Heikkilä Anna-Riitta, Lapinleimu Helena, Virtanen Irina, Rönnlund Hanni, Raaska Hanna, Elovainio Marko
Department of Pediatrics, University of Helsinki, Helsinki, Finland.
Department of Pediatrics, Helsinki University Hospital, Helsinki, Finland.
Front Pediatr. 2022 Sep 9;10:948010. doi: 10.3389/fped.2022.948010. eCollection 2022.
Psychosocial risks and environmental changes experienced by internationally adopted children may predict sleep problems, which are incidentally among the main concerns of adoptive parents. Several questionnaire studies have found sleep of internationally adopted children to be problematic, but none of those used an objective measure in a controlled study.
To determine whether the objectively recorded sleep of internationally adopted children is worse than their controls who are living with their biological parents.
To this case-control part of the Finnish Adoption Study, we recruited children who were adopted internationally to Finland between October 2012 and December 2016. Simultaneously, control children were recruited from 16 daycare centers. To assess sleep in children, actigraphy recordings were made twice, 1 year apart, between December 2013 and April 2018. In the adopted group, the first assessment took place 10 months after they had arrived in their families. The associations between adoption status and sleep parameters were analyzed using linear mixed modeling and adjusted for multiple potential confounders, including child age.
Seventy-eight internationally adopted children (boys 64%) aged 1-7 years and 99 controls (boys 53%) aged 2-6 years attended the first sleep recording. The recordings showed that the internationally adopted children slept longer (B = 0.48, 95% CI 0.23-0.73, < 0.001) than the controls. There were no significant differences in sleep fragmentation or sleep efficiency between the groups. During the 1-year follow-up, the sleep patterns of the adopted children approached those of the controls.
The internationally adopted children spent more time in bed and slept more than their control children in both recordings. However, their sleep patterns were not very different from those of their peers and the differences appeared to vanish during the first years in their new family.
国际收养儿童所经历的心理社会风险和环境变化可能预示着睡眠问题，这也是养父母主要关心的问题之一。多项问卷调查研究发现国际收养儿童的睡眠存在问题，但这些研究均未在对照研究中采用客观测量方法。
确定国际收养儿童经客观记录的睡眠情况是否比与其亲生父母生活在一起的对照儿童更差。
在芬兰收养研究的这个病例对照部分中，我们招募了2012年10月至2016年12月期间被国际收养到芬兰的儿童。同时，从16个日托中心招募对照儿童。为评估儿童的睡眠情况，在2013年12月至2018年4月期间进行了两次活动记录仪记录，间隔1年。在收养组中，首次评估在他们抵达家庭10个月后进行。采用线性混合模型分析收养状态与睡眠参数之间的关联，并对包括儿童年龄在内的多个潜在混杂因素进行了调整。
78名1 - 7岁的国际收养儿童（64%为男孩）和99名2 - 6岁的对照儿童（53%为男孩）参加了首次睡眠记录。记录显示，国际收养儿童的睡眠时间比对照儿童长（B = 0.48，95%CI 0.23 - 0.73，P < 0.001）。两组在睡眠片段化或睡眠效率方面无显著差异。在1年的随访期间，收养儿童的睡眠模式接近对照儿童。
在两次记录中，国际收养儿童在床上花费的时间更多，睡眠时间也比对照儿童长。然而，他们的睡眠模式与同龄人并无太大差异，且这些差异在他们进入新家庭的头几年似乎消失了。
