Sleep Regulation, Physiology and Development, Sleep Duration and Patterns, and Sleep Hygine in Infants, Toddlers, and Preschool-Age Children
Sleep Regulation, Physiology and Development, Sleep Duration and Patterns, and Sleep Hygine in Infants, Toddlers, and Preschool-Age Children
复制标题
DOI：
10.1016/j.cppeds.2016.12.001
复制
发表时间：
2017-02-01
影响因子：
1.6
通讯作者：
Tomopoulos, Suzy
中科院分区：
文献类型：
--
作者：
Bathory, Eleanor;Tomopoulos, Suzy
睡眠问题是常见的，有四分之一的5岁以下儿童的父母报告说，睡眠问题与行为不良，学习成绩差和肥胖有关，此外还对母亲和家庭福祉产生负面的次级影响。然而，已经表明，儿科医生在常规的健康儿童就诊中没有充分解决睡眠问题，并且对睡眠问题诊断不足。儿科医生在医学院或住院医师中几乎没有接受过关于睡眠药物的正式培训。了解睡眠的生理学对于儿科医生有效和自信地为患者提供睡眠咨询的能力至关重要。睡眠和清醒的生物节律通过昼夜节律和体内平衡过程来调节。睡眠也有一个内部的节奏组织，或睡眠结构，其中包括REM和NREM睡眠的睡眠周期。觉醒和睡眠（REM和NREM）是活跃而复杂的神经生理过程，涉及神经通路的激活和抑制。这些生理过程在生命过程中发生变化，特别是在最初的5年。充足的睡眠通常很难实现，但被认为对儿童的最佳日常功能和行为非常重要;因此，了解最佳睡眠时间和模式对儿科医生至关重要。很少有实验证据指导睡眠建议，而是规范数据和专家建议。有效的儿童睡眠咨询必须考虑到影响睡眠的儿童和父母因素（儿童气质，亲子互动和父母影响）以及环境因素（文化，地理和家庭环境，特别是媒体曝光）。为了促进健康，预防和管理睡眠问题，美国儿科学会（AAP）建议父母开始促进良好的睡眠卫生，在婴儿期和整个童年时期建立一个促进睡眠的环境和就寝时间。因此，为家庭提供睡眠咨询需要了解睡眠调节，生理学，发育模式，最佳睡眠时间建议以及影响睡眠和睡眠卫生的许多因素。
Sleep problems are common, reported by a quarter of parents with children under the age of 5 years, and have been associated with poor behavior, worse school performance, and obesity, in addition to negative secondary effects on maternal and family well-being. Yet, it has been shown that pediatricians do not adequately address sleep in routine well child visits, and underdiagnose sleep issues. Pediatricians receive little formal training in medical school or in residency regarding sleep medicine. An understanding of the physiology of sleep is critical to a pediatrician's ability to effectively and confidently counsel patients about sleep. The biological rhythm of sleep and waking is regulated through both circadian and homeostatic processes. Sleep also has an internal rhythmic organization, or sleep architecture, which includes sleep cycles of REM and NREM sleep. Arousal and sleep (REM and NREM) are active and complex neurophysiologic processes, involving both neural pathway activation and suppression. These physiologic processes change over the life course, especially in the first 5 years. Adequate sleep is often difficult to achieve, yet is considered very important to optimal daily function and behavior in children; thus, understanding optimal sleep duration and patterns is critical for pediatricians. There is little experimental evidence that guides sleep recommendations, rather normative data and expert recommendations. Effective counseling on child sleep must account for the child and parent factors (child temperament, parent child interaction, and parental affect) and the environmental factors (cultural, geographic, and home environment, especially media exposure) that influence sleep. To promote health and to prevent and manage sleep problems, the American Academy of Pediatrics (AAP) recommends that parents start promoting good sleep hygiene, with a sleep promoting environment and a bedtime routine in infancy, and throughout childhood. Thus, counseling families on sleep requires an understanding of sleep regulation, physiology, developmental patterns, optimal sleep duration recommendations, and the many factors that influence sleep and sleep hygiene.