Centre for Child and Adolescent Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK; Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, University Road, Leicester, LE1 7RH, UK.
Sleep Med. 2018 Jun;46:26-36. doi: 10.1016/j.sleep.2018.01.005. Epub 2018 Jan 31.
OBJECTIVE/BACKGROUND: Sleep abnormalities are characteristic of chronic fatigue syndrome (CFS, also known as 'ME'), however it is unknown whether sleep might be a causal risk factor for CFS/ME.
PATIENTS/METHODS: We analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. We describe sleep patterns of children aged 6 months to 11 years, who were subsequently classified as having (or not having) 'chronic disabling fatigue' (CDF, a proxy for CFS/ME) between the ages 13 and 18 years, and we investigated the associations of sleep duration at age nine years with CDF at age 13 years, as well as sleep duration at age 11 years with CDF at age 16 years.
Children who had CDF during adolescence had shorter night-time sleep duration from 6 months to 11 years of age, and there was strong evidence that difficulties in going to sleep were more common in children who subsequently developed CDF. The odds of CDF at age 13 years were 39% lower (odds ratio (OR) = 0.61, 95% CI = 0.43, 0.88) for each additional hour of night-time sleep at age nine years, and the odds of CDF at age 16 years were 51% lower (OR = 0.49, 95% CI = 0.34, 0.70) for each additional hour of night-time sleep at age 11 years. Mean night-time sleep duration at age nine years was 13.9 (95% CI = 3.75, 24.0) minutes shorter among children who developed CDF at age 13 years, and sleep duration at age 11 years was 18.7 (95% CI = 9.08, 28.4) minutes shorter among children who developed CDF at age 16 (compared with children who did not develop CDF at 13 and 16 years, respectively).
Children who develop chronic disabling fatigue in adolescence have shorter night-time sleep duration throughout early childhood, suggesting that sleep abnormalities may have a causal role in CFS/ME or that sleep abnormalities and CFS/ME are associated with a common pathophysiological cause.
目的/背景：睡眠异常是慢性疲劳综合征（CFS，也称为“ME”）的特征，但目前尚不清楚睡眠是否是 CFS/ME 的因果风险因素。
患者/方法：我们分析了阿冯纵向研究父母和儿童（ALSPAC）出生队列的数据。我们描述了 6 个月至 11 岁儿童的睡眠模式，随后在 13 至 18 岁之间将他们分类为患有（或不患有）“慢性致残性疲劳”（CDF，CFS/ME 的替代指标），并研究了 9 岁时的睡眠时间与 13 岁时的 CDF 以及 11 岁时的睡眠时间与 16 岁时的 CDF 的关联。
青少年时期患有 CDF 的儿童从 6 个月到 11 岁的夜间睡眠时间较短，并且有强有力的证据表明，随后发展为 CDF 的儿童入睡困难更为常见。9 岁时每增加 1 小时夜间睡眠时间，13 岁时 CDF 的几率降低 39%（优势比（OR）=0.61，95%CI=0.43，0.88），11 岁时每增加 1 小时夜间睡眠时间，16 岁时 CDF 的几率降低 51%（OR=0.49，95%CI=0.34，0.70）。在 13 岁时患有 CDF 的儿童中，9 岁时的平均夜间睡眠时间比未在 13 岁和 16 岁时患有 CDF 的儿童短 13.9 分钟（95%CI=3.75，24.0），11 岁时的睡眠时间短 18.7 分钟（95%CI=9.08，28.4）。
青少年时期患有慢性致残性疲劳的儿童整个幼儿期夜间睡眠时间较短，这表明睡眠异常可能在 CFS/ME 中起因果作用，或者睡眠异常和 CFS/ME 与共同的病理生理原因相关。
