Krakowiak Paula, Goodlin-Jones Beth, Hertz-Picciotto Irva, Croen Lisa A, Hansen Robin L
Division of Epidemiology, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, USA.
J Sleep Res. 2008 Jun;17(2):197-206. doi: 10.1111/j.1365-2869.2008.00650.x.
This study compared parent-reported sleep characteristics in 2- to 5-year-old children with autism spectrum disorders (ASD) to children with other developmental delays (DD) and typical development (TD). We included 529 children (303 ASD [167 males], 63 DD [46 males], and 163 TD [134 males]) enrolled in the CHARGE study, an ongoing population-based case-control study. The mean age of participants was 3.6 years (standard deviation, 0.8 years). ASD diagnosis was confirmed with Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedules (ADOS). Cognitive and adaptive functioning was assessed using Mullen Scales of Early Learning (MSEL) and Vineland Adaptive Behavior Scales (VABS), respectively. Demographic, medical and sleep history information were ascertained from California birth records, telephone interview, medical assessments at clinic visit, and parent-administered questionnaires. Fifty-three percent of children with ASD had at least one frequent sleep problem, followed by 46% of children with DD, and 32% of the TD group (P < 0.0001). Exploratory factor analyses of sleep history data yielded two factors: sleep onset problems and night waking. Children with ASD had marginally higher sleep onset factor scores and significantly higher night waking factor scores compared with the TD group. Factor scores for children with DD were intermediate between the ASD and TD groups. Cognitive or adaptive development did not predict severity of sleep problems in the ASD group.
本研究比较了自闭症谱系障碍（ASD）2至5岁儿童与其他发育迟缓（DD）儿童及发育正常（TD）儿童中家长报告的睡眠特征。我们纳入了参与CHARGE研究的529名儿童（303名ASD儿童[167名男性]、63名DD儿童[46名男性]和163名TD儿童[134名男性]），这是一项正在进行的基于人群的病例对照研究。参与者的平均年龄为3.6岁（标准差为0.8岁）。ASD诊断通过修订版自闭症诊断访谈（ADI-R）和自闭症诊断观察量表（ADOS）得以确认。认知和适应功能分别使用早期学习穆伦量表（MSEL）和文兰适应行为量表（VABS）进行评估。人口统计学、医学和睡眠史信息通过加利福尼亚州出生记录、电话访谈、门诊医疗评估以及家长填写的问卷来确定。53%的ASD儿童至少有一个常见睡眠问题，其次是46%的DD儿童和32%的TD组儿童（P<0.0001）。对睡眠史数据进行探索性因素分析得出两个因素：入睡问题和夜间醒来。与TD组相比，ASD儿童的入睡因素得分略高，夜间醒来因素得分显著更高。DD儿童的因素得分介于ASD组和TD组之间。认知或适应性发育并不能预测ASD组睡眠问题的严重程度。
