Sleep in children with autism with and without autistic regression
Sleep in children with autism with and without autistic regression
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DOI：
10.1111/j.1365-2869.2010.00882.x
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发表时间：
2011-06-01
影响因子：
4.4
通讯作者：
Valente, Donatella
中科院分区：
文献类型：
--
作者：
Giannotti, Flavia;Cortesi, Flavia;Valente, Donatella
本研究的目的是在一个明确的退行性和非退行性自闭症儿童队列和典型发育儿童（TD）中描述和比较传统睡眠结构和非快速眼动（NREM）睡眠微结构。我们假设，患有退行性自闭症的儿童将在宏观或微观层面上表现出更大程度的睡眠中断，并且父母报告的睡眠问题更多。22名非退行性自闭症儿童，18名退行性自闭症儿童，12名TD儿童，年龄5-10岁，接受标准的多通道多导睡眠图评估。父母完成了一份结构化问卷（儿童睡眠习惯调查表-CSHQ）。我们的研究结果支持了最初的假设，即回归儿童有更多的睡眠中断，他们在CSHQ上的得分显著高于非回归同龄人，特别是在睡前阻力，睡眠开始延迟，睡眠持续时间和夜间觉醒CSHQ子域上，并且两者的得分都高于通常的发展控制。与非回归儿童和TD组相比，回归受试者的睡眠效率明显降低，总睡眠时间减少，睡眠潜伏期延长，REM潜伏期延长，入睡后清醒时间延长。回归儿童在浅睡眠中的循环交替模式（CAP）率和A1指数低于非回归儿童和TD儿童。我们的研究结果表明，尽管两组自闭症儿童的睡眠结构没有特别的差异，但从宏观或微观结构的角度来看，那些经历过回归的儿童表现出更多的睡眠障碍和睡眠中断。
P>The purpose of the present investigation was to characterize and compare traditional sleep architecture and non-rapid eye movement (NREM) sleep microstructure in a well-defined cohort of children with regressive and non-regressive autism, and in typically developing children (TD). We hypothesized that children with regressive autism would demonstrate a greater degree of sleep disruption either at a macrostructural or microstructural level and a more problematic sleep as reported by parents. Twenty-two children with non-regressive autism, 18 with regressive autism without comorbid pathologies and 12 with TD, aged 5-10 years, underwent standard overnight multi-channel polysomnographic evaluation. Parents completed a structured questionnaire (Childrens' Sleep Habits Questionnaire-CSHQ). The initial hypothesis, that regressed children have more disrupted sleep, was supported by our findings that they scored significantly higher on CSHQ, particularly on bedtime resistance, sleep onset delay, sleep duration and night wakings CSHQ subdomains than non-regressed peers, and both scored more than typically developing controls. Regressive subjects had significantly less efficient sleep, less total sleep time, prolonged sleep latency, prolonged REM latency and more time awake after sleep onset than non-regressive children and the TD group. Regressive children showed lower cyclic alternating pattern (CAP) rates and A1 index in light sleep than non-regressive and TD children. Our findings suggest that, even though no particular differences in sleep architecture were found between the two groups of children with autism, those who experienced regression showed more sleep disorders and a disruption of sleep either from a macro- or from a microstructural viewpoint.