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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

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Sleep disorder prevalence in at-risk adolescents and potential effects of nightmare triad syndrome

Natalia D. McIver
  • Sleep and Human Health Institute, Albuquerque, NM 87109, USA
  • Maimonides Sleep Arts and Sciences Ltd., Albuquerque, NM 87109, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Barry Krakow
  • Corresponding author
  • Sleep and Human Health Institute, Albuquerque, NM 87109, USA
  • Maimonides Sleep Arts and Sciences Ltd., Albuquerque, NM 87109, USA
  • Los Alamos Medical Center, Los Alamos, NM 87544, USA
  • Email
  • Other articles by this author:
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/ Jessica Krakow
  • Sleep and Human Health Institute, Albuquerque, NM 87109, USA
  • Maimonides Sleep Arts and Sciences Ltd., Albuquerque, NM 87109, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Michael R. Nadorff
  • Department of Psychology, Mississippi State University, Mississippi State, MS 39762, USA
  • Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Victor A. Ulibarri
  • Sleep and Human Health Institute, Albuquerque, NM 87109, USA
  • Maimonides Sleep Arts and Sciences Ltd., Albuquerque, NM 87109, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Robert Baade
Published Online: 2018-02-17 | DOI: https://doi.org/10.1515/ijamh-2017-0125



At-risk high school students, those considered to have a higher probability for academic failure or dropping out, were assessed for various sleep disorders. Effects were compared between students with and without the nightmare triad syndrome (NTS+), the sleep disorders’ cluster of frequent nightmares, insomnia disorder and suspected sleep-disordered breathing (SDB).


Data were gathered at a charter school for at-risk youth using: computer based surveys, physical airway exams, and mental health interviews by school social worker. Ninety-two students were enrolled, and 70 completed all study components.


Students were teenaged [17.10 (1.50) years], male (52.2%) slightly overweight [BMI 25.50 (6.41)] Hispanics (87.0%); two-thirds (65 of 92) subjectively reported a sleep problem. Frequent nightmares (39.1%), insomnia (ISI ≥ 12, 41.3%), and SDB risk (79.3%) were common. Several presumptive sleep disorders (insomnia, SDB risk, parasomnia, or nightmares) were associated with worse sleep quality and lower quality of life. Nineteen students met criteria for NTS. Compared to NTS−, NTS+ showed significantly lower quality of life (p < 0.003, g = 0.84). Regression analyses revealed higher levels of depression and anxiety symptoms in NTS+ students. NTS was associated with reduced quality of life independent of anxiety symptoms.


Prevalence of presumptive sleep disorders was high with a tendency for clusters of sleep disorders in the same individual. Students with NTS+ showed worse outcomes and reduced quality of life, mediated partially by depression and anxiety. To examine relationships between sleep disorders and mental health in at-risk adolescents, research investigations must include both subjective and objective measurements of sleep.

This article offers supplementary material which is provided at the end of the article.

Keywords: anxiety; depression; insomnia; nightmares; sleep-disordered breathing; quality of life


  • [1]

    Epstein RA, Bobo WV, Cull MJ, Gatlin D. Sleep and school problems among children and adolescents in state custody. J Nerv Ment Dis. 2011;199(4):251–6.CrossrefPubMedGoogle Scholar

  • [2]

    Sussman S, Skara S, Ames SL. Substance abuse among adolescents. Subst Use Misuse. 2008;43(12–13):1802–28.PubMedCrossrefGoogle Scholar

  • [3]

    Griswold KS, Aronoff H, Kernan JB, Kahn LS. Adolescent substance use and abuse: recognition and management. Am Fam Physician. 2008;77(3):331–6.PubMedGoogle Scholar

  • [4]

    Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9.PubMedCrossrefGoogle Scholar

  • [5]

    Henry KL, Huizinga DH. School-related risk and protective factors associated with truancy among urban youth placed at risk. J Prim Prev. 2007;28(6):505–19.CrossrefPubMedGoogle Scholar

  • [6]

    Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ, et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2012;69(4):372–80.PubMedCrossrefGoogle Scholar

  • [7]

    Roberts RE, Roberts CR, Xing Y. Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area. J Psychiatr Res. 2007;41(11):959–67.CrossrefGoogle Scholar

  • [8]

    Roberts RE, Roberts CR, Xing Y. Prevalence of youth-reported DSM-IV psychiatric disorders among African, European, and Mexican American adolescents. J Am Acad Child Adolesc Psychiatry. 2006;45(11):1329–37.PubMedCrossrefGoogle Scholar

  • [9]

    Rossa KR, Smith SS, Allan AC, Sullivan KA. The effects of sleep restriction on executive inhibitory control and affect in young adults. J Adolesc Health. 2014;55(2):287–92.PubMedCrossrefGoogle Scholar

  • [10]

    Pagel JF, Kwiatkowski CF. Sleep complaints affecting school performance at different educational levels. Front Neurol. 2010;1:125.PubMedGoogle Scholar

  • [11]

    Sadeh A, Gruber R, Raviv A. Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Dev. 2002;73(2):405–17.CrossrefPubMedGoogle Scholar

  • [12]

    Holley S, Hill CM, Stevenson J. An hour less sleep is a risk factor for childhood conduct problems. Child Care Health Dev. 2011;37(4):563–70.CrossrefPubMedGoogle Scholar

  • [13]

    Accardo JA, Marcus CL, Leonard MB, Shults J, Meltzer LJ, Elia J. Associations between psychiatric comorbidities and sleep disturbances in children with attention-deficit/hyperactivity disorder. J Dev Behav Pediatr. 2012;33(2):97–105.PubMedGoogle Scholar

  • [14]

    Umlauf MG, Bolland AC, Bolland KA, Tomek S, Bolland JM. The effects of age, gender, hopelessness, and exposure to violence on sleep disorder symptoms and daytime sleepiness among adolescents in impoverished neighborhoods. J Youth Adolesc. 2015;44(2):518–42.CrossrefPubMedGoogle Scholar

  • [15]

    Littlewood D, Kyle SD, Pratt D, Peters S, Gooding P. Examining the role of psychological factors in the relationship between sleep problems and suicide. Clin Psychol Rev. 2017;54:1–16.CrossrefPubMedGoogle Scholar

  • [16]

    Sinha D, Guilleminault C. Sleep disordered breathing in children. Indian J Med Res. 2010;131:311–20.PubMedGoogle Scholar

  • [17]

    Smaldone A, Honig JC, Byrne MW. Sleepless in America: inadequate sleep and relationships to health and well-being of our nation’s children. Pediatrics. 2007;119(Suppl 1):S29–37.CrossrefPubMedGoogle Scholar

  • [18]

    Holmberg LI, Hellberg D. Behavioral and other characteristics of relevance for health in adolescents with self-perceived sleeping problems. Int J Adolesc Med Health. 2008;20(3):353–65.PubMedGoogle Scholar

  • [19]

    Reeves G, Blaisdell C, Lapidus M, Langenberg P, Ramagopal M, Cabassa J, et al. Sleep architecture and behavioral abnormalities in children and adolescents. Int J Adolesc Med Health. 2010;22(4):535–45.PubMedGoogle Scholar

  • [20]

    Touchette E, Cote SM, Petit D, Liu X, Boivin M, Falissard B, et al. Short nighttime sleep-duration and hyperactivity trajectories in early childhood. Pediatrics. 2009;124(5):e985–93.PubMedCrossrefGoogle Scholar

  • [21]

    Chervin RD, Clarke DF, Huffman JL, Szymanski E, Ruzicka DL, Miller V, et al. School performance, race, and other correlates of sleep-disordered breathing in children. Sleep Med. 2003;4(1):21–7.PubMedCrossrefGoogle Scholar

  • [22]

    Goll JC, Shapiro CM. Sleep disorders presenting as common pediatric problems. Can Med Assoc J. 2006;174(5):617–9.CrossrefGoogle Scholar

  • [23]

    Simonds JF, Parraga H. Prevalence of sleep disorders and sleep behaviors in children and adolescents. J Am Acad Child Psychiatry. 1982;21(4):383–8.CrossrefPubMedGoogle Scholar

  • [24]

    Calhoun SL, Fernandez-Mendoza J, Vgontzas AN, Liao D, Bixler EO. Prevalence of insomnia symptoms in a general population sample of young children and preadolescents: gender effects. Sleep Med. 2014;15(1):91–5.CrossrefGoogle Scholar

  • [25]

    Carter KA, Hathaway NE, Lettieri CF. Common sleep disorders in children. Am Fam Physician. 2014;89(5):368–77.PubMedGoogle Scholar

  • [26]

    Anderson B, Storfer-Isser A, Taylor HG, Rosen CL, Redline S. Associations of executive function with sleepiness and sleep duration in adolescents. Pediatrics. 2009;123(4):e701–7.PubMedCrossrefGoogle Scholar

  • [27]

    Nadorff MR, Lambdin KK, Germain A. Pharmacological and non-pharmacological treatments for nightmare disorder. Int Rev Psychiatry. 2014;26(2):225–36.CrossrefPubMedGoogle Scholar

  • [28]

    Loredo JS, Ancoli-Israel S, Dimsdale JE. Sleep quality and blood pressure dipping in obstructive sleep apnea. Am J Hypertens. 2001;14(9 Pt 1):887–92.PubMedCrossrefGoogle Scholar

  • [29]

    Lin WH, Yi CC. Unhealthy sleep practices, conduct problems, and daytime functioning during adolescence. J Youth Adolesc. 2015;44(2):431–46.CrossrefPubMedGoogle Scholar

  • [30]

    Beebe DW, Rose D, Amin R. Attention, learning, and arousal of experimentally sleep-restricted adolescents in a simulated classroom. J Adolesc Health. 2010;47(5):523–5.CrossrefGoogle Scholar

  • [31]

    Ipsiroglu OS, Fatemi A, Werner I, Paditz E, Schwarz B. Self-reported organic and nonorganic sleep problems in schoolchildren aged 11–15 years in Vienna. J Adolesc Health. 2002;31(5):436–42.PubMedCrossrefGoogle Scholar

  • [32]

    Gozal D, Kheirandish-Gozal L. Neurocognitive and behavioral morbidity in children with sleep disorders. Curr Opin Pulm Med. 2007;13(6):505–9.CrossrefPubMedGoogle Scholar

  • [33]

    Meldrum RC, Barnes JC, Hay C. Sleep deprivation, low self-control, and delinquency: a test of the strength model of self-control. J Youth Adolesc. 2015;44(2):465–77.CrossrefPubMedGoogle Scholar

  • [34]

    Roberts RE, Roberts CR, Duong HT. Chronic insomnia and its negative consequences for health and functioning of adolescents: a 12-month prospective study. J Adolesc Health. 2008;42(3):294–302.PubMedCrossrefGoogle Scholar

  • [35]

    McIver ND, Krakow B, Krakow J, Baade R, Cox M, Rafferty M. Sleep Disorders in At-Risk Adolescents in a Public Charter High School. Sleep. 2013;36:A375. Abstract 1097.Google Scholar

  • [36]

    McIver ND, Krakow B, Krakow J, Baade R, Cox M, Rafferty M, et al. Nightmare Triad Syndrome in At-Risk Adolescents in a Public Charter High School. Sleep. 2013;36:A367. Abstract 1074.Google Scholar

  • [37]

    Krakow B. Nightmare complaints in treatment-seeking patients in clinical sleep medicine settings: diagnostic and treatment implications. Sleep. 2006;29(10):1313–9.PubMedCrossrefGoogle Scholar

  • [38]

    Bonnet MH, Arand DL. Clinical effects of sleep fragmentation versus sleep deprivation. Sleep Med Rev. 2003;7(4):297–310.PubMedCrossrefGoogle Scholar

  • [39]

    Guilleminault C, Rosekind M. The arousal threshold: sleep deprivation, sleep fragmentation, and obstructive sleep apnea syndrome. Bull Eur Physiopathol Respir. 1981;17(3):341–9.PubMedGoogle Scholar

  • [40]

    Persson HE, Svanborg E. Sleep deprivation worsens obstructive sleep apnea. Comparison between diurnal and nocturnal polysomnography. Chest. 1996;109(3):645–50.CrossrefPubMedGoogle Scholar

  • [41]

    Krakow B, Tandberg D, Scriggins L, Barey M. A controlled comparison of self-rated sleep complaints in acute and chronic nightmare sufferers. J Nerv Ment Dis. 1995;183(10):623–7.PubMedCrossrefGoogle Scholar

  • [42]

    Krakow B, Hollifield M, Johnston L, Koss M, Schrader R, Warner TD, et al. Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial. J Am Med Assoc. 2001;286(5):537–45.CrossrefGoogle Scholar

  • [43]

    Krakow B, Lowry C, Germain A, Gaddy L, Hollifield M, Koss M, et al. A retrospective study on improvements in nightmares and post-traumatic stress disorder following treatment for co-morbid sleep-disordered breathing. J Psychosom Res. 2000;49(5):291–8.CrossrefPubMedGoogle Scholar

  • [44]

    Krakow B, Ulibarri VA, McIver ND, Nadorff MR. A novel therapy for chronic sleep-onset insomnia: a retrospective, nonrandomized controlled study of auto-adjusting, dual-level, positive airway pressure technology. Prim Care Companion CNS Disord. 2016;18(5).PubMedGoogle Scholar

  • [45]

    Krakow B, McIver ND, Ulibarri VA, Nadorff MR. Retrospective, nonrandomized controlled study on autoadjusting, dual-pressure positive airway pressure therapy for a consecutive series of complex insomnia disorder patients. Nat Sci Sleep. 2017;9:81–95.CrossrefPubMedGoogle Scholar

  • [46]

    Tamanna S, Parker JD, Lyons J, Ullah MI. The effect of continuous positive air pressure (CPAP) on nightmares in patients with posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA). J Clin Sleep Med. 2014;10(6):631–6.PubMedGoogle Scholar

  • [47]

    Eakman AM, Schmid AA, Henry KL, Rolle NR, Schelly C, Pott CE, et al. Restoring effective sleep tranquility (REST): A feasibility and pilot study. Br J Occup Ther. 2017;80(6):350–60.CrossrefGoogle Scholar

  • [48]

    Guilleminault C, Davis K, Huynh NT. Prospective randomized study of patients with insomnia and mild sleep disordered breathing. Sleep. 2008;31(11):1527–33.PubMedCrossrefGoogle Scholar

  • [49]

    Berlin KL, Means MK, Edinger JD. Nightmare reduction in a Vietnam veteran using imagery rehearsal therapy. J Clin Sleep Med. 2010;6(5):487–8.Google Scholar

  • [50]

    Augedal AW, Hansen KS, Kronhaug CR, Harvey AG, Pallesen S. Randomized controlled trials of psychological and pharmacological treatments for nightmares: a meta-analysis. Sleep Med Rev. 2013;17(2):143–52.CrossrefPubMedGoogle Scholar

  • [51]

    MSAS. Web-based intake questionnaires. 2011. www.sleeptreatment.com/patients.

  • [52]

    Bastien CH, Vallieres A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med. 2001;2(4):297–307.PubMedCrossrefGoogle Scholar

  • [53]

    Krakow B, Krakow J, Ulibarri VA, Krakow J. Nocturnal time monitoring behavior (“clock-watching”) in patients presenting to a sleep medical center with insomnia and posttraumatic stress symptoms. J Nerv Ment Dis. 2012;200(9):821–5.CrossrefPubMedGoogle Scholar

  • [54]

    Krakow BJ, Melendrez DC, Johnston LG, Clark JO, Santana EM, Warner TD, et al. Sleep dynamic therapy for cerro grande fire evacuees with posttraumatic stress symptoms: a preliminary report. J Clin Psychiatry. 2002;63(8):673–84.CrossrefPubMedGoogle Scholar

  • [55]

    Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.CrossrefPubMedGoogle Scholar

  • [56]

    Endicott J, Nee J, Yang R, Wohlberg C. Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q): reliability and validity. J Am Acad Child Adolesc Psychiatry. 2006;45(4):401–7.PubMedCrossrefGoogle Scholar

  • [57]

    Guilleminault C, Kim YD, Palombini L, Li K, Powell N. Upper airway resistance syndrome and its treatment. Sleep. 2000;23(Suppl 4):S197–200.PubMedGoogle Scholar

  • [58]

    Ito E, Tsuiki S, Maeda K, Okajima I, Inoue Y. Oropharyngeal crowding closely relates to aggravation of OSA. Chest. 2016;150(2):346–52.PubMedCrossrefGoogle Scholar

  • [59]

    Tsuiki S, Isono S, Ishikawa T, Yamashiro Y, Tatsumi K, Nishino T. Anatomical balance of the upper airway and obstructive sleep apnea. Anesthesiology. 2008;108(6):1009–15.PubMedCrossrefGoogle Scholar

  • [60]

    Kumar HV, Schroeder JW, Gang Z, Sheldon SH. Mallampati score and pediatric obstructive sleep apnea. J Clin Sleep Med. 2014;10(9):985–90.PubMedGoogle Scholar

  • [61]

    Beck AT, Steer RA, Brown GK. Beck depression inventory-II manual. San Antonio: Psychological Corporation; 1996.Google Scholar

  • [62]

    Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893–7.CrossrefPubMedGoogle Scholar

  • [63]

    Joiner TE, Jr., Pfaff JJ, Acres JG. A brief screening tool for suicidal symptoms in adolescents and young adults in general health settings: reliability and validity data from the Australian National General Practice Youth Suicide Prevention Project. Behav Res Ther. 2002;40(4):471–81.CrossrefGoogle Scholar

  • [64]

    Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36(7):980–8.PubMedCrossrefGoogle Scholar

  • [65]

    Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012;130(3):576–84.CrossrefPubMedGoogle Scholar

  • [66]

    Krakow B, Melendrez D, Johnston L, Warner TD, Clark JO, Pacheco M, et al. Sleep-disordered breathing, psychiatric distress, and quality of life impairment in sexual assault survivors. J Nerv Ment Dis. 2002;190(7):442–52.PubMedCrossrefGoogle Scholar

  • [67]

    Krakow B, Ulibarri VA. Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report. Sleep Breath. 2013;17(1):317–22.CrossrefGoogle Scholar

  • [68]

    Krakow B, Ulibarri VA, McIver ND. Pharmacotherapeutic failure in a large cohort of patients with insomnia presenting to a sleep medicine center and laboratory: subjective pretest predictions and objective diagnoses. Mayo Clin Proc. 2014;89(12):1608–20.CrossrefGoogle Scholar

  • [69]

    Krakow B, Melendrez D, Warner TD, Clark JO, Sisley BN, Leahigh LK, et al. Atypical clinical presentations of sleep-disordered breathing among trauma survivors. Sleep. 2003;26(Suppl):A554. Abstract 222.Google Scholar

  • [70]

    Morin CM, Belleville G, Belanger L, Ivers H. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34(5):601–8.CrossrefPubMedGoogle Scholar

  • [71]

    Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach (methodology in the social sciences). 1st ed. New York City: The Guilford Press; 2013.Google Scholar

  • [72]

    Accardo JA, Shults J, Leonard MB, Traylor J, Marcus CL. Differences in overnight polysomnography scores using the adult and pediatric criteria for respiratory events in adolescents. Sleep. 2010;33(10):1333–9.CrossrefPubMedGoogle Scholar

  • [73]

    Millman RP. Excessive sleepiness in adolescents and young adults: causes, consequences, and treatment strategies. Pediatrics. 2005;115(6):1774–86.CrossrefGoogle Scholar

  • [74]

    Witmans M, Young R. Update on pediatric sleep-disordered breathing. Pediatr Clin North Am. 2011;58(3):571–89.PubMedCrossrefGoogle Scholar

  • [75]

    Mitchell RB, Kelly J. Quality of life after adenotonsillectomy for SDB in children. Otolaryngol Head Neck Surg. 2005;133(4):569–72.CrossrefPubMedGoogle Scholar

  • [76]

    Ballester E, Badia JR, Hernandez L, Carrasco E, de PJ, Fornas C, et al. Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1999;159(2):495–501.PubMedCrossrefGoogle Scholar

  • [77]

    D’Ambrosio C, Bowman T, Mohsenin V. Quality of life in patients with obstructive sleep apnea: effect of nasal continuous positive airway pressure – a prospective study. Chest. 1999;115(1):123–9.CrossrefPubMedGoogle Scholar

  • [78]

    Kryger MH, Roth T, Elia J. Principles and practice of sleep medicine, 5th ed ed. USA: Saunders, 2010 .Google Scholar

  • [79]

    Bernal B, Ardila A, Bateman JR. Cognitive impairments in adolescent drug-abusers. Int J Neurosci. 1994;75(3–4):203–12.PubMedCrossrefGoogle Scholar

  • [80]

    Schweinsburg AD, Brown SA, Tapert SF. The influence of marijuana use on neurocognitive functioning in adolescents. Curr Drug Abuse Rev. 2008;1(1):99–111.CrossrefPubMedGoogle Scholar

  • [81]

    Hassamal S, Miotto K, Wang T, Saxon AJ. A narrative review: the effects of opioids on sleep disordered breathing in chronic pain patients and methadone maintained patients. Am J Addict. 2016;25(6):452–65.PubMedCrossrefGoogle Scholar

  • [82]

    Tarokh L, Hamann C, Schimmelmann BG. Sleep in child and adolescent psychiatry: overlooked and underappreciated. Eur Child Adolesc Psychiatry. 2014;23(6):369–72.PubMedCrossrefGoogle Scholar

  • [83]

    Brand S, Kirov R. Sleep and its importance in adolescence and in common adolescent somatic and psychiatric conditions. Int J Gen Med. 2011;4:425–42.PubMedGoogle Scholar

  • [84]

    Krakow B, Sandoval D, Schrader R, Keuhne B, McBride L, Yau CL, et al. Treatment of chronic nightmares in adjudicated adolescent girls in a residential facility. J Adolesc Health. 2001;29(2):94–100.CrossrefGoogle Scholar

  • [85]

    Moore M, Kirchner HL, Drotar D, Johnson N, Rosen C, Ancoli-Israel S, et al. Relationships among sleepiness, sleep time, and psychological functioning in adolescents. J Pediatr Psychol. 2009;34(10):1175–83.CrossrefPubMedGoogle Scholar

  • [86]

    Winer ES, Cervone D, Bryant J, McKinney C, Liu RT, Nadorff MR. Distinguishing mediational models and analyses in clinical psychology: atemporal associations do not imply causation. J Clin Psychol. 2016;72(9):947–55.PubMedCrossrefGoogle Scholar

About the article

Received: 2017-07-18

Accepted: 2017-11-26

Published Online: 2018-02-17

Conflict of interest: Authors NDM, JK, MRN, VAU, and RB declare that they have no conflict of interest. Author BK reports: 6 main activities related to my work in sleep medicine:

For websites, I own and operate 6 sites that provide education and offer products and services for sleep disorders patients:www.nightmaretreatment.com: www.ptsdsleepclinic.com: www.sleeptreatment.com: www.sleepdynamictherapy.com: www.soundsleepsoundmind.com: www.nocturiacures.com.

For other professional services, I am the medical director of a national DME company Classic Sleep Care for which my sole functions are consultation and QA; I have neither patient encounters nor do I benefit from the sale of any DME equipment.

For intellectual property, I market and sell 3 books for sleep disorders patients: Insomnia Cures, Turning Nightmares into Dreams, and Sound Sleep, Sound Mind.

For clinical services, I own and operate one commercial sleep center: Maimonides Sleep Arts & Sciences, Ltd.

For educational and consulting services: I conduct CME/CEU educational programs for medical and mental health providers to learn about sleep disorders. Sometimes these programs involve the attendee paying a fee directly to our center. Other times, I conduct the workshops at other locations, which may be paid for by vendors such as Respironics and RESMED or other institutions such as the AMEDDC&S, VAMC, and regional sleep center conferences.

I am also president and principal investigator of a non-profit sleep research center, the Sleep & Human Health Institute (www.shhi.org) that occasionally provides consultation services or receives grants for pilot studies, the most recent: ResMed ∼$400,000 January 2015 (funding for randomized control trial of treatment in insomnia patients).

Funding: This research received funding from the non-profit Simon Foundation, Santa Fe, NM and non-profit Oxnard Foundation, Newport Beach, CA.

Citation Information: International Journal of Adolescent Medicine and Health, 20170125, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2017-0125.

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