45 Risk factors: a systematic review 2 Measurement outcome Risk factor Measurement risk factor Results Risk of bias: QUIPS domains 28-day sleep diary Type of steroid Assigned by protocol Pred better sleep quality (p=.014) and fewer night awakenings (p=.013) 0/6 high Additional 1 item rating sleep disturbance - Steroid dose - Age (<4 / >4) - Sex - Assigned by protocol - Patient record - Patient record High dose pred: no difference Age: no difference Sex: girls more sleep disturbance (p<.05) 4/6 high Actigraphy and sleep diary - Age (<7 / 7-12 / ≥13) - Sex - Steroid dose All patient record Age: older children less sleep duration (p=.018), less sleep minutes/24 hours (p=.002) Sex: boys more awakenings (p=.020), girls more naps (p=.027) Steroid dose: higher dose associated with: sleep efficiency (p=.012), sleep minutes (p=0.13) and nocturnal awakenings (p=.034) 1/6 high Actigraphy and sleep diary - Dex dose - Age (5-12 / 13-17) - Sex - Per protocol - Patient record - Patient record High dose: NS for circadian parameters Age: NS Sex: NS 2/6 high Actigraph and sleep diary - Sex - Patient record Boys increased WASO Girls decreased WASO 1/6 high Actigraphy and sleep diary - Dex PK - Dex dose - Serum albumin - Genotyping - Liquid chromatography - Standard testing method - Per protocol / DNA-Print Genomics PK: increased time above 100nM dex increase in sleep time (p=.05). Higher AUC (univariate) is less sleep efficiency and sleep time. Multivariable NS. Dose: higher dex dose, less sleep efficiency (p=.0015) Albumin: NS AHSG SNP: sleep duration and actual sleep time increased IL6 G174C SNP: NS IL6 C634G SNP: NS 1/6 high
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