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婴儿期早期和晚期的睡眠问题:对多个领域儿童发展轨迹的多种影响。

Sleep problems during early and late infancy: Diverse impacts on child development trajectories across multiple domains.

机构信息

Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC; School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC.

School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC; Department of Pediatric Neurology, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC.

出版信息

Sleep Med. 2024 Mar;115:177-186. doi: 10.1016/j.sleep.2024.02.018. Epub 2024 Feb 10.

Abstract

OBJECTIVE

Child developmental rate holds predictive value for early-stage developmental trajectories, yet few studies explored how sleep problems during different infancy stages impact this rate. This study aims to investigate the correlation between sleep problems and child developmental trajectories.

METHODS

This study utilized a prospective national cohort of 5006 children in Taiwan. The developmental inventories covering motor, cognitive, language, and socioemotional domains were collected through questionnaire-based in-person home interviews conducted at 3, 12, 24, and 36 months. Sleep problems data, encompassing bedtime regularity, sleep duration, and sleep quality, were collected at 3 and 12 months. Child developmental rate was assessed by analyzing the slope of developmental ability estimates over a period of time.

RESULTS

Bedtime regularity and high-quality sleep at 3 and 12 months were found to be significantly associated with intercepts across all domains (estimate = -0.196∼0.233, p < 0.033). Children with high-quality sleep at 3 months showed enhanced developmental slopes in socioemotional domains (estimate = 0.032, p < 0.001). Atypical sleep duration at 3 and 12 months had differential detrimental association with child development in various domains (estimate = -0.108∼-0.016, p < 0.048).

CONCLUSION

The relationship between sleep problems and child development exhibited variability based on the timing of exposure to these issues. Early exposure to low-quality sleep was significantly related to developmental functions and socioemotional developmental rate, potentially leading to increased developmental disparities as children age. Inadequate sleep duration in late infancy and excessive sleep duration in early infancy were both negatively associated with child development trajectories. Policymakers can use these findings to design targeted sleep programs for optimal child development.

摘要

目的

儿童发育速度对早期发育轨迹具有预测价值,但很少有研究探讨不同婴儿期阶段的睡眠问题如何影响这一速度。本研究旨在探讨睡眠问题与儿童发育轨迹之间的相关性。

方法

本研究利用了台湾一个由 5006 名儿童组成的前瞻性全国队列。通过在 3、12、24 和 36 个月时进行基于问卷的上门家访,收集涵盖运动、认知、语言和社会情感领域的发育清单。在 3 个月和 12 个月时收集睡眠问题数据,包括就寝时间规律、睡眠时间和睡眠质量。通过分析一段时间内发育能力估计的斜率来评估儿童发育速度。

结果

发现 3 个月和 12 个月时的就寝时间规律和高质量睡眠与所有领域的截距显著相关(估计值=-0.196∼0.233,p<0.033)。3 个月时睡眠质量高的儿童在社会情感领域的发育斜率提高(估计值=0.032,p<0.001)。3 个月和 12 个月时不典型的睡眠时间与儿童在各个领域的发展呈负相关(估计值=-0.108∼-0.016,p<0.048)。

结论

睡眠问题与儿童发展之间的关系因暴露于这些问题的时间而异。早期接触低质量睡眠与发育功能和社会情感发育速度显著相关,可能导致儿童年龄增长时发育差距加大。婴儿期后期睡眠时间不足和婴儿期早期睡眠时间过多都与儿童发育轨迹呈负相关。政策制定者可以利用这些发现为儿童最佳发育设计有针对性的睡眠计划。

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