Ilter Bahadur Evin, Özalkak Şervan, Özdemir Asena Ayça, Çetinkaya Semra, Özmert Elif Nursel
Department of Pediatrics, Division of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Clinics of Pediatric Endocrinology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2021 Oct 28;35(1):29-38. doi: 10.1515/jpem-2021-0523. Print 2022 Jan 27.
To examine sleep and behavior problems in children with type 1 Diabetes Mellitus (T1DM) compared to nondiabetic controls in a bridging country between east and west and to evaluate the interaction of sleep on behavior problems, maternal sleep, and maternal depressive symptoms.
The study included children with T1DM (4-12 years old) and age/sex-matched healthy controls. Parents completed the Children Sleep Habits Questionnaire (CSHQ), Children Behavior Checklist/4-18 (CBCL/4-18), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and a study-specific sociodemographic questionnaire. Clinical parameters regarding T1DM were collated from medical records.
Participants included 75 children with T1DM and 49 controls. Based on CSHQ results 65.3% of all participants in both groups had sleep problems. Children with T1DM slept less and had higher daytime sleepiness problems than controls (p=0.024, p=0.008, respectively). No association was found between CSHQ or sleep duration and mode of diabetes treatment (pump, multiple daily injections) or glycemic control. CSHQ correlated with maternal PSQI (r=0.336 p=0.004) and BDI (r=0.341 p=0.004) in children with T1DM, but there was no association amongst controls. Children with T1DM had higher internalizing problems compared to controls. CSHQ and BDI correlated with internalizing, externalizing, and the total scores of the CBCL/4-18 in children with T1DM (R=0.260 p<0.001; R=0.207 p<0.001, R=0.381 p<0.001 respectively). In controls, only BDI was associated with internalizing, externalizing, and the total scores of the CBCL/4-18.
Children with T1DM should be evaluated for sleep pattern and quality at follow-up, to identify those at risk for behavior problems and improve maternal life quality. Large longitudinal studies are necessary to assess the effect of new diabetes treatment modalities on sleep.
在一个东西方之间的过渡国家，比较1型糖尿病（T1DM）患儿与非糖尿病对照组儿童的睡眠和行为问题，并评估睡眠对行为问题、母亲睡眠和母亲抑郁症状的相互作用。
该研究纳入了T1DM患儿（4 - 12岁）以及年龄/性别匹配的健康对照组。家长完成了儿童睡眠习惯问卷（CSHQ）、儿童行为量表/4 - 18（CBCL/4 - 18）、匹兹堡睡眠质量指数（PSQI）、贝克抑郁量表（BDI）以及一份特定研究的社会人口学问卷。从医疗记录中整理出有关T1DM的临床参数。
参与者包括75名T1DM患儿和49名对照组儿童。根据CSHQ结果，两组中65.3%的参与者存在睡眠问题。T1DM患儿的睡眠时间比对照组少，白天嗜睡问题比对照组更严重（分别为p = 0.024，p = 0.008）。未发现CSHQ或睡眠时间与糖尿病治疗方式（胰岛素泵、每日多次注射）或血糖控制之间存在关联。在T1DM患儿中，CSHQ与母亲的PSQI（r = 0.336，p = 0.004）和BDI（r = 0.341，p = 0.004）相关，但在对照组中无关联。与对照组相比，T1DM患儿的内化问题更多。在T1DM患儿中，CSHQ和BDI与CBCL/4 - 18的内化、外化及总分相关（分别为R = 0.260，p < 0.001；R = 0.207，p < 0.001，R = 0.381，p < 0.001）。在对照组中，只有BDI与CBCL/4 - 18的内化、外化及总分相关。
应在随访时对T1DM患儿的睡眠模式和质量进行评估，以识别有行为问题风险的患儿并改善母亲的生活质量。有必要进行大型纵向研究以评估新的糖尿病治疗方式对睡眠的影响。
