Abstract: Objective To analyze the sleep status and its influencing factors of children with autism spectrum disorder (ASD), in order to provide evidence for improving the sleep quality of ASD children. Method The general characteristics, sleep status and parents' mental health of 207 ASD children and 204 control children were assessed with the Sleep Habit Questionnaire (CSHQ) and Symptom Checklist 90 (SCL-90) from October 2019 to October 2020. The severity of autism symptoms was assessed with the Childhood Autism Rating Scale (CARS).The differences in the distribution of children's sleep problems and their parents' mental health status between the two groups were compared. Logistic regression was used to analyze the risk factors of sleep problems in ASD children. Results The detection rates of sleep disorders in children in ASD group and control group were 86.47% and 72.55%, respectively, with statistically significant difference (χ² =12.251, P<0.05). Multivariate analysis showed that children with ASD (OR=2.41), parents' total SCL-90 score (OR=1.15) and screen time＞2h/d (OR=3.07) were more likely to have sleep problems. When study population was further limited to ASD children, the results showed that ASD children whose CARS rating was severe (OR=6.81), screen time＞2h/d (OR=9.02) and whose parents were exposed to electronic screens before children went to sleep (OR=9.10) were more likely to have sleep problems. Conclusions ASD children may be more likely to experience sleep problems. The severity of autism symptoms, parents' mental health problems, daily screen time and parents' exposure to electronic screens before falling asleep are potential influencing factors for ASD children to develop sleep problems.

Key words: autism spectrum disorder, sleep, screen time, severity of autism symptoms

摘要： 目的 分析孤独症谱系障碍(ASD)儿童的睡眠状况及其影响因素,为改善ASD儿童的睡眠质量提供依据。方法 2019年10月—2020年10月采用睡眠习惯问卷(CSHQ)和症状自评问卷(SCL-90)对207名ASD儿童和204名对照组儿童的一般情况、睡眠问题、父母心理健康状况展开评估,采用儿童期孤独症评定量表(CARS)对ASD儿童疾病严重程度进行评定。比较儿童睡眠问题及其父母心理健康状况在两组人群中的分布是否存在差异,采用Logistic回归分析影响ASD儿童睡眠的危险因素。结果 睡眠不良在ASD组和对照组儿童中的检出率分别为86.47％和72.55％,差异有统计学意义(χ² =12.251,P<0.05)。多因素分析结果显示,患有ASD(OR=2.41)、父母SCL-90总分(OR=1.15)、视屏时间>2h/d(OR=3.07)的儿童更可能出现睡眠问题。进一步将研究人群限制在ASD儿童中,结果发现,CARS评定结果为重度(OR=6.81)、视屏时间>2h/d(OR=9.02)、儿童入睡前父母接触电子屏幕(OR=9.10)的ASD儿童更可能出现睡眠问题。结论 ASD儿童存在更多的睡眠问题,疾病严重程度、父母心理健康问题、每日视屏时间、入睡前父母接触电子屏幕可能是ASD儿童出现睡眠问题的影响因素。

关键词: 孤独症谱系障碍, 睡眠, 视屏时间, 疾病严重程度