获得性脑损伤后婴儿和幼儿的睡眠障碍。
Sleep disturbances in infants and young children following an acquired brain injury.
机构信息
Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, Oregon.
Department of Pediatrics, Division of Pediatric Psychology, Oregon Health & Science University, Portland, Oregon.
出版信息
J Clin Sleep Med. 2022 Oct 1;18(10):2387-2395. doi: 10.5664/jcsm.10116.
STUDY OBJECTIVES
Sleep disturbances impact over half of older children and teens with acquired brain injury (ABI) following critical care hospitalization but are underevaluated in infants and young children. Given the importance of sleep in brain development and healing after injury, we hypothesized sleep disturbances would be associated with worse neurodevelopmental outcomes in infants with ABI.
METHODS
We performed a retrospective cohort study of 68 children aged 2-32 months following critical care hospitalization for ABI. The Brief Infant Sleep Questionnaire assessed sleep disturbances. Bayley Scales of Infant and Toddler Development, third edition and Adaptive Behavior Assessment System, third edition assessed developmental and adaptive functioning outcomes, respectively. tests compared sleep characteristics in infants with ABI to historical healthy controls. Spearman's correlation evaluated relationships among sleep and outcomes. Multiple linear regression investigated relationships controlling for demographic and ABI characteristics.
RESULTS
Compared to healthy controls, children with ABI had shorter nighttime sleep duration ( = .01), longer daytime sleep duration ( < .001), and longer duration of nighttime awakenings ( < .001). Duration of night awakenings negatively correlated with Bayley Cognitive scores (Spearman's correlation = -.40). Night awakenings negatively correlated with worse Adaptive Behavior Assessment System, third edition General Adaptive Composite scores (Spearman's correlation = -.42). When controlling for demographic and ABI characteristics, ≥ 3 awakenings was significantly associated with worse Adaptive Behavior Assessment System, third edition General Adaptive Composite (β = -11.3; 95% confidence interval = -19.2, -3.5).
CONCLUSIONS
Sleep disturbances are associated with poorer outcomes in infants and toddlers after ABI. Sleep is vital to recovery and a potentially modifiable target to improve outcomes.
CITATION
Klapp JM, Hall TA, Riley AR, Williams CN. Sleep disturbances in infants and young children following an acquired brain injury. . 2022;18(10):2387-2395.
研究目的
在重症监护病房住院后的获得性脑损伤（ABI）的大龄儿童和青少年中，超过一半存在睡眠障碍，但在婴儿和幼儿中却未得到充分评估。鉴于睡眠在大脑发育和受伤后康复中的重要性，我们假设睡眠障碍与 ABI 婴儿的神经发育结果更差有关。
方法
我们对 68 名在重症监护病房住院后因 ABI 而住院的 2-32 月龄婴儿进行了回顾性队列研究。采用婴儿睡眠问卷评估睡眠障碍。贝利婴幼儿发展量表第三版和适应行为评估系统第三版分别评估发育和适应功能结果。t 检验比较了 ABI 婴儿的睡眠特征与历史健康对照组的差异。Spearman 相关分析评估了睡眠与结果之间的关系。多元线性回归分析在控制人口统计学和 ABI 特征的情况下调查了睡眠与结果之间的关系。
结果
与健康对照组相比，ABI 患儿夜间睡眠时间更短（ = .01），白天睡眠时间更长（ < .001），夜间觉醒时间更长（ < .001）。夜间觉醒次数与贝利认知评分呈负相关（Spearman 相关系数 = -.40）。夜间觉醒次数与适应行为评估系统第三版一般适应综合评分呈负相关（Spearman 相关系数 = -.42）。在控制人口统计学和 ABI 特征后，≥3 次觉醒与适应行为评估系统第三版一般适应综合评分更差显著相关（β = -11.3；95%置信区间 = -19.2，-3.5）。
结论
睡眠障碍与 ABI 后婴儿和幼儿的不良结局相关。睡眠对康复至关重要，是一个潜在的可改变的目标，可以改善结果。
引文
Klapp JM, Hall TA, Riley AR, Williams CN. Sleep disturbances in infants and young children following an acquired brain injury.. 2022;18(10):2387-2395.
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