A243 SLEEP, Volume 44, Abstract Supplement, 2021 B. Clinical Sleep Science and Practice VII. Pediatrics fndings after cardiology referral. Our study supports that EKG abnor- malities are rare in PSGs of children and not associated with cardiac disease or sleep disorders, but appear more commonly in males. Support (if any): 618 QUALITATIVE ANALYSIS OF BEDTIME CHALLENGES AND PARENTAL INTERVENTIONS IN FOSTER CARE CHILDREN Josefna Muñoz Nogales, 1 Madeline Valentine, 1 Priscilla Rigos, 2 Josephine Kim, 2 Jinu KIm, 3 Candice Alfano, 3 Eleanor McGlinchey, 2 Carol Ripple, 4 Amy Wolfson 1 1 Loyola University Maryland, 2 Fairleigh Dickinson University, 3 University of Houston, 4 Pajama Program Introduction: Sleep during childhood has a major impact on physio- logical, psychological, and cognitive development. Limited research has focused on vulnerable populations such as children in foster care. Foster care children endure placement instability, which may con- tribute to disrupted sleep patterns and unpredictability around bedtime (Leathers, et al., 2019). The Fostering Sleep study examined foster caregivers’ perceptions of children’s sleep challenges and strategies for improving sleep difculties. Methods: Foster caregivers of children ages 4–11 throughout the US were invited to complete the Qualtrics Sleep Health among Children in Foster Care Survey via foster care Facebook groups. The survey in- cluded quantitative and qualitative questions focused on sleep patterns and behaviors. Qualitative questions on barriers and opportunities to improve sleep were examined: what helps foster care children sleep well; what kinds of difculties do foster care children experience at bedtime? Results: 483 foster care parents responded. Responses to bedtime dif- culties were coded using 27 categories (e.g., parasomnias, bedtime resist- ance, trouble self-soothing); responses to what helps your child sleep well were coded based on 22 categories (e.g., comfort items, melatonin, TV as in intervention, communication to reassure safety). The most preva- lent sleep/bedtime difculties were fear/anxiety (23.2%), nightmares (19.6%), environment (18.4%). For example, one parent responded: “He fears never waking up. He fears that the sun is not going to come back up. He fears that the bad guys will come get him.” Difculties varied by age-- 4–5: fear/anxiety, destabilization from call/visit biological parent, nightmares; 6–9: nightmares, fear/anxiety, environment; 10–11: fear/ anxiety, nightmares, emotional/behavioral difculties. Most frequent parenting approaches were bedtime routine (63.0%), reading before bed- time (36.5%), physical reassurance (26.6%). Interventions also varied ac- cording to age-- 4–5: routine, reading, physical reassurance; 6–9: routine, reading, noise control; 10–11: routine, technology regulation, reading. Conclusion: Foster caregivers reported fear/anxiety as most common bedtime difculty and physical reassurance as most frequent parenting strategy for healthy sleep. Findings suggest that anxiety and fear often interfere with sleep and, in turn, physical reassurance as a helpful bed- time strategy. Undoubtedly, there is a need for sleep research and pre- ventive interventions for children in foster care. Support (if any): Summer Student Research Support, Loyola University Maryland, College of Arts and Sciences 619 ELECTRONIC MEDIA USE AND SLEEP AMONG CHILDREN IN FOSTER CARE WITH ANXIETY Josephine Kim, 1 Priscilla Rigos, 1 Madeline Valentine, 2 Josefna Muñoz Nogales, 2 Jinu KIm, 3 Eleanor McGlinchey, 1 Candice Alfano, 3 Carol Ripple, 4 Amy Wolfson 2 1 Fairleigh Dickinson University, 2 Loyola University Maryland, 3 University of Houston, 4 Pajama Program Introduction: Electronic media (EM) use has long been associated with poor sleep in children. Children’s use of EM may also be related to emotional distress – anxiety being one of the more prevalent issues, which has been tied to sleep-related problems as well (e.g., Fors & Barch, 2019; Alfano et al., 2007). Children in foster care have often been victims of trauma, which can lead to signifcant emotional and sleep difculties (e.g., Kovachy et al., 2013). The Fostering Sleep study examined the association between EM use and sleep among children in foster care; and the additional infuence of anxiety. Methods: Participants were caregivers of foster care children re- cruited from private Facebook foster care support groups across the United States. The study used a cross-sectional design examining sleep patterns and behaviors, EM use and mental health among children in foster care. An online survey, hosted by Qualtrics, was distributed to caregivers via Facebook. The data of 443 foster care children be- tween the ages of four and 11 (M=6.37, SD=2.21) were included in the analyses. Results: Children in foster care using EM at bedtime go to bed later than those who are not (p<.001), and their sleep quality was better than those who did not use EM around bedtime (p<0.01). Additionally, 33.3% reported anxiety as a primary diagnosis by a mental health pro- fessional. Children without anxiety as their primary diagnosis were found to be more likely to use EM around bedtime (p=.038). Conclusion: This preliminary analysis indicates the prevalence of EM use close to bedtime may not necessarily be detrimental to sleep for this population; perhaps activities such as watching one’s favorite programming or talking to a loved one online can be comforting and therefore helpful to sleep onset (Eggermont & Van den Bulck, 2006). However, examination of other factors such as type of technology, con- tent of media, and duration of use is warranted. Moreover, children with anxiety as a primary diagnosis may be using less EM at bedtime because EM use may trigger symptoms of anxiety (i.e., Fors & Barch, 2019). Support (if any): 620 DESCRIPTION OF 14&6 VARIANT ON POLYSOMNOGRAPHY Weston Powell, 1 Jessica Nash, 2 Chris Ruth, 3 Jeremy Chan, 2 Carey Lockhart 2 1 Seattle Children’s Hospital, University of Washington, 2 Seattle Children’s Hospital, 3 Seattle Children’s Hospital, Seattle, Washington, USA Introduction: Benign variants or incidental fndings are often identi- fed on routine polysomnography. One such variant is 14-and-6 hertz positive spikes, frst described on EEG in 1951; however, the signif- cance of 14-and-6 positive spikes found on polysomnography has not been previously described. Methods: We conducted a retrospective review of patients with 14-and-6 Hz spikes on polysomnography and compared clinical fnd- ings on polysomnography with age and sex-matched controls. Results: Mean age was 8.6 years (range 2–16). Sleep indices did not difer between cases and controls. Patients with 14-and-6 Hz spikes had lower obstructive apnea-hypopnea index and were less likely to be diagnosed with obstructive sleep apnea. Patients with 14-and-6 Hz spikes did not difer from controls in frequency of formal neurology evaluation, whether a full EEG was obtained, or neurologic diagnoses. Patients with 14-and-6 Hz spikes were less likely to be diagnosed with behavioral or developmental disorders. Downloaded from https://academic.oup.com/sleep/article/44/Supplement_2/A243/6260753 by guest on 22 February 2023