自闭症谱系障碍幼儿失眠症状的临床相关性

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2025-09-15 DOI:10.1016/j.jpeds.2025.114812

Megan L Wenzell, Stormi L Pulver, Lawrence Scahill, Taylor Davidson, Sandhya Rajagopal, Scott Gillespie, Tracy Huang, Stephanie Griggs, Camdyn Roark, Megha Patil, Manav Patel, William G Sharp

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引用次数: 0

摘要

目的：探讨孤独症谱系障碍（ASD）患儿失眠症状的临床相关因素。研究设计：本分析纳入103名ASD患儿（平均年龄=5.8+2.2岁，范围2-10岁，77.7%为男性）。一个多学科团队使用儿童自闭症失眠评定量表（PAIRS）、异常行为检查表（ABC）、简短自闭症进餐行为清单（BAMBI）以及PedsQL和家庭功能调查中的父母评分来评估医疗和社会心理病史。收集身高和体重。将当前样本中得分为PAIRS bbb22的儿童与平均得分< 22的儿童进行比较。采用单变量和多变量logistic回归模型评估与失眠症状相关的临床因素[j] 22。最佳子集选择方法确定了最重要的预测因子。结果：pair平均值为18.39 + 14.54（范围0 ~ 58）；33%得分为bb22。调整混杂因素后，破坏性用餐时间行为（p < 0.001）、父母HRQoL和家庭功能(p 22。在身高、体重、便秘或人口统计学方面没有组间差异。最佳子集模型显示，ABC多动/不依从性、膳食补充剂和用餐时间行为是最显著的预测因子(ROC = 0.842, χ2（df) = 32.84 (3), χ2 diff）。结论：对自闭症儿童当前失眠症状的性质和严重程度进行表征是有用的。

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Clinical Correlates of Insomnia Symptoms in Young Children with Autism Spectrum Disorder.

Objective: To examine clinical correlates of insomnia symptoms in children with autism spectrum disorder (ASD) ascertained from a general outpatient autism clinic.

Study design: This analysis included 103 children with ASD (mean age=5.8+2.2 years; range 2-10, 77.7% male). A multidisciplinary team assessed medical and psychosocial histories using parent ratings from the Pediatric Autism Insomnia Rating Scale (PAIRS), Aberrant Behavior Checklist (ABC), Brief Autism Mealtime Behavior Inventory (BAMBI), and the PedsQL and Family Functioning Surveys. Height and weight were collected. Children in the current sample with scores on the PAIRS > 22 were compared with those with a mean PAIRS score < 22. Univariable and multivariable logistic regression modeling was used to evaluate clinical correlates with insomnia symptoms > 22. Best subset selection approach identified the most important predictors.

Results: The PAIRS mean was 18.39 + 14.54 (range 0 to 58); 33% scored > 22. After adjusting for confounders, disruptive mealtime behaviors (p < .001), parent HRQoL and family functioning (p<.001 to .001), ABC subscales (p<.001 to .022), and dietary supplements (p=.019) were significantly associated with PAIRS > 22. There were no group differences in height, weight, constipation, or demographics. Best subset modeling showed ABC Hyperactivity/Noncompliance, dietary supplements, and mealtime behaviors as the most significant predictors (ROC = 0.842, χ²(df) = 32.84 (3), χ²Diff. = 4.80, p<0.001).

Conclusions: The PAIRS appears useful for characterizing the nature and severity of current insomnia symptoms in autistic children.

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.