Kang Yu-Qi, Song Xiao-Rong, Wang Geng-Fu, Su Yuan-Yuan, Li Pei-Ying, Zhang Xin
Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China.
Experimental Teaching Center of Preventive Medicine, Tianjin Medical University, Tianjin, China.
Front Psychiatry. 2020 Apr 16;11:273. doi: 10.3389/fpsyt.2020.00273. eCollection 2020.
Sleep disturbances are common in people with autism spectrum disorder (ASD), but research on this topic is still limited in China. In the current study, we evaluated the prevalence of sleep problems in preschool-aged children with ASD and to examine the correlations between sleep disturbances and emotional/behavioral symptoms and repetitive behavior in the unique social context of China. This study recruited 475 preschool-aged children aged 3-6 years old, including 252 children with ASD (mean age 5.13 ± 1.15, 80.6% male) and 223 age-matched typically developing (TD) children (mean age 5.12 ± 0.97, 74.9% male). The parents of all children completed a sociodemographic questionnaire and the Childhood Sleep Habits Questionnaire. The parents of 114 ASD children completed the Strengths and Difficulties Questionnaire (SDQ) and the Repetitive Behavioral Questionnaire-2 (RBQ-2). The prevalence of sleep problems in preschool-aged children with ASD in this study was 81.7%, which was higher than that in TD children (61.0%). The scores for bedtime resistance, sleep anxiety, sleep duration, parasomnias, and sleep onset delay in the ASD group were significantly higher than those in the TD group (t=-7.664, =0.000; t=-10.477, =0.000; t=-4.133, =0.000; Z=-3.916, =0.000; Z=-7.093, =0.000; respectively). Sleep onset delay explained 17.3% of the variance (adjusted R = 0.173) in the total SDQ score of children with ASD, and bedtime resistance explained a large proportion of total RBQ-2 score variance (adjusted R = 0.206). The high rate of sleep disturbances in preschool-aged children with ASD emphasizes the importance of screening for sleep problems in this population. Attention should also be directed toward formulating good sleep hygiene practices for preschool-aged children in the particular social context and cultural setting of China.
睡眠障碍在自闭症谱系障碍（ASD）患者中很常见，但在中国，关于这一主题的研究仍然有限。在本研究中，我们评估了学龄前ASD儿童睡眠问题的患病率，并在中国独特的社会背景下，研究睡眠障碍与情绪/行为症状以及重复行为之间的相关性。本研究招募了475名3至6岁的学龄前儿童，其中包括252名ASD儿童（平均年龄5.13±1.15岁，80.6%为男性）和223名年龄匹配的发育正常（TD）儿童（平均年龄5.12±0.97岁，74.9%为男性）。所有儿童的家长均完成了一份社会人口学调查问卷和儿童睡眠习惯问卷。114名ASD儿童的家长完成了长处与困难问卷（SDQ）和重复行为问卷-2（RBQ-2）。本研究中，学龄前ASD儿童睡眠问题的患病率为81.7%，高于TD儿童（61.0%）。ASD组在睡前抗拒、睡眠焦虑、睡眠时间、异态睡眠和入睡延迟方面的得分显著高于TD组（t=-7.664，P=0.000；t=-10.477，P=0.000；t=-4.133，P=0.000；Z=-3.916，P=0.000；Z=-7.093，P=0.000）。入睡延迟解释了ASD儿童SDQ总分方差的17.3%（调整后R=0.173），睡前抗拒解释了RBQ-2总分方差的很大一部分（调整后R=0.206）。学龄前ASD儿童睡眠障碍的高发生率凸显了在这一人群中筛查睡眠问题的重要性。在中国特定的社会背景和文化环境下，还应关注为学龄前儿童制定良好的睡眠卫生习惯。
