Feasibility of Using Actigraphy and Motivational-Based Interviewing to Improve Sleep Among School-Age Children and Their Parents

Abstract

Inadequate sleep occurs in 25% of our nation’s children; poor sleep is associated with physical, cognitive, and social consequences. Developing good sleep hygiene in middle childhood is important, because habits typically extend to adolescence and adulthood; yet, there has been little research on sleep interventions for school-age children. The purpose of this study was to determine the feasibility of a developmentally tailored, motivation-based intervention (MBI) focused on improving sleep behaviors in school-age children aged 8–11. Nine parent–child dyads participated in an 8-week protocol utilizing MBI and comparisons of objective (actigraphy) and subjective (sleep diaries) data. Results suggest that parent and children are able to identify a target behavior to change and complete the protocol. Further, preliminary evidence indicates that sleep patterns change using MBI. Future research will be directed toward comparative effectiveness testing and exploring ways in which it can be adapted and incorporated into school nursing practice.

Keywords

health/wellness elementary parent/family health education

Get full access to this article

View all access options for this article.

References

Acebo

Sadeh

Seifer

Tzischinsky

Hafer

Carskadon

M. A.

(2005). Sleep/wake patterns derived from activity monitoring and maternal report for healthy 1- to 5-year-old children. Sleep, 28, 1568–1577.

Acebo

Sadeh

Seifer

Tzischinsky

Wolfson

A. R.

Hafer

Carskadon

M. A.

(1999). Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures? Sleep, 22, 95–103.

American Association of Colleges of Nursing. (2008). The Essentials of Baccalaureate Education for Professional Nursing Practice. Retrieved December 6, 2012, from http://www.aacn.nche.edu/education-resources/baccessentials08.pdf

Banks

Dinges

D. F.

(2007). Behavioral and physiological consequences of sleep restriction. Journal of Clinical Sleep Medicine, 3, 519–528.

Bloom

B. J.

Owens

J. A.

McGuinn

Nobile

Schaeffer

Alario

A. J.

(2002). Sleep and its relationship to pain, dysfunction, and disease activity in juvenile rheumatoid arthritis. The Journal of Rheumatology, 29, 169–173.

Buckhalt

J. A.

El-Sheikh

Keller

(2007). Children's sleep and cognitive functioning: race and socioeconomic status as moderators of effects. Child Development, 78, 213–231.

Chandola

Ferrie

J. E.

Perski

Akbaraly

Marmot

M. G.

(2010). The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance: A prospective study from the Whitehall II cohort. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.]. Sleep, 33, 739–744.

Chervin

R. D.

Archbold

K. H.

Dillon

J. E.

Panahi

Pituch

K. J.

Dahl

R. E.

Guilleminault

(2002). Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics, 109, 449–456.

Colvin

Eyberg

Adams

C. D.

(1999). Restandardization of the eyberg child behavior inventory. Available at http://pcit.phhp.ufl.edu/Measures/ECBI%20Restandardization.pdf.

10.

Danielsson

Kowalski

Ekblom

Marcus

(2012). Response of severely obese children and adolescents to behavioral treatment. Archives of Pediatrics & Adolescent Medicine, 166, 1103–1108. doi:10.1001/2013.jamapediatrics.319

11.

Ellenbogen

J. M.

(2005). Cognitive benefits of sleep and their loss due to sleep deprivation. [Review]. Neurology, 64, E25–27. doi:10.1212/01.WNL.0000159942.64562.AD

12.

Eyberg

S. M.

(1985). Behavioral assessment: Advancing methodology in pediatric psychology. Journal of Pediatric Psychology, 10, 123–139.

13.

Fallone

Owens

J. A.

Deane

(2002). Sleepiness in children and adolescents: Clinical implications. Sleep Medicine Reviews, 6, 287–306.

14.

Fry

J. P.

Neff

R. A.

(2009). Periodic prompts and reminders in health promotion and health behavior interventions: systematic review. Journal of Medical Internet Research, 11, e16. doi:v11i2e16 [pii]10.2196/jmir.1138

15.

Gance-Cleveland

(2007). Motivational interviewing: improving patient education. Journal of Pediatrtic Health Care, 21, 81–88.

16.

Halfon

Hochstein

(2002). Life course health development: an integrated framework for developing health, policy, and research. [Research Support, U.S. Gov't, P.H.S. Review]. The Milbank Quarterly, 80, 433–479, iii.

17.

Healthy Schools Campaign. (2012). Health in Mind: Improving Education through Welllness. Retrieved from http://healthyamericans.org/assets/files/Health_in_Mind_Report.pdf

18.

Hooven

Walsh

Willgerodt

Salazar

(2011). Increasing participation in prevention research: strategies for youths, parents, and schools. [Research Support, N.I.H., Extramural Review]. Journal of Child and Adolescent Psychiatric Nursing: Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc, 24, 137–149. doi:10.1111/j.1744-6171.2011.00288.x

19.

Iglowstein

Jenni

O. G.

Molinari

Largo

R. H.

(2003). Sleep duration from infancy to adolescence: reference values and generational trends. Pediatrics, 111, 302–307.

20.

Jenni

O. G.

Molinari

Caflisch

J. A.

Largo

R. H.

(2007). Sleep duration from ages 1 to 10 years: variability and stability in comparison with growth. Pediatrics, 120, e769–776. doi:120/4/e769 [pii]10.1542/peds.2006-3300

21.

Kieckhefer

G. M.

Lentz

M. J.

Tsai

S. Y.

Ward

T. M.

(2009). Parent-child agreement in report of nighttime respiratory symptoms and sleep disruptions and quality. Journal of Pediatrtic Health Care, 23, 315–326. doi:S0891-5245(08)00089-8 [pii]10.1016/j.pedhc.2008.04.001

22.

Kieckhefer

G. M.

Trahms

C. M.

(2000). Supporting development of children with chronic conditions: from compliance toward shared management. Pediatric Nursing, 26, 354–363.

23.

Kieckhefer

G. M.

Trahms

C. M.

Churchill

S. S.

Simpson

J. N.

(2009). Measuring parent-child shared management of chronic illness. Pediatric Nursing, 35, 101–108, 127.

24.

Kieckhefer

G. M.

Ward

T. M.

Tsai

S. Y.

Lentz

M. J.

(2008). Nighttime sleep and daytime nap patterns in school age children with and without asthma. Journal of Developmental & Behavioral Pediatrics, 29, 338–344. doi:10.1097/DBP.0b013e318182a99e

25.

Kushida

C. A.

Chang

Gadkary

Guilleminault

Carrillo

Dement

W. C.

(2001). Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Medicine, 2, 389–396.

26.

Lozano

Hartzler

McPhillips

Richardson

Runkle

Scholz

Stout

Kieckhefer

(2008). Collaborative Management in Pediatrics (CMP): A Pilot RCT of Teaching Brief Motivational Interviewing to Pediatric Trainees. Paper presented at the Pediatric Academic Society Annual Meeting, Honolulu, HI.

27.

Malone

S. K.

(2011). Early to bed, early to rise? An exploration of adolescent sleep hygiene practices. The Journal of School Nursing, 27, 348–354. doi:1059840511410434 [pii]10.1177/1059840511410434

28.

Matricciani

Olds

Petkov

(2012). In search of lost sleep: Secular trends in the sleep time of school-aged children and adolescents. [Review]. Sleep Medicine Reviews, 16, 203–211. doi:10.1016/j.smrv.2011.03.005

29.

Miller

W. R.

Rollnick

(2002). Motivational interviewing: Preparing people for change (2nd ed.). New York, NY: Guilford Press.

30.

Mindell

J. A.

Owens

J. A.

(2003). A clinical guide to pediatric sleep: Diagnosis and management of sleep problems. Philadelphia, PA: Lippincott Williams & Wilkins.

31.

Nathan

R. A.

Sorkness

C. A.

Kosinski

Schatz

J. T.

Marcus

… Pendergraft

T. B.

(2004). Development of the asthma control test: A survey for assessing asthma control. Journal of Allergy and Clinical Immunology, 113, 59–65.

32.

National Sleep Foundation. (2006). 2006 Sleep in America Poll. Retrieved September, 3, 2009, 2009, from http://www.sleepfoundation.org/article/sleep-america-polls/2006-teens-and-sleep

33.

National Sleep Foundation. (2009). 2009 Sleep in America Poll. Retrieved September 6, 2009, from http://www.sleepfoundation.org/article/sleep-america-polls/2009-health-and-safety

34.

Owens

J. A.

(2005). Introduction: Culture and sleep in children. Pediatrics, 115, 201–203.

35.

Owens

J. A.

Spirito

McGuinn

(2000). The children's sleep habits questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep, 23, 1043–1051.

36.

Owens

J. A.

Spirito

McGinn

Nobile

(2000). Sleep habits and sleep disturbances in elementary school-aged children. Developmental and Behavioral Pediatrics, 21, 10.

37.

Palmstierna

Sepa

Ludvigsson

(2008). Parent perceptions of child sleep: A study of 10,000 Swedish children. Acta Paediatrica, 97, 1631–1639. doi:APA967 [pii]10.1111/j.1651-2227.2008.00967.x [doi]

38.

Reilly

J. J.

Armstrong

Dorosty

A. R.

Emmett

P. M.

Ness

Rogers

… Sherriff

(2005). Early life risk factors for obesity in childhood: Cohort study. British Medical Journal, 330, 1357. doi:bmj.38470.670903.E0 [pii]10.1136/bmj.38470.670903.E0

39.

Resnicow

DiIorio

Soet

J. E.

Ernst

Borrelli

Hecht

(2002). Motivational interviewing in health promotion: It sounds like something is changing. Health Psychology, 21, 444–451.

40.

Rubak

Sandbaek

Lauritzen

Christensen

(2005). Motivational interviewing: A systematic review and meta-analysis. British Journal of General Practice, 55, 305–312.

41.

Sadeh

Gruber

Raviv

(2002). Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Development, 73, 405–417.

42.

Sadeh

Gruber

Raviv

(2003). The effects of sleep restriction and extension on school-age children: What a difference an hour makes. Child Development, 74, 444–455.

43.

Sadeh

Sharkey

K. M.

Carskadon

M. A.

(1994). Activity-based sleep-wake identification: An empirical test of methodological issues. Sleep, 17, 201–207.

44.

Schaefer

C. E.

(1990). Night waking and temperament in early childhood. Psychological Reports, 67, 192–194.

45.

Scher

Hall

W. A.

Zaidman-Zait

Weinberg

(2010). Sleep quality, cortisol levels, and behavioral regulation in toddlers. Developmental Psychobiology, 52, 44–53. doi:10.1002/dev.20410

46.

Schwartz

R. P.

Hamre

Dietz

W. H.

Wasserman

R. C.

Slora

E. J.

Myers

E. F.

… Resnicow

K. A.

(2007). Office-based motivational interviewing to prevent childhood obesity: A feasibility study. Archives of Pediatrics & Adolescent Medicine, 161, 495–501.

47.

Smaldone

Honig

J. C.

Byrne

M. W.

(2007). Sleepless in America: Inadequate sleep and relationships to health and well-being of our nation's children. Pediatrics, 119, S29–37.

48.

Snell

E. K.

Adam

E. K.

Duncan

G. J.

(2007). Sleep and the body mass index and overweight status of children and adolescents. Child Develpment, 78, 309–323.

49.

Stein

M. A.

Mendelsohn

Obermeyer

W. H.

Amromin

Benca

(2001). Sleep and behavior problems in school-aged children. Pediatrics, 107, E60.

50.

Suarez

Mullins

(2008). Motivational interviewing and pediatric health behavior interventions. Journal of Developmental and Behavioral Pediatrics: JDBP, 29, 417–428. doi:10.1097/DBP.0b013e31818888b4

51.

Taveras

E. M.

Mitchell

Gortmaker

S. L.

(2009). Parental confidence in making overweight-related behavior changes. Pediatrics, 124, 151–158. doi:124/1/151 [pii]10.1542/peds.2008-2892

52.

Van Cauter

Spiegel

Tasali

Leproult

(2008). Metabolic consequences of sleep and sleep loss. Sleep Medicine 9, S23–S28.

53.

Walker

M. P.

van der Helm

(2009). Overnight therapy? The role of sleep in emotional brain processing. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review]. Psychological bulletin, 135, 731–748. doi:10.1037/a0016570

54.

Ward

T. M.

Gay

Anders

T. F.

Alkon

Lee

K. A.

(2008). Sleep and napping patterns in 3-to-5-year old children attending full-day childcare centers. Journal of Pediatric Psychology, 33, 666–672. doi:jsm102 [pii]10.1093/jpepsy/jsm102

55.

Ward

T. M.

Lentz

Kieckhefer

G. M.

Landis

C. A.

(2012). Polysomnography and actigraphy concordance in juvenile idiopathic arthritis, asthma and healthy children. [Comparative Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't]. Journal of Sleep Research, 21, 113–121. doi:10.1111/j.1365-2869.2011.00923.x

56.

Willgerodt

M. A.

Kieckhefer

G. M.

(2012). School nurses can address existing gaps in school-age sleep research. The Journal of School Nursing. doi: 10.1177/1059840512463438

57.

Williams

M. V.

Davis

Parker

R. M.

Weiss

B. D.

(2002). The role of health literacy in patient-physician communication. [Review]. Family Medicine, 34, 383–389.