Smedje H, Broman J E, Hetta J
Department of Neuroscience, Psychiatry and Child and Adolescent Psychiatry, University Hospital, Uppsala, Sweden.
Acta Paediatr. 2001 Dec;90(12):1456-63. doi: 10.1080/08035250152708897.
The course and psychological correlates of disturbed sleep during middle childhood were investigated using parents' responses to questionnaires. Five specified sleep disturbances were explored in 614 5-8-y-old children, at baseline and at follow-up, 14 +/- 3 mo later. Difficulties falling asleep, in 6.2% of the children at baseline, persisted in 47.4% of the cases at follow-up; night-waking, in 18.6% at baseline, persisted in 45.5%; snoring, in 9.4% at baseline, persisted in 60%; nightmares, in 4.4% at baseline, persisted in 29.6%, and bedwetting, in 6% at baseline, persisted in 46%. Moreover, children with difficulties falling asleep at baseline frequently displayed bedtime resistance and shorter sleep at follow-up, while night-waking at baseline was related to co-sleeping at follow-up. Snoring at baseline was associated with a trend towards restless sleep at follow-up. Nightmares at baseline were related to several other sleep complaints as well as to behavioural difficulties during daytime at follow-up. Bedwetting at baseline was associated with tendencies towards hyperactivity at follow-up. Separate analyses of cases of persisting sleep disturbances showed that persisting difficulties falling asleep were associated with a need to remedy sleep problems, while persisting nightmares were strongly related to reports suggesting behavioural and emotional problems.
During middle childhood, difficulties falling asleep, night-waking, snoring, nightmares or bedwetting commonly persist over the course of a year. Persistent nightmares frequently indicate significant psychological problems in affected children.
通过父母对问卷的回答,对童年中期睡眠障碍的过程及其心理关联因素进行了调查。在614名5至8岁儿童的基线期以及14±3个月后的随访期,对五种特定的睡眠障碍进行了探究。入睡困难方面,基线期6.2%的儿童存在该问题,随访期有47.4%的病例持续存在;夜间醒来方面,基线期为18.6%,随访期持续存在的比例为45.5%;打鼾方面,基线期为9.4%,随访期持续存在的比例为60%;噩梦方面,基线期为4.4%,随访期持续存在的比例为29.6%;尿床方面,基线期为6%,随访期持续存在的比例为46%。此外,基线期入睡困难的儿童在随访期经常表现出就寝抗拒且睡眠时间较短,而基线期夜间醒来与随访期同床睡眠有关联。基线期打鼾与随访期睡眠不安稳的趋势相关。基线期做噩梦与其他几种睡眠问题以及随访期白天的行为困难有关。基线期尿床与随访期多动倾向有关联。对持续存在睡眠障碍的病例进行单独分析显示,持续的入睡困难与解决睡眠问题的需求有关,而持续的噩梦与表明行为和情绪问题的报告密切相关。
在童年中期阶段,入睡困难、夜间醒来、打鼾、做噩梦或尿床等情况通常会在一年的时间里持续存在。持续的噩梦常常表明受影响儿童存在严重的心理问题。