Suzer Gamli Ipek, Keceli Basaran Meryem
Istanbul Erenkoy Mental and Neurological Diseases Training and Research Hospital Child and Adolescent Psychiatry Unit, Istanbul, Turkey.
Basaksehir Cam and Sakura State Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Istanbul, Turkey.
Nat Sci Sleep. 2022 Mar 16;14:449-456. doi: 10.2147/NSS.S354811. eCollection 2022.
Sleep disturbances are common in patients with celiac disease (CD), but their response to a gluten-free diet (GFD) treatment remains scarce. This study investigated the alteration in sleep disturbances within 6 months of starting a GFD in children with CD.
A total of 103 children initially diagnosed with CD, with no psychiatric diagnosis and not receiving psychotropic medication, were included in this study. Sociodemographic data were collected, and the Children's Sleep Habits Questionnaire (CSHQ) was completed both before and after six months of initiating a GFD.
Overall, the total average CSHQ score was 46; after starting the GFD, this decreased to 40, which was under the clinically significant cutoff level for sleep disturbance (p < 0.001). A total of 74 patients (71.8%) had a CSHQ score above the clinically significant cutoff before treatment, which decreased to 40 patients (38.8%) six months after GFD (p < 0.001). A significant improvement was detected in all CSHQ subscale scores and in the total CSHQ score after starting the GFD (p < 0.001). Parasomnia and the total CSHQ score were higher in children who were diagnosed incidentally compared to symptomatic children but did not differ after GFD (p < 0.005). In 39 patients (37.8%), the total CSHQ score remained high 6 months after starting the GFD. Maternal and paternal ages were significantly higher in children whose scores remained high (p < 0.05).
A significant improvement in sleep scores was detected after starting a GFD, regardless of initial age, sex, and symptom status. With a GFD, children may fall asleep more easily and sleep for longer with less interruptions. GFD may help to reduce sleep disturbances in CD, but future studies should investigate the certain conditions in patients who do not respond to a GFD.
睡眠障碍在乳糜泻（CD）患者中很常见，但他们对无麸质饮食（GFD）治疗的反应仍然很少。本研究调查了CD患儿开始GFD治疗6个月内睡眠障碍的变化。
本研究共纳入103例最初诊断为CD的儿童，这些儿童无精神疾病诊断且未接受精神药物治疗。收集了社会人口统计学数据，并在开始GFD治疗6个月前后完成了儿童睡眠习惯问卷（CSHQ）。
总体而言，CSHQ总平均分为46分；开始GFD治疗后，该分数降至40分，低于睡眠障碍的临床显著临界水平（p<0.001）。共有74例患者（71.8%）在治疗前CSHQ分数高于临床显著临界值，GFD治疗6个月后降至40例患者（38.8%）（p<0.001）。开始GFD治疗后，所有CSHQ子量表分数和CSHQ总分均有显著改善（p<0.001）。与有症状的儿童相比，偶然诊断的儿童的异态睡眠和CSHQ总分更高，但在GFD治疗后没有差异（p<0.005）。在39例患者（37.8%）中，开始GFD治疗6个月后CSHQ总分仍然很高。得分仍然很高的儿童的父母年龄显著更高（p<0.05）。
开始GFD治疗后，无论初始年龄、性别和症状状态如何，睡眠评分均有显著改善。通过GFD，儿童可能更容易入睡，睡眠更长，中断更少。GFD可能有助于减少CD患者的睡眠障碍，但未来的研究应调查对GFD无反应的患者的特定情况。
