Valoración e intervención de enfermería de salud mentalLa alteración del patrón de sueño-descanso en población infanto-juvenil

Abstract

BACKGROUND. Neurodevelopmental and mental health disorders during childhood and adolescence have a high rate of comorbidity with sleep problems, up to 80%. OBJECTIVES. In this research we explore methods for the assessment, detection and management of sleep problems in children. Our goals are the following: 1) to explore the presence of behavioral sleep problems in children, as well as variables related to these, 2) to analyze the validity of the Spanish translation of a brief screening interview for pediatric sleep problems and 3) to design and to evaluate the effect of an educational intervention on behavioral sleep problems in children. METHODS. This research is divided in three sections: In the first section, we explore the relationship between co-sleeping (the practice in which parents and children sleep together, in body contact, during all or part of the night (Cortesi, Giannotti, Sebastiani et al., 2008)) and behavioral sleep problems, such as resistance to bedtime, and frequent nocturnal awakenings, as examples, in a sample of 57 children between 6 - 16 years old (80.7% male) attending a Center for Children's Mental Health, with different neurodevelopmental and/or mental health diagnoses. The information about sleep and co-sleeping was collected through an interview with the parents, followed by the completion of the Pediatric Sleep Questionnaire (PSQ), by Chervin et al. (2000). In the second section, we explore the validity of the Spanish translation of the BEARS interview, by Owens and & Dalzell (2005), for the brief screening of common sleep problems in children. Our sample consisted of 60 children attending a center for children's mental health, between 2 - 16 years old (71.7% male), and with a variety of neurodevelopmental and/or mental health diagnoses. The results obtained with the BEARS interview were compared with scores on the subscales of the Childhood Sleep Habits Questionnaire (CSHQ), by Owens et al. (2000). The third section of this research evaluates the effect of a sleep educational intervention on children's sleep. This brief 45-minute intervention was administered to parents of children with a suspicion of a sleep issue in a group format. In this study, children had a variety of neurodevelopmental and / or mental health diagnoses and attended a center for children's mental health aa CDSM IJ (n = 26, 80.8% male). Dependent variables were obtained from a subset of the PSQ items and were evaluated before and 3 months after the intervention. CONCLUSION. The results of these 3 research studies suggest that (1) co-sleeping is a relatively frequent practice for parents of children with neurodevelopmental disorders and / or mental health disorders, and this practice is related to behavioral-type sleep problems, (2) the Spanish translation of the BEARS interview shows adequate concurrent validity to detect sleep problems in children and (3) a brief sleep educational intervention administered to parents of children with a suspicion of sleep issues is related to improvements on different sleep variables Since sleep problems can interfere with the management of neurodevelopmental and mental disorders, health professionals working in pediatric settings should collect information about the child's sleep, explore their sleep environment and, when necessary, conduct appropriate interventions including educating families about practices that promote a healthy sleep. This work highlights the importance of evaluating and addressing common sleep problems by pediatric nurses, in general, and pediatric nurses working in mental health settings, in particular.