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[睡眠与神经发育:一个适时的主题]

[Sleep and neurodevelopment: a timely subject].

作者信息

Langelet Christophe, Schröder Carmen M

机构信息

Service de Psychiatrie de l'Enfant et de l'Adolescent, Pôle Psychiatrie, Santé Mentale et Addictologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France - Centre des Troubles du Sommeil (CIRCSom), Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France.

Service de Psychiatrie de l'Enfant et de l'Adolescent, Pôle Psychiatrie, Santé Mentale et Addictologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France - Centre des Troubles du Sommeil (CIRCSom), Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France - Centre d'Excellence pour l'Autisme et les Troubles du Neurodéveloppement STRAS&ND, Strasbourg, France - CNRS UPR 3212, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France.

出版信息

Biol Aujourdhui. 2025;219(1-2):15-23. doi: 10.1051/jbio/2025006. Epub 2025 Jul 22.

Abstract

Neurodevelopmental disorders (NDDs) include a heterogeneous group of conditions characterized by an alteration of neurodevelopmental processes leading to a significant impact on the individual's personal, social, and/or academic functioning. Among the many comorbidities frequently associated with NDDs, sleep disturbances play a major role, affecting between 30% and 80% of concerned people. This article explores the various links between sleep and NDDs through a review of the scientific literature highlighting the most recent research in this area, with a particular focus on two neurodevelopmental disorders: autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Sleep is an essential physiological process regulated by homeostatic and circadian mechanisms, playing a crucial role in brain maturation. In children with ASD, a decrease in the activity of enzymes responsible for melatonin synthesis has been identified, leading to a melatonin production and secretion deficiency that is associated with sleep-wake cycle disturbances. As a result, autistic people suffer from sleep-onset insomnia, sleep-maintenance insomnia with particularly long nocturnal awakenings, and reduced total sleep duration. In ADHD, on the other hand, the most commonly observed sleep disorders include delayed sleep phase syndrome and restless legs syndrome, both responsible for sleep-onset insomnia. Due to its essential role in memory consolidation, emotional regulation, and attention, sleep directly influences an individual's cognitive and behavioral development. Thus, sleep disorders in children with ADHD exacerbate inattention, hyperactivity and impulsivity, while in children with ASD, they amplify emotional regulation difficulties and behavioral disturbances. Identifying sleep disorders for their management in patients with NDDs is essential to improving their quality of life and reducing the severity of their daytime symptoms. Therapeutic interventions, whether behavioral or pharmacological - particularly melatonin administration - have shown significant efficacy. An integrated, multidisciplinary approach can optimize patient care and enhance their social and cognitive adaptation. A better understanding of the interactions between sleep disorders and NDDs thus opens new avenues for improving strategies in the management of individuals with NDDs.

摘要

神经发育障碍(NDDs)包括一组异质性疾病,其特征是神经发育过程发生改变,对个体的个人、社交和/或学业功能产生重大影响。在与NDDs经常相关的众多共病中,睡眠障碍起着主要作用,影响着30%至80%的相关人群。本文通过回顾科学文献,探讨睡眠与NDDs之间的各种联系,重点介绍该领域的最新研究,特别关注两种神经发育障碍:自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)。睡眠是一个由稳态和昼夜节律机制调节的基本生理过程,在大脑成熟中起着关键作用。在患有ASD的儿童中,已发现负责褪黑素合成的酶活性降低,导致褪黑素产生和分泌不足,这与睡眠-觉醒周期紊乱有关。因此,自闭症患者会出现入睡失眠、夜间觉醒时间特别长的维持睡眠失眠,以及总睡眠时间减少。另一方面,在ADHD中,最常见的睡眠障碍包括睡眠相位延迟综合征和不宁腿综合征,两者都导致入睡失眠。由于睡眠在记忆巩固、情绪调节和注意力方面的重要作用,它直接影响个体的认知和行为发展。因此,ADHD儿童的睡眠障碍会加剧注意力不集中、多动和冲动,而ASD儿童的睡眠障碍则会加剧情绪调节困难和行为障碍。识别NDDs患者的睡眠障碍以便进行管理,对于改善他们的生活质量和减轻白天症状的严重程度至关重要。治疗干预,无论是行为治疗还是药物治疗——特别是褪黑素给药——都已显示出显著疗效。综合的多学科方法可以优化患者护理并增强他们的社交和认知适应能力。因此,更好地理解睡眠障碍与NDDs之间的相互作用为改善NDDs患者的管理策略开辟了新途径。

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