Sleep disorders in children: The Singapore perspective
Paediatric Respiratory and Sleep Service, Department of Pediatrics, National University Hospital, Singapore.Annals of the Academy of Medicine, Singapore (Impact Factor: 1.15). 09/2008; 37(8):706-9.
This review article summarises the current available literature on sleep patterns and sleep problems in Singapore children. Co-sleeping is a culturally dependent practice and its prevalence in Singapore has been determined to be 73%. Co-sleeping is not associated with significant sleep problems in Singapore children. Snoring and habitual snoring occur in 28.1% and 6.0% of Singapore children, respectively. Habitual snoring in Singapore children was significantly associated with obesity, allergic rhinitis, atopic dermatitis, maternal smoking and breastfeeding. Atopy was the strongest risk factor for habitual snoring in Singapore, and the effect was cumulative. Children attending psychiatric services in Singapore may also have sleep disorders, the highest prevalence being in children with attention deficit hyperactivity disorder. The knowledge on childhood sleep disorders (including obstructive sleep apnoea) amongst the public, patients, parents and future doctors in Singapore are inadequate and there is an urgent need for increased education in this area given the importance of good sleep in children. There is also a need to change parental attitudes about sleep disorders and encourage early medical consultation.
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ABSTRACT: Sleep plays a critical role in children's development. Sleep not only impacts on physical growth, behaviour, and emotional development but also is closely related to cognitive functioning, learning, and attention. Sleep problems that include nightmares, night terrors, sleep talking, sleepwalking, bed-wetting, teeth grinding and snoring are very common in Chinese children. In recent years, there has been improvement in the epidemiology of sleep problems in children of different ages in China. Despite growing research efforts, the aetiology of sleep problems has not been clearly identified. A number of surveys suggest that, in addition to biological determinants of sleep, sleep quality appears to be influenced in part by social, cultural and familial issues. In this review, we focus on assessing cultural aspects of sleep in Chinese children of different ages, especially young children. Particular emphasis is given to sociocultural factors (co-sleeping, transitional objects, child-rearing practices, feeding practices, sleep position) and familial environment that are related to the bedtime behaviour of children.
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ABSTRACT: Allergic rhinitis is among the most common chronic disorders of childhood with prevalence of up to 40% in children. Clara cell secretory protein (CCSP) is secreted by Clara cells in the lining fluid of airways. It has an immune-modulatory and anti-inflammatory activity. Study aimed at evaluating CCSP as a biomarker in serum and nasal lavage fluid of children with allergic rhinitis. A case-control study was conducted on sera and nasal lavage fluid samples from 15 children with allergic rhinitis and 15 healthy children as a control group. Children with allergic rhinitis had a male to female ratio 2 to 1, with a mean age of 9.47±2.75 years, while among the healthy group, six were males and nine were females, with a mean age of 8.63±2.28 years. Rhinorrhea and nasal obstruction were the most frequent symptoms (100%) followed by itching (93.3%) then sneezing (73.3%). Among allergic rhinitis patients serum CCSP mean±SD was 2.03±0.59μg/l; it was reliable to predict allergic rhinitis (P<0.0001); while nasal lavage CCSP mean±SD was 12.73±8.25μg/l and it was not reliable to predict allergic rhinitis. Its best cut-off value was 3.75μg/l with a sensitivity of 100%, specificity 80%, with a diagnostic accuracy of 90%. Clara cell secretory protein is a new peripheral sensitive marker of airway injury. Furthermore, serum CCSP level is a predictor of allergic rhinitis but not nasal lavage fluid CCSP.