目的 探讨抽动障碍(TD)患儿的睡眠特点,以提高临床医生对TD患儿睡眠问题的认识。方法 采用方便抽样法抽取2022年6月—2023年6月在西安交通大学第二附属医院儿科门诊就诊的TD患儿50例,进行15h以上的多导睡眠监测检查,分析临床与多导睡眠监测的特征。结果 TD共患睡眠障碍的比例为70%; 50例中睡眠效率降低23例(46%);睡眠潜伏期明显延长19例(38%);片段化睡眠患儿35例(70%);慢波睡眠正常25例,减少7例,增多18例,异常占比50%;27例(54%)合并有低氧血症,觉醒指数异常10例(20%);总睡眠时间减少5例(10%);快速眼动期睡眠百分比下降16例(32%),脑电图异常18例(36%),18例异常者中额区放电16例,2例为中央区放电。慢波睡眠减少与TD的严重程度有关,重度TD更易出现慢波睡眠减少,差异有统计学意义(χ2＝7.103,P＜0.05),Tourette综合征觉醒指数异常更显著,差异有统计学意义(χ2＝9.828,P＜0.05)。结论 儿童TD共患睡眠障碍的比例高达70%,TD不仅干扰患儿的睡眠结构,还影响患儿的睡眠质量,对患儿的身心健康发展具有不良影响,临床医生应加强对TD儿童睡眠问题的重视。
Abstract
Objective To explore the sleep characteristics of children with tic disorder (TD), in order to enhance clinicians′ understanding of sleep issues in these patients. Methods A convenience sampling method was used to select 50 TD children who visited the pediatric outpatient department of the Second Affiliated Hospital of Xi′an Jiaotong University from June 2022 to June 2023. Polysomnography (PSG) monitoring for over 15 hours was conducted, and clinical and PSG characteristics were analyzed. Results The prevalence of comorbid sleep disorders in TD children was 70%. Among the 50 cases, reduced sleep efficiency was observed in 23 cases (46%), prolonged sleep latency in 19 cases (38%), and fragmented sleep in 35 cases (70%). Slow-wave sleep (SWS) was reduced in 7 cases, normal in 25 cases, and increased in 18 cases, with an abnormal proportion of 50%. Hypoxemia was present in 27 cases (54%), abnormal arousal index in 10 cases (20%), reduced total sleep time in 5 cases (10%), and decreased REM sleep percentage in 16 cases (32%). Abnormal EEG findings were observed in 18 cases (36%), with 16 cases showing frontal lobe discharges and 2 cases showing central lobe discharges. Reduced SWS was associated with the severity of TD, with severe TD more likely to exhibit reduced SWS, showing statistical significance (χ2＝7.103, P<0.05). Tourette syndrome showed more significant abnormalities in arousal index, with statistical significance (χ2=9.828, P<0.05). Conclusions The prevalence of comorbid sleep disorders in children with TD is as high as 70%. TD not only disrupts sleep architecture but also impairs sleep quality, adversely affecting the physical and mental health development of these children. Clinicians should pay greater attention to sleep problems in children with TD.
关键词
抽动障碍 /
睡眠障碍 /
多导睡眠监测 /
儿童
Key words
tic disorder /
sleep disorde /
polysomnography /
children
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基金
西安交通大学第二附属医院新技术新疗法项目(XJEFY-028)
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