基于Actiwatch的婴儿期夜晚睡眠-觉醒模式纵向观察  

Longitudinal study on infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch

作　　者：黄小娜[1] 冯围围[1] 赵艳桃[1] 王惠珊[1] 刘玺诚[2] 刘敏娜 徐海青[4] 吴虹[5] 王念蓉[6] 张风华 刘文龙 唐剑波 李红辉 王丽雁[11] 张良芬[12] 

机构地区：[1]中国疾病预防控制中心妇幼保健中心,北京100101 [2]首都医科大学附属北京儿童医院 [3]陕西省妇幼保健院 [4]湖北省妇幼保健院 [5]湖南省妇幼保健院 [6]重庆市妇幼保健院 [7]青岛市妇女儿童医院 [8]厦门市妇幼保健院 [9]湖州市妇幼保健院 [10]柳州市妇幼保健院 [11]第三军医大学新桥医院 [12]北京市海淀区妇幼保健院

出　　处：《中华儿科杂志》2015年第6期442-447,共6页Chinese Journal of Pediatrics

基　　金：中国疾病预防控制中心妇幼保健中心立项基金（2010-FU-001）

摘　　要：目的 应用Actiwatch评估城市婴儿生后第一年夜晚睡眠-觉醒模式发展变化轨迹,为临床实施婴儿早期睡眠评估指导提供参考依据.方法 选择北京市、西安市、青岛市、武汉市、长沙市、重庆市、湖州市、厦门市、柳州市9个城市的10家医疗保健机构为研究现场.调查时间为2009年10月7日至2011年10月30日.采用Actiwatch在家庭自然环境状态下前瞻性追踪婴儿0～12个月的夜晚睡眠-觉醒模式的发展轨迹,监测年龄点包括生后10 d、28 d各1次,第2～6个月每月1次,第9、12个月各1次,共9次.Actiwatch的监测观察时间为每次60 h.采用二水平随机效应模型对婴儿夜晚入睡能力、连续睡眠能力和睡眠效率等睡眠-觉醒模式核心参数的变化趋势进行统计描述.结果本研究共纳入473例健康足月婴儿,其中男246例（52.0％）,女227例（48.0％）.355例（75.1％）婴儿完成为期12个月的随访.随着年龄的增长,婴儿夜晚入睡潜伏期逐渐缩短,从生后10 d的平均66.8min减少为6～12月龄的15.5～18.7 min;夜晚连续睡眠能力增强,最长连续睡眠时间逐步延长,从最初的平均227.6 min延长至12月龄的350.9 min,相应的夜醒次数从每晚3.0次减少为1.6次;整个婴儿期夜晚睡眠效率从新生儿期的66.3％增长至12月龄86.3％.男童夜晚最长连续睡眠时间、睡眠效率平均较女童短19 min（266.6比285.6 min）、低2.2％（74.2％比76.4％）,且随着年龄的增长男女童之间睡眠效率的差异呈缩小趋势.结论 我国城市婴儿夜晚睡眠-觉醒模式在生后6个月内变化发展最为迅速,随年龄增长婴儿夜晚入睡能力和连续睡眠能力增强,睡眠效率提高.Objective To understand the infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch,which would benefit the clinical assessment of infantile sleep.Method This study was a longitudinal study conducted between 7 Oct,2009-30 Oct,2011 in 10 hospitals of 9 cities of China （Beijing,Xi＆#39;an,Qingdao,Wuhan,Changsha,Chongqing,Huzhou,Xiamen and Liuzhou）.Actiwatch was used to track the sleep-wake pattern development trajectory of healthy infants in the first year of life in the home setting.Participating infants were followed up at 10th day and 28th day during the first month,and then monthly from the second to the sixth month after birth,and then at ninth and twelve months of age respectively.Meanwhile,infantile sleep was observed continuously for about 60 hours at each visit.According to the characteristics of repeated measurement data of this study,two-level random effect model was adopted to analyze the trend of infantile nocturnal sleep-wake parameters changing with age,and the gender difference.Result A total of 473 healthy infants were included in this study,among whom 246 （52.0%） were boys,and 227 （48.0%） were girls;355 （75.1%） infants completed the whole year follow-up survey.With infants＆#39; age increasing,the latency of infants＆#39; nighttime sleep onset decreased from 66.8 minutes on 10th day to 15.5-18.7 minutes at 6-12 months of age.The number of night wakes also decreased with age,while uninterrupted sleep periods lengthened with age.On the 10th day,there were 3.0 times of nightwaking on average,and the longest continuous sleeping interval lasted for 227.6 minutes on average.At 12-month of age,infants could sleep continuously for 350.9 minutes at most on average,while the number of nightwaking decreased to 1.6 times per night on average.Generally,nighttime sleep efficiency increased from 66.3% on the 10th day to 86.3% at 12-month of age.The differences of sleep-wake patterns between boys and girls presented as boys＆#39; nocturnal longest uninterrupted sleep per

关 键 词：婴儿 睡眠 纵向研究 

分 类 号：R174[医药卫生—妇幼卫生保健]