Jenni Oskar G, LeBourgeois Monique K
Child Development Center, Department of Pediatrics, University Children's Hospital Zürich, Zürich, Switzerland.
Curr Opin Psychiatry. 2006 May;19(3):282-7. doi: 10.1097/01.yco.0000218599.32969.03.
Sleep-wake problems such as night wakings, excessive crying, or difficulties in falling asleep are frequent behavioral issues during childhood. Maturational changes in sleep and circadian regulation likely contribute to the development and maintenance of such problems. This review highlights the recent research examining bioregulatory sleep mechanisms during development and provides a model for predicting sleep-wake behavior in young humans.
Findings demonstrate that circadian and sleep homeostatic processes exhibit maturational changes during the first two decades of life. The developing interaction of both processes may be a key determinant of sleep-wake and crying behavior in infancy. Evidence shows that the dynamics of sleep homeostatic processes slow down in the course of childhood (i.e., sleep pressure accumulates more slowly with increasing age) enabling children to be awake for consolidated periods during the day. Another current topic is the adolescent sleep phase delay, which appears to be driven primarily by maturational changes in sleep homeostatic and circadian processes.
The two-process model of sleep regulation is a valuable framework for understanding and predicting sleep-wake behavior in young humans. Such knowledge is important for improving anticipatory guidance, parental education, and patient care, as well as for developing appropriate social policies.
夜醒、过度哭闹或入睡困难等睡眠-觉醒问题是儿童期常见的行为问题。睡眠和昼夜节律调节的成熟变化可能导致此类问题的发生和持续存在。本综述重点介绍了近期关于发育过程中生物调节睡眠机制的研究，并提供了一个预测年轻人睡眠-觉醒行为的模型。
研究结果表明，昼夜节律和睡眠稳态过程在生命的前二十年中呈现出成熟变化。这两个过程不断发展的相互作用可能是婴儿睡眠-觉醒和哭闹行为的关键决定因素。有证据表明，睡眠稳态过程的动态变化在儿童时期会减缓（即随着年龄增长，睡眠压力积累得更慢），使儿童能够在白天保持较长时间的清醒。另一个当前的话题是青少年睡眠相位延迟，这似乎主要由睡眠稳态和昼夜节律过程的成熟变化所驱动。
睡眠调节的双过程模型是理解和预测年轻人睡眠-觉醒行为的宝贵框架。这些知识对于改善预期指导、家长教育和患者护理，以及制定适当的社会政策都很重要。
