Department of Neurology, Charles University, 1st Faculty of Medicine and General Teaching Hospital, Katerinska 30, 128 00 Prague 2, Czech Republic.
Eur J Paediatr Neurol. 2013 Nov;17(6):615-9. doi: 10.1016/j.ejpn.2013.05.004. Epub 2013 Jun 15.
Childhood parasomnias are believed to be a benign disorder due to immaturity of some neural circuits, synapses and receptors. The aim of our study was to explore a possible connection with other neurological developmental disorders.
72 children (mean age 9.9 ± 5.0 years, 47 boys) were clinically examined and 88 nocturnal v-PSG and 22 v-EEG recordings were evaluated. The most frequent diagnostic findings were: sleepwalking in 24 children, confusional arousal in 21, sleep terror in 8, groaning and enuresis each in 7, non-specific arousal disorder in 4 patients, and REM-related parasomnia in only one child. For statistical evaluation chi-square test, the two-sample t-test and Mann-Whitney rank test were used.
Perinatal risk history was found in 38% of the cohort. Developmental disorders were diagnosed in 30 children (41.7%), more frequently in combinations with: attention-hyperactivity disorder (30.6%), dyslexia and dysgraphia (13.9%), developmental dysphasia (9.7%), mild motor and/or intellectual dysfunction (6.9%). Abnormal movements in sleep, some of them also regarded as developmental, were diagnosed in 37 children (51.4%). Sleep-related breathing disorders were found in 29 patients (40.3%) -snoring (29.2%) and/or sleep apnea (11.1%). Only 16.7% had no comorbidity. Most of the children (60%) showed 2 or 3, exceptionally up to 5 comorbidities. Children, in whom no parasomnia was found in close relatives, had a mild but non-significant earlier onset of the disease (4.4 ± 4.0 against 6.3 ± 4.3 years).
Childhood parasomnias are frequently associated with perinatal risk factors and developmental comorbidities, and can be regarded as a disorder of sleep maturation.
儿童期睡眠障碍被认为是一种良性疾病，其发生原因是部分神经回路、突触和受体发育不成熟。我们的研究目的是探索其与其他神经发育障碍之间可能存在的关联。
对 72 名儿童（平均年龄 9.9 ± 5.0 岁，男 47 名）进行临床检查，对 88 次夜间 v-PSG 和 22 次 v-EEG 记录进行评估。最常见的诊断发现包括：24 名儿童梦游，21 名儿童意识模糊，8 名儿童睡眠恐怖症，7 名儿童呻吟和遗尿，4 名儿童非特异性觉醒障碍，仅 1 名儿童出现 REM 相关睡眠障碍。为进行统计评估，采用卡方检验、两样本 t 检验和曼-惠特尼秩检验。
该队列中 38%的儿童有围产期危险因素史。30 名儿童（41.7%）被诊断为发育障碍，更常见的是与注意力缺陷多动障碍（30.6%）、阅读障碍和书写障碍（13.9%）、发育性语言障碍（9.7%）、轻度运动和/或智力功能障碍（6.9%）联合存在。37 名儿童（51.4%）被诊断为睡眠期异常运动，其中一些也被认为是发育性的。29 名患者（40.3%）存在睡眠相关呼吸障碍，包括打鼾（29.2%）和/或睡眠呼吸暂停（11.1%）。仅有 16.7%的儿童无合并症。大多数儿童（60%）有 2 种或 3 种，极少数儿童（13.3%）有 5 种合并症。在近亲中未发现睡眠障碍的儿童，其疾病发病年龄较早（4.4 ± 4.0 岁 vs. 6.3 ± 4.3 岁），但无统计学意义。
儿童期睡眠障碍常与围产期危险因素和发育合并症相关，可被视为一种睡眠成熟障碍。
