1～23个月儿童睡眠问题的流行病学研究

An epidemiological study on sleep problems in children aged 1 to 23 months in Shanghai

目的 了解上海市 1～ 2 3个月儿童常见睡眠问题的发生以及不良睡眠习惯的存在状况 ,分析可能影响儿童睡眠问题发生的高危因素。方法 2 0 0 0年 8～ 9月间在上海 5个行政区随机抽取 12 5 2名无严重疾病和异常出生史的正常儿童 ,在严格质量控制的条件下由专人负责对其家长进行儿童家庭社会环境与睡眠健康问卷调查。调查的应答率为 90 18%。结果 上海地区 1～ 2 3个月儿童睡眠问题的发生率为 6 5 90 % ,其中梦魇及夜惊、鼾症及睡眠呼吸暂停男孩的发生率明显高于女孩。儿童不良睡眠习惯包括与父母同睡、入睡需要帮助及睡眠无规律等的发生率较高。影响儿童睡眠问题的主要因素有母亲有焦虑情绪、儿童睡眠无规律、入睡需要帮助、困难型气质及母亲孕期睡眠等。结论 目前上海地区 1～ 2 3个月儿童睡眠问题的发生率较高 ,其主要影响因素还是以社会家庭环境因素为主 ,尤其是父母不重视儿童良好睡眠习惯的养成 ,以及对孩子睡眠行为的不正确应答所致。

Objective To understand prevalence of sleep problems and presence of improper sleep habit of children aged one to 23 months in Shanghai, and to identify their related factors. Methods Totally, 1 252 normal children, without severe illness and abnormal delivery history, aged one to 23 months were randomly selected from five districts of Shanghai.Under strict quality control system, their parents were interviewed with questionnaire to look into their familial and social environment, as well as sleep-related factors. Results Fully-completed information was obtained in 1 129 of 1 252 children, with a response rate of 90.18%.Prevalence of sleep problems in children was 65.90% in Shanghai, remarkably higher than in the other areas.Prevalence of nightmare, frightenedness at night, snore and sleep apnea in boys were significantly higher than those in girls.Prevalence of improper sleep habit in children was also higher, including cosleeping with their parents, parental presence at sleep onset and irregular sleep time.Main risk factors related to children′s sleep problems were maternal anxiety, children′s irregular sleep time, parental presence at sleep onset, difficulty-type temperament and maternal poor sleep during pregnancy.Conclusions In Shanghai, prevalence of sleep problems in children aged one to 23 months was relatively higher and main risk factors for them were social, cultural and familial environment, especially negligence of cultivating proper sleep habit and parental improper response to children′s poor sleep behavior.