乌干达脑瘫儿童睡眠障碍的患病率及相关因素；一项横断面研究。
Prevalence and factors associated with sleep disorders among children with cerebral palsy in Uganda; a cross-sectional study.
作者信息
Munyumu Kisughu, Idro Richard, Abbo Catherine, Kaddumukasa Mark, Katabira Elly, Mupere Ezekiel, Kakooza-Mwesige Angelina
机构信息
Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
出版信息
BMC Pediatr. 2018 Feb 5;18(1):26. doi: 10.1186/s12887-018-0996-z.
BACKGROUND
Sleep plays a prominent role in the growth and development of children. Children with cerebral palsy (CP) are more prone to sleep disorders (SDs) than their peers. Children with CP, have a higher prevalence of disorders involving; initiation and maintenance of sleep, sleep-wake transition, excessive sleepiness and arousal. These sleep disorders impact on the quality of life of these children. Despite, having a high prevalence of CP in Uganda, there is a paucity of data that focuses on sleep disorders in CP, including a lack of prevalence estimates of sleep breathing disorder (SBD) in CP. Understanding the prevalence and disorders of sleep within this population would help advise on the development of tailored interventions to address the needs of these children and improve their quality of life. This study determined the prevalence and associated factors of sleep disorders among children aged 2 - 12 years with cerebral palsy in Uganda.
METHODS
This was a cross sectional study. All participants had a physical examination and screening with the Sleep Disturbances Scale for Children (SDSC) questionnaire to determine the prevalence of sleeps disorders. A total score (TS) ≥ 51 on the Sleep Disturbances Scale for Children was regarded as abnormal.
RESULTS
A total of 135 participants were recruited. The prevalence of sleep disorders was 43/135 (32%) with 95% CI: (24.0-39.7). The most common type of sleep disorders was a disorder of initiating and maintaining sleep 37(27%). The factors associated with sleep disorders among children with cerebral palsy were bilateral spasticity (p = 0.004); OR:(95%CI), 11.193: (2.1 - 59.0), lowest levels of gross motor function V (p = < 0.001); OR:(95%CI), 13.182: (3.7 - 47.0) or IV (p = 0.007); OR:(95%CI), 12.921: (2.0 - 82.3), lowest level of manual ability V (p = 0.004); OR:(95%CI), 11.162: (2.2 - 56.4) and presence of epilepsy (p = 0.011); OR:(95%CI), 3.865: (1.4 - 10.9).
CONCLUSIONS
The prevalence of sleep disorders among children with cerebral palsy in Uganda is high. Severe disability and presence of epilepsy were associated with sleep disorders among children with cerebral palsy.
背景
睡眠在儿童的生长发育中起着重要作用。脑瘫患儿比同龄人更容易出现睡眠障碍。脑瘫患儿在睡眠起始与维持、睡眠-觉醒转换、过度嗜睡和唤醒方面的障碍患病率更高。这些睡眠障碍会影响这些儿童的生活质量。尽管乌干达脑瘫患病率很高，但针对脑瘫患儿睡眠障碍的数据却很匮乏，包括缺乏对脑瘫患儿睡眠呼吸障碍患病率的估计。了解该人群的睡眠患病率和障碍情况将有助于为制定针对性干预措施提供建议，以满足这些儿童的需求并提高他们的生活质量。本研究确定了乌干达2至12岁脑瘫患儿睡眠障碍的患病率及相关因素。
方法
这是一项横断面研究。所有参与者均接受体格检查，并使用儿童睡眠障碍量表（SDSC）问卷进行筛查，以确定睡眠障碍的患病率。儿童睡眠障碍量表总分（TS）≥51分被视为异常。
结果
共招募了135名参与者。睡眠障碍患病率为43/135（32%），95%置信区间为（24.0 - 39.7）。最常见的睡眠障碍类型是睡眠起始与维持障碍，共37例（27%）。与脑瘫患儿睡眠障碍相关的因素包括双侧痉挛（p = 0.004）；比值比：（95%置信区间），11.193：（2.1 - 59.0），粗大运动功能最低为V级（p < 0.001）；比值比：（95%置信区间），13.182：（3.7 - 47.0）或IV级（p = 0.007）；比值比：（95%置信区间），12.921：（2.0 - 82.3），手动能力最低为V级（p = 0.004）；比值比：（95%置信区间），11.162：（2.2 - 56.4）以及存在癫痫（p = 0.011）；比值比：（95%置信区间），3.865：（1.4 - 10.9）。
结论
乌干达脑瘫患儿睡眠障碍患病率很高。严重残疾和癫痫的存在与脑瘫患儿的睡眠障碍有关。
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