儿童和青少年自闭症谱系障碍的睡眠障碍:临床医生综述

IF 0.4 Q4 PEDIATRICS
Mayank Gupta, Nihit Gupta, Yuli Fradkin, T. Petti
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引用次数: 1

摘要

自闭症谱系障碍(ASD/SD)中的睡眠障碍是独特的、广泛的、高度可变的临床实体,无处不在地影响核心症状、共病障碍的发展以及受影响儿童和家庭的整体生活质量。高遗传易感性和并发疾病的存在对评估和适当干预提出了重大挑战。该研究旨在回顾现有的最佳证据,并解决自闭症谱系障碍儿童和青少年睡眠障碍知识的临床空白。该综述对1622篇文章进行了全面的文献检索,并总结了110篇选择的经验证据,以系统地考虑ASD睡眠障碍的关键方面,为临床医生提供有用的信息。临床医生在实践中缺乏有效管理ASD青少年睡眠中断的指导和支持。ASD中睡眠中断的患病率接近80%,其特点是具有独特的亚型,包括但不限于阻塞性睡眠呼吸暂停、昼夜节律障碍和睡眠相关运动障碍。提高对睡眠中断及其神经发育基础、范围和影响的认识,有助于改善这些疾病的治疗和预防工作,对临床实践和未来研究至关重要。破坏性睡眠和ASD的双向性被认为是一个需要进一步澄清的主要领域。临床友好的筛查工具需要用于日常的办公室实践,以识别ASD/SD条件和干预措施,并减轻有害影响。心理教育和认知行为方法改善和支持健康的睡眠卫生,被认为是第一线的治疗,详细。总结了使用精神药理学药物的薄弱数据库,并描述了处方长效褪黑激素的强度,以获得最佳效果。讨论了其他药物的前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sleep Disturbances in Children and Adolescents with Autism Spectrum Disorder: An Overview for Clinicians
Sleep disorders in autism spectrum disorders (ASD/SD) are distinct, broad, and highly variable clinical entities that ubiquitously affect core symptomatology, development of comorbid disorders, and overall quality of life for affected children and families. High genetic predisposition and the presence of co-occurring disorders present significant challenges in assessment and appropriate interventions. The study aimed to review the best available evidence and address the clinical gaps in the knowledge about sleep disorders in children and adolescents with autism spectrum disorders. The review provides a comprehensive literature search of 1622 articles and summarizes 110 selected for empirical evidence to methodically consider critical aspects of sleep disorders in ASD for informing clinicians of useful information. Clinicians have insufficient guidance and support to effectively manage sleep disruptions in ASD youth in practice. Prevalence of sleep disruption in ASD, close to 80%, is characterized by unique subtypes, including but not limited to obstructive sleep apnea, circadian rhythm disorders, and sleep-related movement disorders. Greater awareness of sleep disruption, its neurodevelopmental basis, scope, and impact allows for improved treatment and prevention efforts of these conditions, and is critical for clinical practice and future research. The bidirectional nature of disruptive sleep and ASD is considered a major area requiring further clarification. Clinician-friendly screening tools are needed for everyday office practice to identify ASD/SD conditions and interventions, and mitigate harmful effects. Psychoeducational and cognitive-behavioral approaches for improving and supporting healthy sleep hygiene, considered the first line of treatment, are detailed. The weak database for the use of psychopharmacologic agents is summarized, and the strength of prescribing prolonged-release melatonin for optimal results is described. The promise of other medications is discussed.
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来源期刊
Adolescent Psychiatry
Adolescent Psychiatry PEDIATRICS-
CiteScore
0.80
自引率
0.00%
发文量
20
期刊介绍: Adolescent Psychiatry a peer-reviewed journal, aims to provide mental health professionals who work with adolescents with current information relevant to the diagnosis and treatment of psychiatric disorders in adolescents. Adolescent Psychiatry reports of original research, critical reviews of topics relevant to practitioners, clinical observations with analysis and discussion, analysis of philosophical, ethical or social aspects of the fields of psychiatry and mental health, case reports with discussions, letters, and position papers. Topics include adolescent development and developmental psychopathology, psychotherapy and other psychosocial treatment approaches, psychopharmacology, and service settings and programs. The primary focus of the work should be on adolescents, transition-aged youth, The primary focus of the work should be on adolescents, transition-aged youth, or emerging adults, that is, persons 12-24 years of age . Articles on families of adolescents, or adults who have been followed since adolescence will also be considered.
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