Sleep and circadian health in juvenile justice systems: A descriptive analysis.

OBJECTIVE: Few studies have explored sleep health and environmental influences on sleep and circadian health within juvenile justice facilities. The current study aims to describe sleep and circadian health of adolescents living in detention and treatment facilities. METHODS: Youth (N = 62) were recruited from 11 Department of Juvenile Services facilities. They completed a novel Youth Sleep and Daytime Behavior Questionnaire, daily sleep diary for seven consecutive mornings, and a brief poststudy interview. Healthcare staff completed a Youth Health Background survey for each participating youth. Facilities' 24-hour schedules were also obtained. RESULTS: Descriptive analyses were performed to capture the youths' sleep-wake experience while residing in Department of Juvenile Services facilities. Youth are obtaining the recommended total sleep time (M=8.9 hours, SD=1.2 hours) of 8-10 hours per night. However, they are taking twice as long to fall asleep (M=47 minutes SD=59 minutes) compared to the recommended sleep onset latency of 10-20 minutes. Youths' perceptions reveal potential reasons for long sleep onset latencies, including early facility sleep-wake schedules (78%) and overhead lights (60%) remaining on throughout the night. Furthermore, 37% of youth received facility-ordered behavioral sleep assessments, 36% were taking exogenous melatonin, and the majority of youth were prescribed at least one psychotropic medication. CONCLUSIONS: Findings suggest sleep-wake schedules and light exposure may be associated with an increase in symptoms of insomnia and/or circadian dysregulation. Based on the findings, facility-wide interventions are needed to improve the youths' sleep health.

How Are the Sleep Problems of Children in the US Foster Care System Addressed?

OBJECTIVE: Evidence of poor sleep health among children in foster care continues to mount, but information about whether and how sleep problems are addressed is unavailable. The goal of this study was to begin to fill these significant knowledge gaps. METHODS: Four hundred eighty-five foster caregivers from across the United States completed a survey focused on the sleep health of one child, 4 to 11 years ( M = 6.4; SD = 2.2) currently in their care. Caregivers provided quantitative and qualitative responses to questions regarding training, information, and services received in relation to their child's sleep. Caregivers also reported on the factors and strategies they perceived as most important for helping children in their care sleep well. RESULTS: Only 13% of caregivers reported receiving any information/education about sleep from agencies or case workers, whereas 55% had sought help from a health provider related to their child's sleep. Nearly half of all caregivers (46%) reported giving their child melatonin. Caregivers reported that a bedtime routine/consistency, reassurance of safety/love, and a calming environment were most important for helping their child sleep well. A recurrent theme in qualitative responses was a need to mitigate child fear/anxiety at night. CONCLUSION: Children in foster care face a range of risk factors that increase the likelihood of poor/insufficient sleep, but these findings suggest this critical aspect of health requires greater clinical and research attention. As these data were collected during the initial months of the COVID-19 pandemic, replication studies are necessary.