孤独症谱系障碍儿童的饮食睡眠问题及相关因素

doi:10.11852/zgetbjzz2023-0970

中国儿童保健杂志 ›› 2024, Vol. 32 ›› Issue (3): 329-333.DOI: 10.11852/zgetbjzz2023-0970

孤独症谱系障碍儿童的饮食睡眠问题及相关因素

胥柯¹, 周勤^2,3, 吴明磊⁴, 宋丽¹, 柯晓燕^2,4

1.徐州医科大学,江苏徐州 221004;
2.徐州医科大学附属徐州东方医院;
3.徐州市东方人民医院;
4.南京医科大学附属脑科医院儿童心理卫生研究中心

收稿日期:2023-09-21 修回日期:2023-11-27 发布日期:2024-03-04 出版日期:2024-03-10
通讯作者: 柯晓燕,E-mail: kexiaoyan@njmu.edu.cn
作者简介:胥柯(1998-),女,江苏人,硕士研究生在读,主要研究方向为儿童孤独症谱系障碍。

Eating behaviors and sleep problems in children with autism spectrum disorder and their correlation factors

XU Ke¹, ZHOU Qin^2,3, WU Minglei⁴, SONG Li¹, KE Xiaoyan^2,4

1. Xuzhou Medical University, Xuzhou, Jiangsu 221004, China;
2. The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University;
3. Xuzhou Oriental People's Hospital;
4. Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University

Received:2023-09-21 Revised:2023-11-27 Online:2024-03-10 Published:2024-03-04
Contact: KE Xiaoyan, E-mail: kexiaoyan@njmu.edu.cn

摘要/Abstract

摘要： 目的探讨孤独症谱系障碍(ASD)儿童的睡眠和饮食行为问题的分布情况及其临床特征之间的关系,为今后的机制研究与临床干预奠定基础。方法选取2023年1—6月在南京医科大学附属脑科医院儿童心理卫生研究中心门诊就诊的211名2~7岁ASD患儿和年龄、性别相匹配的91名正常儿童为ASD组和对照组。采用孤独症行为检查表(ABC)评估ASD儿童的行为,采用儿童睡眠习惯问卷(CSHQ)和自编问卷分别评估两组被试的睡眠问题和饮食行为。使用χ²检验、t检验、非参数检验和多元Logistic回归分析ASD儿童睡眠问题和饮食行为问题之间的关系。结果 ASD组睡眠问题和食物选择性问题的发生率高于对照组,差异有统计学意义(χ²=6.876、17.299,P＜0.05)。ASD组患儿CSHQ总分[(48.55±6.07)分]高于对照组[(45.24±5.33)分],差异有统计学意义(t=4.494,P<0.05)。ASD儿童更有可能出现就寝习惯、入睡潜伏期、睡眠持续时间、夜醒、异态睡眠、睡眠呼吸暂停等睡眠问题(P<0.05)。在ASD儿童中,有饮食行为的儿童CSHQ总分增高,且在食物选择性(种类选择性、质地选择性和异食癖)方面差异有统计学意义(Z＝2.803,P＜0.05)。多元有序Logistic回归分析显示入睡潜伏期延长受到ABC量表躯体运动分量表得分(OR=1.063)的正向影响,无食物质地选择性(OR=0.524)和无异食癖(OR=0.343)的负向影响。结论 ASD儿童常伴随更严重的睡眠问题和饮食行为问题。有饮食行为问题的ASD儿童睡眠问题更严重。ASD儿童入睡潜伏期延长受到躯体运动、食物质地选择性和异食癖的影响。

关键词: 孤独症谱系障碍, 睡眠问题, 饮食行为, 儿童

Abstract: Objective To investigate the distribution of sleep and eating behavior problems in children with autism spectrum disorder (ASD), and to analyze their correlations with clinical characteristics,in order to provide basis for fwture mechanism research and clinical intervention. Methods A total of 211 ASD children aged 2 - 7 were enrolled into this study from outpatient department from January to June 2023, and 91 typically developed children matched with age and sex were enrolled into control group.Autism Behavior Checklist (ABC), Children's Sleep Habits Questionnaire (CSHQ) and a self-made questionnaire were used to assess children's autistic behavior, sleep problems and eating behaviors. Chi-square test, t test, non-parametric test and multinomial Logistic regression analysis were performed to analyze the relationship between sleep problems and eating behaviors in children with ASD. Results The prevalence rates of sleep problems and food selectivity were significantly higher in children with ASD than those in control group (χ²=6.876、17.299,P<0.05).The total score of CSHQ of ASD children (48.55±6.07) was significantly higher than that of control group (45.24±5.33)(t=4.494,P<0.05).ASD children were more likely to report bedtime resistance, sleep onset delay, sleep duration, night waking, parasomnias and sleep disordered breathing than control group (P<0.05).The total score of CSHQ was significantly higher in ASD children with aberrant eating behaviors, and the difference was statistically significant in food selectivity (type selectivity, texture selectivity and pica) (Z=2.803, P<0.05).Multinomial Logistic regression indicated that the occurrence of sleep onset delay was positively affected by body and object use (OR=1.063), and negatively affected without food texture selectivity (OR=0.524) and pica (OR=0.343). Conclusions ASD children have a higher risk of sleep problems and aberrant eating behaviors than the typically developed children.Moreover,ASD children with aberrant eating behaviors have more severe sleep problems.The influencing factors of sleep onset delay include body and object use, food texture selectivity and pica.

Key words: autism spectrum disorder, sleep problems, eating behaviors, children

中图分类号:

R749.94

胥柯, 周勤, 吴明磊, 宋丽, 柯晓燕. 孤独症谱系障碍儿童的饮食睡眠问题及相关因素[J]. 中国儿童保健杂志, 2024, 32(3): 329-333.

XU Ke, ZHOU Qin, WU Minglei, SONG Li, KE Xiaoyan. Eating behaviors and sleep problems in children with autism spectrum disorder and their correlation factors[J]. Chinese Journal of Child Health Care, 2024, 32(3): 329-333.

参考文献

[1] Cortese S, Wang F, Angriman M, et al.Sleep disorders in children and adolescents with autism spectrum disorder: Diagnosis, epidemiology, and management[J].CNS Drugs, 2020, 34(4):415-423.
[2] 许志飞, 杨琴, 江帆, 等.中国儿童睡眠健康百问百答[J].中华儿科杂志, 2023, 38(3):169-191.
Xu ZF, Yang Q, Jiang F, et al.One hundred questions and answers about children's sleep health in China[J].Chin J Pediatr, 2023, 38(3):169-191.(in Chinese)
[3] Tyagi V, Juneja M, Jain R.Sleep problems and their correlates in children with autism spectrum disorder: An Indian study[J].J Autism Dev Disord, 2019, 49(3):1169-1181.
[4] Zaidman-Zait A, Zwaigenbaum L, Duku E, et al.Factor analysis of the children's sleep habits questionnaire among preschool children with autism spectrum disorder[J].Res Dev Disabil, 2020, 97: 103548.
[5] Hua X, Zhu J, Yang T, et al.The gut microbiota and associated metabolites are altered in sleep disorder of children with autism spectrum disorders[J].Front Psychiatry, 2020, 11: 855.
[6] Yeung SSY, Chan R, Li L, et al.Eating behaviors and diet quality in chinese preschoolers with and without autism spectrum disorder: A case-control study[J].J Pediatr, 2021, 237: 258-266.
[7] Baraskewich J, von Ranson KM, McCrimmon A, et al.Feeding and eating problems in children and adolescents with autism: A scoping review[J].Autism, 2021, 25(6):1505-1519.
[8] Margari L, Marzulli L, Gabellone A, et al.Eating and mealtime behaviors in patients with autism spectrum disorder: Current perspectives[J].Neuropsychiatr Dis Treat, 2020, 16: 2083-2102.
[9] Park HJ, Choi SJ, Kim Y, et al.Mealtime behaviors and food preferences of students with autism spectrum disorder[J].Foods, 2020, 10(1):49.
[10] Prosperi M, Santocchi E, Balboni G, et al.Behavioral phenotype of ASD preschoolers with gastrointestinal symptoms or food selectivity[J].J Autism Dev Disord, 2017, 47(11):3574-3588.
[11] Li C, Liu Y, Fang H, et al.Study on aberrant eating behaviors, food intolerance, and stereotyped behaviors in autism spectrum disorder[J].Front Psychiatry, 2020, 11: 493695.
[12] Bresciani G, Da Lozzo P, Lega S, et al.Gastrointestinal disorders and food selectivity: Relationship with sleep and challenging behavior in children with autism spectrum disorder[J].Children (Basel), 2023, 10(2):253.
[13] 李生慧, 金星明, 沈晓明, 等.儿童睡眠习惯问卷中文版制定及测量性能考核[J].中华儿科杂志, 2007, 45(3):176-180.
Li SH, Jin XM, Shen XM, et al.Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire[J].Chin J Pediatr, 2007, 45(3):176-180.(in Chinese)
[14] Chen H, Yang T, Chen J, et al.Sleep problems in children with autism spectrum disorder:A multicenter survey[J].BMC Psychiatry, 2021, 21(1):406.
[15] Byrska A, Błażejczyk I, Faruga A, et al.Patterns of food selectivity among children with autism spectrum disorder[J].J Clin Med, 2023, 12(17):5469.
[16] 艾女湉, 李廷玉.孤独症谱系障碍儿童食物选择性的研究进展[J].中国儿童保健杂志, 2021, 29(10):1087-1090,1095.
Ai NT, Li TY.Progress on food selsctivity in children with autism spectrum disorder[J].Chin J Child Health Care, 2021, 29(10):1087-1090,1095.(in Chinese)
[17] Li YJ, Xie XN, Lei X, et al.Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention-deficit hyperactivity disorder: A systematic review and meta-analysis[J].Obes Rev, 2020, 21(12):e13123.
[18] Harris HA, Micali N, Moll HA, et al.The role of food selectivity in the association between child autistic traits and constipation[J].Int J Eat Disord, 2021, 54(6):981-985.
[19] Whelan S, Mannion A, Madden A, et al.Examining the relationship between sleep quality, social functioning, and behavior problems in children with autism spectrum disorder: A systematic review[J].Nat Sci Sleep, 2022, 14: 675-695.
[20] Zickgraf HF, Richard E, Zucker NL, et al.Rigidity and sensory sensitivity: Independent contributions to selective eating in children, adolescents, and young adults[J].J Clin Child Adolesc Psychol, 2022, 51(5):675-687.
[21] Masi A, Moni MA, Azim SI, et al.Clinical and behavioral attributes leading to sleep disorders in children on the autism spectrum[J].Autism Res, 2022, 15(7):1274-1287.
[22] Likhitweerawong N, Thonusin C, Boonchooduang N, et al.Profiles of urine and blood metabolomics in autism spectrum disorders[J].Metab Brain Dis, 2021, 36(7):1641-1671.
[23] Han GT, Trevisan DA, Abel EA, et al.Associations between sleep problems and domains relevant to daytime functioning and clinical symptomatology in autism: A meta-analysis[J].Autism Res, 2022, 15(7):1249-1260.
[24] Fields VL, Soke GN, Reynolds A, et al.Association between pica and gastrointestinal symptoms in preschoolers with and without autism spectrum disorder: Study to explore Early Development[J].Disabil Health J, 2021, 14(3):101052.
[25] Iovene MR, Bombace F, Maresca R, et al.Intestinal dysbiosis and yeast isolation in stool of subjects with autism spectrum disorders[J].Mycopathologia, 2017, 182(3-4):349-363.
[26] Esposito D, Belli A, Ferri R, et al.Sleeping without prescription: Management of sleep disorders in children with autism with non-pharmacological interventions and over-the-counter treatments[J].Brain Sci, 2020, 10(7):441.

孤独症谱系障碍儿童的饮食睡眠问题及相关因素

Eating behaviors and sleep problems in children with autism spectrum disorder and their correlation factors

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	梁雁, 罗小平. 遗传代谢病的治疗进展[J]. 中国儿童保健杂志, 2024, 32(9): 929-933.
[2]	李廷玉, 韦秋宏, 李燕, 魏华, 代英, 陈立. 养育照护融合家庭干预模式用于孤独症谱系障碍的实践与展望[J]. 中国儿童保健杂志, 2024, 32(9): 937-940.
[3]	王雯雷, 张俊, 厚磊, 张荣, 夏木斯叶·木依都力, 董言, 者炜, 沙吾拉西·热加甫, 方萍, 阿迪拉·苏力旦. 新疆7～17岁儿童青少年超重肥胖和血压关系的关联研究[J]. 中国儿童保健杂志, 2024, 32(9): 953-957.
[4]	吴妍, 刘莎, 高利旺, 李超, 魏炜, 龙宇, 张永红, 殷光玲, 白晶, 赵莉, 王友发. 中国西部脱贫地区小学生体重状态和饮食行为干预效果研究[J]. 中国儿童保健杂志, 2024, 32(9): 958-963.
[5]	林崟, 刘军霞, 张林, 颜崇淮. 上海市0~6岁儿童血砷水平与体格生长的关系[J]. 中国儿童保健杂志, 2024, 32(9): 969-973.
[6]	王爱, 周冰倩, 于健, 曹虹. 儿童青少年骨健康的评估及其影响因素[J]. 中国儿童保健杂志, 2024, 32(9): 980-983.
[7]	夏嘉苓, 官计, 方悦, 黄迎春, 刘颖, 李凡, 吉木尔呷木. 儿童家庭饮食环境的研究进展[J]. 中国儿童保健杂志, 2024, 32(9): 984-988.
[8]	孙艳会, 李杨方. 儿童语言发育迟缓临床特征及诊治研究进展[J]. 中国儿童保健杂志, 2024, 32(9): 999-1003.
[9]	谢婷婷, 裴梓贻, 张悦. 音乐疗法在儿童康复中的应用研究进展[J]. 中国儿童保健杂志, 2024, 32(9): 1004-1007.
[10]	陈秀锦, 蒋晓兰, 陈红夷, 王琪, 陈俊霖. 0～6岁儿童维生素D水平的影响因素及其与维生素K1和K2的相关性分析[J]. 中国儿童保健杂志, 2024, 32(9): 1014-1018.
[11]	张霆. 儿童早期发育的表观遗传运动调控机制的认识进展[J]. 中国儿童保健杂志, 2024, 32(8): 821-825.
[12]	鹿文英, 柏品清, 徐划萍, 任亚萍, 胡卉, 解辉. 运动及行为干预改善儿童超重和肥胖效果评价[J]. 中国儿童保健杂志, 2024, 32(8): 832-837.
[13]	苏比努尔·沙依提, 高雯颖, 郭心宇, 任姿锦, 李蕴伶, 张莹. 喀什地区维吾尔族学龄期哮喘儿童的运动状况及影响因素[J]. 中国儿童保健杂志, 2024, 32(8): 838-843.
[14]	程轲, 王宝西, 王春晖, 宋丽佳, 习颖, 郭薇, 杨茜, 兰莉. 5~14岁儿童青少年体成分与骨密度的关联[J]. 中国儿童保健杂志, 2024, 32(8): 844-849.
[15]	周琼, 刘海波, 胡必梅, 郭玉清. 母亲喂养方式、婴幼儿饮食行为及气质对儿童超重肥胖的影响[J]. 中国儿童保健杂志, 2024, 32(8): 850-855.