针对自闭症谱系障碍儿童和成人睡眠障碍的认知行为疗法及相关干预措施：系统评价与荟萃分析方案
Cognitive behavioural therapy and related interventions for sleep disorders in children and adults with autism spectrum disorder: protocol for a systematic review and meta-analysis.
作者信息
Zhai Qianyi, Wu Yuxin, Wu Yinan, Ji Youyou, Li Yutong, Xu Ronglin, Zhong Yi, Xiao Bin, Zhou Lanshu
机构信息
School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Key Laboratory of Health Identification and Assessment of Shanghai, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
出版信息
BMJ Open. 2025 Jul 22;15(7):e101084. doi: 10.1136/bmjopen-2025-101084.
INTRODUCTION
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by deficits in social communication and repetitive behaviours, often accompanied by sleep disturbances. These sleep problems, including prolonged sleep latency and fragmented sleep, affect more than half of autistic individuals, exacerbating functional impairments and diminishing quality of life. Cognitive behavioural therapy (CBT) has shown promise in addressing sleep disturbances in ASD, with preliminary studies indicating improvements in sleep quality. However, no systematic review has comprehensively summarised the effects of CBT on sleep in autistic individuals.
METHODS AND ANALYSIS
This systematic review and meta-analysis will synthesise evidence on the efficacy of CBT for improving sleep quality in individuals with ASD. We will search multiple databases (eg, PubMed, Web of Science) for studies published until May 2025. Inclusion criteria encompass randomised controlled trials, single-arm studies and observational studies involving children and adults with ASD and moderate sleep problems. Interventions targeting sleep quality using CBT techniques will be considered. Data extraction will focus on study details, participant information, intervention specifics and sleep outcome measures (eg, total sleep time, sleep onset latency, etc). Risk of bias will be assessed using tools such as Cochrane Risk of Bias Tool V.2, Risk Of Bias In Non-randomised Studies-of Interventions and Review Manager 5.3. A meta-analysis will be conducted using Stata 18, with heterogeneity evaluated using the I² statistic and Cochran's Q test.
ETHICS AND DISSEMINATION
Given that the dataset for this investigation is derived from publicly accessible databases, there is no direct interaction with patients; thus, ethical approval is not required.
PROSPERO REGISTRATION NUMBER
CRD42025643701.
引言
自闭症谱系障碍（ASD）是一种神经发育疾病，其特征为社交沟通缺陷和重复行为，常伴有睡眠障碍。这些睡眠问题，包括入睡时间延长和睡眠碎片化，影响超过半数的自闭症患者，加剧功能障碍并降低生活质量。认知行为疗法（CBT）在解决ASD患者的睡眠障碍方面显示出前景，初步研究表明睡眠质量有所改善。然而，尚无系统评价全面总结CBT对自闭症患者睡眠的影响。
方法与分析
本系统评价和荟萃分析将综合关于CBT改善ASD患者睡眠质量疗效的证据。我们将检索多个数据库（如PubMed、科学网），查找截至2025年5月发表的研究。纳入标准包括随机对照试验、单臂研究和涉及患有ASD且存在中度睡眠问题的儿童及成人的观察性研究。将考虑使用CBT技术针对睡眠质量的干预措施。数据提取将聚焦于研究细节、参与者信息、干预具体情况和睡眠结局指标（如总睡眠时间、入睡潜伏期等）。将使用Cochrane偏倚风险工具V.2、非随机干预研究中的偏倚风险和Review Manager 5.3等工具评估偏倚风险。将使用Stata 18进行荟萃分析，使用I²统计量和Cochrane Q检验评估异质性。
伦理与传播
鉴于本调查的数据集来自可公开访问的数据库，不存在与患者的直接互动；因此，无需伦理批准。
PROSPERO注册号：CRD42025643701。
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