it is our hope that parents and also researchers, who are interested in the sleep disorders of children with fasd, will benefit from this presentation and that this discussion will stimulate much needed evidence-based research. however, caregivers and clinicians familiar with fasd agree that sleep disorders tend to begin in the neonatal period. the causes of sleep difficulties in children with fasd are frequently multifactorial because in addition to brain maldevelopment, sleep disturbances may be secondary to health problems, inadequate sleep hygiene, emotional and social issues. when children sleep poorly, the sleep of their caregivers and of other children are also affected . currently, there is no documented research on the promotion of sleep health for children with fasd and it is unclear how frequently sleep hygiene interventions are effective. the same problem is evident when children with fasd are surrounded by a large number of people.
all of these factors need to be analyzed when designing an appropriate and individualized sleep environment for children with fasd. there is full parental agreement that the sequence of bedtime activities needs to be supervised and firmly enforced because children with fasd tend to have a poor concept of time and also have difficulty with order. for typical children, the sleep hygiene literature emphasizes only appropriate presleep activities but for children with fasd, stress or excitement may need to be avoided during the entire day which may not be possible when they are in school. the caregivers are placed in a position where they constantly have to educate others about the nature of fasd and their children’s needs. it is the collective experience of the authors that sleep hygiene interventions are increasingly harder to enforce and less effective in children with more severe cognitive loss and brain damage. this is an open access article distributed under the creative commons attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
objectives were to: (1) assess sleep concerns in children with fasd using a caregiver-report survey, the children’s sleep habits questionnaire (cshq); (2) compare cshq results with those of previously reported community sample; and (3) describe pilot polysomnography findings in children with fasd. multiple studies have found that both the prevalence and severity of sleep problems in children with underlying neurodevelopmental disorders are significantly higher, and appear to have a profound impact on daytime functioning of the child and family. a total score ≥ 41 has a sensitivity of 80% and specificity of 72% for differentiating between groups of children with and without sleep disorders diagnosed by a sleep medicine specialist.21 referral for a sleep medicine consultation and psg was offered to participants with fasd whose cshq scores exceeded the clinical cutoff (≥ 41). group characteristics of the community sample and larger washington state fasd sample are provided for the reader’s reference but were not statistically compared with this study’s participants, given methodologic differences in original data collection.
in addition, 85% of children with fasd attained a total score above the clinical cutoff of 41 for sleep dysfunction compared with only 30% of the community sample (p < 0.001). the elevation in average cshq total score for children with fasd was driven primarily by increased scores in subdomains related to the initiation and maintenance of sleep, best described as pediatric insomnia. while a comorbid diagnosis of adhd in children with fasd may contribute to sleep problems in this population, it is unlikely to be the sole explanation. the current study is congruent with previous case series and a very recent systematic study of preschoolers in which high rates of concerning sleep problems were observed in children with fasd. the high prevalence of sleep problems observed in children with fasd suggests that children with fasd should routinely be evaluated for sleep complaints.
many children diagnosed with fetal alcohol spectrum disorders (fasd) have long-standing sleep disturbances which interfere with their daily activities, sleep problems are reported to be common among children with fetal alcohol spectrum disorders (fasd), yet these sleep problems have not been well described in accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (fasd). multiple animal and clinical, related symptoms, related symptoms, related conditions, fetal alcohol syndrome, fasd melatonin.
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