Search

Study Objectives We set out to examine how chronotype (diurnal preference) is connected to ability to function in natural conditions where individuals cannot choose their sleep schedule. We conducted a cross-sectional study in military conscript service to test the hypothesis that sleep deprivation mediates the adverse effects of chronotype on cognitive functioning. We also examined the effects of time of day. Methods One hundred forty participants (ages 18–24 years) completed an online survey, including the Morningness-Eveningness Questionnaire and a Cambridge Neuropsychological Test Automated Battery. Most (n = 106) underwent an actigraphy recording. After bivariate analyses, we created a mediation model (self-reported sleepiness and sleep deprivation mediating effect of chronotype on cognition) and a moderation model (synchrony between most alert time and testing time). Results Reaction times in inhibition task correlated negatively with sleep efficiency and positively with sleep latency in actigraphy. There was no relation to ability to inhibit responses. More significantly, spatial working memory performance (especially strategicness of performance) correlated positively with morning preference and negatively with sleep deprivation before service. Synchrony with most alert time of the day did not moderate these connections. No other cognitive task correlated with morningness or sleep variables. Conclusions In line with previous research, inhibitory control is maintained after insufficient sleep but with a tradeoff of slower performance. The connection between morning preference and working memory strategy is a novel finding. We suggest that diurnal preference could be seen as an adaptive strategy, as morningness has consistently been associated with better academic and health outcomes.

Increased task demand will increase the pilot mental workload (PMWL). When PMWL is increased, mental overload may occur resulting in degraded performance. During pilots' instrument flight rules (IFR) proficiency test, PMWL is typically not measured. Therefore, little is known about workload during the proficiency test and pilots' potential to cope with higher task demands than those experienced during the test. In this study, fighter pilots' performance and PMWL was measured during a real IFR proficiency test in an F/A-18 simulator. PMWL was measured using heart rate (HR) and heart rate variation (HRV). Performance was rated using Finnish Air Force's official rating scales. Results indicated that HR and HRV differentiate varying task demands in situations where variations in performance are insignificant. It was concluded that during a proficiency test, PMWL should be measured together with the task performance measurement.

Fighter pilots' heart rate (HR), heart rate variation (HRV) and performance during instrument approaches were examined. The subjects were required to fly instrument approaches in a high-fidelity simulator under various levels of task demand. The task demand was manipulated by increasing the load on the subjects by reducing the range at which they commenced the approach. HR and the time domain components of HRV were used as measures of pilot mental workload (PMWL). The findings of this study indicate that HR and HRV are sensitive to varying task demands. HR and HRV were able to distinguish the level of PMWL after which the subjects were no longer able to cope with the increasing task demands and their instrument landing system performance fell to a sub-standard level. The major finding was the HR/HRV's ability to differentiate the sub-standard performance approaches from the high-performance approaches. Practitioner Summary: This paper examined if HR and HRV were sensitive to varying task demands in a fighter aviation environment and if these measures were related to variations in pilot's performance.

BACKGROUND: Inadequate sleep in children relates to medical and psychosocial problems. However, not much is known about the effects of sleep problems persisting from pre-school to school age on somatic and psychosocial symptoms. OBJECTIVES: To examine the associations between sleep disturbances and psychosocial symptoms, somatic complaints, medical problems at school age. METHODS: This was a population-based 4-year follow-up study of sleep problems in Finnish children (n = 470). Parents filled in Sleep Disturbance Scale for Children during pre-school and school years. Children were categorized into four groups: no sleep problems, sleep problems only at pre-school or only at school age, and persistent sleep problems. At follow-up the parents filled in Child Behavior Checklist and a background questionnaire. RESULTS: The children with persistent sleep problems (9%) had a 16-fold risk of having psychosocial symptoms on subclinical/clinical range compared with the children without sleep problems. The psychosocial symptoms that were related strongest to prolonged sleep problems were aggression, social and attention problems, and anxious/depressed mood. Also, somatic complaints (ninefold risk) and medical problems (P Language: en

Aim: To investigate parent–adolescent agreement on psychosocial and somatic symptoms in adolescents with inflammatory bowel disease (IBD). Methods: A questionnaire-based postal survey comprising Finnish adolescents aged 10–18 years with IBD (n = 156) and their parents. Emotional, behavioural and somatic symptoms were measured using the Child Behaviour Checklist (parent report) and the Youth Self-Report. Results: In paediatric IBD, adolescents and parents agreed on the presence of a psychosocial problem (in subclinical/clinical range) in 5% of the cases but disagreed in 21%. In 74% of the dyads, respondents agreed that no problems existed. Agreement in reporting psychosocial or somatic symptoms was poor to low (κ = 0.00–0.38). The lowest agreement was on anxious/depressed mood (κ = 0.02) and thought problems (κ = 0.00) and the highest on social problems. The parents reported more somatic symptoms in their adolescents than the adolescents themselves (p

Objective To study the prevalence of various sleep problems at school age in a Finnish community sample and to evaluate the persistence of the sleep problems from the preschool age to school age in a 4-year follow-up. Methods Parents completed the Sleep Disturbance Scale for Children questionnaire on their child's sleep during the preschool years (3–6 years) and again during the school years (7–11 years). At follow-up the parents also completed a questionnaire on family structure and socio-economic status. Results The parents of 481 children completed the questionnaires during both the first study and the follow-up (girls 49%, boys 51%; mean age 9, range 7–11). At the population level, sleep problems slightly declined from preschool to school age (P < 0.05). However, sleep problems at preschool age showed a strong persistence to school age. At the follow-up, 35% of the children who were considered to have a sleep disorder at preschool age still suffered from it at school age. At the community level, this equates to 9% of the children. The children with no sleep problems at preschool age rarely developed sleep problems at school age. Conclusions This study showed that various types of sleep problems are common at school age. Sleep problems persisted from preschool to school age at the individual level. It is important to recognize all types of sleep problems, especially persistent ones. Persistent sleep problems in children may cause and exacerbate other somatic, cognitive and psychiatric problems. Therefore, more attention should be focused on sleep problems in paediatric health care with interventions aimed particularly at children with prolonged sleep problems.

Motor retardation is a cardinal feature in adult depression. Limited information exists about motor activity in depressed children. The present study evaluated motor activity in depressed children compared to controls and investigated whether motor activity can be linked with the severity of symptoms in depressed children.Motor activity during both day- and night time was recorded by actigraphy in twenty-two depressed children and their controls. A K-SADS-PL interview of the child and his/her mother was used to diagnose depression. The depressed children filled in the Child Depression Inventory (CDI) as a self-report of the severity of depression. Parents and teachers of both depressed children and controls filled in the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF).Motor activity was reduced during the daytime in depressed children compared to controls (p0.001). Depressed children spent more time in total immobility during the night time than their peers (p0.05). In depressed children motor activity was linked with the severity of self- (r=-0.45, p0.05) and teacher-reported (r=-0.52, p0.05) symptoms. Depressed children with suicidal ideation (n=10) differed significantly in motor activity compared to depressed children without suicidal ideation (n=12) and controls (n=22).Sample size was only moderate.Reduced motor activity is an important feature of childhood depression. Objectively measured motor activity can distinguish depressed children from their peers. Motor retardation can be linked with the severity of depression, especially suicidal ideation and possibly subtype depressed children into groups with different etiology, treatment needs and course of illness.

INFLAMMATORY BOWEL DISEASE (IBD), NAMELY CROHN DISEASE (CD) AND ULCERATIVE COLITIS (UC), IS MOST TYPICALLY DIAGNOSED IN LATE adolescence and early adulthood.1 The incidence of pediatric IBD is on the rise in many Western countries. In Finland, the incidence almost doubled from 1987 to 2003,2 and the same trend has been observed elsewhere.3–6 Primary causes of IBD or factors underlying the increasing incidence and geographic variation remain obscure.7 Symptoms of IBD, such as uncontrollable bowel function, rectal bleeding, diarrhea, abdominal pain, weight loss, fatigue, and, in CD, aphthous ulcers and fever, may be severe and may disturb sleep. Surprisingly, very few studies have investigated the quality of sleep and daytime tiredness in patients with IBD. A recent report on sleep disturbances compared adults with inactive IBD (n = 16) with patients with irritable bowel syndrome (IBS) (n = 9) and healthy control subjects (n = 7).8 Patients with IBD did not differ significantly from patients with IBS with respect to sleep parameters assessed by a single night of polysomnography and questionnaires. However, sleep quality of both patient groups was lower than that of the control group. The 3 groups did not differ with respect to daytime dysfunction.8 Another questionnaire-based study of sleep disturbances among adult patients with inactive IBD (n = 80) showed prolonged sleep latency, frequent sleep fragmentation, higher rate of using sleeping pills, decreased daytime energy, increased tiredness, and poor overall sleep quality in IBD compared with healthy control subjects (n = 15).9 In this study, patient-reported sleep quality correlated with disease severity. Of the patients with IBD, 66% assessed their sleep as poor during the active state of the disease, and 49% believed disturbed sleep affected their inflammatory disease.9 Likewise, in a study focusing on extraintestinal symptoms in adults with IBD (n = 55), patients with IBD were noted to have significantly more sleep disturbances than control subjects, and diarrhea predicted sleep disturbances in these patients.10 In all of these studies, only adult patients were included. The sample sizes were small, and population-based control groups were lacking. Data on sleep disturbances in young patients with IBD are sparse. We found only 1 preliminary study on sleep disturbances among young patients with IBD (n = 41) in Israel, published as an abstract.11 This questionnaire-based study concluded that moderate and severe sleep disturbances are frequent among young patients with IBD. No correlation was found between sleep disturbance and disease characteristics of IBD (e.g., disease type, disease activity, or medication). No precise information was given about the method of collecting data on sleep or disease activity. For other inflammatory conditions, such as juvenile rheumatoid arthritis (JRA), sleep quality and daytime tiredness have been explored in a few studies.12–16 These findings reveal that sleep is disrupted in children with JRA. For example, comparable child and parent questionnaires, the Sleep Self-Report (SSR) and the Children's Sleep Habit Questionnaire (CSHQ), were used in a retrospective study of 25 children with active JRA to assess sleep and its relationship to pain, dysfunction, and disease activity.15 Parents of patients with JRA reported significantly higher total scores on the CSHQ and on the subscales assessing nighttime waking, parasomnias, sleep anxiety, sleep-disordered breathing, and morning wakening/daytime sleepiness than did parents of healthy control subjects. However, the total score on the CSHQ did not correlate with disease severity; this was in contrast with the total score on the SSR, which correlated highly with pain but not with other arthritis-related variables.15 Lack of knowledge about the quality and quantity of sleep in pediatric patients with IBD warrants studies in these patients. Sleep disturbances may increase the risk for psychosocial symptoms or disorders such as tiredness and depression.17 Thus, more research is needed on sleep in adolescents with IBD and the association between sleep and IBD symptom severity. The first objective of the current study was to evaluate sleep problems, quality of sleep, and daytime tiredness among adolescents with IBD in comparison with population-based control subjects. The second objective was to evaluate the effect of the severity of IBD symptoms on sleep problems, quality of sleep, and daytime tiredness. This questionnaire-based study includes both parent and self-reports.

Background: The aim was to evaluate psychosocial symptoms and competence as reported by the parents and the adolescents themselves among patients with inflammatory bowel disease (IBD) in relation to population-based controls. Methods: Standardized Achenbach questionnaires—Child Behavior Checklist (CBCL) for the parents and Youth Self-Report (YSR) for the adolescents—were sent to Finnish families of adolescents with IBD (age 10–18 years), and their controls matched for age, gender, and place of residence. The final study group comprised 160 adolescents with IBD and 236 controls with their parents, respectively. Results: According to parent reports, adolescents with IBD had more symptoms of anxious/depressed mood (P < 0.001), withdrawn/depressed mood (P < 0.05), social problems (P < 0.05), thought problems (P < 0.001), somatic complaints (P < 0.001), and lower competence (P < 0.05) than population-based controls. Unexpectedly, there was no group difference in the amount of self-reported psychosocial symptoms, somatic complaints, or competence between adolescents with IBD and their peers. However, adolescents with severe IBD reported significantly more emotional problems (P < 0.001) than those with mild symptoms or controls. Conclusions: According to parents, adolescents with IBD have more emotional problems, social problems, thought problems, and lower competence than their population-based peers. Self-perceived severity of the IBD symptoms is associated with a larger amount of parent and self-reported emotional symptoms. Complementary methods should be used while assessing the psychosocial well-being of adolescents with IBD as questionnaires alone may be insufficient. (Inflamm Bowel Dis 2010;)

To study emotional and behavioral problems and sleep and cognitive performance in snoring and nonsnoring 3- to 6-year-old children.As part of an epidemiological study of sleep disordered breathing (SDB) in preschool-aged children, 43 snorers and 46 nonsnorers participated in a clinical study. Their parents completed the Child Behavior Checklist (CBCL). The children were assessed with Wechsler Preschool and Primary Scale of Intelligence, Revised and subtests of the Developmental Neuropsychological Assessment (NEPSY-A) representing aspects of attention, language skills, sensorimotor functions, memory, and learning.On the CBCL snoring children had significantly more parent reported internalizing symptoms (p.05) than the nonsnoring children, especially symptoms of anxious/depressed mood (p.01) and emotional reactivity (p.05). More children from the snoring group than from the nonsnoring group (22 vs 11%) scored in the subclinical or clinical range on the internalizing scale. Interestingly, no significant difference between the groups was found in the amount of externalizing symptoms. The amount of sleep problems other than snoring was higher in the snoring than in the nonsnoring group (p.01). On tests measuring auditory attention (p.01) and language skills (verbal IQ, p.05), the snoring group performed worse than the nonsnoring group.Our results support the view that SDB should be considered a possible risk factor for mood disorder symptoms and impaired cognitive performance in children.