Division of Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA.
J Dev Behav Pediatr. 2018 Jan;39(1):72-76. doi: 10.1097/DBP.0000000000000518.
The present study compared sleep sufficiency in youth with current Tourette's disorder (TD), history of TD and matched case controls, and examined predictors of sufficient sleep using a large US population-based survey.
Participants were 673 caregivers of youth aged 6 to 17 years (298 with current TD, 122 with a history of TD with no endorsement of current diagnosis, and 254 matched case controls) from the 2007 and 2011-2012 versions of the National Survey of Children's Health. History and current TD status, current comorbidity (attention deficit/hyperactivity disorder, anxiety, and depression) and psychiatric medication status were assessed by yes/no items. Current TD severity was dichotomized into mild or moderate/severe symptoms. Sleep was assessed by parent-reported number of sufficient nights their child slept in the past week.
Univariate analysis of variance yielded significant group differences in nights of sufficient sleep (F[2,369.70] = 71.53, p < .001), with controls having 1.5 more nights per week relative to both TD groups (p < .001). With respect to predictors of sufficient sleep, the analysis of covariance yielded a significant age × sex × TD severity interaction (F[1,15.84] = 4.28, p = .04) such that older adolescent males with mild TD had significantly fewer nights of sufficient sleep than children (p = .004) and early adolescents (p = .002; F[2,54.93] = 7.45, p = .001). Early adolescent females with moderate/severe TD had fewer nights of sufficient sleep relative to males (p = .008). Comorbidity type and psychiatric medication status did not significantly predict sleep.
Findings suggest that insufficient sleep in youth with TD persists independently of comorbidity or psychiatric medication status. Findings highlight the importance of clinical sleep monitoring in this population.
本研究比较了当前患有妥瑞氏症(TD)、有 TD 病史且无当前诊断的病例对照者以及大量基于美国人群的调查中匹配病例对照者的青少年睡眠充足程度,并利用该调查研究预测充足睡眠的相关因素。
参与者为 673 名年龄在 6 至 17 岁的青少年的照顾者,其中 298 名患有当前 TD,122 名有 TD 病史且无当前诊断,254 名为匹配病例对照者。数据来源于 2007 年和 2011-2012 年全国儿童健康调查。通过是/否项目评估病史和当前 TD 状态、当前合并症(注意缺陷多动障碍、焦虑症和抑郁症)和精神科药物治疗情况。当前 TD 严重程度分为轻度或中重度/严重症状。睡眠由父母报告过去一周孩子充足睡眠的夜间次数来评估。
单变量方差分析得出,在充足睡眠的夜间数量上(F[2,369.70] = 71.53,p <.001),对照组每周比 TD 组多 1.5 个夜间(p <.001),存在显著的组间差异。就充足睡眠的预测因素而言,协方差分析得出,年龄×性别×TD 严重程度交互作用具有显著差异(F[1,15.84] = 4.28,p =.04),即患有轻度 TD 的青少年男性比儿童(p =.004)和青少年早期(p =.002;F[2,54.93] = 7.45,p =.001)的青少年有明显更少的充足睡眠夜间。患有中重度 TD 的青春期女性与男性相比(p =.008),有较少的充足睡眠夜间。合并症类型和精神科药物治疗情况并未显著预测睡眠。
研究结果表明,患有 TD 的青少年的睡眠不足情况持续存在,与合并症或精神科药物治疗情况无关。研究结果强调了在该人群中进行临床睡眠监测的重要性。