婴儿夜晚睡眠模式发展的前瞻性研究

A prospective study of the development of nocturnal sleep patterns in infants

目的了解婴儿生后第1年夜晚睡眠模式的发展规律。方法采用非侵入性的睡眠监测仪Actiwatch监测50名在重庆市妇幼保健院出生的健康足月新生儿的12项婴儿夜晚睡眠参数。监测时间为生后第10天、28天,以及2、3、4、5、6、9、12月龄的第1个星期二,每次连续监测60 h。采用二水平混合效应模型进行统计学分析。结果 22名男童和25名女童完成了为期1年的纵向随访。从生后第10天到12月龄,夜间入睡潜伏期3月龄时降低了48%,6月龄时降低了83%;夜晚睡眠效率从66%增加到87%;夜晚睡眠总时间从416 min增加到517 min;夜晚最长连续睡眠时间从197 min增加到327 min。夜晚睡眠效率、夜晚睡眠总时间和夜晚最长连续睡眠时间均随年龄增大呈增长趋势（P〈0.01）,其3月龄与12月龄的比值分别是86%、84%和72%,6月龄与12月龄的比值分别是97%、91%和94%。夜晚平均、最长连续觉醒时间和觉醒总时间均随年龄呈下降趋势（P〈0.01）,且生后前半年的下降速度均是后半年下降速度的5~6倍。男童的夜间睡眠时间、连续睡眠能力和睡眠效率均稍差于女童（P〈0.05）。结论婴儿夜晚睡眠模式在生后前半年,尤其生后3个月内发展迅速。婴儿期部分睡眠参数与性别有关。

Objective To investigate the development of nocturnal sleep pattern in infants. Methods Fifty healthy full-term newborns born in Chongqing Maternal and Child Health Care Hospital were chosen for a prospective longitudinal study. A non-invasive sleep monitor, Actiwatch, was used to monitor infants＇ 12 sleep parameters on the 10 th day, 28 th day, the first Tuesday at the 2nd, 3rd, 4th, 5th, 6th, 9th and 12 th month after birth, each monitoring time lasting 60 hours. All sleep parameters were analyzed by two-level mixed effect model. Results Twenty-two boys and 25 girls completed the whole follow-up study. From birth to the 12 th month after birth, the nocturnal sleep onset latency（NSOL） decreased by about 48% at 3 months of age and by 83% at 6 months of age. The nocturnal sleep efficiency（NSE%） increased from 66% to 87%, the nocturnal total sleep time（NTST） increased from 416 minutes to 517 minutes, and the longest nocturnal continuous sleeping time（L-NCST） increased from 197 minutes to 327 minutes. NSE%, NTST and L-NCST increased with age（P〈0.01）. The 3rd to 12 th month ratios of NSE%, NTST and L-NCST were 86%, 84% and 72%, respectively, and the 6th to 12 th month ratios of those were 97%, 91% and 94%, respectively. The nocturnal total wake time（NTWT） and longest nocturnal continuous waking times（L- NCWT） decreased with age（P〈0.01）. The decline speeds in the first half year were 5-6 times of those in the second half year after birth（P〈0.05）. NTST, nocturnal continuous sleeping ability and NSE% in boys were lower than those in girls（P〈0.05）. Conclusions Infantile nocturnal sleep patterns develop rapidly during the first 6 months, especially within the first 3 months after birth. Partial infantile sleep parameters are related to gender.