Behavioral Treatment of Insomnia and Sleep Disturbances in School-Aged Children and Adolescents.
Behavioral Treatment of Insomnia and Sleep Disturbances in School-Aged Children and Adolescents.
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DOI：
10.1016/j.chc.2020.08.006
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发表时间：
2021-01
影响因子：
2.4
通讯作者：
Sloan JS
中科院分区：
文献类型：
--
作者：
Lunsford-Avery JR;Bidopia T;Jackson L;Sloan JS
失眠和相关的睡眠障碍通常影响青少年，学龄儿童（6-12岁）的患病率估计约为30%，青少年（13-18岁）的患病率约为24%。1，2在患有精神疾病的儿童人群中，包括注意力缺陷/多动障碍（ADHD），自闭症谱系障碍（ASD）以及焦虑和抑郁症的估计值较高。3-6患有失眠症的青少年面临许多有害的后果，包括生活质量下降，认知受损，行为/情绪问题，更严重的肥胖，在学校表现较差，以及更大的冒险行为。2，7，8 Inflammation也会影响家庭功能，并与父母的压力增加和睡眠中断有关。9这些负面结果，加上慢性化的可能性和青年的高患病率，值得关注儿童睡眠障碍的有效治疗方法的开发和实施。10临床医生在治疗儿童睡眠障碍时经常依赖药物干预;然而，关于青少年失眠药物的安全性和耐受性的证据有限，药物也提供了相对短暂的效果，停药后无法维持。11在成人中，行为干预，如失眠的认知行为疗法（CBT-I），被认为是治疗睡眠障碍的第一线。12在过去的十年中，越来越多的文献表明，行为干预可能对青少年同样有效; 13-16然而，儿科睡眠评估和治疗很少在医疗环境中实施。17.本次审查旨在提供
Insomnia and related sleep disturbances commonly affect youth, with prevalence rates estimated at~ 30% in school-aged children (6–12 years) and~ 24% in adolescents (13–18 years). 1, 2 Estimates are higher in pediatric populations with psychiatric diagnoses, including Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and anxiety and depression. 3–6 Youth with insomnia face many deleterious consequences, including reduced quality of life, impaired cognition, behavioral/emotional problems, greater obesity, poorer performance in school, and greater risk-taking behaviors. 2, 7, 8 Insomnia also affects family functioning and is associated with increased stress and disrupted sleep for parents. 9 These negative outcomes, coupled with potential for chronicity and high prevalence in youth, warrant attention on the development and implementation of efficacious treatments for pediatric sleep disturbances. 10Clinicians frequently rely on pharmacological interventions when treating pediatric sleep disturbances; however, limited evidence exists for the safety and tolerability of medications for insomnia in youth, and medications also provide relatively short-lived effects not maintained following discontinuation. 11 In adults, behavioral interventions, such as cognitive behavioral therapy for insomnia (CBT-I), are considered first-line in treating sleep disturbances. 12 In the last decade, a growing literature has suggested that behavioral interventions may be similarly effective for youth; 13–16 however, pediatric sleep assessments and treatments are rarely implemented in medical settings. 17 This review aims to provide
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