与罕见癫痫综合征患儿相关的照顾者睡眠质量的相关因素
Factors Associated with Caregiver Sleep Quality Related to Children with Rare Epilepsy Syndromes.
作者信息
Hesdorffer Dale C, Kroner Barbara L, Shen Jing, Farrell Kathleen, Roberds Steve, Fureman Brandy
机构信息
Gertrude H. Sergievsky Center and Department of Epidemiology and Statistics, Columbia University, New York, NY.
Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC.
出版信息
J Pediatr X. 2020 May 12;2:100021. doi: 10.1016/j.ympdx.2020.100021. eCollection 2020 Spring.
OBJECTIVE
To evaluate the impact of pediatric sleep disturbances and night-time seizure monitoring of children with rare epilepsy syndromes on the sleep quality and mental health of caregivers.
STUDY DESIGN
A cross-sectional study was conducted using caregiver entered data from the Rare Epilepsy Network on pediatric sleep disturbances and Patient Reported Outcomes Measurement Information System measures for caregiver fatigue, sleep disturbance, sleep-related impairment, depression, anxiety, companionship, and cognition. Logistic regression was used to examine associations between risk factors and caregiver sleep quality.
RESULTS
Non-Hispanic white mothers comprised 83% of the 742 respondents in this study. After adjusting for covariates, difficulty falling asleep, excessive daytime sleepiness, frequent night-time awakenings, and very restless sleep in children were associated with fatigue (aOR 95% CI, 1.5-2.2), sleep-related disturbance (aOR 95% CI, 1.7-2.6) and sleep impairment (aOR 95% CI, 1.5-2.4) in caregivers. Caregiver anxiety (aOR 95% CI, 3.6-6.0) and depression (aOR 95% CI, 2.8-6.0) were also highly associated with their fatigue and sleep quality, whereas companionship (aOR 95% CI, 0.3-0.4) and higher caregiver cognition (aOR 95% CI, 0.1-0.2) were protective. In addition, sharing a room or bed or using methods that require listening for seizures were significantly related to sleep disturbance and fatigue in the caregivers.
CONCLUSIONS
In rare epilepsies, pediatric sleep disturbances and night-time seizure monitoring are significantly associated with caregiver fatigue and poor sleep quality. In addition to the intense caregiving needs of children with rare epilepsies, fatigue and poor sleep quality in caregivers may contribute to or result from mental health problems.
目的
评估小儿睡眠障碍及对患有罕见癫痫综合征儿童进行夜间癫痫监测对照顾者睡眠质量和心理健康的影响。
研究设计
采用横断面研究,使用来自罕见癫痫网络中照顾者录入的关于小儿睡眠障碍的数据,以及患者报告结局测量信息系统中关于照顾者疲劳、睡眠障碍、睡眠相关损害、抑郁、焦虑、陪伴和认知的测量数据。采用逻辑回归分析来检验危险因素与照顾者睡眠质量之间的关联。
结果
本研究的742名受访者中,非西班牙裔白人母亲占83%。在对协变量进行调整后,儿童入睡困难、白天过度嗜睡、夜间频繁醒来以及睡眠非常不安稳与照顾者的疲劳(调整后比值比95%置信区间为1.5 - 2.2)、睡眠相关障碍(调整后比值比95%置信区间为1.7 - 2.6)和睡眠损害(调整后比值比95%置信区间为1.5 - 2.4)相关。照顾者的焦虑(调整后比值比95%置信区间为3.6 - 6.0)和抑郁(调整后比值比95%置信区间为2.8 - 6.0)也与他们的疲劳和睡眠质量高度相关,而陪伴(调整后比值比95%置信区间为0.3 - 0.4)和照顾者较高的认知水平(调整后比值比95%置信区间为0.1 - 0.2)具有保护作用。此外,共用一个房间或床铺或采用需要监听癫痫发作的方法与照顾者的睡眠障碍和疲劳显著相关。
结论
在罕见癫痫中,小儿睡眠障碍及夜间癫痫监测与照顾者疲劳和睡眠质量差显著相关。除了患有罕见癫痫儿童的高强度护理需求外,照顾者的疲劳和睡眠质量差可能导致心理健康问题或由心理健康问题引起。
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