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意大利自闭症谱系障碍儿童和青少年的睡眠障碍与同床睡眠

Sleep Disturbances and Co-sleeping in Italian Children and Adolescents with Autism Spectrum Disorder.

作者信息

Scarpelli Serena, Menghini Deny, Alfonsi Valentina, Giumello Francesca, Annarumma Ludovica, Gorgoni Maurizio, Valeri Giovanni, Pazzaglia Mariella, De Gennaro Luigi, Vicari Stefano

机构信息

Department of Psychology, Sapienza University of Rome, Rome, Italy.

Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

出版信息

J Autism Dev Disord. 2024 Aug 8. doi: 10.1007/s10803-024-06507-y.

Abstract

The current study aimed (1) to provide an analysis of the frequency and prevalence of sleep disturbances in a large Italian sample of children and adolescents with ASD, detecting specific predictors of the presence/absence of sleep disorders, (2) to examine the phenomenon of co-sleeping within a subgroup of participants with ASD. A total of 242 children and adolescents with ASD (194 males, mean age 5.03 ± 3.15 years) were included. After the diagnostic procedure, caregivers were requested to complete the Sleep Disturbance Scale for Children (SDSC) to assess sleep disorders among participants. The presence of co-sleeping was investigated in a subgroup of 146 children and adolescents with ASD. An elevated or clinically relevant global score for sleep disorders (≥ 60) was found in 33% of participants. The most prevalent sleep disorder in our group was related to difficulties with sleep onset and sleep maintenance (~ 41% of cases). Sleep disturbances were predicted by higher intelligence quotient (IQ)/developmental quotient (DQ), increased internalizing problems, and elevated parental stress. The subgroup of participants engaged in co-sleeping (N = 87) were younger and had lower IQ/DQ scores, reduced adaptive functioning, and diminished psychological wellbeing than the non-co-sleeping group. Our findings are consistent with the current literature highlighting that insomnia is the most widespread sleep problem associated with ASD. The relationship between IQ/DQ and sleep alterations is a crucial topic that deserves additional research. Future studies should assess sleep by objective measures such as EEG topography to better understand the mechanisms underlying sleep alterations in this neurodevelopmental disorder.

摘要

本研究旨在

(1)对意大利大量自闭症儿童和青少年样本中的睡眠障碍频率和患病率进行分析,找出睡眠障碍存在与否的具体预测因素;(2)在自闭症参与者亚组中研究同睡现象。共纳入242名自闭症儿童和青少年(194名男性,平均年龄5.03±3.15岁)。在诊断程序完成后,要求照料者填写儿童睡眠障碍量表(SDSC)以评估参与者的睡眠障碍情况。在146名自闭症儿童和青少年亚组中调查了同睡情况。33%的参与者存在睡眠障碍的升高或临床相关总体评分(≥60)。我们组中最常见的睡眠障碍与入睡困难和睡眠维持困难有关(约41%的病例)。智商(IQ)/发育商(DQ)较高、内化问题增加和父母压力升高可预测睡眠障碍。与非同睡组相比,同睡的参与者亚组(N = 87)年龄更小,IQ/DQ得分更低,适应功能降低,心理健康状况更差。我们的研究结果与当前文献一致,该文献强调失眠是与自闭症相关的最普遍的睡眠问题。IQ/DQ与睡眠改变之间的关系是一个值得进一步研究的关键话题。未来的研究应该通过脑电图地形图等客观测量方法来评估睡眠,以更好地理解这种神经发育障碍中睡眠改变的潜在机制。

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