Inadequate Sleep in Children and Adolescents
Clete A. Kushida in Sleep Deprivation, 2004
Many researchers believe that mood disorders in children and adolescents represent one of the most underdiagnosed emotional disorders in the mental health field. Population studies report prevalence rates of depression in children between 0.4 and 2.5% and in adolescents between 4 and 8.5% (reviewed in Ref. 98). Subjective sleep complaints are very common in children and adolescents diagnosed with major depressive disorder (MDD). Symptoms include insomnia (75% of cases) and hypersomnia (25%). Hypersomnia difficulties are reported more frequently after puberty. Insomnia symptoms usually include difficulty falling asleep and a subjective sense of not having slept deeply all night. Early-morning awakenings are less prevalent in children and adolescents than in adults with depression. Clinicians and researchers have seen increasingly more adolescents with overlapping phase delay disorders and/or other sleep/wake schedule disorders with depression. Studies suggest that depressed adolescents may have difficulty falling asleep and maintaining sleep, are unable to get up or refuse to go to school, sleep in late in the day, complain of daytime tiredness, and, over time, shift to increasingly more delayed sleep/wake schedules (e.g., Refs. 99,100).
Insomnia
Charles Theisler in Adjuvant Medical Care, 2023
Insomnia is a common sleep disorder that makes it hard to fall asleep (sleep latency), hard to stay asleep, and/or hard to get back to sleep. Insomnia has also been associated with a higher risk of developing chronic diseases.1 There are many possible psychological and medical causes of insomnia. Psychological causes can be bipolar disorder, depression, and anxiety or psychotic disorders. Some medical causes include chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD), chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson’s and Alzheimer’s diseases, hormonal imbalances, hyperthyroidism, arthritis, brain lesions, tumors, and stroke.1 Certain medications (e.g., corticosteroids, alpha or beta blockers, statins, ACE, or cholinesterase inhibitors) can also cause insomnia.
Digital Therapeutics for Sleep and Mental Health
Oleksandr Sverdlov, Joris van Dam in Digital Therapeutics, 2023
The currently available treatments for insomnia can be broadly categorized into psychological (e.g., cognitive behavioral therapy) and pharmacological (e.g., sleep-promoting medications) approaches. Their use is dependent, amongst other factors, on whether treatment is being administered in the short ( weeks) or longer-term (Xu and Anderson, 2019). Short-term treatment of insomnia may include pharmacological approaches if cognitive behavioral therapy (CBT) for insomnia is not available. However, the efficacy of sleep-promoting medications for treating insomnia in the longer term is limited and generally not recommended because of the potential for harm (Qaseem et al., 2016; Riemann et al., 2017). This is why CBT is considered the first-line treatment for insomnia (Qaseem et al., 2016).
Sleep Discrepancy in a Randomized Controlled Trial of Brief Behavioral Therapy for Chronic Insomnia in Older Adults
Published in Behavioral Sleep Medicine, 2021
Wai Sze Chan, Natalie D. Dautovich, Joseph P.H. McNamara, Ashley Stripling, Joseph M. Dzierzewski, Karin McCoy, Christina S. McCrae
Chronic insomnia is diagnosed by subjective complaints of difficulty initiating sleep, difficulty maintaining sleep, or early waking for at least three nights per week for at least 3 months and are accompanied by significant distress or impaired functioning (American Psychiatric Association, 2013; Edinger et al., 2006). The hyperarousal model of chronic insomnia postulates that, following the initiation of an insomnia episode, individuals engage in maladaptive cognitive and behavioral compensatory strategies including increased worry and concern about sleep, attentional biases toward insomnia-related consequences, behavioral changes leading to increased time in bed during wakefulness, and increased consumption of stimulants and reduction in daytime activities to counteract daytime consequences; these strategies lead to heightened cognitive and physiological arousal, sustained by neurobiological alterations, leading to difficulties falling and staying asleep (Perlis et al., 1997; Riemann et al., 2010). Sleep discrepancy is the consequence of increased sensory and information processing during the transition between wakefulness and sleep, resulting from heightened physiological and cognitive arousal (Harvey & Tang, 2012; Perlis et al., 1997). Indeed, experimentally induced pre-sleep cognitive and physiological arousal were found to increase sleep discrepancy (Tang & Harvey, 2004). Sleep discrepancy was also found to be associated with increased neuroactivity in the prefrontal-parietal cortex during sleep onset (Hsiao et al., 2018).
A Scoping Study of Insomnia Symptoms in School Teachers
Published in Behavioral Sleep Medicine, 2023
Madelaine Gierc, Robyn A. Jackowich, Sandra Halliday, Judith R. Davidson
Symptoms of insomnia include difficulty falling asleep, staying asleep, and/or waking too early in the morning. Chronic insomnia disorder applies when these symptoms occur at least three times per week, are associated with impaired functioning, and persist for at least three months (American Academy of Sleep Medicine, 2014). People with chronic insomnia often experience irritability and depressive symptoms (Baglioni et al., 2011) and show impairments in cognitive functioning, especially attention, reaction time, problem solving, and working memory (Wardle-Pinkston et al., 2019). Over time, insomnia increases the likelihood of developing major depressive disorder, cardiovascular disease, and type 2 diabetes (Baglioni et al., 2011; LeBlanc et al., 2018; Sofi et al., 2014). These difficulties may have negative repercussions on teachers’ classroom performance given that teachers’ emotional wellbeing predicts effective classroom management, positive teacher-student interactions, and an enhanced learning environment (Jennings & Greenberg, 2009).
Implicit and Explicit Stigma of Chronotype in Emerging Adults
Published in Behavioral Sleep Medicine, 2023
Jessica R. Dietch, Megan Douglas, Kelly Kim
Insomnia disorder has substantial overlap with delayed sleep-phase type in both symptomatology and co-occurrence. Insomnia symptoms include difficulty initiating or maintaining sleep, and insomnia disorder is diagnosed when these symptoms occur at least 3 nights per week for at least 3 months and are accompanied by a sleep-related difficulty in daytime functioning (American Psychiatric Association, 2013). Delayed sleep-phase type can co-occur with or be diagnosed independently from insomnia disorder. The primary differentiating feature is the involvement of the schedule in the sleep-wake pathology; individuals with delayed sleep-phase type without co-occurring insomnia disorder do not experience insomnia symptoms when they are allowed to sleep on their preferred schedule (American Psychiatric Association, 2013). Because of the similarity between symptoms experienced by individuals with delayed sleep-phase type and insomnia disorder, and the high rate of co-occurrence between these disorders, it is possible that similar experiences of stigma may also be common to individuals with both disorders.
Related Knowledge Centers
- Chronic Pain
- Heartburn
- Hyperthyroidism
- Irritability
- Psychological Stress
- Sleep
- Sleep Disorder
- Depression
- Heart Failure
- Traffic Collision