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Sleep disturbances and their co‑occurrence with emotional and behavioural problems in elementary school children

A network analysis

Schlafstörungen und ihre Assoziation mit emotionalen Problemen sowie Verhaltensauffälligkeiten bei Grundschülern

Eine Netzwerkanalyse

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Abstract

Background

Sleep disturbances are likely to be associated with emotional and behavioural problems in children.

Aim

The goal was to evaluate co-occurrences between sleep disturbances and behavioural and emotional problems in elementary school children by means of network analysis.

Patients and methods

The study was performed in St. Petersburg in 2017 and comprised 186 typically developing children (92 boys, 94 girls) aged 6 to 8 (median 7) years. The mothers were requested to fill in the Child Sleep Habit Questionnaire (CSHQ) aimed to measure certain sleep troubles in children. The teachers were approached with the Achenbach Teacher Report Form for Ages 6–18 years aimed to find major emotional and behavioural disturbances. The EBICglasso (Extended Bayesian Information Criterion graphical least absolute shrinkage and selection operator) algorithm was used to estimate a regularized graphical model and to find the most important associations.

Results

There were 14 nodes in the network with 26 non-zero edges. Some variables had strong connections. The daytime sleepiness scale had the highest betweenness score (normalized value 2.54), and it bridged sleep problems and the signs of emotional/behavioural disturbances. Other variables with high betweenness scores were parasomnias (normalized value 1.14), acting as the bridge that connects other features of sleep problems, and depressive problems (normalized value 1.46), bridging the nodes related to emotional/behavioural disturbances. These clinical signs may play important roles in the network and should be regarded cautiously as possible indicators of co-occurring sleep and emotional disturbances.

Conclusion

Network analysis offers the potential for insight into structural relationships among core psychological processes related to sleep disturbances in children.

Zusammenfassung

Hintergrund

Schlafstörungen sind bei Kindern wahrscheinlich mit emotionalen Problemen und Verhaltensauffälligkeiten assoziiert.

Zielsetzung

Ziel der Studie war es, in einer Netzwerkanalyse das gemeinsame Vorkommen von Schlafstörungen sowie Verhaltensauffälligkeiten und emotionalen Problemen bei Grundschulkindern zu untersuchen.

Patienten und Methoden

Die Studie wurde im Jahr 2017 in Sankt Petersburg durchgeführt. Eingeschlossen wurden 186 in ihrer Entwicklung unauffällige Kinder (92 Jungen, 94 Mädchen) im Alter von 6 bis 8 Jahren (Median 7 Jahre). Ihre Mütter wurden gebeten, den Child Sleep Habit Questionnaire (CSHQ) auszufüllen, mit dem bestimmte Schlafprobleme bei Kindern bewertet werden. Ihre Lehrer erhielten die Achenbach Teacher Report Form für die Altersgruppe von 6 bis 18 Jahren, die wichtige emotionale Probleme und Verhaltensauffälligkeiten erfasst. Mit dem EBICglasso-Algorithmus („Extended Bayesian Information Criterion graphical least absolute shrinkage and selection operator“) sollten ein regularisiertes grafisches Modell geschätzt und die wichtigsten Assoziationen ermittelt werden.

Ergebnisse

Es fanden sich 14 Knoten im Netzwerk mit 26 Kanten ungleich null („non-zero edges“). Einige Variablen hatten starke Verbindungen. Die Skala für Tagesschläfrigkeit wies den höchsten Betweenness-Wert auf (normalisierter Wert 2,54) und verband Schlafprobleme und die Anzeichen von emotionalen/verhaltensbezogenen Störungen. Weitere Variablen mit hohen Betweenness-Werten waren Parasomnien (normalisierter Wert 1,14), die als die Verbindung anderer Merkmale von Schlafproblemen fungierten, und depressive Störungen (normalisierter Wert 1,46), die die Knoten mit Bezug zu emotionalen/verhaltensbezogenen Störungen verbanden. Diese klinischen Zeichen könnten eine wichtige Rolle im Netzwerk spielen und sollten mit Bedacht als mögliche Indikatoren gemeinsam vorliegender Schlaf- und emotionaler Störungen betrachtet werden.

Schlussfolgerung

Die Netzwerkanalyse hat das Potenzial, strukturelle Beziehungen zwischen psychischen Kernprozessen mit Bezug zu Schlafstörungen bei Kindern aufzuzeigen.

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Acknowledgements

The author would like to thank the undergraduate students for their help in collecting raw data.

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Authors and Affiliations

  1. Department of Children’s Diseases of the Institute for Medical Education, the V.A. Almazov National Medical Research Centre, 2 Akkuratova Str., 197341, St. Petersburg, Russian Federation

    Igor A. Kelmanson

  2. St. Petersburg State Institute for Psychology and Social Work, 13‑A Vasilyevsky Ostrov 12th Line, 199178, St. Petersburg, Russian Federation

    Igor A. Kelmanson

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Correspondence to Igor A. Kelmanson.

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I.A. Kelmanson declares that he has no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent for the participation in a scientific study was obtained from all mothers involved, and confidentiality was guaranteed.

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Kelmanson, I.A. Sleep disturbances and their co‑occurrence with emotional and behavioural problems in elementary school children. Somnologie 23, 281–290 (2019). https://doi.org/10.1007/s11818-019-00216-w

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