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Sleep Initiation and Maintenance Disorders: HELP
Articles by Kelly C. Byars
Based on 5 articles published since 2010
(Why 5 articles?)

Between 2010 and 2020, Kelly Byars wrote the following 5 articles about Sleep Initiation and Maintenance Disorders.
+ Citations + Abstracts
1 Guideline A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders. 2012

Malow, Beth A / Byars, Kelly / Johnson, Kyle / Weiss, Shelly / Bernal, Pilar / Goldman, Suzanne E / Panzer, Rebecca / Coury, Daniel L / Glaze, Dan G / Anonymous1500741. ·Departments of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. beth.malow@vanderbilt.edu ·Pediatrics · Pubmed #23118242.

ABSTRACT: OBJECTIVE: This report describes the development of a practice pathway for the identification, evaluation, and management of insomnia in children and adolescents who have autism spectrum disorders (ASDs). METHODS: The Sleep Committee of the Autism Treatment Network (ATN) developed a practice pathway, based on expert consensus, to capture best practices for an overarching approach to insomnia by a general pediatrician, primary care provider, or autism medical specialist, including identification, evaluation, and management. A field test at 4 ATN sites was used to evaluate the pathway. In addition, a systematic literature review and grading of evidence provided data regarding treatments of insomnia in children who have neurodevelopmental disabilities. RESULTS: The literature review revealed that current treatments for insomnia in children who have ASD show promise for behavioral/educational interventions and melatonin trials. However, there is a paucity of evidence, supporting the need for additional research. Consensus among the ATN sleep medicine committee experts included: (1) all children who have ASD should be screened for insomnia; (2) screening should be done for potential contributing factors, including other medical problems; (3) the need for therapeutic intervention should be determined; (4) therapeutic interventions should begin with parent education in the use of behavioral approaches as a first-line approach; (5) pharmacologic therapy may be indicated in certain situations; and (6) there should be follow-up after any intervention to evaluate effectiveness and tolerance of the therapy. Field testing of the practice pathway by autism medical specialists allowed for refinement of the practice pathway. CONCLUSIONS: The insomnia practice pathway may help health care providers to identify and manage insomnia symptoms in children and adolescents who have ASD. It may also provide a framework to evaluate the impact of contributing factors on insomnia and to test the effectiveness of nonpharmacologic and pharmacologic treatment strategies for the nighttime symptoms and daytime functioning and quality of life in ASD.

2 Article Rates of Mental Health Symptoms and Associations With Self-Reported Sleep Quality and Sleep Hygiene in Adolescents Presenting for Insomnia Treatment. 2019

Van Dyk, Tori R / Becker, Stephen P / Byars, Kelly C. ·Department of Psychology, Loma Linda University, Loma Linda, California. · Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. · Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio. · Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. ·J Clin Sleep Med · Pubmed #31596208.

ABSTRACT: STUDY OBJECTIVES: Despite high prevalence rates of both psychopathology and sleep problems during adolescence, as well as frequent co-occurrence, little is known about the mental health of adolescents presenting for insomnia evaluation and treatment. This study describes (1) rates of mental health symptoms and (2) associations of mental health symptoms with sleep behaviors and schedules in adolescents presenting to a behavioral sleep medicine clinic within an accredited sleep disorders center. METHODS: As a part of routine clinical care, 376 adolescents (ages 11 to 18 years) presenting for insomnia evaluation completed measures of insomnia and sleep behavior. Their caregiver reported on mental health diagnoses and symptoms. RESULTS: Adolescents had high rates of mental health diagnoses (75%) and clinically elevated symptoms (64%). Affective, anxiety, and attention deficit-hyperactivity disorder (ADHD) symptoms were most commonly reported. Mental health symptoms were related to sleep behaviors and insomnia severity, with ADHD symptoms and affective problems most consistently associated with disrupted sleep. CONCLUSIONS: Health providers should assess for mental health problems in youth presenting with sleep-related concerns. Intervening with both sleep and mental health problems should be considered to most effectively improve functioning.

3 Article Mental Health Diagnoses and Symptoms in Preschool and School Age Youth Presenting to Insomnia Evaluation: Prevalence and Associations with Sleep Disruption. 2019

Van Dyk, Tori R / Becker, Stephen P / Byars, Kelly C. ·Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA. · Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati , OH , USA. · Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA. ·Behav Sleep Med · Pubmed #30260686.


4 Article Validation of a Brief Insomnia Severity Measure in Youth Clinically Referred for Sleep Evaluation. 2017

Byars, Kelly C / Simon, Stacey L / Peugh, James / Beebe, Dean W. ·Pulmonary Medicine, Cincinnati Children's Hospital Medical Center. · Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center. · Department of Pediatrics, University of Cincinnati College of Medicine. · Children's Hospital Colorado, University of Colorado School of Medicine. ·J Pediatr Psychol · Pubmed #27694574.

ABSTRACT: Objectives: Evaluate psychometric properties of the Pediatric Insomnia Severity Index (PISI), a brief measure of insomnia severity. Methods: Clinically referred youth ( n = 462; 283 males, 179 females, mean age = 7.28 ± 2.05 years) and their caregiver(s) completed sleep evaluation including the PISI, Children's Sleep Habits Questionnaire, and sleep disorders inventory for students. Tests of reliability and validity and confirmatory factor analysis (CFA) were conducted to assess PISI psychometric properties. Exploratory analyses were conducted to examine insomnia severity by insomnia diagnosis. Results: Measures of internal consistency for the PISI factor scores varied. CFA indicated that a two-factor model had optimal fit relative to a single-factor solution. Overall, convergent and discriminant validity of PISI factors were supported. Insomnia severity varied by diagnosis. Conclusions: Findings provide preliminary support for the reliability and validity of the PISI within a large pediatric sample and for its clinical utility as a brief measure of insomnia severity.

5 Article Parental functioning and pediatric sleep disturbance: an examination of factors associated with parenting stress in children clinically referred for evaluation of insomnia. 2011

Byars, Kelly C / Yeomans-Maldonado, Gloria / Noll, Jennie G. ·Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, OH 45229-3039, USA. Kelly.Byars@cchmc.org ·Sleep Med · Pubmed #21940206.

ABSTRACT: BACKGROUND: Parenting stress is an aspect of parent functioning relevant in clinical settings. Within the context of behavioral sleep medicine, the role of parenting stress is not well understood. METHODS: Prospective evaluation of patients 1.5-10 years old with insomnia. Subjects were 156 primary caregiver-child pairs who completed the Parenting Stress Index-Short Form (PSI-SF), Child Sleep Habits Questionnaire (CSHQ) and Child Behavior Checklist (CBCL). AIMS: (1) determine prevalence of clinically significant parenting stress in primary caregivers of children clinically referred for insomnia; (2) identify childhood sleep problems that play a role in parenting stress; (3) identify relevant correlates of parenting stress within the context of a behavioral sleep medicine clinic; and (4) identify the most salient child sleep and behavioral variables associated with parenting stress. RESULTS: Forty-seven percent of primary caregivers had clinically significant parenting stress. When examining the relationship between child sleep problems and parenting stress, bedtime resistance (p=0.030) and daytime sleepiness (p=0.0003) stood alone as having the most salient associations with parenting stress. When considering a broader range of covariates (child age and child gender) and clinically relevant variables (parent history of sleep problems, parent history of psychiatric conditions, child behavior problems and child sleep problems) in a single regression equation, both child externalizing behavior problems (β=0.570, p<0.0001) and child daytime sleepiness (β=0.152, p=0.028) independently explained significant variability in parenting stress. CONCLUSIONS: Many primary caregivers of children clinically-referred for insomnia evaluation and treatment have significant parenting stress. Parenting stress is associated with daytime behavioral problems and sleepiness in children with insomnia. Clinicians working with pediatric insomnia patients should carefully evaluate parenting stress and child daytime behavior as these aspects of functioning may have an impact on service delivery and treatment outcomes.