Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.
Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Medicina (Kaunas). 2021 Jan 22;57(2):95. doi: 10.3390/medicina57020095.
Sleep disorders are common in children with Autism Spectrum Disorder (ASD). The aims of this study were to describe the incidence and characteristics of sleep disorders using a questionnaire completed by the caregiver in a sample of preschool-aged children with ASD and to identify possible differences in a control group of peers. Sleep disorders were investigated with the Sleep Disturbance Scale for Children (SDSC) in a population of pre-school-aged (3-5 years) ASD children and in a control group. The Autism Diagnostic Observation Schedule-second ed. (ADOS-2) was further used to assess autism symptom severity. A total of 84 children (69 males; mean age 3.9 ± 0.8 years) with a diagnosis of ASD and 84 healthy controls (65 males; mean age of 3.7 ± 0.8 years) that were matched for age and sex were enrolled. ASD children reported significantly higher (pathological) scores than the control group on the SDSC total scores and in some of the factor scores, such as Difficulty in Initiating and Maintaining Sleep (DIMS), disorders of excessive somnolence (DOES), and sleep hyperhidrosis. A total of 18% of ASD children had a pathological SDSC total T-score, and 46% had an abnormal score on at least one sleep factor; DIMS, parasomnias, and DOES showed the highest rates among the sleep factors. Younger children (3 years) reported higher scores in DIMS and sleep hyperhidrosis than older ones (4 and 5 years). No specific correlation was found between ADOS-2 and SDSC scores. Pre-school children with ASD showed a high incidence of sleep disorders with different distributions of specific sleep factors according to their age. We suggest a screening assessment of sleep disorders using the SDSC in these children with a more in-depth evaluation for those reporting pathological scores on the questionnaire.
睡眠障碍在自闭症谱系障碍（ASD）儿童中很常见。本研究的目的是使用照顾者填写的问卷描述学龄前 ASD 儿童睡眠障碍的发生率和特征，并确定在对照组中是否存在差异。使用儿童睡眠障碍量表（SDSC）对学龄前（3-5 岁）ASD 儿童和对照组进行睡眠障碍调查。自闭症诊断观察量表第二版（ADOS-2）进一步用于评估自闭症症状严重程度。共有 84 名儿童（69 名男性；平均年龄 3.9 ± 0.8 岁）被诊断为 ASD，84 名健康对照组（65 名男性；平均年龄 3.7 ± 0.8 岁）与年龄和性别相匹配。ASD 儿童在 SDSC 总分和某些因子评分（如入睡和维持睡眠困难（DIMS）、过度嗜睡障碍（DOES）和睡眠多汗症）上的得分明显高于对照组（病理性）。共有 18%的 ASD 儿童 SDSC 总分 T 分数为病理性，46%的儿童至少有一个睡眠因子得分异常；DIMS、睡眠障碍和 DOES 在睡眠因子中发生率最高。3 岁的儿童在 DIMS 和睡眠多汗症方面的得分高于 4 岁和 5 岁的儿童。ADOS-2 和 SDSC 评分之间没有发现特定的相关性。学龄前 ASD 儿童睡眠障碍发生率较高，不同年龄的特定睡眠因素分布不同。我们建议使用 SDSC 对这些儿童进行睡眠障碍筛查评估，并对问卷得分异常的儿童进行更深入的评估。
