners.

Adult↗