儿童青少年睡眠障碍的物理治疗研究进展

Progress in physical therapy for sleep disorders in children and adolescents

睡眠障碍在儿童青少年中非常普遍,在患有神经发育障碍、精神心理疾病等特殊人群中患病率更高,这对儿童青少年睡眠障碍的治疗提出了挑战。儿童青少年睡眠障碍的治疗方法主要包括认知行为治疗、手术治疗、药物治疗及物理治疗。传统的认知行为治疗费用高、合格的睡眠医师及治疗师数量少、患者依从性低。药物治疗虽然是儿童青少年失眠最常用的治疗方法,但缺少适应证和安全性数据的支持,不良反应多,长期疗效未知。通过磁、电、声、光等物理刺激改变中枢和外周神经活性的物理治疗技术可能为无法获得常规治疗、耐受性差或无效的睡眠障碍个体提供有价值的替代治疗选择或补充治疗方案。现就经颅磁刺激、经颅直流电刺激、光照疗法和高压氧治疗4种临床常见的物理治疗及其在儿童青少年睡眠障碍中的应用进展进行综述,为今后儿童青少年睡眠障碍临床治疗提供科学依据和新思路。

Sleep disorders are common in children and adolescents,especially in those with neurodevelopmental and mental disorders,but treatment strategies remain limited.The main therapeutic methods for sleep disorders in children and adolescents include cognitive behavioral therapy,surgical therapy,drug therapy,and physical therapy.Conventional cognitive behavioral therapy is expensive;plus,the number of qualified sleep physicians and therapists is limited,and patient′s compliance is low.Drug therapy is the most commonly used treatment for insomnia in children and adolescents,but it lacks evidence-based indications and safety and has many adverse reactions,and its long-term efficacy is unknown.Physical therapy that changes the activity of central and peripheral nerves through physical stimulation such as magnetism,electricity,sound and light can provide valuable alternative or complementary treatment for individuals with sleep disorders who can′t get conventional treatment,have poor tolerance or are ineffective.In this paper,4 common clinical physical therapies(transcranial magnetic stimulation,transcranial direct current stimulation,light therapy,and hyperbaric oxygen therapy)and their application in treating sleep disorders in children and adolescents are reviewed,providing scientific basis and new ideas for the future clinical treatment of sleep disorders in children and adolescents.