Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-05-12T11:59:10.764Z Has data issue: false hasContentIssue false

Sleep problems and associations with psychopathology and cognition in young people with 22q11.2 deletion syndrome (22q11.2DS)

Published online by Cambridge University Press:  30 May 2019

H. A. Moulding
Affiliation:
MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
U. Bartsch
Affiliation:
School Physiology, Pharmacology & Neuroscience, University of Bristol, Biomedical Sciences Building, University Walk, BS8 1TD, UK Lilly UK, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
J. Hall
Affiliation:
MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
M. W. Jones
Affiliation:
School Physiology, Pharmacology & Neuroscience, University of Bristol, Biomedical Sciences Building, University Walk, BS8 1TD, UK
D. E. Linden
Affiliation:
MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK Cardiff University Brain Research Imaging Centre, Maindy Road, Cardiff, CF24 4HQ, UK
M. J. Owen
Affiliation:
MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
M. B. M. van den Bree*
Affiliation:
MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
*
Author for correspondence: M. B. M. van den Bree, E-mail: vandenBreeMB@cardiff.ac.uk

Abstract

Background

Young people with 22q11.2 deletion syndrome (22q11.2DS) are at high risk for neurodevelopmental disorders. Sleep problems may play a role in this risk but their prevalence, nature and links to psychopathology and cognitive function remain undescribed in this population.

Method

Sleep problems, psychopathology, developmental coordination and cognitive function were assessed in 140 young people with 22q11.2DS (mean age = 10.1, s.d. = 2.46) and 65 unaffected sibling controls (mean age = 10.8, s.d.SD = 2.26). Primary carers completed questionnaires screening for the children's developmental coordination and autism spectrum disorder.

Results

Sleep problems were identified in 60% of young people with 22q11.2DS compared to 23% of sibling controls (OR 5.00, p < 0.001). Two patterns best-described sleep problems in 22q11.2DS: restless sleep and insomnia. Restless sleep was linked to increased ADHD symptoms (OR 1.16, p < 0.001) and impaired executive function (OR 0.975, p = 0.013). Both patterns were associated with elevated symptoms of anxiety disorder (restless sleep: OR 1.10, p = 0.006 and insomnia: OR 1.07, p = 0.045) and developmental coordination disorder (OR 0.968, p = 0.0023, and OR 0.955, p = 0.009). The insomnia pattern was also linked to elevated conduct disorder symptoms (OR 1.53, p = 0.020).

Conclusions

Clinicians and carers should be aware that sleep problems are common in 22q11.2DS and index psychiatric risk, cognitive deficits and motor coordination problems. Future studies should explore the physiology of sleep and the links with the neurodevelopment in these young people.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Accardo, JA and Malow, BA (2014) Sleep, epilepsy, and autism. Epilepsy Behaviour 47, 202206.CrossRefGoogle ScholarPubMed
Andrade, DM, Krings, T, Chow, EWC, Kiehl, T-R and Bassett, AS (2013) Hippocampal malrotation is associated with chromosome 22q11.2 microdeletion. The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques 40, 652656.10.1017/S0317167100014876CrossRefGoogle ScholarPubMed
Angold, A, Prendergast, M, Cox, A, Harrington, R, Simonoff, E and Rutter, M (1995) The child and adolescent psychiatric assessment (CAPA). Psychological Medicine 25, 739753.CrossRefGoogle Scholar
Barnett, AL and Wiggs, L (2012) Sleep behaviour in children with developmental co-ordination disorder. Child Care Health and Development 38, 403411.10.1111/j.1365-2214.2011.01260.xCrossRefGoogle ScholarPubMed
Bassell, JL, Phan, H, Leu, R, Kronk, R and Visootsak, J (2015) Sleep profiles in children with down syndrome. American Journal of Medical Genetics. Part A 167A, 18301835.10.1002/ajmg.a.37096CrossRefGoogle ScholarPubMed
Bélanger, L, Morin, CM, Langlois, F and Ladouceur, R (2004) Insomnia and generalized anxiety disorder. Journal of Anxiety Disorders 18, 561571.10.1016/S0887-6185(03)00031-8CrossRefGoogle ScholarPubMed
Benca, RM, Okawa, M, Uchiyama, M, Ozaki, S, Nakajima, T, Shibui, K and Obermeyer, WH (1997) Sleep and mood disorders. Sleep Medicine Reviews 1, 4556.10.1016/S1087-0792(97)90005-8CrossRefGoogle ScholarPubMed
Benjamini, Y and Hochberg, Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society. Series B Methodological 57, 289300. doi: 10.2307/2346101.Google Scholar
Berument, SK, Rutter, M, Lord, C, Pickles, A and Bailey, A (1999) Autism screening questionnaire: diagnostic validity. The British Journal of Psychiatry: The Journal of Mental Science 175, 444451.10.1192/bjp.175.5.444CrossRefGoogle ScholarPubMed
Cambridge Cognition Ltd (2006) CANTAB Eclipse Test Administration Guide. Cambridge Cognition Limited.Google Scholar
Chang, SJ and Chae, KY (2010) Obstructive sleep apnea syndrome in children: epidemiology, pathophysiology, diagnosis and sequelae. Korean Journal of Pediatrics 53, 863871.10.3345/kjp.2010.53.10.863CrossRefGoogle ScholarPubMed
Chawner, SJRA, Doherty, JL, Moss, H, Niarchou, M, Walters, JTR, Owen, MJ and van den Bree, MBM (2017) Childhood cognitive development in 22q11.2 deletion syndrome: case-control study. The British Journal of Psychiatry 211, 223230.CrossRefGoogle ScholarPubMed
Chervin, RD, Dillon, JE, Bassetti, C, Ganoczy, DA and Pituch, KJ (1997) Symptoms of sleep disorders, inattention, and hyperactivity in children. Sleep 20, 11851192.10.1093/sleep/20.12.1185CrossRefGoogle ScholarPubMed
Chervin, RD, Archbold, KH, Dillon, JE, Pituch, KJ, Panahi, P, Dahl, RE and Guilleminault, C (2002) Associations between symptoms of inattention, hyperactivity, restless legs, and periodic leg movements. Sleep 25, 213218.Google ScholarPubMed
Chorney, DB, Detweiler, MF, Morris, TL and Kuhn, BR (2007) The interplay of sleep disturbance, anxiety, and depression in children. Journal of Pediatric Psychology 33, 339348.CrossRefGoogle ScholarPubMed
Cohen, S, Conduit, R, Lockley, SW, Rajaratnam, SMW and Cornish, KM (2014) The relationship between sleep and behavior in autism spectrum disorder (ASD): a review. Journal of Neurodevelopmental Disorders 6, 44.10.1186/1866-1955-6-44CrossRefGoogle ScholarPubMed
Conway, JM and Huffcutt, AI (2003) A review and evaluation of exploratory factor analysis practices in organizational research. Organizational Research Methods 6, 147168.10.1177/1094428103251541CrossRefGoogle Scholar
Corkum, P, Tannock, R and Moldofsky, H (1998) Sleep disturbances in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry 37, 637646.10.1097/00004583-199806000-00014CrossRefGoogle ScholarPubMed
Crockett, DJ, Goudy, SL, Chinnadurai, S and Wootten, CT (2014) Obstructive sleep apnea syndrome in children with 22q11.2 deletion syndrome after operative intervention for velopharyngeal insufficiency. Frontiers in Pediatrics 2, 84.10.3389/fped.2014.00084CrossRefGoogle ScholarPubMed
Cunningham, AC, Delport, S, Cumines, W, Busse, M, Linden, DEJ, Hall, J, Owen, MJ and van den Bree, MBM (2017) Developmental coordination disorder, psychopathology and IQ in 22q11.2 deletion syndrome. The British Journal of Psychiatry 212, 2733.10.1192/bjp.2017.6CrossRefGoogle Scholar
De Leersnyder, H, de Blois, M-CC, Claustrat, B, Romana, S, Albrecht, U, Von Kleist-Retzow, J-CC, Delobel, B, Viot, G, Lyonnet, S, Vekemans, M and Munnich, A (2001) Inversion of the circadian rhythm of melatonin in the Smith-Magenis syndrome. Journal of Pediatrics 139, 111116.CrossRefGoogle ScholarPubMed
Eastabrook, S, Krupa, T, Horgan, S, Gerber, G, Grant, R, Mayo, J, Leeder, M and Stiemerling, N (2003) Substance abuse in a Canadian population of assertive community treatment (ACT). Clients: implications for service planning and delivery. Canadian Journal of Nursing Research 35, 4451.Google Scholar
Etherington, N, McDougall, J, DeWit, D and Wright, V (2016) Maternal factors and the emotional and behavioural functioning of adolescents with chronic health conditions. Disability and Rehabilitation 38, 13591369.CrossRefGoogle ScholarPubMed
Ferrarelli, F, Huber, R, Peterson, MJ, Massimini, M, Murphy, M, Riedner, BA, Watson, A, Bria, P and Tononi, G (2007) Reduced sleep spindle activity in schizophrenia patients. American Journal of Psychiatry 164, 483492.10.1176/ajp.2007.164.3.483CrossRefGoogle ScholarPubMed
Flahault, A, Schaer, M, Ottet, M-C, Debbané, M and Eliez, S (2012) Hippocampal volume reduction in chromosome 22q11.2 deletion syndrome (22q11.2DS): a longitudinal study of morphometry and symptomatology. Psychiatry Research: Neuroimaging 203, 15.CrossRefGoogle ScholarPubMed
Gorsuch, RL (1983) Factor Analysis, 2nd Edn. Edited by Routledge Classic Editions. Lawrence Erlbaum: Brighton & Hove.Google Scholar
Gozal, D, Shata, A, Nakayama, M and Spruyt, K (2011) Seasonal variability of sleep-disordered breathing in children. Pediatric Pulmonology 46, 581586.CrossRefGoogle ScholarPubMed
Heaton, RK, Chelune, GJ, Talley, JL, Kay, GG and Curtiss, G (1993) Wisconsin Card Sorting Test Manual: Revised and Expanded. Odessa, FL: Psychological Assessment Resources.Google Scholar
Heike, CL, Avellino, AM, Mirza, SK, Kifle, Y, Perkins, J, Sze, R, Egbert, M and Hing, AV (2007) Sleep disturbances in 22q11.2 deletion syndrome: a case with obstructive and central sleep apnea. Cleft Palate Craniofacial Journal 44, 340346.CrossRefGoogle ScholarPubMed
Hiscock, H, Sciberras, E, Mensah, F, Gerner, B, Efron, D, Khano, S and Oberklaid, F (2015) Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial. British Medical Journal 350, h68.10.1136/bmj.h68CrossRefGoogle ScholarPubMed
Hooper, SR, Curtiss, K, Schoch, K, Keshavan, MS, Allen, A and Shashi, V (2013) A longitudinal examination of the psychoeducational, neurocognitive, and psychiatric functioning in children with 22q11.2 deletion syndrome. Research in Developmental Disabilities 34, 17581769.10.1016/j.ridd.2012.12.003CrossRefGoogle ScholarPubMed
Ivanenko, A, Crabtree, VM, Tauman, R and Gozal, D (2003) Melatonin in children and adolescents with insomnia: a retrospective study. Clinical Pediatrics 42, 5158.10.1177/000992280304200108CrossRefGoogle ScholarPubMed
Johnson, KP and Malow, BA (2008) Sleep in children with autism spectrum disorders. Current Neurology and Neuroscience Reports 8, 155161.CrossRefGoogle ScholarPubMed
Kennedy, WP, Mudd, PA, Maguire, MA, Souders, MC, McDonald-McGinn, DM, Marcus, CL, Zackai, EH, Solot, CB, Mason, TB, Jackson, OA and Elden, LM (2014) 22q11.2 Deletion syndrome and obstructive sleep apnea. International Journal of Pediatric Otorhinolaryngolgy 78, 13601364.CrossRefGoogle ScholarPubMed
Kotagal, S and Pianosi, P (2006) Sleep disorders in children and adolescents. British Medical Journal 332, 828832.CrossRefGoogle ScholarPubMed
Ledesma, RD, Macbeth, G and Valero-Mora, P (2011) Software for Computing the Tetrachoric Correlation Coefficient. Revista Latinoamericana de Psicología 43, 181189. Available at http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-05342011000100015 (Accessed 2 October 2018).Google Scholar
Lycett, K, Sciberras, E, Mensah, FK and Hiscock, H (2015) Behavioral sleep problems and internalizing and externalizing comorbidities in children with attention-deficit/hyperactivity disorder. European Child and Adolescent Psychiatry 24, 3140.CrossRefGoogle ScholarPubMed
Maddox, WT, Glass, BD, Wolosin, SM, Savarie, ZR, Bowen, C, Matthews, MD and Schnyer, DM (2009) The effects of sleep deprivation on information-integration categorization performance. Sleep 32, 14391448.CrossRefGoogle ScholarPubMed
Malow, BA, Katz, T, Reynolds, AM, Shui, A, Carno, M, Connolly, HV, Coury, D and Bennett, AE (2016) Sleep difficulties and medications in children with autism spectrum disorders: a registry study. Pediatrics 137(Suppl 2), S98S104.CrossRefGoogle ScholarPubMed
McDonald-McGinn, DM, Tonnesen, MK, Laufer-Cahana, A, Finucane, B, Driscoll, DA, Emanuel, BS and Zackai, EH (2001) Phenotype of the 22q11.2 deletion in individuals identified through an affected relative: cast a wide FISHing net! Genetic Medicine 3, 2329.CrossRefGoogle Scholar
Monks, S, Niarchou, M, Davies, AR, Walters, JTRR, Williams, N, Owen, MJ, van den Bree, MBMM and Murphy, KC (2014) Further evidence for high rates of schizophrenia in 22q11.2 deletion syndrome. Schizophrenia Research 153, 231236.CrossRefGoogle ScholarPubMed
Muzur, A, Pace-Schott, EF and Hobson, JA (2002) The prefrontal cortex in sleep. Trends in Cognitive Sciences 6, 475481.CrossRefGoogle ScholarPubMed
Niarchou, M, Zammit, S, van Goozen, SHM, Thapar, A, Tierling, HMLM, Owen, MJ and van den Bree, MBM (2014) Psychopathology and cognition in children with 22q11.2 deletion syndrome. British Journal of Psychiatry 204, 4654.10.1192/bjp.bp.113.132324CrossRefGoogle ScholarPubMed
Niarchou, M, Calkins, ME, Moore, TM, Tang, SX, McDonald-McGinn, DM, Zackai, EH, Emanuel, BS, Gur, RC and Gur, RE (2018) Attention deficit hyperactivity disorder symptoms and psychosis in 22q11.2 deletion syndrome. Schizophrenia Bulletin 44, 824833.CrossRefGoogle ScholarPubMed
Owens, JA and Mindell, JA (2011) Pediatric insomnia. Pediatric Clinics of North America 58, 555569.10.1016/j.pcl.2011.03.011CrossRefGoogle ScholarPubMed
Papadopoulos, N, Sciberras, E, Hiscock, H, Mulraney, M, McGillivray, J and Rinehart, N (2015) The efficacy of a brief behavioral sleep intervention in school-aged children with ADHD and comorbid autism spectrum disorder. Journal of Attention Disorders 23, 341350.10.1177/1087054714568565CrossRefGoogle ScholarPubMed
Pearson, ES (1900) Student’: A Statistical Biography of William Sealy Gosset. Oxford: Clarendon Press. Available at http://www.buttelake.com/corr.htm#chisq (accessed 2 October 2018).Google Scholar
Pritchett, D, Wulff, K, Oliver, PL, Bannerman, DM, Davies, KE, Harrison, PJ, Peirson, SN and Foster, RG (2012) Evaluating the links between schizophrenia and sleep and circadian rhythm disruption. Journal of Neural Transmission 119, 10611075.CrossRefGoogle ScholarPubMed
R: The R Project for Statistical Computing (2018) Available at https://www.r-project.org/ (accessed 9 May 2018).Google Scholar
Reynolds, AM and Malow, BA (2011) Sleep and autism spectrum disorders. Pediatric Clinics of North America 58, 685698.10.1016/j.pcl.2011.03.009CrossRefGoogle ScholarPubMed
Robinson-Shelton, A and Malow, BA (2016) Sleep disturbances in neurodevelopmental disorders. Current Psychiatry Reports 18, 6.CrossRefGoogle ScholarPubMed
Rutter, M, Bailey, A and Lord, C (2003) The Social Communication Questionnaire – Manual. Los Angeles, CA: Western Psychological Services.Google Scholar
Rydell, A-M (2010) Family factors and children's disruptive behaviour: an investigation of links between demographic characteristics, negative life events and symptoms of ODD and ADHD. Social Psychiatry and Psychiatric Epidemiology 45, 233244.10.1007/s00127-009-0060-2CrossRefGoogle ScholarPubMed
Saletu, B, Anderer, P, Saletu, M, Hauer, C, Lindeck-Pozza, L and Saletu-Zyhlarz, G (2002) EEG mapping, psychometric, and polysomnographic studies in restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) patients as compared with normal controls. Sleep Medicine 3(Suppl), S35S42.CrossRefGoogle ScholarPubMed
Schneider, M, Debbané, M, Bassett, AS, Chow, EWC, Fung, WLA, van den Bree, MBM, Owen, M, Murphy, KC, Niarchou, M, Kates, WR, Antshel, KM, Fremont, W, McDonald-McGinn, DM, Gur, RE, Zackai, EH, Vorstman, J, Duijff, SN, Klaassen, PW, Swillen, A, Gothelf, D, Green, T, Weizman, A, Van Amelsvoort, T, Evers, L, Boot, E, Shashi, V, Hooper, SR, Bearden, CE, Jalbrzikowski, M, Armando, M, Vicari, S, Murphy, DG, Ousley, O, Campbell, LE, Simon, TJ and Eliez, S, International Consortium on Brain and Behavior in 22q11.2 Deletion, Syndrome (2014) Psychiatric disorders from childhood to adulthood in 22q11.2 deletion syndrome: results from the international consortium on brain and behavior in 22q11.2 deletion syndrome. American Journal of Psychiatry 171, 627639.CrossRefGoogle Scholar
Scott, JA, Goodrich-Hunsaker, N, Kalish, K, Lee, A, Hunsaker, MR, Schumann, CM, Carmichael, OT and Simon, TJ (2016) The hippocampi of children with chromosome 22q11.2 deletion syndrome have localized anterior alterations that predict severity of anxiety. Journal of Psychiatry & Neuroscience: JPN 41, 203213.10.1503/jpn.140299CrossRefGoogle ScholarPubMed
Souders, MC, Mason, TBA, Valladares, O, Bucan, M, Levy, SE, Mandell, DS, Weaver, TE, Pinto-Martin, J, Hargrave, D, Smith, L and Gibson, F (2009) Sleep behaviors and sleep quality in children with autism spectrum disorders. Sleep 32, 15661578.CrossRefGoogle ScholarPubMed
Spruyt, K and Gozal, D (2011) Sleep disturbances in children with attention-deficit/hyperactivity disorder. Expert Review of Neurotherapeutics 11, 565577.CrossRefGoogle ScholarPubMed
Staner, L (2003) Sleep and anxiety disorders. Dialogues in Clinical Neuroscience 5, 249258.Google ScholarPubMed
Sun, D, Ching, CRK, Lin, A, Forsyth, JK, Kushan, L, Vajdi, A, Jalbrzikowski, M, Hansen, L, Villalon-Reina, JE, Qu, X, Jonas, RK, van Amelsvoort, T, Bakker, G, Kates, WR, Antshel, KM, Fremont, W, Campbell, LE, McCabe, KL, Daly, E, Gudbrandsen, M, Murphy, CM, Murphy, D, Craig, M, Vorstman, J, Fiksinski, A, Koops, S, Ruparel, K, Roalf, DR, Gur, RE, Schmitt, JE, Simon, TJ, Goodrich-Hunsaker, NJ, Durdle, CA, Bassett, AS, Chow, EWC, Butcher, NJ, Vila-Rodriguez, F, Doherty, J, Cunningham, A, van den Bree, MBM, Linden, DEJ, Moss, H, Owen, MJ, Murphy, KC, McDonald-McGinn, DM, Emanuel, B, van Erp, TGM, Turner, JA, Thompson, PM and Bearden, CE (2018) Large-scale mapping of cortical alterations in 22q11.2 deletion syndrome: convergence with idiopathic psychosis and effects of deletion size. Molecular Psychiatry. doi: 10.1038/s41380-018-0078-5.Google ScholarPubMed
Swillen, A and McDonald-McGinn, D (2015) Developmental trajectories in 22q11.2 deletion. American Journal of Medical Genetics Part C: Seminars in Medical Genetics 169, 172181.10.1002/ajmg.c.31435CrossRefGoogle ScholarPubMed
Trickett, J, Alba, G, Richards, C and Oliver, C (2017) Sleep: A Guide for Parents – Cerebra. Available at http://www.cerebra.org.uk/help-and-information/guides-for-parents/sleep-a-guide-for-parents/ (Accessed 26 June 2018).Google Scholar
Trickett, J, Heald, M, Oliver, C and Richards, C (2018) A cross-syndrome cohort comparison of sleep disturbance in children with Smith-Magenis syndrome, Angelman syndrome, autism spectrum disorder and tuberous sclerosis complex. Journal of Neurodevelopmental Disorders 10, 9.10.1186/s11689-018-9226-0CrossRefGoogle ScholarPubMed
Turnbull, K, Reid, GJ and Morton, JB (2013) Behavioral sleep problems and their potential impact on developing executive function in children. Sleep 36, 10771084.CrossRefGoogle ScholarPubMed
Vergaelen, E, Claes, S, Kempke, S and Swillen, A (2017) High prevalence of fatigue in adults with a 22q11.2 deletion syndrome. American Journal of Medical Genetics Part A 173, 858867.CrossRefGoogle ScholarPubMed
Vriend, J and Corkum, P (2011) Clinical management of behavioral insomnia of childhood. Psychology Research and Behavior Management 4, 6979.Google ScholarPubMed
Wechsler, D (1999) Wechsler Abbreviated Scale of Intelligence. San Antonio, Texas: Psychological Corporation.Google Scholar
Wiggs, L (2001) Sleep problems in children with developmental disorders. Journal of the Royal Society of Medicine 94, 177179.CrossRefGoogle ScholarPubMed
Wiggs, L, Montgomery, P and Stores, G (2005) Actigraphic and parent reports of sleep patterns and sleep disorders in children with subtypes of attention-deficit hyperactivity disorder. Sleep 28, 14371445.CrossRefGoogle ScholarPubMed
Wiggs, L, Sparrowhawk, M and Barnett, AL (2016) Parent report and actigraphically defined sleep in children with and without developmental coordination disorder; links with fatigue and sleepiness. Frontiers in Pediatrics 4, 81.10.3389/fped.2016.00081CrossRefGoogle ScholarPubMed
Williams, CA, Beaudet, AL, Clayton-Smith, J, Knoll, JH, Kyllerman, M, Laan, LA, Magenis, RE, Moncla, A, Schinzel, AA, Summers, JA, Clayton-Smith, J, Knoll, JH, Kyllerman, M, Laan, LA, Magenis, RE, Moncla, A, Schinzel, AA, Summers, JA and Wagstaff, J (2006) Angelman syndrome 2005: updated consensus for diagnostic criteria. American Journal of Medical Genetics 140, 413418.CrossRefGoogle ScholarPubMed
Wilson, BN, Kaplan, BJ, Crawford, SG, Campbell, A and Dewey, D (2009) Reliability and validity of a parent questionnaire on childhood motor skills. The American Journal of Occupational Therapy 54, 484493.CrossRefGoogle Scholar
Wulff, K, Dijk, D-JJ, Middleton, B, Foster, RG and Joyce, EM (2012) Sleep and circadian rhythm disruption in schizophrenia. British Journal of Psychiatry 200, 308316.10.1192/bjp.bp.111.096321CrossRefGoogle Scholar
Supplementary material: File

Moulding et al. supplementary material

Tables S1-S3 and Figures S1-S2

Download Moulding et al. supplementary material(File)
File 83 KB