学龄前孤独症谱系障碍儿童睡眠问题的影响因素分析

关键词：孤独症谱系障碍  睡眠  影响因素

Keywords:autism spectrum disorder  sleep  influencing factor

摘要：

      摘要 目的：探讨学龄前孤独症谱系障碍儿童睡眠问题的影响因素。 方法：选取学龄前孤独症谱系障碍儿童142例，使用儿童睡眠习惯问卷（CSHQ）进行睡眠习惯调查，使用0—6岁儿童神经心理发育量表、儿童孤独症评定量表（CARS）、孤独症行为评定量表（ABC）、长处和困难问卷（SDQ）、感觉讯息处理及自我调节功能检核表（SPSRC）对儿童躯体功能、核心症状、感觉统合、情绪状况进行调查。使用焦虑自评量表（SAS）、抑郁自评量表（SDS）评估照顾者的焦虑及抑郁状况，得出学龄前孤独症谱系障碍儿童睡眠问题的影响因素。 结果：睡眠障碍临床检出率82%，学龄前ASD儿童睡眠问题的主要特征为就寝习惯差（57.7%）、异态睡眠（47.1%）、入睡潜伏期延长（35.2%）、睡眠焦虑（34.5%）、睡眠时间（0.09%）、白天嗜睡（0.05%）、夜醒（0%）、睡眠呼吸障碍（0%）；相关性分析结果发现，CSHQ总分和CARS、ABC总分、感觉、交往、语言能力、SDQ（情绪分量表）、SAS、SDS均呈正相关（P＜0.05），其中CSHQ总分和CARS、ABC总分、感觉、交往、语言能力、SAS、SDS呈显著正相关（P＜0.001）。CSHQ总分和视觉、触觉、前庭平衡感觉、本体感觉均呈负相关（P＜0.05），其中CSHQ总分与触觉呈显著负相关（P＜0.001）；多重线性回归分析结果表明，CARS、感觉、语言能力、触觉是ASD儿童睡眠问题的影响因素。 结论：ASD儿童以就寝习惯差、入睡潜伏期延长、睡眠焦虑、异态睡眠表现型为主要特征；ASD症状严重程度、感觉、语言能力可能为ASD儿童睡眠问题的预测因素。

Abstract:

      Abstract Objective：To explore the influencing factors of sleep problems in preschool children with autism spectrum disorder. Method：A total of 142 preschool children with autism spectrum disorder were selected to investigate their sleep habits using the children's sleep habits questionnaire （CSHQ）. The children's physical function， core symptoms， sensory integration and emotional status were evaluated using the neuropsychological development scale， children's autism rating scale （CARS）， autism behavior rating scale （ABC）， strengths and difficulties questionnaire （SDQ）， and sensory information processing and self-regulation function checklist （SPSRC） for 0—6 years old children investigate. Self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were used to evaluate the anxiety and depression status of caregivers. To study the influencing factors of sleep problems in preschool children with autism spectrum disorder. Result：The clinical detection rate of sleep disorder was 82%. The main characteristics of sleep problems in preschool children with ASD were poor sleeping habits （57.7%）， abnormal sleep （47.1%）， prolonged sleep latency （35.2%）， sleep anxiety （34.5%）， sleep duration （0.09%）， daytime sleepiness （0.05%）， night wakefulness （0%）， and sleep dyspnea （0%）. Correlation analysis results showed that CSHQ score was positively correlated with CARS， ABC score， sensation， communication， language ability， SDQ （emotional subscale）， SAS and SDS （P<0.05）. The total score of CSHQ was significantly positively correlated with the total score of CARS， ABC， sensation， communication， language ability， SAS and SDS （P<0.001）. The total CSHQ score was negatively correlated with the sense of vision， touch， vestibular balance and proprioception （P<0.05）， and the total CSHQ score was significantly negatively correlated with the sense of touch （P<0.001）. Multiple linear regression analysis indicated that CARS， sensation， language ability and touch were significant factors influencing sleep problems in children with ASD. Conclusion：Preschool children with ASD commonly exhibit poor bedtime habits, prolonged sleep latency, sleep anxiety, and abnormal sleep patterns. The severity of ASD symptoms， sensory and language skills may serve as predictors of sleep problems in children with ASD.