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      Sleep in Infancy Predicts Gender Specific Social-Emotional Problems in Toddlers

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          Abstract

          Despite strong evidence linking sleep to developmental outcomes, the longitudinal relationship between sleep and emotional well-being remains largely unknown. To address this gap in our knowledge, the current study examined sleep in infancy, measured via actigraphy, as a predictor of social-emotional problems in toddlers. A total of 47 children (29 males) were included in this longitudinal study. At time one, actigraphy measures of sleep were obtained from 3- to 4-month-old infants. At time two, parents rated their 18- to 24-month-old toddler’s social-emotional well-being using the Brief Infant Toddler Social Emotional Assessment. Results indicated that boys tended to have higher levels of externalizing behaviors than did girls. Additionally, boys with longer sleep durations also showed lower sleep efficiency. In girls, sleep duration in infancy was a significant predictor of autism spectrum disorder behaviors and approached significance as a predictor of externalizing problems in toddlerhood. Our findings are the first to show a relationship between sleep measured in infancy and autism spectrum disorder symptomatology measured in early childhood. They suggest that the etiology of social-emotional problems may differ between genders and raise the possibility that sleep/wake cycles may be differentially related to autism spectrum disorder symptoms in girls and boys.

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          Most cited references54

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          The human emotional brain without sleep--a prefrontal amygdala disconnect.

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            Further validation of actigraphy for sleep studies.

            Actigraphy is generally compared to polysomnography (PSG), which has been considered the gold standard for sleep studies. The objective of the present study was to evaluate the concordance between PSG and two previously proposed algorithms (Cole et al, 1992; Sadeh et al, 1994) to analyze actigraphic recordings. The minute-by-minute agreement rate was evaluated through calculation of sensitivity, specificity, and accuracy. Regarding the sleep parameters, the concordance was performed through the Bland and Altman technique. A night of adaptation to the sleep laboratory followed by simultaneous polysomnographic and actigraphic recordings throughout the night. 21 healthy volunteers. A sleep laboratory None. Ninety-one percent of all PSG epochs were correctly identified by both algorithms, and this accuracy is reasonably satisfactory. The actigraphy was a sensitive method, with values of 99% and 97% for Cole's and Sadeh's algorithms, respectively. However, actigraphy had a low specificity: 34% and 44% for Cole's and Sadeh's algorithms, respectively. The Bland and Altman technique showed that actigraphy systematically overestimated Sleep Latency, Total Sleep Time and Sleep Efficiency while it underestimated Intermittent Awakenings. The results of this study show the utility of actigraphy as a useful method for assessment of sleep, despite its limitations regarding identification of waking epochs during sleep. The Bland and Altman concordance technique was revealed to be a powerful tool to evaluate how well actigraphy agreed with polysomnography. This technique, combined with calculations of sensitivity and specificity, appears to be the most adequate procedure for the assessment of concordance.
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              Sleep problems in childhood: a longitudinal study of developmental change and association with behavioral problems.

              The objective of the study was to examine specificity, order of appearance, and developmental changes in the relationships between sleep problems and behavioral problems in children. Four hundred ninety children were selected from a large-scale longitudinal study of children growing up in adoptive and nonadoptive (biological) families in Colorado. Parental ratings of children's sleep and behavioral problems on the Child Behavior Checklist were obtained from ages 4 to 15 years. Sleep problems decreased from age 4 years to mid-adolescence, but there was modest stability of individual differences across this age range (r = 0.29). Regression analyses indicated that sleep problems at age 4 predicted behavioral/emotional problems in mid-adolescence after accounting for child sex, adoptive status, and stability of behavioral/emotional problems. Finally, the correlation between sleep problems and depression/anxiety increased significantly during this age period from r = 0.39 at age 4 years to r = 0.52 at mid-adolescence. Early sleep problems may forecast behavioral/emotional problems, and there may be important developmental change in the overlap between sleep problems and behavioral/emotional problems.
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                Author and article information

                Contributors
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                11 May 2015
                2015
                : 3
                : 42
                Affiliations
                [1] 1Department of Psychology, Texas A&M University , College Station, TX, USA
                [2] 2Division of Adolescent Medicine, Children’s Hospital Los Angeles , Los Angeles, CA, USA
                Author notes

                Edited by: Ashok Mysore, St. John’s Medical College Hospital, India

                Reviewed by: Magdalena Romanowicz, Stanford University, USA; Rajshekhar Bipeta, Gandhi Medical College and Hospital, India

                *Correspondence: Janet Saenz, Division of Adolescent Medicine, Children’s Hospital Los Angeles, 5000 Sunset Boulevard, Suite 540, Los Angeles, CA 90027, USA, jasaenz@ 123456chla.usc.edu

                Specialty section: This article was submitted to Child and Neurodevelopmental Psychiatry, a section of the journal Frontiers in Pediatrics

                Article
                10.3389/fped.2015.00042
                4426713
                c6ea0a45-27da-47f6-8eab-0c2de4289979
                Copyright © 2015 Saenz, Yaugher and Alexander.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 05 February 2015
                : 25 April 2015
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 60, Pages: 6, Words: 5073
                Funding
                Funded by: National Science Foundation
                Award ID: BCS-0618411
                Funded by: Texas A&M University Online Access to Knowledge (OAK)
                Funded by: University Libraries and the Office of the Vice President for Research
                Categories
                Pediatrics
                Original Research

                actigraphy,sleep,infants,toddlers,social-emotional,longitudinal studies

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