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荷兰健康儿童的睡眠和睡眠-觉醒节律的活动记录仪估计值以及6-硫酸氧褪黑素水平。

Actigraphic estimates of sleep and the sleep-wake rhythm, and 6-sulfatoxymelatonin levels in healthy Dutch children.

作者信息

Rensen Niki, Steur Lindsay M H, Wijnen Noa, van Someren Eus J W, Kaspers Gertjan J L, van Litsenburg Raphaële R L

机构信息

Princess Máxima Center for Pediatric Oncology , Utrecht, The Netherlands.

Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Pediatric Oncology , Amsterdam, The Netherlands.

出版信息

Chronobiol Int. 2020 May;37(5):660-672. doi: 10.1080/07420528.2020.1727916. Epub 2020 Mar 4.

Abstract

Sleep and the sleep-wake rhythm are essential for children's health and well-being, yet reference values are lacking. This study therefore aimed to assess actigraphic estimates of sleep and the 24-h sleep-wake rhythm, as well as 6-sulfatoxymelatonin (aMT6s) levels in healthy children of different age groups. Additionally, relationships between the outcomes and sex, highest parental educational level (as an indication of socioeconomic status (SES)), and body-mass-index (BMI) were explored. In this cross-sectional study, healthy Dutch children (2-18 years) wore an actigraph (GT3x) for 7 consecutive days, collected first-morning void urine and completed a sleep log and sociodemographic questionnaire. Actigraphically estimated sleep variables were sleep onset latency (SOL), sleep efficiency (SE), total sleep time (TST), and wake after sleep onset (WASO). Non-parametric sleep-wake rhythm variables were intradaily variability (IV); interdaily stability (IS); the activity counts and timing of the least active 5-h period (L5counts and midpoint) and of the most active 10-h period (M10 counts and midpoint); and the relative amplitude (RA), i.e. the ratio of the difference and the sum of M10 and L5 counts. Finally, creatinine-corrected aMT6s levels were obtained by isotope dilution mass spectrometry. Effects of age group (preschool 2-5 years/school-aged 6-12 years/teenager 13-18 years), sex, highest parental educational level and BMI (Z-scores) were explored. Ninety-four children participated, equally divided across age groups (53% boys). Teenagers slept less, but more efficiently, than younger children, while their 24 h sleep-wake rhythm was the least stable and most fragmented (likely due to fragmentation of daytime activity). Additionally, aMT6s levels significantly declined over the age groups. Children from highly educated parents had lower sleep efficiency, but a more stable sleep-wake rhythm. Finally, sex or increase in BMI was not associated with any of the outcomes in this study. In conclusion, this study provides reference values of healthy children across different age groups and different sociodemographic factors. In the future, this information may help to better interpret outcomes in clinical populations.

摘要

睡眠及睡眠-觉醒节律对儿童的健康和幸福至关重要,但目前缺乏相关参考值。因此,本研究旨在评估不同年龄组健康儿童的睡眠活动记录仪睡眠估计值、24小时睡眠-觉醒节律以及6-硫酸氧褪黑素(aMT6s)水平。此外,还探讨了这些结果与性别、父母最高教育水平(作为社会经济地位(SES)的指标)和体重指数(BMI)之间的关系。在这项横断面研究中,健康的荷兰儿童(2至18岁)连续7天佩戴活动记录仪(GT3x),收集晨尿,并完成睡眠日志和社会人口统计学调查问卷。通过活动记录仪估计的睡眠变量包括入睡潜伏期(SOL)、睡眠效率(SE)、总睡眠时间(TST)和睡眠中觉醒时间(WASO)。非参数睡眠-觉醒节律变量包括日内变异性(IV);日间稳定性(IS);最不活跃的5小时时间段(L5计数和中点)和最活跃的10小时时间段(M10计数和中点)的活动计数和时间;以及相对振幅(RA),即M10和L5计数之差与和的比值。最后,通过同位素稀释质谱法获得肌酐校正后的aMT6s水平。探讨了年龄组(学龄前儿童2至5岁/学龄儿童6至12岁/青少年13至18岁)、性别、父母最高教育水平和BMI(Z评分)的影响。94名儿童参与了研究,各年龄组人数均等(53%为男孩)。青少年的睡眠时间比年幼儿童少,但睡眠效率更高,而他们的24小时睡眠-觉醒节律最不稳定且最碎片化(可能是由于白天活动的碎片化)。此外,aMT6s水平在各年龄组中显著下降。来自高学历父母家庭的儿童睡眠效率较低,但睡眠-觉醒节律更稳定。最后,在本研究中,性别或BMI增加与任何结果均无关联。总之,本研究提供了不同年龄组和不同社会人口统计学因素的健康儿童的参考值。未来,这些信息可能有助于更好地解释临床人群的结果。

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