Unit of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Center, Mainz, Germany; Working Group on Pediatric Sleep Medicine, Department of Neonatology, University Children's Hospital, Tuebingen, Germany.
Sleep Med. 2013 Oct;14(10):1005-12. doi: 10.1016/j.sleep.2013.05.014. Epub 2013 Aug 28.
We aimed to assess subjective and objective sleepiness in schoolchildren and adolescents by using questionnaires and the Pupillographic Sleepiness Test (PST).
An observational, cross-sectional, community-based study was performed. Participants were recruited and balanced by age and gender from schools using stratified random sampling. Sleep problems and subjective sleepiness were assessed using parent- and self-reported questionnaires. Objective sleepiness was assessed in schools under standardized conditions by using the PST and by calculating the natural logarithm of the pupillary unrest index (lnPUI).
In total 163 children (82 boys; age range, 6.6-17.8 years) were enrolled. Age and sleep problems were predictors of subjective sleepiness. Nine PST recordings (5.5%) were excluded due to artifacts (feasibility, 94%). Gender, sleep problems, and sleep duration were predictors of objective sleepiness. Compared to adults (age range, 20-60 years), the lnPUI was higher in children (mean±standard deviation [SD], 1.5±0.4 vs. 2.0±0.4; P<.001) and showed significant gender differences. There was no agreement between measures of subjective sleepiness and the lnPUI (r<0.3). After excluding children with sleep problems, preliminary reference values (mean±SD) for the lnPUI were 2.01±0.43 for boys and 1.93±0.43 for girls, respectively.
The PST is a feasible method in schoolchildren and adolescents. Sleep problems are predictors of both subjective and objective sleepiness; there is no agreement between the latter. Results of the PST are influenced by sleep duration and specific pediatric gender-stratified reference values are definitively needed.
我们旨在通过问卷和瞳孔睡眠测试（PST）评估学童和青少年的主观和客观嗜睡情况。
进行了一项观察性、横断面、基于社区的研究。通过分层随机抽样，从学校中按年龄和性别招募并平衡参与者。使用家长和自我报告的问卷评估睡眠问题和主观嗜睡情况。在标准化条件下，通过 PST 和计算瞳孔无规则指数的自然对数（lnPUI）在学校评估客观嗜睡情况。
共纳入 163 名儿童（82 名男孩；年龄范围 6.6-17.8 岁）。年龄和睡眠问题是主观嗜睡的预测因素。由于伪影，排除了 9 份 PST 记录（5.5%）（可行性，94%）。性别、睡眠问题和睡眠时间是客观嗜睡的预测因素。与成年人（年龄范围 20-60 岁）相比，儿童的 lnPUI 更高（均值±标准差 [SD]，1.5±0.4 与 2.0±0.4；P<.001），且存在显著的性别差异。主观嗜睡测量与 lnPUI 之间没有一致性（r<0.3）。在排除有睡眠问题的儿童后，lnPUI 的初步参考值（均值±SD）分别为男孩 2.01±0.43，女孩 1.93±0.43。
PST 是一种在学童和青少年中可行的方法。睡眠问题是主观和客观嗜睡的预测因素；后者之间没有一致性。PST 的结果受睡眠时间的影响，需要明确的特定儿科性别分层参考值。
