孤独症谱系障碍患儿的睡眠特征及其相关性研究

Sleep characteristics and correlation of children with autism spectrum disorder

目的研究孤独症谱系障碍(ASD)患儿睡眠状况、特征及其与年龄、神经发育功能、核心症状严重程度的相关性。方法选取2019年1月至2020年7月在清远市妇幼保健院儿童语言行为科诊治的ASD患儿,符合入选标准的ASD患儿共198例,最终顺利完成评估的患儿共150例,其中男性116例、女性34例,年龄(3.57±1.24)岁。采用儿童睡眠习惯调查问卷(CSHQ)评估睡眠,盖泽尔发展量表(GDS)评估神经发育功能,儿童孤独症评定量表(CARS)评估核心症状严重程度,确定不同年龄、神经发育功能和核心症状严重程度患儿的睡眠特征。结果共患睡眠障碍的患儿共占60.0%(90/150),其在不同年龄、神经发育功能和核心症状严重程度分组组间比较差异均有统计学意义(均P<0.05)。CSHQ各分量表分值及总分在不同年龄组间比较,差异均无统计学意义(均P>0.05);不同神经发育功能组间比较,睡眠抵触、睡眠焦虑、总分方面,差异均有统计学意义(均P<0.05);不同核心症状严重程度组间比较,睡眠抵触、异态睡眠、睡眠呼吸障碍、总分差异均有统计学意义(均P<0.05)。CSHQ总分与患儿的年龄(r=0.202,P<0.05)、CARS得分(r=0.283,P<0.05)呈正相关,而与神经发育功能得分呈负相关(r=-0.261,P<0.05)。结论ASD患儿常共患睡眠障碍,随着年龄增大和CARS得分越高,共患睡眠障碍的比例增加;但神经发育功能越好,共患睡眠障碍比例则减少。重度发育迟缓患儿睡眠抵触、睡眠焦虑和睡眠障碍更为严重。核心症状越严重其睡眠抵触、异态睡眠、睡眠呼吸障碍、睡眠障碍也越严重。

Objective To study the sleep status and characteristics of children with autism spectrum disorder(ASD)and their correlation with age,neurodevelopmental function,and severity of core symptoms.Methods ASD children diagnosed and treated in the Department of Children's Language Behavior of Maternal and Child Health Hospital of Qingyuan City from Jan.2019 to Jul.2020 were selected,a total of 198 ASD children met the selection criteria,and a total of 150 ASD children were successfully evaluated.Among them,there were 116 males and 34 females,with an age of(3.57±1.24)years old.The sleep was assessed by Children's Sleep Habit Questionnaire(CSHQ),the neurodevelopmental function was assessed by Gesell Development al Scale(GDS),and the severity of core symptoms was assessed by Childhood Autism Rating Scale(CARS),to find out the sleep characteristics in children of different ages,neurodevelopmental functions,and severities of core symptoms.Results Among them,60.0%(90/150)of the children suffered from sleep disorder.There were statistically significant differences among children of different ages,neurodevelopmental functions,and severities of core symptoms(all P<0.05).There were no statistically significant differences in the scores of all subscales and the total score of CSHQ among children of different ages(all P>0.05);there were statistically significant differences in the scores of sleep resistance and sleep anxiety and the total score among children of different neurodevelopmental functions(all P<0.05);there were statistically significant differences in the scores of sleep resistance,abnormal sleep,and dyspnea,and the total score among children of different severities of core symptoms(all P<0.05).CSHQ score was positively correlated with age(r=0.202,P<0.05)and CARS score(r=0.283,P<0.05),but was negatively correlated with neurodevelopmental function score(r=-0.261,P<0.05).Conclusions Children with ASD often suffer from sleep disorders.With the increase of age and the CARS score,the prevalence of sleep disorders in children with ASD increases,but the prevalence of sleep disorders decreases with the improvement of neurodevelopmental function.Sleep resistance,sleep anxiety,and sleep disorders are more serious in children with severe developmental retardation.The more severe the core symptoms are,the more serious their sleep resistance,abnormal sleep,breathing disorder,and sleep disorders are.