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Botanicals and Dietary Supplements
Published in Hilary McClafferty, Integrative Pediatrics, 2017
In supplement form, melatonin advances sleep onset in patients with delayed sleep phase disorder and has become widely used to decrease sleep latency in children. It is still sold over the counter in the U.S., but regulated in Europe and the U.K. According to the National Health Interview Survey results, use of melatonin has increased significantly from 0.1% of children in 2007 to 0.7% of children in 2012 (Black et al. 2015). Difficulty with sleep initiation and maintenance is a common problem in children, with up to 40% of normally developing children noted to have difficulty with sleep at some point in childhood. Prevalence of sleep disturbance climbs sharply in children with developmental disorders such as ADHD and autism, and in those with depression or anxiety (Heussler et al. 2013; Hochadel et al. 2014).
Air Pollution
Published in William J. Rea, Kalpana D. Patel, Air Pollution and the Electromagnetic Phenomena as Incitants, 2018
William J. Rea, Kalpana D. Patel
Delayed sleep phase disorder (DSPD) is a disorder of the timing of sleep; people suffering from DSPD typically go to bed late and wake up late (3–6 hours later than normal sleeping hours). This pattern interferes with people's normal functioning because they have difficulty waking up in the morning for work, school, and social obligations, and since they go to bed late, they do not sleep for as many hours as those going to bed at more normal hours. DSPD in adolescents is common and probably associated with hormonal changes that occur at puberty. The exact causes of DSPD are not actually known, but light exposure after minimum core body temperature and dim light during the evening have been shown to advance the phase of the master clock of persons with DSPD.122 Using this information, two field studies123,124 were very recently conducted to investigate the impact of light exposures on dim light melatonin onset (DLMO), a primary marker for the timing of the master clock, and on sleep duration for two populations of eighth graders. It was hypothesized for one study conducted in North Carolina that the lack of morning short-wavelength light (by wearing orange goggles) would delay the timing of the students’ master clocks. For the other study, conducted in New York, it was hypothesized that exposure to more evening light in spring relative to winter would also delay the master clocks of adolescents. In both studies, as expected, the students exhibited delayed DLMO as a result of removing short-wavelength morning light and as a result of seasonal changes in evening daylight. Also as expected, both sets of adolescents exhibited shorter sleep times; because of the delay in the timing of the master clock, they fell asleep later but still had to get up at a fixed time in the morning. These two field studies clearly demonstrate that by controlling circadian light exposures, it is possible to practically and effectively control circadian time and thereby affect meaningful outcome measures like sleep duration.
Light Therapy With Scheduled Rise Times in Young Adults With Delayed Sleep Phase Disorder: Therapeutic Outcomes and Possible Predictors
Published in Behavioral Sleep Medicine, 2018
Katarina Danielsson, Markus Jansson-Fröjmark, Jan-Erik Broman, Agneta Markström
During puberty, there is a known delay in sleep–wake preference and circadian rhythm (Carskadon, Acebo, & Jenni, 2004; Carskadon, Vieira, & Acebo, 1993). If this delay becomes persistent and causes a functional impairment, the person has developed delayed sleep phase disorder (DSPD). DSPD is most common among adolescents and young adults, and the prevalence is about 1–10% in this group (American Academy of Sleep Medicine, 2014; Lovato, Gradisar, Short, Dohnt, & Micic, 2013; Weitzman et al., 1981). This disorder often includes difficulties initiating sleep, fatigue, daytime sleepiness, concentration difficulties, irritability, depressive symptoms, and anxiety. Social consequences often related to DSPD are truancy, late arrival to school or work, substance abuse, and poor academic performance (Barion & Zee, 2007; Dagan, Stein, Steinbock, Yovel, & Hallis, 1998; Dewald, Meijer, Oort, Kerkhof, & Bogels, 2010; Lovato et al., 2013; Ohta, Iwata, Kayukawa, & Okada, 1992; Saxvig, Pallesen, Wilhelmsen-Langeland, Molde, & Bjorvatn, 2012; Sivertsen, Harvey, Pallesen, & Hysing, 2015; Sivertsen et al., 2013; Sivertsen, Glozier, Harvey, & Hysing, 2015; Thorpy, Korman, Spielman, & Glovinsky, 1988).
Sleep Timing During Adolescence: A Latent Transition Analysis Approach
Published in Behavioral Sleep Medicine, 2020
Christopher A. Magee, Sarah Blunden
This paper demonstrates the utility of person-centered approaches for investigating adolescent sleep, and these approaches may help to inform a more targeted approach to assessment and management of sleep problems. Existing sleep interventions, including school-based education programs and cognitive-behavioral interventions, are widely used to address sleep problems in young people (Blake, Sheeber, Youssef, Raniti, & Allen, 2017; Blunden & Rigney, 2015; Gruber, 2017). Existing data suggests these interventions can be effective, but a potential limitation is that they often employ a one-size-fits-all approach with limited success (Blunden & Rigney, 2015; Gruber, 2017). It is possible that some existing sleep interventions overestimate the uniformity of adolescent sleep patterns instead of targeting sleep education and treatment more individually. Our findings support this view since the identified sleep profiles reflected distinct subpopulations with different levels of risk. Some recent work has examined the efficacy of more targeted sleep interventions for adolescents who display significant evening chronotypes resembling the Owls, Variable Owls, and Late Owls profiles (e.g., Gradisar et al., 2011a; Harvey et al., 2018). Gradisar et al. (2011a) found that a combination of cognitive behavioral therapy and bright light treatment was effective in improving sleep in adolescents with delayed sleep phase disorder. Harvey et al. (2018) also targeted adolescents with an evening chronytype and found that a multicomponent sleep intervention, including cognitive behavioral therapy and motivational interviewing, was more effective than psychoeducation in improving sleep. Person-centered research could help to further understand the heterogeneous nature of adolescent sleep and inform more tailored and effective interventions.
Evening wear of blue-blocking glasses for sleep and mood disorders: a systematic review
Published in Chronobiology International, 2021
Landon Hester, Deanna Dang, Christopher J Barker, Michael Heath, Sidra Mesiya, Tekenari Tienabeso, Kevin Watson
An open-label trial and two RCTs found that blocking blue light impacted sleep onset and quality. However, one conference presentation found no significant changes in these respects. A study of 9 patients with delayed sleep-phase disorder found a statistically significant advance in sleep onset time of 132 minutes after treatment and a non-statistically significant advance in dim-light melatonin onset of 78 minutes (Esaki et al. 2016). An RCT by Shechter et al. (2018) involved 14 participants with chronic insomnia who wore BB glasses or clear placebo lenses 2 hours prior to their bedtime every night for 1 week. The participants completed a sleep diary every night in which they documented bedtime, wake time, and the time they wore the lenses and wore an accelerometer on their wrist to collect movement data. The Pittsburgh Insomnia Rating Scale (PIRS) was used to document symptoms, sleep parameters, and quality of life. The BB glasses group had improved PIRS scores and significantly higher total sleep time, overall quality, and soundness of sleep. Algorta et al. (2018) conducted a 2-week crossover RCT with thirteen first-year undergraduates with sleep complaints/disorders. The participants were instructed to wear BB glasses or placebo glasses at least 3 hours before going to bed. The participants were assessed with sleep log diaries and pulse oximetry; The 7 Up-7 Down self-report scale and the Positive Affect-Negative Affect Schedule (PANAS) were used to assess mood. The study found preliminary evidence that BB glasses trials are feasible and can provide data on the effectiveness of BB glasses to enhance sleep and mood levels in young adults. However, a conference presentation (Smolders and De Kort 2016) involving 32 patients concluded that although participants felt sleepier in the evening when blue light was blocked, the sleep timing and quality of sleep remained unaffected.