天津市神经发育障碍儿童青少年睡眠障碍潜在类别分析  

Latent class analysis of sleep disturbances among children and adolescents with neurodevelopmental disorders in Tianjin

作　　者：李芃宏 车亦凡 赵梓瑜 崔庭凯 LI Penghong;CHE Yifan;ZHAO Ziyu;CUI Tingkai(School of Public Health,Tianjin Medical University,Tianjin(300070),China)

机构地区：[1]天津医科大学公共卫生学院,天津300070 [2]天津大学图书馆

出　　处：《中国学校卫生》2025年第2期186-190,195,共6页Chinese Journal of School Health

基　　金：天津市教委科研计划项目(2021KJ256)。

摘　　要：目的了解天津市神经发育障碍儿童青少年睡眠障碍潜在类别及其与行为、社交问题的关系,为预防和改善神经发育障碍儿童青少年睡眠障碍提供依据。方法2021年9月至2024年6月,在天津市特殊教育学校和定点康复机构招募272名2~23岁神经发育障碍儿童青少年,采用儿童睡眠习惯问卷(CSHQ)评估睡眠障碍,孤独症儿童行为量表(ABC)、儿童孤独症评定量表(CARS)评估社交、行为问题及孤独症症状严重程度。采用潜在类别分析(LCA)将研究对象分为不同睡眠障碍类别,Cochran-Armitage检验分析不同年龄组睡眠障碍检出率的趋势性;采用Spearman秩相关分析各量表评分的关联,广义线性模型分析睡眠障碍对CARS、ABC量表得分的影响;采用协方差分析不同类别间儿童青少年行为、社交问题的差异。结果272名调查对象中,有197名(72.4%)神经发育障碍儿童青少年检出睡眠障碍。不同年龄组睡眠障碍检出率分别为2~6岁88.9%、7~12岁70.6%、13~18岁66.7%、19~23岁50.0%,随年龄增长呈下降趋势(Z=3.58,P<0.01);CSHQ总分与ABC总分呈正相关(r=0.16,P=0.01)。广义线性模型分析表明,在调整年龄、性别、父母文化程度、家庭月总收入后,就寝习惯(β=3.60)和入睡潜伏期障碍(β=3.36)与CARS得分呈正相关,就寝习惯(β=16.73)和夜醒(β=17.46)与ABC得分呈正相关(P值均<0.05)。LCA分析表明,神经发育障碍儿童青少年睡眠障碍可分为4个类别;协方差分析结果显示,不同类别(类别1~4)研究对象CSHQ(70.84±9.05,50.96±6.64,50.33±5.82,43.84±5.44)和ABC(49.44±39.34,53.04±39.75,63.51±40.31,38.14±34.23)平均得分差异均有统计学意义(F值分别为92.09,3.95,P值均<0.05)。结论神经发育障碍儿童青少年睡眠障碍较严重且可分为不同潜在类别。Objective To understand the latent categories of sleep disturbances among children and adolescents with neurodevelopmental disorders(NDDs)in Tianjin and their relationship with behavioral and social issues,so as to provide a basis for preventing and improving sleep disturbances in the population.Methods From September 2021 to June 2024,272 children and adolescents aged 2-23 years with neurodevelopmental disorders were recruited from special education schools and designated rehabilitation institutions in Tianjin.Sleep disturbances were assessed using the Children's Sleep Habits Questionnaire(CSHQ).Behavioral and social issues and severity were evaluated using the Autism Behavior Checklist(ABC)and Childhood Autism Rating Scale(CARS).Latent class analysis(LCA)was employed to categorize the subjects into different sleep disturbances categories.Cochran-Armitage test was used to analyze the trend of detection rate of sleep disturbances in different age groups.Spearman rank correlation was used to analyze the correlation between the scores of each scale.The generalized linear model was used to analyze the influence of CARS and ABC scale scores.Covariance analysis was used to examine differences in behavioral and social issues among the different categories.Results Among 272 survey respondents,a total of 197(72.4%)children and adolescents with NDDs were identified with sleep disturbances.The detection rates of sleep disturbances were 88.9%for those aged 2-6 years,70.6%for aged 7-12,66.7%for aged 13-18 and 50.0%for 19-23 years old,which was decreased across age group(Z=3.58,P<0.01).There was a positive correlation between the total CSHQ score and the total ABC score(r=0.16,P=0.01).The generalized linear model analysis showed that after adjusting age,gender,parents'education level and family monthly income,bedtime habit(β=3.60)and sleeping latency disorder(β=3.36)were positively correlated with CARS scores,while the bedtime habit(β=16.73)and waking up at night(β=17.46)were positively correlated with ABC scores(P<0.05).

关 键 词：神经发育障碍 睡眠 潜在类别分析 儿童 青少年 

分 类 号：R179[医药卫生—妇幼卫生保健] R748[医药卫生—公共卫生与预防医学] Q428[生物学—神经生物学]