小儿失眠行为干预的系统评价与荟萃分析
Systematic review and meta-analysis of behavioral interventions for pediatric insomnia.
作者信息
Meltzer Lisa J, Mindell Jodi A
机构信息
Department of Pediatrics, National Jewish Health, Department of Psychology, Saint Joseph's University, and Sleep Center, Children's Hospital of Philadelphia
Department of Pediatrics, National Jewish Health, Department of Psychology, Saint Joseph's University, and Sleep Center, Children's Hospital of Philadelphia Department of Pediatrics, National Jewish Health, Department of Psychology, Saint Joseph's University, and Sleep Center, Children's Hospital of Philadelphia.
出版信息
J Pediatr Psychol. 2014 Sep;39(8):932-48. doi: 10.1093/jpepsy/jsu041. Epub 2014 Jun 19.
OBJECTIVE
To evaluate and quantify the evidence for behavioral interventions for pediatric insomnia.
METHODS
Meta-analysis of 16 controlled trials and qualitative analysis of 12 within-subject studies were conducted (total n = 2,560).
RESULTS
Meta-analysis found significant effects for four specified sleep outcomes: sleep-onset latency, number of night wakings, and duration of night wakings, and sleep efficiency, with small to large effect sizes across the controlled clinical trials involving typical children. No significant effects were found for the two studies conducted with special needs populations. Finally, within-subjects studies demonstrated significant effects for all sleep outcomes with large effect sizes. Risk of bias assessment and GRADE ratings of the quality of the evidence are described.
CONCLUSION
Moderate-level evidence supports behavioral interventions for pediatric insomnia in young children. However, low evidence for children, adolescents, and those with special needs (due to a lack of studies that met inclusion criteria) highlights the need for future research.
目的
评估并量化针对儿童失眠的行为干预证据。
方法
对16项对照试验进行荟萃分析，并对12项受试者内研究进行定性分析（总计n = 2560）。
结果
荟萃分析发现，对于四个特定的睡眠结果有显著效果：入睡潜伏期、夜间醒来次数、夜间醒来时长以及睡眠效率，在涉及典型儿童的对照临床试验中，效应大小从小到大都有。针对特殊需求人群开展的两项研究未发现显著效果。最后，受试者内研究表明，所有睡眠结果均有显著效果，且效应大小较大。描述了证据质量的偏倚风险评估和GRADE评级。
结论
中等水平的证据支持对幼儿期儿童失眠进行行为干预。然而，对于儿童、青少年以及有特殊需求的人群（由于缺乏符合纳入标准的研究）证据不足，这凸显了未来研究的必要性。
Zotero 插件