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The Study Population:
Published in Lynne M. Bianchi, Research during Medical Residency, 2022
Lynne M. Bianchi, Luke J. Rosielle
Common inclusion or exclusion criteria are age, gender, and disease status. Other considerations are the ability to complete the study tasks and willingness to report for follow-up visits. To ensure generalizability, studies should include as many representative individuals as possible. Therefore, list as few exclusion criteria as feasible, given your study purpose. Some exclusion criteria are usually necessary, however. You cannot study adolescent sleep patterns in 30- to 40-year-old adults, and you cannot study pregnancy in males. However, you do not exclude a group of individuals based on convenience or arbitrary criteria. Except for valid scientific or ethical reasons, studies should include men, women and children.
Pediatric Sleep Disorders
Published in Mark A. Richardson, Norman R. Friedman, Clinician’s Guide to Pediatric Sleep Disorders, 2016
Older children and teenagers can develop circadian rhythm disturbances such as delayed sleep phase. Most teenagers have difficulty settling in the evening. If allowed to, they may stay up well into the night. This causes marked problems related to insufficient sleep and difficulty waking up in the morning. Patients with delayed sleep phase are best treated by appropriate limit-setting and consistency in bedtime routine. Good sleep hygiene measures as described earlier remain very important in routine sleep. See Chapter 18 for a further discussion of adolescent sleep disorders.
Social drinking
Published in Philip N. Murphy, The Routledge International Handbook of Psychobiology, 2018
Christian L. Nicholas, Caitlyn G. Gourlay, Julia K. M. Chan
Additionally, it has been theorised that developmental changes to systems important for reward may interact with developmental changes in sleep and circadian rhythms to increase the risk of alcohol use disorders during adolescence (Hasler, Soehner, & Clark, 2015). This theory suggests that the developmentally related phase delay in adolescent sleep timing and circadian phase, leads to adolescents being chronically subjected to misalignment between sleep/wake schedule and internal circadian timing. The associated sleep loss is thought to impact the neural circuitry of reward processing, which manifests in increased alcohol use and other risk-taking behaviours. In other words, circadian misalignment is a risk factor associated with changes in reward processing in this age group, and this may tip developmentally typical changes in reward function into pathological patterns of behaviour, including excessive alcohol use, which can in turn exacerbate sleep and circadian disturbance. This cycle may, therefore, accelerate the development of alcohol use disorders that continue well after the normal circadian misalignment produced by early school start times in combination with the circadian delay in sleep timing during adolescence is resolved (generally occurring early in the third decade of life). Evidence for this theory includes that the neurophysiologic underpinnings of the circadian system are integral to normal reward functioning. For example, circadian genes are expressed widely throughout the ventral tegmental area and striatum and disruptions to the function of these genes disrupts key elements of the reward system (Logan, 2014); daily circadian rhythms are present in reward-related experience (Hasler, Forbes, & Franzen, 2014; Hasler et al., 2015; Ikeda et al., 2013); and disrupted sleep and circadian rhythms are associated with symptoms, behaviours and neural processing associated with alterations in reward functioning (Forbes et al., 2012; Holm et al., 2009; Telzer, Fuligni, Lieberman, & Galvan, 2013). However, the presence and role of more specific changes in the sleep EEG in chronic alcohol using adolescents, or those at risk of developing an alcohol use disorder, in the development of patterns of chronic alcohol use thus far remains unknown.
A feasibility study to explore the use of digital treatment of sleep as a first-step intervention to improve adolescent mental health
Published in Behavioral Sleep Medicine, 2023
Abigail Mathews, Naomi Gibbons, Emma Harrison, Obioha C Ukoumunne, Paul Stallard
If these findings were replicated in a randomized controlled trial, they would have important clinical implications. Firstly, the online treatment of sleep for those with insomnia may offer an alternative and acceptable way of improving adolescent sleep and mental health. Secondly, the use of an automated programme potentially offers a scalable low-cost intervention. Whilst support was offered, this was limited and provided by non-mental health specialists (psychology assistants). Thirdly, access to online CBTi was rapid, thereby reducing the lengthy waiting times for traditional child and adolescent mental health services. Finally, the introduction of online CBTi within the CAMHS referral pathway offers patients greater choice. One third of those participating in this study preferring an online intervention to a face-to-face intervention.
Sleep across childhood during the COVID-19 pandemic: a narrative review of the literature and clinical case examples
Published in Children's Health Care, 2022
Melanie A. Stearns, Carolyn E. Ievers-Landis, Christina S. McCrae, Stacey L. Simon
Six studies were located that explored adolescent sleep during the academic year of the COVID-19 pandemic in samples in the U.S., Italy, Canada, China, and Spain. The literature to date indicates that adolescent sleep has changed during the COVID-19 pandemic, with some studies suggesting improvements in certain areas of sleep, while others suggest sleep has worsened in other aspects. Broadly, adolescents reported delayed bed and wake times during the COVID-19 pandemic, but slept more and reported less daytime sleepiness compared to pre-pandemic reports (Becker et al., 2021; Bruni et al., 2021; Gruber, Saha, Somerville, Boursier, & Wise, 2020). Forty-five Canadian adolescents completed semi-structured telephone interviews with researchers and endorsed a two-hour delay in estimated sleep-wake times (Gruber et al., 2020). However, despite this delay, participants stated that they obtained longer sleep durations and endorsed improved sleep quality and less daytime sleepiness compared to their pre-COVID-19 pandemic school schedule (Gruber et al., 2020). Adolescents attributed these changes to not having to wake up early for school and lower school-related stress while participating in online learning (Gruber et al., 2020).
Psychological Interventions to Improve Sleep in Young Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Published in Behavioral Sleep Medicine, 2022
Ali Kodsi, Ben Bullock, Gerard A. Kennedy, Loredana Tirlea
Young adults are a vulnerable age group undergoing a critical transitional period that involves many life challenges. Due to multiple interacting lifestyle and environmental factors (e.g., changes in work, residence, social habits, tertiary studies, caffeine consumption, electronic media use), there are profound changes in sleep-wake patterns in this age group (Owens & Adolescent Sleep Working Group & Committee on Adolescence, 2014; Zitting et al., 2018), which make them particularly vulnerable to sleep loss. Evidence suggests that the quality and quantity of sleep in young adults has decreased significantly over the past decade. Sivertsen et al. (2019), for example, reported a substantial increase in the reported incidence of insomnia from 2010 (22.6%) to 2018 (30.5%) among 50,054 college students aged 18–35 years. These findings coincide with the results of asurvey of young adults attending university (N = 1,125), which found that more than 60% of students reported symptoms of sleep disturbance (Lund et al., 2010). These relatively high rates are concerning given the variety of negative wellbeing outcomes associated with disturbed sleep, including the significant negative effects on mental health (Glozier et al., 2010).