孤独症谱系障碍儿童睡眠问题及其与褪黑素相关性研究进展

王瀞萩; 王成举; 胡斌

doi:10.11852/zgetbjzz2021-0215

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中国儿童保健杂志 ›› 2022, Vol. 30 ›› Issue (6) : 651-654. DOI: 10.11852/zgetbjzz2021-0215

综述

孤独症谱系障碍儿童睡眠问题及其与褪黑素相关性研究进展

王瀞萩, 王成举综述, 胡斌审校

作者信息 +

Research advances on the relationship between melatonin and sleep problems in children with autism spectrum disorder

WANG Jing-qiu, WANG Cheng-ju, HU Bin

Author information +

文章历史 +

摘要

孤独症谱系障碍(ASD)是一组神经发育障碍性疾病,常伴有的昼夜节律失常和睡眠问题,睡眠问题不仅可能加重ASD儿童的某些核心症状,还可能影响康复训练效果。ASD儿童睡眠问题的临床表现形式多样,但确切机制尚不明确,研究发现其与褪黑素分泌代谢异常密切相关,且褪黑素治疗有效、安全。本文主要对ASD儿童睡眠问题及其与褪黑素相关研究进展作一综述,旨在为改善ASD儿童睡眠问题以及制定有效的干预方案提供依据。

Abstract

Autism spectrum disorder(ASD) is a group of neurodevelopmental disorders,often accompanied by circadian rhythm disorders and sleep problems. Sleep problems may not only aggravate some of the core symptoms of ASD children,but also affect the effect of rehabilitation training. The clinical manifestations of sleep problems in ASD children are various,but the exact mechanism is not clear. Studies have found that it is closely related to abnormal melatonin secretion and metabolism,and melatonin treatment is effective and safe. This paper mainly reviews the sleep problems of ASD children and the research progress related to melatonin in order to provide basis for improving sleep quality of ASD children and formulating effective intervention programs.

导出引用

王瀞萩, 王成举, 胡斌. 孤独症谱系障碍儿童睡眠问题及其与褪黑素相关性研究进展[J]. 中国儿童保健杂志. 2022, 30(6): 651-654 https://doi.org/10.11852/zgetbjzz2021-0215

WANG Jing-qiu, WANG Cheng-ju, HU Bin. Research advances on the relationship between melatonin and sleep problems in children with autism spectrum disorder[J]. Chinese Journal of Child Health Care. 2022, 30(6): 651-654 https://doi.org/10.11852/zgetbjzz2021-0215

中图分类号： R749.94

参考文献

[1] Wu ZY,Huang SD,Zou JJ,et al.Autism spectrum disorder(ASD):disturbance of the melatonin system and its implications[J].Biomed Pharmacother,2020,130: 110496.
[2] 刘贤,林穗芳,陈文雄,等. 中国儿童孤独症谱系障碍患病率Meta分析[J].中国儿童保健杂志,2018,26(4):402-406.
[3] Klein N,Kemper KJ. Integrative approaches to caring for children with autism[J].Curr Probl Pediatr Adolesc Health Care,2016,46(6):195-201.
[4] Goldman SE,Alder ML,Burgess HJ,et al.Characterizing sleep in adolescents and adults with autism spectrum disorders[J].J Autism Dev Disord,2017,47(6):1682-1695.
[5] Dmitrzak-Weglarz M,Reszka E. Pathophysiology of depression: molecular regulation of melatonin homeostasis—current status[J].Neuropsychobiology,2017,76(3):117-129.
[6] Maitra S,Bhattacharya D,Das S,et al.Melatonin and its anti-glioma functions:A comprehensive review[J].Rev Neurosci,2019,30(5),527-541.
[7] Rana M,Kothare S,DeBassio W. The assessment and treatment of sleep abnormalities in children and adolescents with autism spectrum disorder:A review[J].J Can Acad Child Adolesc Psychiatry,2021,30(1):25-35.
[8] Murata E,Mohri I,Kato-Nishimura K,et al.Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder[J].Res Dev Disabil,2017,65:127-139.
[9] Kanney ML,Durmer JS,Trotti LM,et al.Rethinking bedtime resistance in children with autism:Is restless legs syndrome to blame?[J].J Clin Sleep Med,2020,16(12):2029-2035.
[10] Reynolds AM,Soke GN,Sabourin KR,et al.Sleep problems in 2- to 5-year-olds with autism spectrum disorder and other developmental delays[J].Pediatrics,2019,143(3):e20180492.
[11] Kamara D,Beauchaine TP. A review of sleep disturbances among infants and children with neurodevelopmental disorders[J].Rev J Autism Dev Disord,2020,7(3):278-294.
[12] Köse S,Y¹lmaz H,Ocakoglu FT,et al.Sleep problems in children with autism spectrum disorder and intellectual disability without autism spectrum disorder[J].Sleep Med,2017,40:69-77.
[13] Sivertsen B,Posserud MB,Gillberg C,et al.Sleep problems in children with autism spectrum problems: A longitudinal population-based study[J].Autism,2012,16(2):139-150.
[14] 韩盼盼,邹明扬,杨晓蕾,等. 孤独症谱系障碍患儿睡眠问题及其与6-羟基硫酸褪黑素水平的关联性[J].中华儿科杂志,2017,55(12):911-915.
[15] Rzepka-Migut B,Paprocka J. Efficacy and safety of melatonin treatment in children with autism spectrum disorder and attention-deficit/hyperactivity disorder-a review of the literature[J].Brain Sci,2020,10(4):219.
[16] Abdulamir HA,Abdul-Rasheed OF,Abdulghani EA. Low oxytocin and melatonin levels and their possible role in the diagnosis and prognosis in Iraqi autistic children[J].Saudi Med J,2016,37(1):29-36.
[17] Maruani A,Dumas G,Beggiato A,et al.Morning plasma melatonin differences in autism: beyond the impact of pineal gland volume[J].Front Psychiatry,2019,10:11.
[18] Pagan C,Delorme R,Callebert J,et al.The serotonin-N-acetylserotonin-melatonin pathway as a biomarker for autism spectrum disorders[J].Transl Psychiatry,2014,4(11):e479.
[19] Braam W,Ehrhart F,Maas APHM,et al.Low maternal melatonin level increases autism spectrum disorder risk in children[J].Res Dev Disabil,2018,82:79-89.
[20] Liang Y,Xiao Z,Ke X,et al.Urinary metabonomic profiling discriminates between children with autism and their healthy siblings[J].Med Sci Monit,2020,26:e926634.
[21] Botbol M,Cabon P,Kermarrec S,et al.Biological and psychological rhythms:An integrative approach to rhythms disturbances in autistic disorder[J].J Physiol Paris,2013,107(4):298-309.
[22] 赵琴,邵智. 孤独症谱系障碍儿童睡眠障碍发生机制和治疗的研究进展[J].中国儿童保健杂志,2020,28(1):52-56.
[23] Yuge K,Nagamitsu S,Ishikawa Y,et al.Long-term melatonin treatment for the sleep problems and aberrant behaviors of children with neurodevelopmental disorders[J].BMC Psychiatry,2020,20(1):445.
[24] Bruni O,Alonso-Alconada D,Besag F,et al.Current role of melatonin in pediatric neurology:Clinical recommendations[J].Eur J Paediatr Neurol,2015,19(2):122-133.
[25] Cortesi F,Giannotti F,Sebastiani T,et al.Controlled-release melatonin,singly and combined with cognitive behavioral therapy,for persistent insomnia in children with autism spectrum disorders:A randomized placebo-controlled trial[J].J Sleep Res,2012,21(6):700-709.
[26] Gringras P,Nir T,Breddy J,et al.Efficacy and safety of pediatric prolonged-release melatonin for insomnia in children with autism spectrum disorder[J].J Am Acad Child Adolesc Psychiatry,2017,56(11):948-957.
[27] Schroder CM,Malow BA,Maras A,et al.Pediatric prolonged-release melatonin for sleep in children with autism spectrum disorder: impact on child behavior and caregiver's quality of life[J].J Autism Dev Disord,2019,49(8):3218-3230.
[28] Andersen IM,Kaczmarska J,McGrew SG,et al.Melatonin for insomnia in children with spectrum disorders[J].J Child Neurol,2008,23(5):482-485.
[29] Cuomo BM,Vaz S,Lee EAL,et al.Effectiveness of sleep-based interventions for children with autism spectrum disorder:A Meta-synthesis[J].Pharmacotherapy,2017,37(5):555-578.
[30] Malow BA,Findling RL,Schroder CM,et al.Sleep,growth,and puberty after two years of prolonged-release melatonin in children with autism spectrum disorder[J].J Am Acad Child Adolesc Psychiatry,2021,60(2):252-261.
[31] Maras A,Schroder CM,Malow BA,et al.Long-term efficacy and safety of pediatric prolonged-release melatonin for insomnia in children with autism spectrum disorder[J].J Child Adolesc Psychopharmacol,2018,28(10):699-710.
[32] Van Geijlswijk IM,Mol RH,Egberts TC,et al.Evaluation of sleep,puberty and mental health in children with long-term melatonin treatment for chronic idiopathic childhood sleep onset insomnia[J].Psychopharmacology,2011,216(1):111-120.
[33] Carr R,Wasdell MB,Hamilton D,et al.Long-term effectiveness outcome of melatonin therapy in children with treatment-resistant circadian rhythm sleep disorders[J].J Pineal Res,2007,43(4):351-359.
[34] Howes OD,Rogdaki M,Findon JL,et al.Autism spectrum disorder:Consensus guidelines on assessment,treatment and research from the British association for psychopharmacology[J].J Psychopharmacol,2018,32(1):3-29.