Mahr Fauzia, Brennan Grace, Billman Marley, Lane-Loney Susan
Pediatrics/Eating Disorders, Penn State College of Medicine, Hershey, USA.
Psychology, Yale University, New Haven, USA.
Cureus. 2022 Jun 3;14(6):e25628. doi: 10.7759/cureus.25628. eCollection 2022 Jun.
Objective No studies have investigated sleep disturbance in avoidant/restrictive food intake disorder (ARFID). We examined sleep disturbance in ARFID and its association with eating problems, body mass index (BMI), gender, internalizing and externalizing symptoms, cognitive performance, and academic difficulties. Methods Data from 71 ARFID patients from our partial hospitalization program (PHP) for children and adolescents were examined. Sleep data were extracted from measures administered at admission including Achenbach Child Behavior Checklist (CBCL), Children's Depression Inventory (CDI), and Revised Children's Manifest Anxiety Scale (RCMAS). Correlational analyses were conducted to evaluate the convergent validity of parent-reported and participant-reported sleep problems. Association with the severity of eating problems, BMI, percentage of median body weight (% MBW), age, gender, psychotropic medication, psychopathology, and academic difficulties was examined using analysis of variance (ANOVA) and Pearson's correlation. Results Fifty-two percent of parents and 74% of participants reported two or more sleep symptoms. Trouble sleeping was reported by 46.48% and nightmares by 35.21% of parents. Parent-reported trouble sleeping highly correlated with internalizing disorders. Parent-reported trouble sleeping and participant-reported difficulty sleeping positively correlated with attention and attention-deficit/hyperactivity disorder (ADHD) problems. Parent-reported less sleep and feeling tired correlated with sluggish cognitive tempo, while walking/talking in sleep negatively correlated with school performance. Gender differences were noted in parent-reported sleep problems. Sleep disturbances were not associated with lower BMI or median body weight at intake. Parent-reported talking/walking in sleep and participant-reported bad dreams and bedtime worries positively correlated with Children's Eating Attitudes Test (ChEAT) scores at intake and discharge. Discussion Our results provide compelling evidence to screen for sleep disturbance in ARFID patients regardless of median body weight and BMI. Exploration of sleep disturbances in ARFID using objective measures is warranted.
尚无研究对回避/限制性食物摄入障碍（ARFID）患者的睡眠障碍进行调查。我们对ARFID患者的睡眠障碍及其与进食问题、体重指数（BMI）、性别、内化与外化症状、认知表现及学业困难之间的关联进行了研究。方法：对来自我们儿童及青少年部分住院项目（PHP）的71例ARFID患者的数据进行了分析。睡眠数据取自入院时所采用的测量指标，包括阿肯巴克儿童行为量表（CBCL）、儿童抑郁量表（CDI）及修订版儿童显性焦虑量表（RCMAS）。进行相关性分析以评估家长报告和患者报告的睡眠问题的收敛效度。采用方差分析（ANOVA）和皮尔逊相关性分析，研究睡眠障碍与进食问题严重程度、BMI、中位体重百分比（%MBW）、年龄、性别、精神药物使用、精神病理学及学业困难之间的关联。结果：52%的家长和74%的患者报告有两种或更多睡眠症状。46.48%的家长报告孩子存在睡眠困难，35.21%的家长报告孩子有噩梦。家长报告的睡眠困难与内化障碍高度相关。家长报告的睡眠困难和患者报告的入睡困难与注意力及注意力缺陷/多动障碍（ADHD）问题呈正相关。家长报告的睡眠不足和感到疲倦与认知节奏迟缓相关，而说梦话/梦游与学业成绩呈负相关。在家长报告的睡眠问题方面存在性别差异。睡眠障碍与入院时较低的BMI或中位体重无关。家长报告的说梦话/梦游以及患者报告的噩梦和就寝时间担忧与入院时及出院时的儿童饮食态度测试（ChEAT）得分呈正相关。讨论：我们的研究结果提供了令人信服的证据，表明无论中位体重和BMI如何，均应对ARFID患者进行睡眠障碍筛查。有必要采用客观测量方法对ARFID患者的睡眠障碍进行探索。
