Department of Rehabilitation Medicine, Bundang Jesaeng Hospital, Gyeonggi-Do, Republic of Korea.
Department of Rehabilitation Medicine, Yeungnam University Hospital, Daegu, 42415, Republic of Korea.
BMC Pediatr. 2023 Jun 15;23(1):291. doi: 10.1186/s12887-023-04067-1.
Although the importance of sleep problems has been increasingly emphasized due to the effects on children's development and children's and families' daytime behaviors, physical health, and quality of life, they have been overlooked in clinical practice. However, there have been few studies on the effects of rehabilitation on sleep problems. Therefore, in this study, we investigated the effects of an intensive rehabilitation program on sleep problems in children with developmental delays (DD).
We included 36 children with DD (30 outpatients, 6 inpatients) and their caregivers who completed all items on the Sleep Disturbance Scale for Children. Of the children with DD, 19 (59.3%) had cerebral palsy (CP) and 13 (40.7%) had DD of non-CP origins, of which 6 (18.8%) had prematurity, 4 (12.5%) had genetic causes, and 3 (9.4%) had an unknown origin. Changes in sleep problems after the intensive rehabilitation program were evaluated using a paired or unpaired t-test, depending on the distribution of the continuous variables.
After the intensive rehabilitation program, in 36 children with DD, there was a significant improvement in the difficulty in initiating and maintaining sleep (DIMS) sub-score (p < 0.05). However, there was no significant improvement in the total score or other sub-scores, such as those for sleep breathing disorders (SBD), disorders of arousal (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DOES), and sleep hyperhidrosis (SH). In the subgroup analysis according to the cause of DD, children with CP had a significant improvement in DIMS and DOES sub-scores (p < 0.05).
The intensive rehabilitation program, consisting of more than two sessions per day, effectively alleviated sleep problems in children with DD, especially in those with CP. Among the sleep problems, the intensive rehabilitative program was most effective at improving the DIMS. However, further prospective studies with a larger number of patients with DD and a more standardized protocol are necessary to generalize this effect.
尽管睡眠问题对儿童发展以及儿童和家庭的日间行为、身体健康和生活质量有重要影响,但在临床实践中仍被忽视。然而,关于康复对睡眠问题影响的研究较少。因此,本研究旨在探讨强化康复方案对发育迟缓(DD)儿童睡眠问题的影响。
我们纳入了 36 名完成儿童睡眠障碍量表所有项目的 DD 儿童(30 名门诊,6 名住院)及其照护者。36 名 DD 儿童中,19 名(59.3%)患有脑瘫(CP),13 名(40.7%)为非 CP 来源的 DD,其中 6 名(18.8%)为早产儿,4 名(12.5%)有遗传原因,3 名(9.4%)病因不明。采用配对或非配对 t 检验,根据连续变量的分布情况评估强化康复方案后睡眠问题的变化。
在 36 名 DD 儿童中,强化康复方案后入睡和维持睡眠困难(DIMS)子量表评分显著改善(p<0.05)。但总评分或其他子量表评分(如睡眠呼吸障碍[SBD]、觉醒障碍[DA]、睡眠-觉醒转换障碍[SWTD]、过度嗜睡障碍[DOES]和睡眠多汗障碍[SH])无显著改善。根据 DD 病因的亚组分析中,CP 儿童的 DIMS 和 DOES 子量表评分显著改善(p<0.05)。
每天进行 2 次以上的强化康复方案可有效缓解 DD 儿童的睡眠问题,尤其对 CP 儿童效果更明显。在睡眠问题中,强化康复方案对 DIMS 的改善最有效。但需要更多的前瞻性研究,纳入更多的 DD 儿童和更标准化的方案,以推广这一效果。