Stores Gregory, Montgomery Paul, Wiggs Luci
Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
Pediatrics. 2006 Oct;118(4):e1116-23. doi: 10.1542/peds.2006-0647.
Narcolepsy is a predominantly rapid eye movement sleep disorder with onset usually in the second decade but often in earlier childhood. Classically it is characterized by combinations of excessive sleepiness especially sleep attacks, cataplexy, hypnagogic hallucinations, and sleep paralysis. The psychosocial effects of this lifelong condition are not well documented, especially in children. This study aims to describe the psychosocial profile of a large group of children with narcolepsy compared with other excessively sleepy children and controls.
We used an international cross-sectional questionnaire survey of children aged from 4 to 18 years who had received from a physician a diagnosis of narcolepsy compared with age- and gender-matched controls. Assessments were made of behavior, mood, quality of life, and educational aspects.
Recruited children were separated into those who met conventional criteria for narcolepsy (n = 42) and those whose primary complaint was excessive daytime sleepiness without definite additional features of narcolepsy (excessive daytime sleepiness group; n = 18). Compared with controls, children with narcolepsy and also those with excessive daytime sleepiness alone showed significantly higher rates of behavioral problems and depression. Again, to a significant extent, their quality of life was poorer and they had more educational problems. The children with narcolepsy and the excessive daytime sleepiness group were indistinguishable from each other on these measures.
A range of psychosocial problems can be identified in children with narcolepsy. The origins of these problems are unclear. The similar profiles of difficulties in the narcolepsy and excessive daytime sleepiness groups suggest that excessive sleepiness is the main cause. Clinicians and others responsible for the care of such children need to be mindful of the importance of early detection, intervention, and, ideally, the prevention of these problems.
发作性睡病是一种主要的快速眼动睡眠障碍，通常在第二个十年发病，但常在儿童早期发病。典型症状包括过度嗜睡尤其是睡眠发作、猝倒、入睡幻觉和睡眠麻痹。这种终身疾病的社会心理影响尚无充分记录，尤其是在儿童中。本研究旨在描述一大群发作性睡病儿童与其他过度嗜睡儿童及对照组相比的社会心理特征。
我们对4至18岁已被医生诊断为发作性睡病的儿童进行了一项国际横断面问卷调查，并与年龄和性别匹配的对照组进行比较。对行为、情绪、生活质量和教育方面进行了评估。
招募的儿童分为符合发作性睡病传统标准的儿童（n = 42）和主要抱怨为白天过度嗜睡但无发作性睡病明确附加特征的儿童（白天过度嗜睡组；n = 18）。与对照组相比，发作性睡病儿童以及仅白天过度嗜睡的儿童行为问题和抑郁发生率显著更高。同样，在很大程度上，他们的生活质量较差，教育问题更多。在这些指标上，发作性睡病儿童和白天过度嗜睡组儿童之间没有区别。
发作性睡病儿童存在一系列社会心理问题。这些问题的根源尚不清楚。发作性睡病组和白天过度嗜睡组的困难情况相似，表明过度嗜睡是主要原因。临床医生和其他负责照顾此类儿童的人员需要意识到早期发现、干预以及理想情况下预防这些问题的重要性。
