Koo Ho Wai, Ismail Juriza, Yang Wai Wai, Syed Zakaria Syed Zulkifli
Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.
Department of Paediatrics, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
Front Pediatr. 2021 Jan 18;8:608242. doi: 10.3389/fped.2020.608242. eCollection 2020.
Children with autism spectrum disorder (ASD) have a variety of co-morbid medical problems, including sleep disturbances. Prevalence of sleep disorders has been reported to be higher in this group as compared to the general population. Identifying sleep problems in children with ASD may help increase awareness and improve the overall quality of care for them. The aim of this study was to determine the prevalence of sleep problems and associated factors in a group of Malaysian children aged 6-16 years, with ASD. This is a cross-sectional study at the Child Development Centre of UKM Medical Centre (UKM MC) on ASD children aged 6-16 years. Demographic data was obtained and the Sleep Disturbances Scale for Children (SDSC) questionnaire was completed by the main caregiver. Logistic regression analysis was used to determine factors related to higher total SDSC scores. A total of 128 patients were recruited (111 boys) with a median age of 8 years 3 months (IQR: 2 years 10 months). Forty-seven (36.7%) of them obtained total SDSC scores in the pathological range with 19 (14.8%) scoring high for overall disturbances and 28 (21.9%) for at least one subtype of sleep disorders: 25 (19.5%) DIMS, 18 (14.1%) SBD, 10 (7.8%) DOES, 5 (3.9%) DOA, 6 (4.7%) SWTD, and 3 (2.3%) SHY. More than half of the children (57.8%) were reported to have sufficient sleep duration of 8-11 h, but longer sleep latency of at least 15 min (82.8%). Half of the ASD children also had co-morbidities in which one-third (34.4%) had attention-deficit hyperactivity disorder (ADHD). Using logistic regression analysis, four factors were significantly associated with higher total SDSC scores; female gender ( = 0.016), older age group (11-16 years old) ( = 0.039), shorter sleep length ( = 0.043), and longer sleep latency ( < 0.001). The prevalence of sleep disturbances is high among Malaysian children with ASD, especially DIMS. Female gender, older age group, shorter sleep length, and longer sleep latency were found to be associated with the sleep disturbances. Evaluation of sleep problems should form part of the comprehensive care of children with ASD.
患有自闭症谱系障碍（ASD）的儿童存在多种共病的医学问题，包括睡眠障碍。据报道，与普通人群相比，该群体中睡眠障碍的患病率更高。识别ASD儿童的睡眠问题可能有助于提高认识并改善对他们的整体护理质量。本研究的目的是确定一组6至16岁的马来西亚ASD儿童中睡眠问题的患病率及相关因素。这是在UKM医学中心（UKM MC）儿童发展中心对6至16岁的ASD儿童进行的一项横断面研究。收集了人口统计学数据，主要照顾者完成了儿童睡眠障碍量表（SDSC）问卷。采用逻辑回归分析来确定与较高SDSC总分相关的因素。共招募了128名患者（111名男孩），中位年龄为8岁3个月（四分位间距：2岁10个月）。其中47名（36.7%）患者的SDSC总分处于病理范围内，19名（14.8%）在总体障碍方面得分较高，28名（21.9%）在至少一种睡眠障碍亚型方面得分较高：25名（19.5%）为入睡困难型（DIMS），18名（14.1%）为睡眠呼吸障碍型（SBD），10名（7.8%）为梦呓磨牙型（DOES），5名（3.9%）为夜惊型（DOA），6名（4.7%）为睡眠中周期性肢体运动型（SWTD），3名（2.3%）为害羞型（SHY）。据报告，超过一半的儿童（57.8%）有8至11小时的充足睡眠时间，但睡眠潜伏期较长，至少15分钟（82.8%）。一半的ASD儿童也患有共病，其中三分之一（34.4%）患有注意力缺陷多动障碍（ADHD）。通过逻辑回归分析，有四个因素与较高的SDSC总分显著相关；女性性别（P = 0.016）、年龄较大组（11至16岁）（P = 0.039）、睡眠时间较短（P = 0.043）和睡眠潜伏期较长（P < 0.001）。马来西亚ASD儿童中睡眠障碍的患病率很高，尤其是入睡困难型。发现女性性别、年龄较大组、睡眠时间较短和睡眠潜伏期较长与睡眠障碍有关。对睡眠问题的评估应成为ASD儿童综合护理的一部分。
