Paavonen E Juulia, Nieminen-von Wendt Taina, Vanhala Raija, Aronen Eeva T, von Wendt Lennart
Department of Child Psychiatry, University of Helsinki, Lastenlinnantie 11 C 29, PO Box 280, 00029 HUS, Helsinki, Finland.
J Child Adolesc Psychopharmacol. 2003 Spring;13(1):83-95. doi: 10.1089/104454603321666225.
Sleep disturbances are common in patients with Asperger disorder. Although these sleep problems are often persistent and may significantly impair the child's daytime well-being, no treatment studies have been reported. In this open clinical trial, the effectiveness of melatonin was studied in a sample of 15 children with Asperger disorder (13 boys, 2 girls) aged 6-17 years using several questionnaires and actigraph measurements. They included assessments of sleep quality, tiredness, and behavior. Melatonin (3 mg/day) was used for 14 days. All the measurements were made three times: before the treatment period, during the treatment (days 12-14), and 3 weeks after the discontinuation of the treatment. The sleep patterns of all the children improved, and half of them displayed excellent responses to melatonin. In particular, actigraphically measured sleep latency decreased from 40.02 +/- 24.09 minutes to 21.82 +/- 9.64 minutes (p = 0.002), whereas sleep duration remained steady at 477.40 +/- 55.56 minutes and 480.48 +/- 50.71 minutes. Despite the short duration of the treatment, behavioral measures also displayed a significant improvement, and most of the effect disappeared after the discontinuation of the melatonin (p = 0.001). In conclusion, melatonin may provide an interesting new and well-tolerated treatment option for children with Asperger disorder suffering from chronic insomnia. However, these results must be confirmed in a controlled study.
睡眠障碍在阿斯伯格综合征患者中很常见。尽管这些睡眠问题往往持续存在,可能会严重损害儿童的日间健康,但尚未有治疗研究报告。在这项开放性临床试验中,使用几份问卷和活动记录仪测量方法,对15名年龄在6至17岁的阿斯伯格综合征儿童(13名男孩,2名女孩)进行了褪黑素疗效研究。测量内容包括对睡眠质量、疲劳程度和行为的评估。使用褪黑素(3毫克/天),为期14天。所有测量均进行三次:治疗期前、治疗期间(第12至14天)以及治疗停止后3周。所有儿童的睡眠模式均有改善,其中一半对褪黑素表现出良好反应。特别是,通过活动记录仪测量的入睡潜伏期从40.02±24.09分钟降至21.82±9.64分钟(p = 0.002),而睡眠时间则稳定在477.40±55.56分钟和480.48±50.71分钟。尽管治疗时间较短,但行为测量也显示出显著改善,且褪黑素停用后大部分效果消失(p = 0.001)。总之,褪黑素可能为患有慢性失眠的阿斯伯格综合征儿童提供一种有趣的、耐受性良好的新治疗选择。然而,这些结果必须在对照研究中得到证实。