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当孩子就是不睡时:儿童睡眠减少对患有和未患有神经遗传综合征儿童的照料者的抑郁、焦虑和压力的不同影响。

When they just don't sleep: differential impacts of reduced child sleep on depression, anxiety, and stress among caregivers of children with and without neurogenetic syndromes.

作者信息

Gálvez-Ortega Kimberly, Marceau Kristine, Foti Dan, Kelleher Bridgette

机构信息

Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States.

Department of Human Development and Family Science, Purdue University, West Lafayette, IN, United States.

出版信息

Front Psychiatry. 2024 Apr 19;15:1352881. doi: 10.3389/fpsyt.2024.1352881. eCollection 2024.

Abstract

INTRODUCTION

Children with neurogenetic syndromes commonly experience significant and pervasive sleep disturbances, however, associations with caregiver mental health remains unclear. Previous studies have linked sleep disturbances with increased caregiver depression in typically developing populations, and heightened caregiver stress among neurogenetic populations. The present study expands on findings by exploring the longitudinal association between child sleep duration and caregiver mental health (depression, anxiety, stress) throughout development (infancy to school-aged children) in dyads with and without a child affected by a neurogenetic syndrome.

METHODS

Participants were drawn from the Purdue Early Phenotype Study, including 193 caregivers (Age: = 34.40 years, = 4.53) of children with neurogenetic syndromes (Age: = 40.91 months, =20.72) and typically developing children (n = 55; Age: = 36.71 months, = 20.68). Children in the neurogenetic group were diagnosed with Angelman (n = 49), Prader Willi (n = 30), Williams (n = 51), and Fragile X (n = 8) syndromes. Caregivers completed assessments every six months up to child age three, and annual assessments thereafter. Child sleep duration was measured using the Brief Infant Sleep Questionnaire, and caregiver internalizing symptoms were assessed using the Depression, Anxiety, Stress Scale. Multilevel models were conducted to examine caregiver depression, anxiety, and stress in relation to child sleep duration at both between- and within-person levels, with child age as a moderator.

RESULTS

Results indicated a between-person effect of child sleep duration on caregiver depression (i.e., differences between families) and a within-person effect on caregiver stress (i.e., change over time) in the full, combined sample. These effects were not maintained when examined separately in neurogenetic and typically developing groups, except for a between-person effect on caregiver stress in the typically developing cohort. Moderating effects of child age were significant for depression and stress only in the typically developing cohort.

DISCUSSION

In summary, persistent child sleep disruptions were linked to exacerbated caregiver depression across the sample, while acute child sleep disruptions exacerbate caregiver stress within dyads over time. These findings emphasize the importance of addressing child sleep to enhance caregiver wellbeing and has potential relevance for a wide range of neurogenetic syndromes.

摘要

引言

患有神经遗传综合征的儿童通常会经历严重且普遍的睡眠障碍,然而,其与照顾者心理健康之间的关联仍不明确。先前的研究已将睡眠障碍与正常发育人群中照顾者抑郁情绪增加以及神经遗传人群中照顾者压力增大联系起来。本研究通过探索在有和没有受神经遗传综合征影响儿童的二元组中,从婴儿期到学龄期整个发育过程中儿童睡眠时间与照顾者心理健康(抑郁、焦虑、压力)之间的纵向关联,对现有研究结果进行了拓展。

方法

参与者来自普渡早期表型研究,包括193名患有神经遗传综合征儿童(年龄:均值 = 40.91个月,标准差 = 20.72)和正常发育儿童(n = 55;年龄:均值 = 36.71个月,标准差 = 20.68)的照顾者(年龄:均值 = 34.40岁,标准差 = 4.53)。神经遗传组中的儿童被诊断患有天使综合征(n = 49)、普拉德 - 威利综合征(n = 30)、威廉姆斯综合征(n = 51)和脆性X综合征(n = 8)。照顾者在孩子三岁前每六个月完成一次评估,此后每年进行评估。使用简短婴儿睡眠问卷测量儿童睡眠时间,使用抑郁、焦虑、压力量表评估照顾者的内化症状。采用多水平模型在个体间和个体内水平上检验照顾者的抑郁、焦虑和压力与儿童睡眠时间的关系,并将儿童年龄作为调节变量。

结果

结果表明,在整个合并样本中,儿童睡眠时间对照顾者抑郁有个体间效应(即家庭间差异),对照顾者压力有个体内效应(即随时间变化)。在神经遗传组和正常发育组中分别进行检验时,这些效应并不持续,不过在正常发育队列中儿童睡眠时间对照顾者压力有个体间效应。儿童年龄的调节效应仅在正常发育队列中对抑郁和压力有显著影响。

讨论

总之,持续性的儿童睡眠中断与整个样本中照顾者抑郁加剧有关,而急性儿童睡眠中断会随着时间推移加剧二元组中照顾者的压力。这些发现强调了解决儿童睡眠问题对提高照顾者幸福感的重要性,并且对广泛的神经遗传综合征具有潜在相关性。

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