Association between sleep disorders and behavioral problems in preschool children
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摘要:
目的 探讨芜湖地区学龄前儿童睡眠情况及与儿童情绪行为问题的关联，为改善儿童睡眠质量和情绪行为问题提供依据。 方法 2017年5月对芜湖市12所幼儿园1 158名大班儿童进行整群抽样调查，采用自制问卷调查儿童的一般情况和入睡前情况，采用《长处与困难问卷(SDQ)父母版》和《2~5岁儿童睡眠状况调查问卷》调查情绪行为及睡眠障碍问题。 结果 调查儿童情绪行为问题异常总的检出率为44.21%，其中同伴交往问题最为突出；学龄前儿童入睡前情况存在性别差异，主要体现在是否单独睡眠及睡前是否需要安慰物两个方面；41.97%的学龄前儿童检出至少1种睡眠障碍类型，其中睡眠不安的检出率女童为33.83%，高于男童的25.97%；睡眠影响学龄前儿童情绪行为问题出现，异态睡眠(OR=2.33，95%CI=1.25~4.34)和睡眠不安(OR=4.92，95%CI=1.28~19.00)增加女童该问题的风险，睡眠充足会降低此风险(OR=0.46，95%CI=0.27~0.77)；异态睡眠增加男童情绪行为异常的风险(OR=1.86，95%CI=1.08~3.19)，而单独睡眠降低该风险(OR=0.59，95%CI=0.37~0.95)。 结论 睡眠障碍增加学龄前儿童情绪行为问题的发生，充足的睡眠及儿童单独的睡眠习惯可减少其情绪行为问题的出现，睡眠与儿童情绪行为问题的发生具有性别差异。 Abstract:Objective To investigate the association between sleep with emotional and behavioral problems of preschool children in Wuhu City. Methods A cluster sampling survey was conducted among senior class of 12 kindergartens in Wuhu City, a total of 1 158 preschool children were investigated. The self-designed questionnaire was used to investigate the general situation and sleep characteristics. Strengths and Difficulties Questionnaire (SDQ) and Sleeping Quality Questionnaire for Children Aged 2-5 years were used to investigate their emotional behavior and sleep disorders. Results About 44.21% of respondents had emotional and behavioral problems, among which peer interaction was the most prominent. There were gender differences in sleeping alone and the need of comforters for sleep. 41.97% of preschool children detected at least one type of sleep disorder, and the detection rate of disturbed sleep was 33.83% in girls, which was higher than that of boys(25.97%). Abnormal sleep and disturbed sleep increased the risk of emotional and behavioral problems in preschool girls(OR=2.33, 95%CI=1.25-4.34; OR=4.92, 95%CI=1.28-19.00), adequate sleep reduced the risk(OR=0.46, 95%CI=0.27-0.77). Abnormal sleep increased the risk of boys' emotional and behavioral abnormalities(OR=1.86, 95%CI=1.08-3.19), while sleeping alone reduced the risk(OR=0.59, 95%CI=0.37-0.95). Conclusion Sleep behaviors are associated with the occurrence of emotional and behavioral problems in preschool children in a sex-specific manner. -
Key words:
- Sleep disorders /
- Emotions /
- Mental health /
- Regression analysis /
- Child, preschool
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表 1 不同性别学龄前儿童情绪行为问题检出率比较
Table 1. Comparison of the detection rate of emotional and behavioral problems among preschool children of different genders
性别 人数 情绪问题 品行问题 多动 同伴交往问题 亲社会行为 困难总分 男 620 59(9.51) 51(8.22) 54(8.71) 203(32.74) 72(11.61) 72(11.61) 女 538 69(12.82) 41(7.62) 33(6.13) 137(25.46) 47(8.73) 41(7.62) χ2值 3.21 0.14 2.75 7.36 2.59 5.21 P值 0.07 0.70 0.10 0.01 0.11 0.02 注：()内数字为检出率/%。 
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表 2 学龄前儿童入睡前一般情况构成性别间比较
Table 2. Comparison of before going to bed situation among preschool children of different genders
入睡前情况 选项 男童(n=620) 女童(n=538) χ2值 P值 睡床情况 单独睡眠 123(19.84) 78(14.50) 6.80 0.03 与家人同睡 489(78.87) 457(84.94) 缺失 8(1.29) 3(0.56) 变换睡眠地点 从不 234(37.74) 207(38.48) 3.29 0.51 偶尔 224(36.13) 213(39.59) 较少 106(17.10) 77(14.31) 经常 42(6.77) 34(6.32) 总是 8(1.29) 4(0.74) 缺失 6(0.97) 3(0.56) 睡眠环境 安静 395(63.71) 363(67.47) 2.56 0.28 较安静 211(34.03) 163(30.30) 吵闹 12(1.94) 7(1.30) 缺失 2(0.32) 5(0.93) 就寝时间是否固定 是 518(83.55) 439(81.60) 0.22 0.64 否 67(10.81) 62(11.52) 缺失 35(5.64) 37(6.88) 睡前视屏 是 233(37.58) 210(39.03) 0.20 0.65 否 382(61.61) 326(60.60) 缺失 5(0.81) 2(0.37) 睡前是否需要安慰物 是 145(23.39) 168(31.23) 8.98 < 0.01 否 475(76.61) 370(68.77) 入睡前情绪 平静 610(98.39) 527(97.96) 0.11 0.75 哭闹 10(1.61) 10(1.86) 缺失 0 1(0.18) 睡眠是否充足 是 513(82.74) 449(83.46) 0.06 0.82 否 102(16.45) 86(15.99) 缺失 5(0.81) 3(0.55) 注：()内数字为构成比/%。
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表 3 学龄前儿童睡眠障碍与情绪行为问题的Spearman秩相关分析(n=1 158，r值)
Table 3. Spearman rank correlation analysis of sleep disorders and emotional behavior problems in preschool children(n=1 158, r)
项目 情绪问题 品行问题 多动 同伴交往问题 亲社会行为 睡眠不安 睡眠节律紊乱 品行问题 0.30** 多动 0.15** 0.24** 同伴交往问题 0.22** 0.17** 0.07* 亲社会行为 0.02 -0.14 -0.07* 0.18** 睡眠不安 0.13** 0.09** 0.08** 0.02 -0.03 睡眠节律紊乱 0.12** 0.11** 0.09** 0.08** -0.02 0.12** 异态睡眠 0.13** 0.13** 0.14** 0.11** 0.03 0.10** 0.16** 注：*P < 0.05，**P < 0.01。
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表 4 睡眠对学龄前儿童情绪行为问题影响的多因素Logistic回归分析
Table 4. Multivariate Logistic analysis of the influence of sleep on emotional and behavioral problems of preschool children
性别 自变量 β值 Wald χ2值 OR值(OR值95%CI) P值 女 异态睡眠 0.84 7.02 2.33(1.25~4.34) 0.01 (n=538) 睡眠不安 1.59 5.36 4.92(1.28~19.00) 0.02 睡眠充足 -0.78 8.59 0.46(0.27~0.77) < 0.01 男 异态睡眠 0.62 4.97 1.86(1.08~3.19) 0.03 (n=620) 睡床情况 -0.52 4.74 0.59(0.37~0.95) 0.03
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