ABSTRACT
Nonpharmacological treatments for insomnia in adolescents with depression are lacking. This qualitative study was a thematic analysis of the unique characteristics of and preferences for an insomnia treatment in a group of depressed adolescents. Fourteen adolescents with insomnia (age range = 14-19, mean = 17, SD ± 1.7; 71% female) and depression completed a 90-min focus group. Information was elicited about sleep disruptions, insomnia's impact on mood, and preferences for insomnia treatments. Themes included poor daytime functioning affecting sleep, lack of benefit from sleep medication, and bedtime rumination. Most identified sleep diaries as a barrier to treatment regardless of mode of delivery. Participants also preferred an in-person therapy. Insomnia therapy in adolescents should consider the unique characteristics of depression. Larger studies are warranted.
Subject(s)
Depression/complications , Depression/therapy , Focus Groups , Patient Preference/psychology , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/therapy , Adolescent , Affect , Depression/psychology , Female , Humans , Male , Motivation , Patient Compliance/psychology , Pilot Projects , Qualitative Research , Sleep , Sleep Initiation and Maintenance Disorders/psychology , Young AdultSubject(s)
Esophageal Achalasia/etiology , Fabry Disease/complications , Adolescent , Esophageal Achalasia/therapy , Humans , MaleABSTRACT
Excessive sleepiness is a common but under-recognized problem in children. This article examines the clinical and laboratory evaluation of sleepiness in children, including the use of polysomnography, the multiple sleep latency test, and other varieties of neurophysiologic testing. Where applicable, technical aspects of laboratory testing are reviewed. Alternative laboratory and neurobehavioral techniques used to investigate daytime sleepiness are also briefly covered.
Subject(s)
Polysomnography/methods , Sleep Wake Disorders/diagnosis , Child , Child, Preschool , Circadian Rhythm , Humans , Neuropsychological Tests , Surveys and QuestionnairesABSTRACT
The effectiveness of lamotrigine as a monotherapeutic agent for a variety of pediatric epilepsies was reviewed retrospectively. Children were categorized as having focal vs generalized epilepsy and according to whether they were antiepileptic drug naive or drug exposed. Data collected included dosages, side effects, length of follow-up, number of prior drugs, and treatment response. Treatment was considered successful if the patient was seizure free for 6 months or more. Eighty-three children were identified (average age = 8.7 years); 43 had focal epilepsy, 32 had generalized epilepsy, and eight were not classified. Twenty-nine patients were classified as having specific syndromes. Fourteen patients were drug naive. The median follow-up period was 8 months (mean = 8.5). Overall, 45% were seizure free, 44% with focal epilepsy and 36% with generalized epilepsy. All children with juvenile myoclonic epilepsy and benign rolandic epilepsy of childhood were seizure free, although not all had been treated for at least 6 months. One third of drug-naive patients were seizure free. Rash was the most common side effect and was reported in five patients (6%); two patients discontinued the drug. None had Stevens-Johnson syndrome. One quarter of children experienced nonquantifiable improvements, namely increased alertness and improved behavior regardless of seizure control. Lamotrigine is effective as a monotherapeutic agent in children for both focal and generalized epilepsies. Side effects are relatively uncommon. Lamotrigine may be an effective firstline agent.
