Prevalence of parasomnia in autistic children with sleep disorders.

Clinical medicine. Pediatrics Pub Date : 2009-01-22 Print Date: 2009-01-01 DOI:10.4137/cmped.s1139
Xue Ming, Ye-Ming Sun, Roberto V Nachajon, Michael Brimacombe, Arthur S Walters
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Abstract

The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD). Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG) and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights' PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible.

患有睡眠障碍的自闭症儿童中寄生虫性失眠的发病率。
问卷调查显示,自闭症谱系障碍(ASD)儿童中与睡眠相关的主诉发生率高达 83.3%。问卷调查显示,自闭症谱系障碍儿童中存在各种寄生虫性失眠。然而,没有一项多导睡眠图研究报告了自闭症儿童的非快速动眼期寄生虫病,只有一项研究报告了自闭症儿童的快速动眼期相关寄生虫病。我们通过多导睡眠图研究和问卷调查,对 23 名 ASD 儿童和 23 名年龄匹配的非自闭症对比组儿童的睡眠障碍患病率和特征进行了调查。结果显示,14 名 ASD 儿童的多导睡眠图(PSG)和 16 名 ASD 儿童的问卷调查显示,非快速眼动期寄生虫明显增多,这一发现与药物使用、其他合并症或精神疾病或睡眠呼吸紊乱无关。在 14 名通过 PSG 证明患有寄生虫性失眠症的 ASD 儿童中,有 11 名通过问卷调查提示患有寄生虫性失眠症。通过问卷调查得出的 ASD 儿童寄生虫症状对预测 PSG 中是否存在寄生虫症状的敏感性较高,但特异性较低。在实验室记录的寄生虫症中,13 名 ASD 儿童有部分唤醒障碍,与睡眠惊恐或迷惑性唤醒一致。此外,在 13 名有 PSG 部分唤醒障碍证据的 ASD 儿童中,有 11 名出现了多次部分唤醒。在这 11 名出现多次部分唤醒的 ASD 儿童中,有 6 名 ASD 儿童在两个晚上的 PSG 研究中都出现了多次部分唤醒。ASD 儿童的睡眠结构异常,其特点是自发唤醒增加、快速眼动潜伏期延长和快速眼动百分比降低。这些结果表明,寄生虫性失眠在这批 ASD 儿童中的发病率很高,在无法进行 PSG 的情况下,仔细了解与寄生虫性失眠症状相符的病史对诊断 ASD 儿童的寄生虫性失眠很有帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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