Department of Psychology, Brigham Young University, Provo, Utah.
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
J Clin Sleep Med. 2022 Apr 1;18(4):1083-1091. doi: 10.5664/jcsm.9806.
Children with overweight or obesity are more likely to experience sleep disorders, although the role of weight in pediatric insomnia treatment has not been examined. The current study examined the relationships of high body mass with pretreatment insomnia severity and global sleep problems and the potential moderating impact of weight on changes in insomnia severity following insomnia treatment.
Participants included 1,133 youth ages 2-18 years clinically referred for insomnia treatment. The Pediatric Insomnia Severity Index was collected at the initial assessment and throughout treatment as part of routine clinical care. Treatment status was coded as no treatment, early termination, and completed treatment. Secondary measures of global sleep problems at the initial assessment included the Adolescent Sleep Wake Scale, Adolescent Sleep Hygiene Scale, and Children's Sleep Habits Questionnaire. Medical chart review of visits within ± 3 months of baseline was used to obtain age-adjusted and sex-adjusted body mass index Z-score.
Among adolescents, regression analyses found that higher body mass index Z-score modestly predicted baseline insomnia severity ( .021) and worse sleep hygiene ( < .001). For children, higher body mass index Z-score was modestly associated with baseline total sleep problems ( = .006) but not insomnia severity ( = .792). Across ages, body mass index Z-score predicted neither treatment status nor insomnia improvement ( > .05). Findings were similar in categorical analyses comparing patients with overweight/obesity to healthy weight.
Although there is evidence that children of higher body mass present for insomnia treatment with greater sleep concerns, body mass does not predict treatment completion or insomnia improvement. Data suggest insomnia treatment is effective irrespective of weight status.
Duraccio KM, Simmons DM, Beebe DW, Byars KC. Relationship of overweight and obesity to insomnia severity, sleep quality, and insomnia improvement in a clinically referred pediatric sample. . 2022;18(4):1083-1091.
超重或肥胖的儿童更有可能出现睡眠障碍，尽管体重在儿科失眠治疗中的作用尚未得到研究。本研究检查了高体重与治疗前失眠严重程度和总体睡眠问题的关系，以及体重对失眠治疗后失眠严重程度变化的潜在调节作用。
参与者包括 1133 名年龄在 2 至 18 岁之间因失眠而接受临床治疗的青少年。儿科失眠严重程度指数在初始评估和整个治疗过程中作为常规临床护理的一部分进行收集。治疗状态编码为无治疗、早期终止和完成治疗。初始评估时总体睡眠问题的次要测量指标包括青少年睡眠觉醒量表、青少年睡眠卫生量表和儿童睡眠习惯问卷。使用基线±3 个月内就诊的医疗记录审查，获得年龄和性别调整后的体重指数 Z 分数。
在青少年中，回归分析发现，较高的体重指数 Z 分数适度预测了基线失眠严重程度（.021）和较差的睡眠卫生（ <.001）。对于儿童，较高的体重指数 Z 分数与基线总睡眠问题适度相关（ =.006），但与失眠严重程度无关（ =.792）。在所有年龄段，体重指数 Z 分数既不能预测治疗状态，也不能预测失眠改善（ >.05）。在将超重/肥胖患者与健康体重患者进行比较的分类分析中，结果相似。
尽管有证据表明，体重较高的儿童在接受失眠治疗时存在更多的睡眠问题，但体重并不能预测治疗完成或失眠改善。数据表明，无论体重状况如何，失眠治疗都是有效的。
Duraccio KM、Simmons DM、Beebe DW、Byars KC。超重和肥胖与临床转介的儿科样本中失眠严重程度、睡眠质量和失眠改善的关系。睡眠医学，2022；18（4）：1083-1091。
