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幼儿的昼夜节律相位及其与夜间睡眠的关系。

Circadian phase and its relationship to nighttime sleep in toddlers.

机构信息

Sleep and Development Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.

出版信息

J Biol Rhythms. 2013 Oct;28(5):322-31. doi: 10.1177/0748730413506543.


DOI:10.1177/0748730413506543
PMID:24132058
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3925345/
Abstract

Circadian phase and its relation to sleep are increasingly recognized as fundamental factors influencing human physiology and behavior. Dim light melatonin onset (DLMO) is a reliable marker of the timing of the circadian clock, which has been used in experimental, clinical, and descriptive studies in the past few decades. Although DLMO and its relationship to sleep have been well documented in school-aged children, adolescents, and adults, very little is known about these processes in early childhood. The purpose of this study was 1) to describe circadian phase and phase angles of entrainment in toddlers and 2) to examine associations between DLMO and actigraphic measures of children's nighttime sleep. Participants were 45 healthy toddlers aged 30 to 36 months (33.5 ± 2.2 months; 21 females). After sleeping on a parent-selected schedule for 5 days (assessed with actigraphy and diaries), children participated in an in-home DLMO assessment involving the collection of saliva samples every 30 minutes for 6 hours. Average bedtime was 2015 ± 0036 h, average sleep onset time was 2043 ± 0043 h, average midsleep time was 0143 ± 0038 h, and average wake time was 0644 ± 0042 h. Average DLMO was 1929 ± 0051 h, with a 3.5-hour range. DLMO was normally distributed; however, the distribution of the bedtime, sleep onset time, and midsleep phase angles of entrainment were skewed. On average, DLMO occurred 47.8 ± 47.6 minutes (median = 39.4 minutes) before bedtime, 74.6 ± 48.0 minutes (median = 65.4 minutes) before sleep onset time, 6.2 ± 0.7 hours (median = 6.1 hours) before midsleep time, and 11.3 ± 0.7 hours before wake time. Toddlers with later DLMOs had later bedtimes (r = 0.46), sleep onset times (r = 0.51), midsleep times (r = 0.66), and wake times (r = 0.65) (all p < 0.001). Interindividual differences in toddlers' circadian phase are large and associated with their sleep timing. The early DLMOs of toddlers indicate a maturational delay in the circadian timing system between early childhood and adolescence. These findings are a first step in describing the fundamental properties of the circadian system in toddlers and have important implications for understanding the emergence of sleep problems and the consequences of circadian misalignment in early childhood.

摘要

昼夜节律相位及其与睡眠的关系越来越被认为是影响人类生理和行为的基本因素。褪黑素分泌起始时间(DLMO)是昼夜节律计时的可靠标志物,在过去几十年的实验、临床和描述性研究中得到了应用。尽管在学龄儿童、青少年和成年人中已经很好地记录了 DLMO 及其与睡眠的关系,但对于幼儿期的这些过程知之甚少。本研究的目的是 1)描述幼儿的昼夜节律相位和授时相位角,2)探讨 DLMO 与儿童夜间睡眠的活动记录仪测量值之间的关系。参与者为 45 名健康的 30 至 36 个月大的幼儿(33.5±2.2 个月;21 名女性)。在按照父母选择的时间表连续 5 天睡眠(通过活动记录仪和日记评估)后,孩子们在家中进行了一次 DLMO 评估,包括每 30 分钟采集一次唾液样本,持续 6 小时。平均入睡时间为 2015±0036 h,平均入睡时间为 2043±0043 h,平均午夜时间为 0143±0038 h,平均醒来时间为 0644±0042 h。平均 DLMO 为 1929±0051 h,范围为 3.5 小时。DLMO 呈正态分布;然而,睡眠时间、入睡时间和午夜相位授时的分布呈偏态。平均而言,DLMO 发生在睡前 47.8±47.6 分钟(中位数=39.4 分钟),发生在入睡时间前 74.6±48.0 分钟(中位数=65.4 分钟),发生在午夜时间前 6.2±0.7 小时(中位数=6.1 小时),发生在醒来时间前 11.3±0.7 小时。DLMO 较晚的幼儿,其入睡时间(r=0.46)、入睡时间(r=0.51)、午夜时间(r=0.66)和醒来时间(r=0.65)均较晚(均 p<0.001)。幼儿昼夜节律相位的个体间差异较大,与他们的睡眠时间有关。幼儿早期的 DLMO 表明,从幼儿期到青春期,昼夜节律计时系统存在发育延迟。这些发现是描述幼儿昼夜节律系统基本特性的第一步,对于理解儿童早期睡眠问题的出现和昼夜节律失调的后果具有重要意义。

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本文引用的文献

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