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Dive into the research topics where Lisa J. Meltzer is active.

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Featured researches published by Lisa J. Meltzer.


Sleep Medicine | 2009

Developmental aspects of sleep hygiene: Findings from the 2004 National Sleep Foundation Sleep in America Poll

Jodi A. Mindell; Lisa J. Meltzer; Mary A. Carskadon; Ronald D. Chervin

OBJECTIVE To examine the associations between sleep hygiene and sleep patterns in children ages newborn to 10 years. The relationships between key features of good sleep hygiene in childhood and recognizable outcomes have not been studied in large, nationally representative samples. PARTICIPANTS AND METHODS A national poll of 1473 parents/caregivers of children ages newborn to 10 years was conducted in 2004. The poll included questions on sleep hygiene (poor sleep hygiene operationally defined as not having a consistent bedtime routine, bedtime after 9:00 PM, having a parent present when falling asleep at bedtime, having a television in the bedroom, and consuming caffeinated beverages daily) and sleep patterns (sleep onset latency, frequency of night wakings, and total sleep time). RESULTS Across all ages, a late bedtime and having a parent present when the child falls asleep had the strongest negative association with reported sleep patterns. A late bedtime was associated with longer sleep onset latency and shorter total sleep time, whereas parental presence was associated with more night wakings. Those children (ages 3+) without a consistent bedtime routine also were reported to obtain less sleep. Furthermore, a television in the bedroom (ages 3+) and regular caffeine consumption (ages 5+) were associated with shorter total sleep time. CONCLUSIONS Overall, this study found that good sleep hygiene practices are associated with better sleep across several age ranges. These findings support the importance of common US based recommendations that children of all ages should fall asleep independently, go to bed before 9:00 PM, have an established bedtime routine, include reading as part of their bedtime routine, refrain from caffeine, and sleep in bedrooms without televisions.


Journal of Family Psychology | 2007

Relationship between child sleep disturbances and maternal sleep, mood, and parenting stress: a pilot study.

Lisa J. Meltzer; Jodi A. Mindell

Although sleep disturbances in children are common, little is known about the relationship between childrens sleep disruptions and maternal sleep and daytime functioning. Forty-seven mothers completed measures of sleep, depression, parenting stress, fatigue, and sleepiness. Significant differences in maternal mood and parenting stress were found between mothers of children with and without significant sleep disturbances. Regression analyses showed that the quality of the childrens sleep significantly predicted the quality of maternal sleep. In addition, maternal sleep quality was a significant predictor of maternal mood, stress, and fatigue. Results from this pilot study support the need for future research examining the relationship between child sleep disturbances and maternal daytime functioning, and they highlight the importance of screening for and treating pediatric sleep disruptions.


Sleep | 2012

Direct comparison of two new actigraphs and polysomnography in children and adolescents.

Lisa J. Meltzer; Colleen M. Walsh; Joel Traylor; Anna M. L. Westin

STUDY OBJECTIVES To evaluate the validity and reliability of 2 new models of commercially available actigraphs compared to polysomnography for children and adolescents. DESIGN AND SETTING Subjects concurrently wore the Ambulatory Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Phillips Respironics Mini-Mitter Actiwatch-2 (PRMM) while undergoing overnight polysomnography (PSG) in a pediatric sleep laboratory housed in a tertiary care childrens hospital. PARTICIPANTS 115 youth (59 girls, 56 boys), ages 3-18 years (mean 8.8 years, SD 4.4 years). MEASUREMENTS Outcome variables were total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE). Epoch-by-epoch comparisons were made between the 2 devices and PSG to determine sensitivity, specificity, and accuracy. Agreement between the 2 devices was determined with t-tests and the Bland-Altman concordance technique. Different algorithms/sensitivities, developmental age groups, and sleep disordered breathing (SDB) status were also examined. RESULTS For both device brands, sensitivity (0.89-0.97), specificity (0.54-0.77), and accuracy (0.87-0.90) were similar to previous reports. Notably, compared to PSG, both device brands significantly overestimated WASO, while the AMI device also significantly underestimated TST. Inter-device comparison of the 2 brands found poor agreement for TST, WASO, and SE. Agreement with PSG differed depending on the scoring algorithm (AMI) or sensitivity setting (PRMM), as well as across developmental age group and sleep disordered breathing (SDB) status. CONCLUSIONS Similar to previous reports, both new actigraph brands were found to have good sensitivity (to detect sleep), but poorer specificity (to detect wake). Study results also suggest that researchers should adjust the scoring algorithm/sensitivity depending on a studys design (e.g., young children vs. adolescents, healthy children vs. youth with SDB). Further, inter-device reliability was poor, suggesting the need for caution when comparing results across studies that use different brands of actigraphic devices.


Paediatric Respiratory Reviews | 2008

The sleepy adolescent: causes and consequences of sleepiness in teens

Melisa Moore; Lisa J. Meltzer

The majority of adolescents do not obtain the recommended amount of sleep, resulting in significant daytime sleepiness. For most adolescents, insufficient sleep results from the interaction between intrinsic factors such as puberty and extrinsic factors such as school start times. Insufficient sleep and sleepiness impact all areas of adolescent functioning, including academic, psychological and behavioural, which underscores the importance of evaluating sleepy adolescents. While polysomnography is required for the diagnosis of certain sleep disorders, causes of sleepiness are generally best identified with a detailed sleep history and daily sleep diary. The management of sleep problems in adolescents involves treating any underlying sleep disorders, increasing total sleep time and improving other environmental factors that impact sleep. Recognition and management of insufficient sleep and sleepiness is important for the health and functioning of adolescents.


Pediatrics | 2010

Prevalence of Diagnosed Sleep Disorders in Pediatric Primary Care Practices

Lisa J. Meltzer; Courtney Johnson; Jonathan Crosette; Mark Ramos; Jodi A. Mindell

OBJECTIVES: The primary aim was to determine the prevalence of International Classification of Diseases, Ninth Revision (ICD-9), sleep disorders diagnosed by pediatric providers in a large, primary care network. Secondary aims were to examine demographic variables related to these diagnoses and to examine the frequency of prescriptions for medications potentially used to treat sleep disorders. METHODS: Electronic medical records were reviewed for 154957 patients (0–18 years) seen for a well-child visit in 2007. Information collected included ICD-9 sleep diagnoses, demographic variables, comorbid attention-deficit/hyperactivity disorder and autism spectrum disorders, provider type, and medications. RESULTS: Across all ages, 3.7% of youths had an ICD-9 diagnosis for a sleep disorder. The most-common diagnoses were sleep disorder not otherwise specified, enuresis, and sleep-disordered breathing. Predictors of sleep disorders varied according to developmental age group and included growth parameters, comorbid attention-deficit/hyperactivity disorder or autism spectrum disorder, and provider type. Potential sleep-related medications were prescribed for 6.1% of the sample subjects. CONCLUSIONS: This study is one of the first to examine comprehensively ICD-9 sleep diagnoses given by primary care providers in a large representative sample of children 0 to 18 years of age. The 3.7% of patients with ICD-9 sleep diagnoses is significantly lower than prevalence rates reported in epidemiological studies, which suggests that primary care providers may be underdiagnosing sleep disorders in children and adolescents. Because sleep disorders are treatable when recognized, the results from this study suggest a significant need for additional education and support for primary care providers in the diagnosis and treatment of pediatric sleep disorders.


Journal of Pediatric Psychology | 2014

Systematic Review and Meta-Analysis of Behavioral Interventions for Pediatric Insomnia

Lisa J. Meltzer; Jodi A. Mindell

OBJECTIVE To evaluate and quantify the evidence for behavioral interventions for pediatric insomnia. METHODS Meta-analysis of 16 controlled trials and qualitative analysis of 12 within-subject studies were conducted (total n = 2,560). RESULTS Meta-analysis found significant effects for four specified sleep outcomes: sleep-onset latency, number of night wakings, and duration of night wakings, and sleep efficiency, with small to large effect sizes across the controlled clinical trials involving typical children. No significant effects were found for the two studies conducted with special needs populations. Finally, within-subjects studies demonstrated significant effects for all sleep outcomes with large effect sizes. Risk of bias assessment and GRADE ratings of the quality of the evidence are described. CONCLUSION Moderate-level evidence supports behavioral interventions for pediatric insomnia in young children. However, low evidence for children, adolescents, and those with special needs (due to a lack of studies that met inclusion criteria) highlights the need for future research.


Journal of Pediatric Nursing | 2009

The experience of secondary traumatic stress upon care providers working within a children's hospital.

Paul M. Robins; Lisa J. Meltzer; Nataliya Zelikovsky

This study examined the impact of routine occupational exposure to traumatic aspects of child illness, injury, and medical treatment upon care providers working within a childrens hospital. Three hundred fourteen providers completed a demographic data sheet and four questionnaires. Results suggested overall that the level of Compassion Fatigue in this sample was similar to a trauma worker comparison group. In addition, 39% of the sample was at moderately to extremely high risk for Compassion Fatigue, and 21% was at moderate to high risk for Burnout. Burnout and Compassion Fatigue were related to type of profession and length of employment. Various dimensions of empathy were related to both Burnout and Compassion Fatigue. Regression analyses indicated that years in direct care and greater blurring of caregiver boundaries were predictive of greater Burnout and Compassion Fatigue. There is a need to further refine the assessment of occupational exposure to potential traumatic aspects of care within pediatric hospital settings and link assessment to prevention and intervention efforts.


American Journal of Respiratory and Critical Care Medicine | 2012

Effects of Positive Airway Pressure Therapy on Neurobehavioral Outcomes in Children with Obstructive Sleep Apnea

Carole L. Marcus; Jerilynn Radcliffe; Sofia Konstantinopoulou; Suzanne E. Beck; Mary Anne Cornaglia; Joel Traylor; Natalie DiFeo; Laurie Karamessinis; Paul R. Gallagher; Lisa J. Meltzer

RATIONALE Positive airway pressure therapy is frequently used to treat obstructive sleep apnea in children. However, it is not known whether positive airway pressure therapy results in improvements in the neurobehavioral abnormalities associated with childhood sleep apnea. OBJECTIVES We hypothesized that positive airway pressure therapy would be associated with improvements in attention, sleepiness, behavior, and quality of life, and that changes would be associated with therapy adherence. METHODS Neurobehavioral assessments were performed at baseline and after 3 months of positive airway pressure therapy in a heterogeneous group of 52 children and adolescents. MEASUREMENTS AND MAIN RESULTS Adherence varied widely (mean use, 170 ± 145 [SD] minutes per night). Positive airway pressure therapy was associated with significant improvements in attention deficits (P < 0.001); sleepiness on the Epworth Sleepiness Scale (P < 0.001); behavior (P < 0.001); and caregiver- (P = 0.005) and child- (P < 0.001) reported quality of life. There was a significant correlation between the decrease in Epworth Sleepiness Scale at 3 months and adherence (r = 0.411; P = 0.006), but not between other behavioral outcomes and adherence. Behavioral factors also improved in the subset of children with developmental delays. CONCLUSIONS These results indicate that, despite suboptimal adherence use, there was significant improvement in neurobehavioral function in children after 3 months of positive airway pressure therapy, even in developmentally delayed children. The implications for improved family, social, and school function are substantial. Clinical trial registered with www.clinicaltrials.gov (NCT 00458406).


Children's Health Care | 2005

Oncology Summer Camp: Benefits of Social Comparison

Lisa J. Meltzer; Mary T. Rourke

In this study, we examined social comparison, perceived self-competence, and social isolation among 34 adolescents with cancer who attended an oncology summer camp. Participants completed questionnaires on the first and last day of camp. The results indicate that adolescents felt more similar to camp peers than home peers and that these peer comparisons were related to social acceptance, physical appearance, global self-worth, and loneliness. The results of this study demonstrate that disease-specific summer camps provide adolescents with a community of similar peers who are an appropriate comparison group for self-evaluation. In turn, these social comparisons are related to improved psychosocial outcomes. The benefit of social comparison at an oncology camp should not be overlooked by researchers and health care professionals who plan, staff, and refer children to these programs.


Pediatric Clinics of North America | 2011

Sleep in the family.

Lisa J. Meltzer; Hawley E. Montgomery-Downs

Family systems are dynamic, with reciprocal interactions among family members. When children have sleep problems, they often awaken a parent, affecting parent sleep and subsequent parent daytime functioning. Child sleep patterns can also be disrupted by parent cognitions related to the childs sleep, as well as when parents are experiencing external stressors (eg, work or marital problems). This article focuses on sleep in a family context, reviewing the relationship between sleep among children and their parents from infancy to adolescence. Sleep in the family when a child has a chronic illness or development disorder is also reviewed.

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Jodi A. Mindell

Children's Hospital of Philadelphia

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Carole L. Marcus

University of Pennsylvania

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Valerie McLaughlin Crabtree

St. Jude Children's Research Hospital

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Joel Traylor

Children's Hospital of Philadelphia

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Sarah N. Biggs

Hudson Institute of Medical Research

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Kristin T. Avis

University of Alabama at Birmingham

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Christopher B. Forrest

Children's Hospital of Philadelphia

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Colleen M. Walsh

University of Pennsylvania

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Melisa Moore

Children's Hospital of Philadelphia

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