Papers by Dagmara Dimitriou
PloS one, Mar 20, 2024
Background Childhood experiences either adverse (ACE) or benevolent (BCE) can indirectly impact s... more Background Childhood experiences either adverse (ACE) or benevolent (BCE) can indirectly impact sleep quality in adult life, which in turn are modulated by the interplay of a variety of factors such as depression, anxiety, resilience and mental health problems. Methods A cross-sectional observational study was conducted across the UK and the Middle Eastern countries during the COVID-pandemic on 405 participants. An online survey used a combination of questionnaires to assess ACE and BCEs. The following tools were then used to assess the contribution of resilience, stress, depression and anxiety respectively: Brief Resilience Scale (BRS), Perceived Stress Scale (PSS-10), Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorder-2 (GAD-2) scale on childhood experiences. The extent of sleep disturbances experienced over a period of seven days was assessed using the PROMIS Sleep Disturbance Short-Form Tool. A serial-parallel mediation model was used to evaluate the impact of the mediators on childhood experiences and sleep quality. Results Over 50% of the cohort were from Middle Eastern countries. Four or more BCEs were experienced by 94.3% of the cohort. In contrast, 67.9% of participants experienced at least one ACE before the age of 18 years, with moderate levels of stress, mild depression and anxiety were reported in 3.7%, 13% and 20% of participants respectively. Whilst 25.4% of participants reported having had four or more ACEs, with higher reports in the middle easter
Sleep Medicine, Dec 1, 2019
Research in Developmental Disabilities, Sep 1, 2022
school (aged 5e6), and performance on standardised tests in the 3rd year of school (aged 7e9). Co... more school (aged 5e6), and performance on standardised tests in the 3rd year of school (aged 7e9). Cox proportional hazards and modified Poisson regression models were used to calculate hazard and risk ratios for outcomes in children exposed to maternal apnoea compared to those not exposed. Results: 209 of 626,188 singleton infants were exposed to maternal sleep apnoea. Maternal apnoea was not significantly associated with mortality (Fisher's exact p¼0.48), developmental vulnerability (adjusted RR 1.29; 95% CI 0.75e2.21), special needs status (1.58; 0.61e4.07), or low numeracy test scores (1.03; 0.63e1.67) but was associated with low reading test scores (1.55; 1.08e2.23). Maternal apnoea significantly increased hospitalisations in the 1st year of life (adjusted HR 1.81; 95% CI 1.40e2.34) and between the 1st and 6th birthdays (1.41; 1.14e1.75). This is partly due to admissions for suspected paediatric sleep apnoea. Conclusions: Maternal sleep apnoea during pregnancy is associated with poorer childhood health. Its impact on developmental and cognitive outcomes warrants further investigation. Acknowledgements: This research was supported by the use of population data from the Australian Government Department of Education and Training and the New South Wales Ministry of Health. Data linkage was conducted by the Centre for Health Record Linkage (CHeReL). The findings and views reported in this article are those of the authors and should not be attributed to any of these departments.
Advances in Child Development and Behavior, 2021
This chapter addresses sleep research challenges for the study of neurodevelopmental disorders dr... more This chapter addresses sleep research challenges for the study of neurodevelopmental disorders drawing upon two disorders such as Down Syndrome and Williams syndrome. General sleep problems are outlined here, however particular consideration is given to the syndrome-specific issues or challenges that may be crucial to advancing our understanding of sleep-related cognitive and behavioral issues.
Frontiers in Psychiatry, Sep 21, 2021
Background: The longer-term impact of the pandemic on autistic adults' sleep are yet to be reveal... more Background: The longer-term impact of the pandemic on autistic adults' sleep are yet to be revealed, with studies concentrating on sleep in autistic children or mental health outcomes and coping strategies of autistic adults. Given the prevalence of sleep problems experienced by autistic adults and the changes in routine that have occurred as a result of COVID-19 societal restrictions, this study assessed the impact of the COVID-19 pandemic on sleep problems via a longitudinal subjective assessment method. Methods: Sleep data were gathered at three time points from 95 autistic adults, namely prior to the pandemic, at the start of COVID-19 and several months into COVID-19 to obtain a rich longitudinal dataset ascertaining how/if sleep patterns have changed in autistic adults over these several months. Results: In comparison to pre-lockdown, several sleep components were shown to improve during the lockdown. These improvements included reduced sleep latency (time taken to fall asleep), longer sleep duration, improved sleep efficiency, improved sleep quality, as well as improved daytime functioning. Pre-sleep cognitive arousal scores were found to decrease compared to pre-lockdown, meaning cognitive arousal improved. Approximately 65% of participants reported that they felt their sleep had been impacted since COVID-19 since Time 1, with the most common reasons reported as waking up exhausted (36.92%), not being able to get to sleep (33.85%), waking up in the night (29.23%), having a disrupted sleep pattern (27.69%), and nightmares (18.46%). Conclusions: Improvements in sleep may be related to societal changes (e.g., working from home) during the pandemic. Some of these changes are arguably beneficial for autistic adults in creating a more autism-inclusive society, for example telehealth opportunities for care. Further exploration of the associations between mental health and sleep are warranted.
Autism, May 9, 2021
Sleep problems are one of the most common complaints in autistic adults. This study aimed to repo... more Sleep problems are one of the most common complaints in autistic adults. This study aimed to report the perspectives of autistic adults in the United Kingdom on treatment of their sleep problems. A total of 288 autistic adults living in the United Kingdom completed an online survey including assessments of their sleep quality using the Pittsburgh Sleep Quality Index, reporting their experiences and preferences of sleep treatment with UK healthcare professionals and, their experiences of self-management of their sleep. Self-report data revealed 58% of participants had not attended a consultation with a healthcare professional regarding their sleep problem despite 90% meeting the criteria for poor sleep quality (based on the Pittsburgh Sleep Quality Index). Of the participants who attended a consultation for their sleep, 72% were prescribed medication and 60% were not satisfied with the outcome. Self-management of sleep problems was not effective for 80% of participants; 41% reported a preference for non-medication options such as education, advice and talking therapies for sleep treatment. This report highlights the need for a fundamental shift in the consideration of sleep problems in autistic adults given the high levels of co-morbidity. The development of successful management strategies in adulthood that importantly considering autistic adults' preferences could reduce sleep problems and overall improve quality of life for autistic adults. Long term this could also reduce the need for prescribed medication in this population. Lay abstract Sleep problems are one of the most common complaints by autistic adults. This study aimed to report the perspectives of autistic adults on treatment of their sleep problems; 288 autistic adults living in the United Kingdom completed an online survey which assessed their sleep quality. We also gathered data on experiences and preferences of sleep treatment with UK healthcare professionals and their experiences of self-management of their sleep; 58% of autistic adults never had a visit with a healthcare professional regarding their sleep problem, despite 90% meeting the criteria for poor sleep quality. Some of those who attended a consultation for their sleep were prescribed medication (72%), but 60% were not satisfied with the outcome. The participants also reported that sleep self-management was not effective (80%); 41% reported a preference for non-medication including education, advice and talking therapies for sleep treatment. This report highlights the need for a fundamental shift in treatment of sleep problems in autistic adults. The current treatments are not resolving sleep issues; hence, it is imperative to develop management strategies that considers autistic adults' preferences, reduces sleep problems and thus improves quality of life for autistic adults.
International Journal of Environmental Research and Public Health, Feb 19, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Sleep Medicine, Dec 1, 2017
school (aged 5e6), and performance on standardised tests in the 3rd year of school (aged 7e9). Co... more school (aged 5e6), and performance on standardised tests in the 3rd year of school (aged 7e9). Cox proportional hazards and modified Poisson regression models were used to calculate hazard and risk ratios for outcomes in children exposed to maternal apnoea compared to those not exposed. Results: 209 of 626,188 singleton infants were exposed to maternal sleep apnoea. Maternal apnoea was not significantly associated with mortality (Fisher's exact p¼0.48), developmental vulnerability (adjusted RR 1.29; 95% CI 0.75e2.21), special needs status (1.58; 0.61e4.07), or low numeracy test scores (1.03; 0.63e1.67) but was associated with low reading test scores (1.55; 1.08e2.23). Maternal apnoea significantly increased hospitalisations in the 1st year of life (adjusted HR 1.81; 95% CI 1.40e2.34) and between the 1st and 6th birthdays (1.41; 1.14e1.75). This is partly due to admissions for suspected paediatric sleep apnoea. Conclusions: Maternal sleep apnoea during pregnancy is associated with poorer childhood health. Its impact on developmental and cognitive outcomes warrants further investigation. Acknowledgements: This research was supported by the use of population data from the Australian Government Department of Education and Training and the New South Wales Ministry of Health. Data linkage was conducted by the Centre for Health Record Linkage (CHeReL). The findings and views reported in this article are those of the authors and should not be attributed to any of these departments.
Healthcare, Apr 1, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
International Journal of Environmental Research and Public Health, Sep 4, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Healthcare, Jul 25, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Children with Fetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD) experie... more Children with Fetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD) experience significantly higher rates of sleep disturbances than their typically developing peers. Pre-sleep anxiety and waking emotional content is known to affect the content and frequency of nightmares, which can be distressing to children and caregivers. This is the first study to analyse nightmare frequency and content in FASD, and to assess its association with psychometric outcomes. We assessed reports from 277 caregivers of children with ASD (n=61), FASD (n=112), and TD children (n=104) using the Children's Sleep Habits Questionnaire (CSHQ), the Child Behavior Checklist (CBCL), the Spence Children's Anxiety Scale (SCAS) and the Behavior Rating Inventory for Executive Functioning (BRIEF). Within the ASD group, 40.3% of caregivers reported their children had nightmares. Within the FASD group, 73.62% of caregivers reported their children had nightmares and within the TD group, 21.36% of caregivers reported their children had nightmares. Correlation analysis revealed significant associations between anxiety and nightmares, maladaptive behaviour and nightmares, and executive functioning and nightmares in the TD and FASD groups, but not ASD group. This paper adds to the emerging body of work supporting the need for sleep interventions as part of clinical practice with regard to children with ASD and FASD. As a relatively niche but important area of study this warrants much needed further research.
Genes, Sep 14, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Cancers, Jul 4, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Behavioral sciences, May 24, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
medRxiv (Cold Spring Harbor Laboratory), Dec 4, 2020
Background: Children with intellectual and developmental difficulties often experience 2 sleep pr... more Background: Children with intellectual and developmental difficulties often experience 2 sleep problems, which in turn may impact parental sleep patterns. This study explored the role of parental sleep knowledge as a moderator on the relationship between child sleep and parental sleep impairment. Methods: 582 parents or caregivers (92.6% mothers) of children with different developmental disabilities (Age M = 9.34, 29.5 % females) such as Down's syndrome, participated in an online survey. Multiple regression analysis was conducted. Results: Parental sleep knowledge of child sleep was a moderating variable in the relationship between child sleep nocturnal duration and parental sleep impairment. Although overall, sleep knowledge was high in this sample, two specific knowledge gaps were identified namely child sleep duration requirements, and the recognition of signs of a well-rested child. Conclusion: This study has provided evidence that increased parental sleep knowledge can positively impact both child and parental sleep outcomes.
Sleep Medicine, Dec 1, 2017
Applied sciences, Jan 5, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Disabilities, Mar 19, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Acta Psychologica, Sep 1, 2022
Social Media Disorder (SMD) is characterised by the intense and excessive use of social media. Al... more Social Media Disorder (SMD) is characterised by the intense and excessive use of social media. Although previous studies have shown that SMD was associated with poor mental health, research across types of usage and platforms remain limited. Here, we conducted an initial investigation of social media usage across platforms and its relation to anxiety, sleep and loneliness in female adolescents. Forty one 16-to 19-year-old British female adolescents were administered online questionnaires. Intensity of social media activity across Facebook, Instagram, Snapchat and Twitter was measured with the Social Media Disorder Scale. Anxiety was indicated by the Beck Anxiety Inventory Trait, loneliness was examined via a short three-point questionnaire and sleep quality was measured via both the Pittsburgh Sleep Quality Index and self-reported seven-day sleep diaries. Results showed that, compared to those without SMD, users with SMD experienced elevated levels of loneliness and had less sleep on average, and during the weekdays in particular. Only frequency of posting on Facebook, but not general usage, was associated with poorer sleep quality. These preliminary findings showed that social media disorder across platforms and usage could potentially have different associations to mental health and sleep.
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Papers by Dagmara Dimitriou