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- Larsson, Ingrid, 1968-, et al.
(author)
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Sleep interventions for children with attention deficit hyperactivity disorder (ADHD) : A systematic literature review
- 2023
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In: Sleep Medicine. - Amsterdam : Elsevier. - 1389-9457 .- 1878-5506. ; 102, s. 64-75
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Research review (peer-reviewed)abstract
- Objective/background: Healthy sleep is particularly important for children with attention deficit hyperactivity disorder (ADHD), as sleep disturbances might aggravate disease symptoms. This review aims to synthesize and report evidence on the effectiveness of sleep interventions in increasing sleep, quality of life (QoL), and ADHD symptoms among children with ADHD. Patients/methods: The systematic literature review follows the Cochrane Collaboration methodology recommendations for literature reviews. Four databases were used based on the population, intervention, control and outcome (PICO) framework. Controlled trials with minimum 20 children in each group, aged 6–18, and published from 2005 and onwards were included. Results from the studies were reported in forest plots and three of the seven review outcomes were synthesized in meta-analyses. Results: The search identified 7710 records; of which 4808 abstracts were screened. After fulltext-screening of 99 papers, eight papers from five studies were included. The studies included behavioral sleep interventions and pharmacological interventions using melatonin and eszopiclone. For six of the seven outcomes, the effect sizes were small to moderate and the certainty of the evidence was low. For one outcome, sleep disturbances, the effect size was a moderate −0.49 standardized mean differences (95% confidence interval −0.65;-0.33), with a moderate certainty of evidence for the behavioral interventions for children aged 5–13 years with ADHD. Conclusions: This review identified few and heterogeneous studies. A moderate certainty of evidence for a moderate effect size was only obtained for sleep disturbances from the behavioral interventions. A low certainty of the evidence for a moderate effect size was found for the total sleep time from the pharmacological intervention using melatonin and one behavioral intervention, which indicates that these sleep interventions impact sleep quantity and quality among children with ADHD. © 2022 The Authors
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- Lönn, Maria, Doktorand, 1981-, et al.
(author)
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Changed sleep according to weighted blanket adherence in a 16-week sleep intervention among children with attention-deficit/hyperactivity disorder
- 2024
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In: Journal of Clinical Sleep Medicine (JCSM). - Darien : The American Academy of Sleep Medicine. - 1550-9389 .- 1550-9397.
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Journal article (peer-reviewed)abstract
- Study objectives: To examine differences in sample characteristics and longitudinal sleep outcomes according to weighted blanket adherence.Methods: Children with attention-deficit/hyperactivity disorder (ADHD) (n =94), mean age 9.0 (sd 2.2, range 6-14) participated in a 16-week sleep intervention with weighted blankets (WB). Children were classified as WB adherent (use of WB ≥ 4 nights/week) or non-adherent (use of WB ≤ 3 nights/week). Changes in objectively measured sleep by actigraphy, parent-reported sleep problems (Children's Sleep Habits Questionnaire (CSHQ)) and child-reported Insomnia Severity Index (ISI) were evaluated according to adherence with mixed effect models. Gender, age, and ADHD subtype were examined as potential moderators.Results: Children adherent to WBs (48/94) showed an early response in sleep outcomes and an acceptance of the WB after four weeks of use as well as a decrease in parent- (CSHQ) (-5.73, P = .000) and child-reported sleep problems (ISI) (-4.29, P = .005) after 16 weeks. The improvement in sleep was larger among WB adherent vs. non-adherent (between-group difference: CSHQ: -2.09, P = .038; ISI: -2.58, P =.007). Total sleep time was stable for children adherent to WB but decreased for non-adherent (between-group difference: +16.90, P = .019).Conclusions: An early response in sleep and acceptance of the WB predicted later adherence to WBs. Improvements in sleep were more likely among WB adherents vs. non-adherents. Children with ADHD may thus benefit from using WBs to handle their sleep problems.© 2024 American Academy of Sleep Medicine
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- Lönn, Maria, Doktorand, 1981-, et al.
(author)
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Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties
- 2023
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In: Occupational Therapy International. - Oxford : John Wiley & Sons. - 0966-7903 .- 1557-0703. ; 2023, s. 1-12
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Journal article (peer-reviewed)abstract
- Introduction. Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children’s individual needs in connection with sleep and daytime functioning. Aim. To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets. Methods. An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis. Results. Children’s experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep. Conclusions. Using weighted blankets promoted children’s management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves. Copyright © 2023 Maria Lönn et al.
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| 4. |
- Lönn, Maria, Doktorand, 1981-, et al.
(author)
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The efficacy of weighted blankets for sleep in children with attention-deficit/hyperactivity disorder—A randomized controlled crossover trial
- 2024
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In: Journal of Sleep Research. - Chichester : Wiley-Blackwell Publishing Inc.. - 0962-1105 .- 1365-2869.
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Journal article (peer-reviewed)abstract
- Weighted blankets are a non-pharmacological intervention for treating sleep and anxiety problems in children with attention-deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention-deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention-deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T-tests were used to evaluate efficacy. The study included 94 children with attention-deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. −2.79 min, p = 0.015, Cohen's d = −0.27), but not on sleep-onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11–14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention-deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions. © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.
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| 10. |
- Nygren, Maria, 1981-
(author)
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Stress in childhood and the risk of type 1 diabetes
- 2015
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Doctoral thesis (other academic/artistic)abstract
- Background: It is still unknown why children develop type 1 diabetes (T1D), although both genetic predisposition and environmental factors seems to be involved. Stress has been suggested as one environmental factor contributing to the development of T1D since the stress hormones may increase the need for insulin or increase insulin resistance. The family is important for the child’s emotional security, development, and regulation of emotions, hence stress among the parent’s may influence the child’s experiences of stress and coping with stressors.Aim: The aim of the current thesis was to evaluate self--‐assessment measurements of psychological stress in the family and to investigate if psychological stress in the family is involved in the development of childhood T1D.Methods: The All Babies in Southeast Sweden (ABIS) study is a prospective cohort study following children born in southeast Sweden between 1997 and 1999. All parents of children born in the region, approximately 21600 were asked to participate. In total, questionnaire data has been obtained from n=16142 (response rate approximately 75%) in some of the six data--‐collections and between 15845 (73%) and 4022 (19%) at each data collection. Psychological stress in the family was measured by questionnaires assessing: Serious life events experienced by the child and the parent, parenting stress, parental dissatisfaction, parental worries, the parent’s adult attachment, and the parents’ social support. Identification of cases with T1D was done through the national register SweDiabKids. At Dec the 31st 2012 had in total 104 (0,64%) children been diagnosed with T1D. Diabetes--‐cases included in the study samples was n=42 and n=58.Results: Parenting stress, parental worries, and size of social support were judged as reliable measurements assessing different aspects of psychological stress in the family, as well as they were all associated to children’s mental health in early adolescence. A serious life event experienced in childhood (measured by checklist at age 5--‐6, 8 and 10--‐ 14 years) was associated with an increase in risk for manifest T1D up to 13--‐15 years of age. None of the variables measuring psychological stress among parents were found to associate with risk of T1D.Conclusions: In addition to a checklist assessing serious life events experienced by the child is self--‐assessment measurements of parenting stress, parental worries and the parent’s social support be useful in large--‐scale studies as proxies for psychological stress of the child. The current study is the first unbiased prospective study that can confirm an association between the experience of a serious life event and increased risk of T1D. The result was independent of the child’s BMI and the parents’ educational level. Our results gives us strong reason to believe that psychological stress caused by serious life events can play a part in the immunological process leading to the onset of T1D.
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