父母养育方式与学龄孤独症谱系障碍儿童睡眠问题的关联

王馨; 陈嘉洁; 林力孜; 詹晓玲; 刘斯宇; 金诚开; 李秀红; 静进

doi:10.16835/j.cnki.1000-9817.2023.02.006

父母养育方式与学龄孤独症谱系障碍儿童睡眠问题的关联

doi: 10.16835/j.cnki.1000-9817.2023.02.006

1.
中山大学公共卫生学院妇幼卫生学系，广东广州 510080
2.
中山大学公共卫生学院劳动卫生与环境卫生学系/广州市环境污染与健康风险评价重点实验室

基金项目:

国家社会科学基金重大项目 20&ZD296

国家自然科学基金项目 81872639

详细信息

作者简介:
王馨(1985-), 女, 山西省人, 博士, 主治医师, 主要研究方向为孤独症谱系障碍的神经心理机制

通讯作者:
静进，E-mail：jingjin@mail.sysu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R748 G78 B844.1
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- 被引次数: 0
出版历程
- 收稿日期: 2022-05-27
- 修回日期: 2022-08-23
- 网络出版日期: 2023-03-02
- 刊出日期: 2023-02-25

Association between parenting style and sleep problems among school-aged children with autism spectrum disorder

1.
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou(510080), China

摘要

摘要: 目的探讨父母养育方式与学龄孤独症谱系障碍(ASD)儿童睡眠问题的关联性，为开展相应的干预和家庭支持提供参考。方法在中山大学儿童青少年心理行为研究中心招募就读于普通小学的6~10岁ASD儿童和年龄、性别匹配的典型发展(typically developing, TD)儿童各98名。采用父母行为问卷和儿童睡眠习惯问卷调查父母养育方式和睡眠问题发生情况，评估ASD症状严重程度和智力水平等指标，采用广义线性模型分析父母养育方式与儿童睡眠问题的关联性。结果两组儿童的父母养育方式各维度得分差异均无统计学意义(P值均>0.05)；ASD儿童的周末睡眠时间低于TD儿童[(9.1±0.7)(9.5±0.8)h，P < 0.01]，入睡潜伏期延长问题得分高于TD儿童[(1.8±0.7)(1.5±0.7)，P < 0.01]，两组在总的睡眠问题和各类问题的发生率上差异均无统计学意义(P值均>0.05)。ASD儿童父母支持/参与的养育方式得分与睡眠问题总分(β=-2.68，95%CI=-4.88~-0.47)、就寝阻抗得分(β=-1.65，95%CI=-2.54~-0.77)和睡眠焦虑得分(β=-1.01，95%CI=-1.70~-0.32)呈负相关；敌意/强制的教养方式与日间困倦得分呈正相关(β=1.41，95%CI=0.53~2.29)(P值均 < 0.05)。结论父母支持/参与的养育方式与儿童睡眠问题的降低有关，而敌意/强制的养育方式与睡眠问题的增加有关。应改善父母的养育方式，以减少ASD儿童睡眠问题的发生。
- 教育 /
- 孤独性障碍 /
- 睡眠 /
- 回归分析 /
- 儿童
Abstract: Objective To investigate the association between parenting style and sleep problems among school-aged children with autism spectrum disorder (ASD). Methods A total of 98 children with ASD aged 6-10 years old and 98 age-and gender-matched typically developing (TD) children from mainstream schools were recruited. Parenting style and sleep problems were measured via Parent Behavior Inventory (PBI) and Children's Sleep Habits Questionnaire(CSHQ), respectively. The symptom severity and intelligence level were also evaluated. Generalized linear model was used to analyze the relationship between parenting style and sleep problems. Results There was no statistically significant difference in the parenting style of the two groups of children(P>0.05); weekend sleep time of children with ASD was significantly shorter than that of the TD group [(9.1±0.7)(9.5±0.8)h, P < 0.01], and the score of sleep onset delay was significantly higher than that of the TD group[(1.8±0.7)(1.5±0.7), P < 0.01]. However, there was no statistically significant difference in the incidence of total sleep problems and various problems between the two groups of children(P>0.05). The parental support/engagement of children with ASD was negatively associated with the total score of sleep problems(β=-2.68, 95%CI=-4.88--0.47), bedtime resistance (β=-1.65, 95%CI=-2.54--0.77) and sleep anxiety(β=-1.01, 95%CI=-1.70--0.32). The parental hostility/coercion was positively correlated with score of daytime sleepiness(β=1.41, 95%CI=0.53-2.29)(P < 0.05). Conclusion Parenting style of support/engagement is associated with lower sleep problems in children with ASD, while hostile/coercion is associated with higher sleep problems. It should be improve parental style to reduce the sleep problems in children with ASD.
- Education /
- Autistic disorder /
- Sleep /
- Regression analysis /
- Child
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1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 学龄ASD儿童与TD儿童每日睡眠时间和睡眠问题得分比较(x±s)

Table 1. Comparison of daily sleep time and scores of sleep problems between school-aged children with ASD and TD(x±s)

组别	人数	每日睡眠时间/h			睡眠问题
组别	人数	工作日	周末	平均	总得分	就寝阻抗	入睡潜伏期延长	睡眠持续时间	睡眠焦虑	夜醒	异态睡眠	睡眠呼吸障碍	日间困倦
ASD组	98	8.6±0.6	9.1±0.7	8.7±0.5	47.8±6.4	10.3±2.9	1.8±0.7	5.4±1.7	6.9±2.1	3.3±0.8	8.2±1.2	3.3±0.6	12.8±3.3
TD组	98	8.6±0.5	9.5±0.8	8.9±0.5	47.5±6.8	9.8±2.8	1.5±0.7	5.3±1.7	6.5±2.2	3.4±0.9	7.9±1.2	3.3±0.7	13.4±2.7
t值		-0.19	-3.74	-1.73	0.38	1.25	2.62	0.50	1.35	-0.84	1.26	-0.11	-1.54
P值		0.85	< 0.01	0.09	0.71	0.21	< 0.01	0.62	0.18	0.40	0.21	0.91	0.13

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表 2 学龄ASD儿童与TD儿童睡眠时长不足和睡眠问题检出率比较

Table 2. Comparison of the detection rate of insufficient sleep duration and sleep problems between school-aged children with ASD and TD

组别	人数	睡眠时长不足			睡眠问题
组别	人数	工作日	周末	平均	总得分	就寝阻抗	入睡潜伏期延长	睡眠持续时间	睡眠焦虑	夜醒	异态睡眠	睡眠呼吸障碍	日间困倦
ASD组	98	68(69.4)	33(33.7)	64(65.3)	79(80.6)	52(53.1)	18(18.4)	49(50.0)	37(37.8)	3(3.1)	5(5.1)	5(5.1)	20(20.4)
TD组	98	65(66.3)	21(21.4)	54(55.1)	84(85.7)	39(39.8)	10(10.2)	46(46.9)	36(36.7)	6(6.1)	4(4.1)	5(5.1)	19(19.4)
χ²值		0.09	3.09	1.72	0.58	2.95	2.04	0.08	0.00	0.47	0.00	0.00	0.00
P值		0.65	0.06	0.14	0.34	0.06	0.10	0.67	0.88	0.31	1.00	1.00	0.86
注： ()内数字为检出率/%。

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表 3 学龄ASD儿童父母教养方式和睡眠问题的关联性分析[β值(β值95%CI)，n=98]

Table 3. Association between parenting style and sleep problems among school aged children with ASD[β(β 95%CI), n=98]

自变量	CSHQ总评分	就寝阻抗	入睡潜伏期延长	睡眠持续时间	睡眠焦虑	夜醒	异态睡眠	睡眠呼吸障碍	日间困倦
支持/参与	-2.68(-4.88~-0.47)	-1.65(-2.54~-0.77)	-0.09(-0.34~0.17)	-0.53(-1.14~0.08)	-1.01(-1.70~-0.32)	0.09(-0.17~0.36)	-0.27(-0.71~0.17)	0.17(-0.03~0.36)	-0.19(-1.38~1.00)
敌意/强制	1.35(-0.40~3.10)	-0.66(-1.38~0.07)	-0.01(-0.21~0.19)	0.47(-0.00~0.94)	-0.50(-1.05~0.06)	-0.03(-0.24~0.18)	0.19(-0.15~0.53)	0.08(-0.07~0.23)	1.41(0.53~2.29)

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表 4 学龄TD儿童父母教养方式和睡眠问题的关联性分析[β值(β值95%CI)，n=98]

Table 4. Association between parenting style and sleep problems among school aged children with TD[β(β 95%CI), n=98]

自变量	CSHQ总评分	就寝阻抗	入睡潜伏期延长	睡眠持续时间	睡眠焦虑	夜醒	异态睡眠	睡眠呼吸障碍	日间困倦
支持/参与	-1.15(-3.70~1.40)	-0.13(-1.17~0.91)	-0.26(-0.51~-0.02)	0.33(-0.29~0.95)	-0.07(-0.90~0.77)	-0.31(-0.64~0.02)	-0.10(-0.52~0.32)	-0.12(-0.37~0.14)	-0.51(-1.50~0.47)
敌意/强制	2.37(0.35~4.38)	0.03(-0.81~0.88)	-0.01(-0.21~0.20)	0.32(-0.18~0.82)	0.17(-0.50~0.85)	0.24(-0.02~0.51)	0.35(0.01~0.68)	0.12(-0.09~0.32)	0.99(0.22~1.77)

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