Reuter Antonia, Silfverdal Sven-Arne, Lindblom Kristin, Hjern Anders
Child and Youth Healthcare, Region Västra Götaland, Gothenburg, Sweden.
Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Acta Paediatr. 2020 Sep;109(9):1717-1732. doi: 10.1111/apa.15182. Epub 2020 Feb 6.
The aim of this review was to evaluate the evidence for interventions for behavioural sleep problem in infants.
Systematic review based on a search in MEDLINE, Web of Science and PsychINFO in December 2017 for articles published in English during 2007-2017 about preventive and treatment interventions for sleep problems in infants. The review included controlled trials and meta-analyses with at least 20 infants in study groups assessed according to the Grading of Recommendations Assessment, Development and Evaluation criteria.
Out of 476 original articles assessed for eligibility, 12 studies were included in the synthesis. Interventions with behavioural, educational and massage strategies were evaluated. No intervention was evaluated in more than one trial. Five interventions with behavioural methods for establishing consistent routines or controlled crying showed modest short-term effects, while the evidence for elements of education was inconsistent. Studies of massage were of poor quality. Knowledge gaps were identified regarding interventions in cross-cultural context, involving fathers, in children below six months of age, in high-risk populations and consequences of interventions that include extinction.
Some support for short-term effects of behavioural treatment strategies was found, but more studies are needed to establish evidence.
本综述旨在评估针对婴儿行为性睡眠问题的干预措施的证据。
基于2017年12月对MEDLINE、科学网和心理文摘数据库的检索进行系统综述,检索2007 - 2017年期间发表的关于婴儿睡眠问题预防和治疗干预措施的英文文章。该综述纳入了根据推荐分级评估、制定与评价标准进行评估的研究组中至少有20名婴儿的对照试验和荟萃分析。
在评估是否符合纳入标准的476篇原始文章中,有12项研究被纳入综述。对行为、教育和按摩策略的干预措施进行了评估。没有一项干预措施在超过一项试验中得到评估。五项采用行为方法建立一致作息或控制哭闹的干预措施显示出适度的短期效果,而教育元素的证据并不一致。按摩研究质量较差。在跨文化背景下、涉及父亲的干预措施、六个月以下儿童、高危人群以及包括消退法在内的干预措施的后果等方面存在知识空白。
发现了一些对行为治疗策略短期效果的支持,但需要更多研究来确立证据。