Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine, Seattle, WA, USA.
J Clin Sleep Med. 2012 Aug 15;8(4):421-9. doi: 10.5664/jcsm.2038.
Sleep problems in children with fetal alcohol spectrum disorders (FASD) are reportedly common but not well characterized. Objectives were to: (1) assess sleep concerns in children with FASD using a caregiver-report survey, the Children's Sleep Habits Questionnaire (CSHQ); (2) compare CSHQ results with those of previously reported community sample; and (3) describe pilot polysomnography findings in children with FASD.
Children with FASD were recruited from a behavioral intervention study, and participating caregivers completed the CSHQ. CSHQ results were compared with the original data from a previously published community sample of similar age. Participants with FASD and elevated CSHQ scores were offered overnight polysomnography.
Thirty-three children with FASD (4.1-12.1 years) were enrolled; 85% of children with FASD scored above the clinical cutoff Total Score of 41, reflecting marked sleep disturbance. Elevated subdomain scores occurred primarily in areas concerning for pediatric insomnia. Those with comorbid ADHD had elevated CSHQ on additional subdomains with no difference in Total Scores. Compared with the community sample, children with FASD had higher Total Scores on the CSHQ (52 vs. 39, p < 0.001). Polysomnography, completed in 5 subjects, revealed mild sleep disordered breathing and fragmented sleep with elevated non-respiratory arousal indices.
Clinically significant sleep problems are present in children with FASD on both subjective and objective measures. Further investigation is needed to better describe these sleep disturbances and their impact on overall health and daytime neurobehavioral problems in this clinical population.
据报道，患有胎儿酒精谱系障碍（FASD）的儿童存在睡眠问题，但尚未得到充分描述。本研究旨在：（1）使用照顾者报告调查问卷（儿童睡眠习惯问卷，CSHQ）评估 FASD 儿童的睡眠问题；（2）将 CSHQ 结果与先前报道的社区样本进行比较；（3）描述 FASD 儿童的初步多导睡眠图研究结果。
从一项行为干预研究中招募了患有 FASD 的儿童，参与的照顾者完成了 CSHQ。将 CSHQ 结果与先前发表的社区样本的原始数据进行比较。CSHQ 评分升高的 FASD 患儿接受了过夜多导睡眠图检查。
共纳入 33 名患有 FASD（4.1-12.1 岁）的儿童；85%的 FASD 患儿的 CSHQ 总分超过 41 分的临床临界值，表明存在明显的睡眠障碍。主要在与儿童失眠相关的领域出现了升高的子域评分。患有共病 ADHD 的患儿在 CSHQ 的其他子域中出现了升高的评分，但总分没有差异。与社区样本相比，FASD 患儿的 CSHQ 总分更高（52 分 vs. 39 分，p<0.001）。5 名患儿完成了多导睡眠图检查，结果显示存在轻度睡眠呼吸障碍和睡眠片段化，非呼吸性觉醒指数升高。
FASD 儿童在主观和客观测量中均存在明显的睡眠问题。需要进一步研究以更好地描述这些睡眠障碍及其对该临床人群整体健康和日间神经行为问题的影响。
