儿童睡眠障碍诊疗现状

doi:10.11852/zgetbjzz2024-0208

摘要/Abstract

摘要： 睡眠是指一种自然而可逆的周期性生理和行为状态,对健康有着重要的影响。睡眠对儿童的生长发育、学习记忆、情绪行为调节以及免疫调节等有着重要的影响。儿童睡眠医学领域涉及神经、精神心理、呼吸、耳鼻喉、口腔以及内分泌等诸多专业,随着对儿童睡眠的关注,帮助儿童改善睡眠、学习、生活以及家庭功能是所有医务工作者的共同目标。本文就目前儿童睡眠障碍的分类、评估及干预等方面进行综述,以期提高儿童睡眠障碍的诊断和治疗。

关键词: 儿童, 睡眠障碍, 评估, 诊断, 治疗

Abstract: Sleep refers to a natural, reversible, periodic physiological and behavioral state that has significant impacts on health. It plays a critical role in the growth and development, learning and memory, emotional and behavioral regulation, as well as immune modulation in children. The field of pediatric sleep medicine encompasses various specialties such as neurology, psychiatry, pulmonology, otolaryngology, stomatology, and endocrinology. With growing attention to children′s sleep, assisting children in improving their sleep, learning, daily living, and family functioning is a shared goal among all pediatricians.This review aims to summarize the current classification, assessment, and interventions for pediatric sleep disorders,in order to improve the diagnosis and treatment of sleep disorders in children.

Key words: children, sleep disorders, assessment, diagnosis, treatment

中图分类号:

R179

曾向东, 胡文广. 儿童睡眠障碍诊疗现状[J]. 中国儿童保健杂志, 2025, 33(9): 997-1002.

ZENG Xiangdong, HU Wenguang. Current situation of the diagnosis and treatment of sleep disorders in children[J]. Chinese Journal of Child Health Care, 2025, 33(9): 997-1002.

参考文献

[1] 赵忠新,叶京英. 睡眠医学[M].2版.北京:人民卫生出版社,2022.
[2] El-Sheikh M, Philbrook LE, Kelly RJ, et al. What does a good night′s sleep mean? Nonlinear relations between sleep and children′s cognitive functioning and mental health[J]. Sleep,2019,42(12):1-12.
[3] Hausenblas H, Hooper S. Effectiveness of the Contours Vibes^TM soothing vibrations infant and toddler crib mattress on infant and maternal sleep quality and health outcomes: an intervention study[J]. Sleep Sci, 2022,15(Spec1):239-243.
[4] Forest G, Gaudreault P, Michaud F, et al. Gender differences in the interference of sleep difficulties and daytime sleepiness on school and social activities in adolescents[J]. Sleep Med,2022,100:79-84.
[5] American Academy of Sleep Medicine. International classification of sleep disorders[M]. 3rd ed. Westchester (IL): American Academy of Sleep Medicine, 2020.
[6] American Psychiatric Association. Diagnostic and statistical manual of mental disorders[M]. 4th ed. Washington, DC: American Psychiatric Association, 2020.
[7] Guo Y,Chen ZY,Xu K,et al.International classification of diseases,tenth revision,clinical modification social determinants of health codes are poorly used in electrionic health records[J].Medicine,2020,99(52):pe23818.
[8] Sen T, Spruyt K. Pediatric sleep tools: An updated literature review[J]. Front Psychiatry, 2020,11:317.
[9] 国家卫生健康委员会. 0～5岁儿童睡眠卫生指南: WS/T 579—2017[S]. 北京:中国标准出版社,2017.
[10] 陈先睿,林晓霞,徐萍,等.中文版学龄前儿童睡眠障碍量表的信效度检验[J].中国全科医学,2023,26(3):313-320
Chen XR, Lin XX, Xu P, et al. Reliability and validity of the Chinese version of the Sleep Disorder Scale for preschool children[J].Chin Gen Prac,2019,26(3):313-320. (in Chinese)
[11] Kang KT, Chang IS, Tseng CC, et al. Impacts of disease severity on postoperative complications in children with sleep-disordered breathing[J]. Laryngoscope, 2019,127(11):2646-2652.
[12] Noller MW, Guillemtnault C, Gouveia CJ, et al. Mandibular advancement for pediatric obstructive sleep apnea: A systematic review and meta-analysis[J]. J Craniomaxillofac Surg, 2019,46(8):1296-1302
[13] Koptagal S, Nichols CD, Grogg-Damberger MM, et al. Non-respiratory indications for polysomnography and related procedures in children:An evidence-based review[J]. Sleep, 2019,35(11):1451-1466.
[14] Aurora RN, Lamm CI, Zak RS, et al. Practice parameters for the nonrespiratory indications for polysomnography and multiple sleep latency testing for children[J]. Sleep,2019,35(11):1467-1473.
[15] Ferr>é Á, Poca MA, de la Calzada MD,et al. Sleep-related breathing disorders in Chiari Malformation Type 1: A prospective study of 90 patients[J]. Sleep, 2019,40(6):1-10.
[16] Berry RB, Albertario CL, Harding SM, et al. The AASM manual of the scoring of sleep and associated events: Rules, terminology and technical specifications[M].Version 2.5. Westchester, IL: American Academy of Sleep Medicine, 2018, 1-90.
[17] Littner MR, Kushida C, Wise M et al.Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test[J]. Sleep, 2005,28(1):113-21.
[18] Littner M,Kushida CA,Anderson WM,et al. Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms:An update for 2019[J]. Sleep,2020,26:337-341.
[19] Zhao K, Zhang J, Wu Z, et al. The relationship between insomnia symptoms and school performance among 4966 adolescents in Shanghai China[J]. Sleep Health, 2019;5:273-279.
[20] Huhdanpaa H, Morales-Munoz I, Aronen ET, et al. Sleep difficulties in infancy are associated with symptoms of inattention and hyperactivity at the age of 5 years:A longitudinal study[J]. J Dev Behav Pediatr,2019,40:432-440.
[21] Macias MI, Malhotra S. Behavioral insomnia of childhood[J]. Am J Respir Crit Care Med,2021,203:20-21.
[22] Dewald-Kaufmann J, de Bruin E, Michael G. Cognitive behavioral therapy for insomnia (CBT-i) in school-aged children and adolescents[J]. Sleep Med Clin,2019,14:155-165.
[23] Wesselhoeft R, Rasmussen L, Jensen PB, et al. Use of hypnotic drugs among children, adolescents, and young adults in Scandinavia[J]. Acta Psychiatr Scand,2021,144:100-112.
[24] Skrzelowski M, Broookhaus A, Shea LA, et al. Melatonin Use in pediatrics: Evaluating the discrepancy in evidence based on country and regulations regarding production[J]. J Pediatr Pharmacol Ther,2021,26:4-20.
[25] Gringras P, Nir T, Breddy J, et al. Effificacy and safety of pediatric rolonged-release melatonin for insomnia in children with autism spectrum disorder[J]. J Am Acad Child Adolesc Psychiatry, 2017,56:948-957.
[26] Han F, Lin L, Schormair B, et al. HLA DQB1*06:02 negative narcolepsy with hypocretin/orexin deficiency[J]. Sleep, 2019, 37(10): 16011608.
[27] 董霄松, 李玉茜, 李静, 等. 脑脊液下丘脑分泌素水平测定对中国发作性睡病患者的诊断价值[J]. 中华医学杂志, 2013, 93(26): 20382042.
Dong XS, LI YQ, Li J, et al. The diagnostic value of cerebrospinal fluid hypothalamic secretin level in Chinese patients with narcolepsy[J]. Chinese Medical Journal, 2013, 93(26): 2038-2042(in Chinese).
[28] Huang WT, Huang YS, Hsu CY, et al. Narcolepsy and 2009 H1N1 pandemic vaccination in Taiwan[J]. Sleep Med, 2020, 66: 276281.
[29] 中华医学会神经病学分会睡眠障碍学组. 中国发作性睡病诊断与治疗指南(2022版)[J]. 中华神经科杂志, 2022, 55(5): 406-420.
Sleep Disorders Group, Chinese Society of Neurology. Chinese guidelines for diagnosis and treatment of narcolepsy (2022 edition)[J]. Chinese Journal of Neurology, 2022, 55(5): 406-420. (in Chinese)
[30] Rosen CL, Lapkin EK, Kirchner HL, et al. Prevalence and risk factors for sleepdisordered breathing in 8 to 11-year-old children:Association with race and prematurity[J]. J Pediatr,2023,142:383-389
[31] Kaditis A, Kheirandish GL, Gozal D. Pediatric OSAS: Oximetry can provide answers when polysomnography is not available[J]. Sleep Med Rev,2019,27:96-105.
[32] Xu ZF, Gutierrez-Tobal GC, Wu YX, et al. Cloud algorithm-driven oximetry-based diagnosis of obstructive sleep apnoea in symptomatic habitually snoring children[J]. Eur Respir J,2019,53:1-7.
[33] Liming BJ, Ryan M, Mack D, et al. Montelukast and nasal corticosteroids to treat pediatric obstructive sleep apnea: A systematic review and Meta-analysis[J]. Otolaryngology Head Neck Surg,2019,160:594-602.
[34] Taranto-Montemurro L, Messineo L, Sands SA, et al. The combination of atomoxetine and oxybutynin greatly reduces obstructive sleep apnea severity. A randomized, placebo-controlled, double-blind crossover trial[J]. Am J Respir Crit Care Med,2019,199:1267-1276.
[35] Hawkins SM, Jensen EL, Simon SL, et al. Correlates of pediatric CPAP adherence[J]. J Clin Sleep Med JCSM,2019,12:879-884.
[36] Kiprkham E, Ma CC, Filipek N, et al. Polysomnography outcomes of sleep endoscopy-directed intervention in surgically naive children at risk for persistent obstructive sleep apnea[J]. Sleep Breath,2020,24:1143-1150.
[37] Esteller E, Villatoro JC, Aguero A, et al. Outcome of drug-induced sleep endoscopy-directed surgery for persistent obstructive sleep apnea after adenotonsillar surgery[J]. Int J Pediatr Otorhinolaryngol,2019,120:118-122.
[38] Idir Y, Oudiette D, Arnulf I. Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: The old and the new[J]. J Sleep Res, 2022,31(4):e13596.
[39] Arnulf I, Zhang B, Uguccioni G,et al. A scale for assessing the severity of arousal disorders[J]. Sleep, 2019,37(1):127-136.
[40] van Mierlo P, Hermans LWA, Arnulf I, et al. Validation of the Dutch translation of the Paris Arousal Disorders Severity Scale for non-REM parasomnias in a 1-year and 1-month version[J]. J Clin Sleep Med,2022,18(4):1135-1143.
[41] Holzinger B, Klösch G, Saletu B. Studies with lucid dreaming as add-on therapy to Gestalt therapy[J]. Acta Neurologica Scandinavica,2019,131: 355-363.
[42] Kunze AE, Amtz A, Morina N, et al. Efficacy of imagery rescripting and imaginal exposure for nightmares: A randomized wait-list controlled trial[J]. Behavior Research and Therapy, 2019,97:14-25.
[43] Picchietti DL, Bruni O, de Weerd A, et al. Pediatric restless legs syndrome diagnostic criteria:An update by the International Restless Legs Syndrome Study Group[J]. Sleep Med,2019,14(12):1253-1259.
[44] Picchietti DL, Rajendran RR, Wilson MP, et al. Pediatric restless legs syndrome and periodic limb movement disorder:Parent-child pairs[J]. Sleep Med,2019,10(8):925-931.
[45] Gossard TR, Trotti LM, Videnovic A, et al. Restless legs syndrome: Contemporary diagnosis and treatment[J]. Neurotherapeutics,2021,18(1):140-155.
[46] Delrosso LM, Lockhart C, Wrede JE, et al. Comorbidities in children with elevated periodic limb movement index during sleep[J]. Sleep,2020,43(2):zsz221.
[47] Delrosso L, Bruni O. Treatment of pediatric restless legs syndrome[J]. Adv Pharmacol,2019,84:237-253.
[48] Bega D, Malkani R. Alternative treatment of restless legs syndrome: An overview of the evidence for mind-body interventions, lifestyle interventions, and neutraceuticals[J]. Sleep Med,2019,17:99-105.
[49] Allen RP, Picchietti DL, Auerbach M, et al. Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome/Willis Ekbom disease in adults and children: An IRLSSG task force report[J]. Sleep Med,2018,41:27-44.
[50] Arns M, Kooij JJS, Coogan AN. Review: Identification and management of circadian rhythm sleep disorders as a transdiagnostic feature in child and adolescent psychiatry[J]. J Am Acad Child Adolesc Psychiatry,2021,60(9):1085-1095.