Steinsbekk Silje, Wichstrøm Lars
*Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; †Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway; ‡NTNU Social Science, Trondheim, Norway.
J Dev Behav Pediatr. 2015 May;36(4):243-51. doi: 10.1097/DBP.0000000000000134.
To examine the prevalence and stability of DSM-4-defined sleep disorders from preschool to first grade and to explore the bidirectional relationship between sleep disorders and symptoms of psychiatric disorders.
All children born in 2003 or 2004 in Trondheim, Norway, who attended regular community health checkups for 4-year-olds, were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) in this study. The authors recruited a screen-stratified subsample of 1250 children and interviewed 994 parents (79.6%) using a structured diagnostic interview (the Preschool Age Psychiatric Assessment). Two years later, 795 of the parents completed the interview.
There was stability in insomnia (adjusted odds ratio [OR] = 4.03, confidence interval [CI] = 2.83-5.75) and sleepwalking (adjusted OR = 19.28, CI = 4.53-82.10), whereas none of the children with hypersomnia or nightmare disorder at age 4 had the same disorder 2 years later. Insomnia increased the risk for developing symptoms of conduct disorder, major depressive disorder (MDD), and social phobia when the initial levels of insomnia were adjusted for. Symptoms of attention-deficit hyperactivity disorder, oppositional defiant disorder, and MDD at age 4 were statistically linked to insomnia at age 6. Sleepwalking predicted later separation anxiety disorder, whereas hypersomnia was unrelated to symptoms of psychiatric disorders.
Insomnia is a prevalent and stable disorder in children and is bidirectionally related to psychiatric symptoms.
研究从学龄前到一年级期间DSM-4定义的睡眠障碍的患病率和稳定性，并探讨睡眠障碍与精神障碍症状之间的双向关系。
邀请所有在挪威特隆赫姆于2003年或2004年出生、参加过4岁儿童常规社区健康检查的儿童参与本研究（出勤率97.2%；同意率82.0%，n = 2475）。作者选取了1250名儿童的筛查分层子样本，并使用结构化诊断访谈（学龄前儿童精神评估）对994名家长（79.6%）进行访谈。两年后，795名家长完成了访谈。
失眠（调整后的优势比[OR]=4.03，置信区间[CI]=2.83 - 5.75）和梦游（调整后的OR = 19.28，CI = 4.53 - 82.10）具有稳定性，而4岁时患有发作性睡病或梦魇障碍的儿童在两年后均未患相同疾病。在对初始失眠水平进行调整后，失眠增加了出现品行障碍、重度抑郁症（MDD）和社交恐惧症症状的风险。4岁时注意缺陷多动障碍、对立违抗障碍和MDD的症状与6岁时的失眠在统计学上相关。梦游预示着后期会出现分离焦虑障碍，而发作性睡病与精神障碍症状无关。
失眠在儿童中是一种普遍且稳定的疾病，并且与精神症状存在双向关系。
