Sleep and the Transition to Adolescence: A Longitudinal Study

Study Objectives:

To assess the links between sleep and pubertal development using a longitudinal design.

Design:

Three consecutive annual assessments of sleep and pubertal development. Sleep was assessed using a week of home actigraphy.

Setting:

Naturalistic sleep in the home setting of school children, Tel Aviv Area, Israel.

Participants:

A sample of 94 (41 boys) typically developing healthy school-age children (age range at first assessment: 9.9–11.2 years).

Intervention:

N/A

Measurements and Results:

The Petersen''s Pubertal Development Scale (PDS) and Sexual Maturation Scale (SMS) were used to assess pubertal development, and a week of actigraphy served to assess naturalistic sleep patterns. The results reflect expected developmental trends: an increase in signs of pubertal maturation, delayed sleep onset, and shorter sleep time. After controlling for age, significant relationships were found between sleep onset time, true sleep time, and number of night wakings at Time 1 and pubertal ratings at Time 2, and pubertal changes from Time 1 to Time 2. Delayed and disrupted sleep at Time 1 predicted faster pubertal changes from Time 1 to Time 2. These results were supported by structural equation modeling. These findings were similar in boys and girls.

Conclusions:

Based on these longitudinal data, it appears that pubertal changes in sleep (delayed sleep phase and disrupted sleep patterns) antedate bodily changes associated with puberty. The underlying mechanisms explaining these predictive links should be further explored.

Citation:

Sadeh A; Dahl RE; Shahar G; Rosenblat-Stein S. Sleep and the transition to adolescence: a longitudinal study. SLEEP 2009;32(12):1602-1609.     

Variability of Sleep Measures in Normal Subjects

Variability of sleep measures during 4 nights was examined in 10 normal young adults. The variables analyzed included: Sleep Stage Percentages; Sleep Time; Latency, Duration, and Cycle Time of REM; No. of REM Periods; and No. of Eye Movements (EM). No indication of First Night Effect was found, except that EM showed significant increases across nights. Although group means corresponded to conventional norms, considerable inter- and intraindividual variability was apparent, with Stage 2 and REM yielding lowest Variability Coefficients. Between nights, consistent positive correlations were found for Awake, REM, REM Latency, and particularly for Stage 4 and EM. Consistency of the relationship between nights for the sleep stages was not generally improved by equating sleep time either within or between Ss. Few intercorrelations between variables were significant. Within nights the first REM Duration was the shortest and the first Non-REM Duration the longest, while neither REM nor Non-REM Cycle Time changed significantly. In 25% of the records, Stage 3 terminated before Stage 4. Variability was discussed in terms of procedural aspects, trait characteristics, and situational factors.     

A Dose-Response Study of Sleep Loss and Spontaneous Sleep Termination

Recent concepts of sleep/wake regulation have emphasized circadian influences and largely disregarded homeostatic ones. The present experiment was designed to study sleep loss homeostasis while minimizing confounding circadian influences. Eight male subjects participated in the study. Night sleep was curtailed across four conditions to yield 0, 2, 4, or 8 hrs of sleep. The effects were studied on subsequent day sleep begun at 1100h and spontaneously terminated. Total sleep time (TST), Stage 2 (S2), and Stages 3+4 (SWS) showed very strong dose-dependent increases with increasing loss. REM sleep did not respond. After maximum sleep loss TST and S2 doubled whereas SWS increased fivefold. Sleep did not terminate until the prior loss of SWS had been recovered. The total SWS recovery approximately matched the loss. TST, S2, and REM failed to recover more than limited amounts of the loss. The results show that homeostatic influences on sleep may be much larger than usually acknowledged and that SWS closely, although not perfectly, reflects the “active component’ of sleep homeostasis.     

Longitudinal Evaluation of Sleep-Disordered Breathing and Sleep Symptoms with Change in Quality of Life: The Sleep Heart Health Study (SHHS)

Study Objectives:

Findings from population studies evaluating the progression and incidence of sleep disordered breathing have shown evidence of a longitudinal increase in the severity of sleep disordered breathing. The present study evaluates the association among changes in sleep disordered breathing, sleep symptoms, and quality of life over time.

Design:

Prospective cohort study. Data were from the Sleep Heart Health Study.

Setting:

Multicenter study.

Participants:

Three thousand seventy-eight subjects aged 40 years and older from the baseline and follow-up examination cycles were included.

Measurements:

The primary outcomes were changes in the Physical Component Summary and Mental Component Summary scales obtained from the Medical Outcomes Study Short-Form Health Survey. The primary exposure was change in the respiratory disturbance index obtained from unattended overnight polysomnograms performed approximately 5 years apart. Other covariates included measures of excessive daytime sleepiness and difficulty initiating and maintaining sleep.

Results:

Mean respiratory disturbance index increased from 8.1 ± 11 SD at baseline to 10.9 ± 14 (P < 0.0001) at follow-up. The mean Physical Component Summary and Mental Component Summary scores were 48.5 and 54.1 at baseline and 46.3 and 54.8 at follow-up. No associations between change in respiratory disturbance index and changes in Physical Component Summary or Mental Component Summary scores were seen. However, worsening of difficulty initiating and maintaining sleep and excessive daytime sleepiness were significantly associated with lower quality of life.

Conclusions:

A slight increase in severity of sleep disordered breathing was seen over 5 years; this was not associated with worsening of quality of life. However, subjective symptoms of quality of sleep and daytime sleepiness were associated with declining quality of life.

Citation:

Silva GE; An MW; Goodwin JL; Shahar E; Redline S; Resnick H; Baldwin CM; Quan SF. Longitudinal evaluation of sleep-disordered breathing and sleep symptoms with change in quality of life: the Sleep Heart Health Study (SHHS). SLEEP 2009;32(8):1049-1057.     

The Sleep of Skydivers: A Study of Stress

In this paper we report the results of a study in which we were able to assess the effects of a demonstrably stressful event—a sport parachute jump—on EEG recorded sleep. The sleep of 9 novice (one previous jump) and of 9 experienced (41 or more previous jumps) sport parachutists was monitored throughout the night for 4 nights prior to and for 1 night following the day during which a parachute jump had been scheduled to occur. A control group of sport parachutists who agreed not to make a jump during the course of their participation in the study were similarly seen for 5 consecutive nights. The results indicate that the execution, and to a lesser extent the anticipation, of the jump was stressful, especially for the novice group. However, the stressor induced only negligible changes in the sleep variables assessed. It is possible that there are critical differences in the effects on sleep of voluntarily imposed stresses and those which are commonly experienced in everyday life.     

A Passive Behavioral Measure of Sleep Onset in High-Alpha and Low-Alpha Subjects

Polygraph recordings were conducted with normal subjects who were not sleep-deprived lo examine the association between EFG alpha dynamics and a passive behavioral index of sleep/ wake status, and to assess the usefulness of that index in subjects who do not produce abundant wakeful alpha activity. I In- behavioral indicator of sleep unset comprised the depression of a telegraph key initialed by loss of extensor tension in the finger. Alpha abundant (high-alpha) subjects showed a strong association of alpha level (as sleep Stage Wake (w) vs. Stage I sleep) with behavioral level, and a strong association of alpha loss events with key closure events. Mean latencies between alpha loss and key closure varied from - 1.8 to 18.4 s with a median of 1.0 s. As expected, high-alpha subjects also showed significant correlations between alpha level and changes in peripheral physiological variables in the vicinity of sustained alpha losses. Compared with Stage W. Stage 1 was associated with a greater incidence of slow eye movements, lower abdominal breathing amplitude, and a higher thoracic:abdominal breathing ratio. Similar correlations were observed in both high-alpha and low-alpha subjects between these variables and the key index, supporting its potential generality as an indicator of sleep onset.     

Sleep Duration and Cardiovascular Disease: Results from the National Health Interview Survey

Background:

Previous studies have shown that both short and long sleep durations are related to increased likelihood of diabetes and hypertension. However, the relation between sleep duration and cardiovascular disease (CVD) is not clear. We examined the hypothesis that compared with sleep duration of 7 hours, shorter and longer sleep durations are independently related to CVD.

Methods:

We conducted a cross-sectional study of 30,397 National Health Interview Survey 2005 participants ≥ 18 years of age (57.1% women). Sleep duration was categorized as ≤ 5 hours, 6 hours, 7 hours, 8 hours, and ≥ 9 hours. The main outcome of interest was the presence of any CVD (n = 2146), including myocardial infarction, angina, and stroke.

Results:

We found both short and long sleep durations to be independently associated with CVD, independent of age, sex, race-ethnicity, smoking, alcohol intake, body mass index, physical activity, diabetes mellitus, hypertension, and depression. Compared with a sleep duration of 7 h (referent), the multivariate odds ratio (95% confidence interval) of CVD was 2.20 (1.78, 2.71), 1.33 (1.13, 1.57), 1.23 (1.06, 1.41), and 1.57 (1.31, 1.89) for sleep duration ≤ 5 h, 6 h, 8 h, and ≥ 9 h. This association persisted in subgroup analyses by gender, race-ethnicity, and body mass index categories. Also, similar associations were observed when we examined myocardial infarction and stroke separately.

Conclusion:

Compared with sleep duration of 7 h, there was a positive association between both shorter and longer sleep durations and CVD in a representative sample of US adults. These results suggest that sleep duration may be an important marker of CVD.

Citation:

Sabanayagam C; Shankar A. Sleep duration and cardiovascular disease: results from the National Health Interview Survey. SLEEP 2010;33(8):1037-1042.     

铁路在职职工睡眠行为的现况调查

目的探讨铁路在职职工睡眠行为的特点。方法采用分层整群随机抽样的方法,抽取302名济南铁路分局在职职工。对所抽样本进行睡眠行为与睡眠质量评定量表（SBQS）及一般项目调查表的调查。全部资料用SAS软件包进行统计分析。结果铁路在职职工一般晚10时半左右上床,入睡时间需要24分钟左右,早上6时40分左右起床,每晚睡眠7小时零10分钟左右。有超过1/3的男性和超过1/2的女性有午睡的习惯,而超过40%的男性和超过30%的女性午睡的原因是因为上夜班。结论铁路在职职工的睡眠行为具有自身的特点,铁路主管部门需要针对这些特点采取应对措施,合理安排作息时间,以提高睡眠质量。     

生理盐水喷雾辅助治疗婴儿鼻塞及对其睡眠质量的影响

目的 分析生理盐水喷雾辅助治疗鼻塞的婴儿及对其睡眠质量的临床影响和治疗情况。方法 选取2017年3月~2018年3月我科收治的鼻塞患儿86例,随机分为对照组和观察组,每组43例。对照组给予常规治疗,观察组在对照组基础上加用生理盐水喷雾辅助治疗。对比两组患儿的鼻塞症状消失的时间及治疗前后鼻塞以及睡眠质量的评分情况。结果 治疗后,观察组鼻塞评分低于对照组[（1.40±0.49）分 vs（2.14±0.46）分],差异有统计学意义（P＜0.05）。观察组鼻塞症状消失时间短于对照组[（5.95±1.02）d vs （10.95±1.77）d],差异有统计学意义（P＜0.05）。观察组睡眠质量评分低于对照组[（1.41±0.59）分 vs （2.07±0.63）分],差异有统计学意义（P＜0.05）。观察组治疗总有效率高于对照组（95.35% vs 72.09%）,差异有统计学意义（P＜0.05）。结论 应用生理盐水喷雾辅助治疗鼻塞的婴儿,能够有效缩短病程,消除鼻塞症状,改善睡眠治疗,提高临床治疗效果。     

78例睡眠呼吸暂停综合征患者的睡眠特征及其与夜间低氧血症的关系

目的 :了解SAS患者的睡眠特征及其与夜间低氧血症的关系。方法 :采用PSG对 78例SAS患者和 30例正常对照者进行整夜睡眠监测 ,比较两组间的睡眠特征。并对不同严重程度的夜间低氧血症SAS患者进行睡眠变量比较 ,分析二者的关系。结果 :与正常对照者相比 ,SAS患者夜间睡眠结构紊乱 ,主要为深睡眠减少、浅睡眠相对增加、REM睡眠减少、觉醒增加、睡眠潜伏期缩短、呼吸暂停或低通气次数增加、动脉血氧饱和显著下降 (P <0 .0 5 )。SAS患者夜间最低血氧饱和度与夜间总睡眠时间、睡眠效率、NREM睡眠时间及呼吸紊乱指数呈显著负相关 (r>0 .3,P <0 .0 5 ) ,与觉醒比例呈显著正相关 (r >0 .5 ,P <0 .0 1)。结论 :SAS患者睡眠结构紊乱突出 ,夜间反复发作的低氧血症对睡眠质量产生较大影响。     

Association of Short Sleep Duration with Weight Gain and Obesity at 1-Year Follow-Up: A Large-Scale Prospective Study

Study Objectives:

To investigate the association between short sleep duration and elevated body mass index (BMI) and obesity in a large sample of Japanese adults over a short period

Design:

Prospective design with baseline in 2006 and 1-year follow-up

Setting:

Workplaces of an electric power company in Japan

Participants:

35,247 company employees (31,477 men, 3,770 women) distributed throughout Japan

Measurements and Results:

Measured weight and height and self-reported sleep duration were obtained at annual health checkup in 2006 and 2007. Weight change was defined as the difference in body mass index (BMI) between the baseline and 1 year later. Relative to the reference category (sleep duration 7-8 h), short sleep duration (< 5 and 5-6 h) and long sleep duration ≥ 9 h were associated with an increased risk of weight gain among men after adjustment for covariates. Of the non-obese (BMI < 25) men at baseline, 5.8% became obese (BMI ≥ 25) 1 year later. Higher incidence of obesity was observed among the groups with shorter sleep duration. Adjusted odds ratios for the development of obesity were 1.91 (95%CI 1.36, 2.67) and 1.50 (95%CI 1.24, 1.80) in men who slept < 5 and 5-6 h, respectively. No significant association between sleep duration and weight gain or obesity was found for women.

Conclusions:

Short sleep duration was associated with weight gain and the development of obesity over 1 year in men, but not in women.

Citation:

Watanabe M; Kikuchi H; Tanaka T; Takahashi M. Association of short sleep duration with weight gain and obesity at 1-year follow-up: a large-scale prospective study. SLEEP 2010;33(2):161-167.     

Sex Differences in Subjective and Actigraphic Sleep Measures: A Population-Based Study of Elderly Persons

Study Objectives:

To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons.

Design:

Cross-sectional study.

Setting:

The study was embedded in the Rotterdam Study, a population-based study.

Participants:

Nine hundred fifty-six participants aged 59 to 97 years.

Interventions:

N/A.

Measurements and Results:

Participants wore an actigraph and kept a sleep diary for an average of 6 consecutive nights. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Unadjusted sex differences in sleep parameters were assessed with t tests. Women reported shorter total sleep time, a less favorable sleep-onset latency, lower sleep efficiency, and worse global sleep quality, as compared with men. When assessed with actigraphy, however, women were found to have longer and less-fragmented sleep than men. Sex differences in diary-reported sleep duration and other subjective sleep parameters were attenuated by adjustment for marital status, the use of sleep medication, and other covariates, but all sex differences remained significant in a multivariate-adjusted model. Sex differences in actigraphic sleep parameters were barely attenuated by multivariate adjustment, although the shorter actigraphically measured sleep duration in men was partly explained by their higher alcohol consumption. Some covariates (eg, sleep medication) had a different relationship with diary-reported or actigraphic total sleep time in men and women.

Conclusions:

If assessed by diary or interview, elderly women consistently reported shorter and poorer sleep than elderly men. In contrast, actigraphic sleep measures showed poorer sleep in men. These discrepancies are partly explained by determinants of sleep duration, such as sleep medication use and alcohol consumption.

Citation:

van den Berg JF; Miedema HME; Tulen JHM; Hofman A; Knuistingh Neven A; Tiemeier H. Sex differences in subjective and actigraphic sleep measures: a population-based study of elderly persons. SLEEP 2009;32(10):1367-1375.     

Sleep Duration and Five-Year Abdominal Fat Accumulation in a Minority Cohort:The IRAS Family Study

Study Objective:

To study 5-year change in computed tomography (CT)-derived visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) associated with sleep duration in 2 minority groups.

Design:

Longitudinal epidemiologic study.

Setting:

Three US communities.

Participants:

African Americans (N = 332) and Hispanic Americans (N = 775), aged 18-81 years, participating in the IRAS Family Study.

Interventions:

none

Measurements and Results:

Abdominal CT scans and BMI obtained at a 5-year interval. Sleep duration was assessed by questionnaire at baseline and categorized as ≤5 h, 6-7 h, and ≥8 h. Generalized estimating equations assessed the association between sleep duration and 5-year fat accumulation with adjustment for age, race, gender, study site, baseline fat measure, physical activity, total calories, smoking status, and education. Age interacted with sleep duration to predict change in fat measures (P < 0.01). In those younger than 40 years, ≤5 h of sleep was related to a greater accumulation of BMI (1.8 kg/m², P < 0.001), SAT (42 cm², P < 0.0001), and VAT (13 cm², P > 0.01), compared to sleep duration between 6 and 7 h. Eight hours or more of sleep was also significantly related to a greater accumulation of BMI (0.8 kg/m², P < 0.001), SAT (20 cm², P < 0.01) and VAT (6 cm², P < 0.05) compared to sleep duration between 6 and 7 h. No significant relationship existed between sleep duration and fat depot change in participants older than 40 years old.

Conclusions:

In this minority cohort, extremes of sleep duration are related to increases in BMI, SAT, and VAT in persons younger than 40 years old.

Citation:

Hairston KG; Bryer-Ash M; Norris JM; Haffner S; Bowden DW; Wagenknecht LE. Sleep duration and five-year abdominal fat accumulation in a minority cohort: the IRAS family study.     

贝利婴幼儿发展量表临床测试结果分析

目的　通过分析 BSID临床测试结果 ,了解儿保门诊中儿童身心发展状况以及偏离正常范围程度、发生原因及干预措施。方法　应用湖南医科大学编制的中国城市修订版“贝利婴幼儿发展量表”临床测试结果进行分析。结果　 3 0 1例不同性别 MDI与 PDI差异无显著性 ,MDI79以下男女发生率分别为 2 0 .86%、1 3 .1 6% ;PDI79以下男女发生率分别为2 0 .3 2 %、1 5 .1 6% ;3 0 1例不同年龄 MDI与 PDI差异有显著性 ;2 47例正常儿未通过项目主要表现在认知能力、精细运动、粗大运动发展不良 ;5 4例发育迟滞及临界状态病因以围产因素为第 1位 ,社会心理因素居第 2位。结论　通过 BSID测试可以早期发现发育落后、智力低下儿童。应抓紧时机开展早期教育及早期干预 ,使大脑潜能得到充分开发利用     

Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study

BACKGROUND: Previously published cohort studies in clinical populations have suggested that obstructive sleep apnea (OSA) is a risk factor for mortality associated with cardiovascular disease. However, it is unknown whether sleep apnea is an independent risk factor for all-cause mortality in a community-based sample free from clinical referral bias. METHODS: Residents of the Western Australian town of Busselton underwent investigation with a home sleep apnea monitoring device (MESAM IV). OSA was quantified via the respiratory disturbance index (RDI). Mortality status was determined in 397/400 participants (99.3%) after up to 14 years (mean follow-up 13.4 years) by data matching with the Australian National Death Index and the Western Australian Death Register. Univariate analyses and multivariate Cox proportional hazards modelling were used to ascertain the association between sleep apnea and mortality after adjustment for age, gender, body mass index, mean arterial pressure, total cholesterol, high-density lipoprotein cholesterol, diabetes, and medically diagnosed angina in those free from heart attack or stroke at baseline (n = 380). RESULTS: Among the 380 participants, 18 had moderate-severe OSA (RDI > or = 15/hr, 6 deaths) and 77 had mild OSA(RDI 5 to < 15/hr, 5 deaths). Moderate-to-severe OSA was independently associated with greater risk of all-cause mortality (fully adjusted hazard ratio [HR] = 6.24, 95% CL 2.01, 19.39) than non-OSA (n = 285, 22 deaths). Mild OSA (RDI 5 to < 15/hr) was not an independent risk factor for higher mortality (HR = 0.47, 95% CL 0.17, 1.29). CONCLUSIONS: Moderate-to-severe sleep apnea is independently associated with a large increased risk of all-cause mortality in this community-based sample.     

The Detection of Sleep Onset: Behavioral and Physiological Convergence

Reaction time (RT), a behavioral measure of arousal, was used to examine standard criteria (Rechtschaffen & Kales, 1968) for assessing sleep onset (SO) and the sensitivity of changes in respiratory patterns at SO. Following 24 hrs without sleep, RT, respiratory, and EEG measures were used to study SO in 12 subjects. Sleep deprivation (SD) permitted multiple examinations of SO in 2 daytime testing periods. Strong relationships between RT and EEG-based measures of SO serve to confirm the distinction between wakefulness and stage 1 sleep, and moderate to weak correlations between RT and respiratory indices describe the usefulness of the latter. Behavioral, respiratory and EEG assessments of the shift from wakefulness to sleep were observed to be orderly and rapid in these SD volunteers, suggesting that the detection of SO could be sharpened by adding behavioral and respiratory measures to the usual EEG criteria. The close temporal correspondence among these changes has interesting implications for sleep/waking mechanisms.     

Gender Differences in the Cross-Sectional Relationships Between Sleep Duration and Markers of Inflammation: Whitehall II Study

Objective:

To examine the relationships between sleep and inflammatory markers because these may be important in the development of cardiovascular disease.

Methods and Results:

The relationship between self-reported sleep duration and interleukin-6 (IL-6) (n = 4642) and high-sensitivity C-reactive protein (hs-CRP) (n = 4677) was examined in individuals from the Whitehall II study. Following multiple adjustments, there were no overall linear or nonlinear trends between sleep duration and IL-6. However, in women but not men (interaction P < 0.05), levels of IL-6 tended to be lower in individuals who slept 8 hours (11% [95% confidence interval 4 to 17]) as compared to 7 hours. With hs-CRP, in the adjusted model, there was no association between hs-CRP and sleep duration in men. However, there was a significant nonlinear association in women, the level of hs-CRP being significantly higher in women short sleepers (5 hours or less) after multiple adjustments (P = 0.04) (interaction P < 0.05).

Conclusions:

No significant variation in inflammatory markers with sleep duration was observed in men. By contrast, both IL-6 and hs-CRP levels varied with sleep duration in women. The observed pattern of variation was different according to the inflammatory marker observed. Further longitudinal studies are required to fully investigate possible temporal relationships between short sleep and markers of inflammation.

Citation:

Miller MA; Kandala NB; Kivimaki M; Kumari M; Brunner EJ; Lowe GDO; Marmot MG; Cappuccio FP. Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study. SLEEP 2009;32(7):857-864.     

A Longitudinal Study of Infant Vocalization in the First Year

Brief observations of infant vocalization were obtained duringhealth maintenance clinic visits at monhly intervals duringthe first year to determine when and how much observations mightbe useful in assessing characteristics of the mother-child relationshipand predicting later development. There was an overall increasein amount of vocalization observed during the first year. Themost reliable assessment of individual differences was obtainedin the age range of 4–6 months. The mean of two observationsin this age range showed significant correlations with scoreson the Verbalization factor of the Bayley Scales of Infant Developmentobtained at 11–15 months of age. Predictive value of obtaininga quotient above 100 on the Verbalization factor was 79% forat least one observation of vocalization at a rate above 19in 5 minutes. Results suggest that brief observations of infantvocalization between 4 and 6 months may have practical valuein identifying infants whose caretaker is szifficiently responsiveto promote development in the first year.     

孤独症儿童睡眠障碍对照研究

目的比较孤独症儿童与正常儿童睡眠障碍发生情况。方法对140例确诊的孤独症儿童和82例正常儿童,用自编睡眠及一般情况问卷进行调查。结果在140名孤独症儿童中,共有102名儿童目前或既往存在睡眠障碍,其中,男孩85人,女孩17人,孤独症儿童睡眠障碍的终生患病率为72.86%,男孩终生患病率(72.03%)和女孩终生患病率(77.27%)差异无统计学意义(χ2=1.912,P=0.384)。在82名正常儿童中,共有14名儿童目前或既往存在睡眠障碍,其中,男孩10人,女孩4人,正常儿童睡眠障碍的终生患病率为17.07%,男孩终生患病率(16.67%)和女孩终生患病率(18.19%)差异无统计学意义(χ2=0.080,P=0.117)。孤独症儿童的睡眠障碍发病率明显高于正常儿童,差异无统计学意义(χ2=32.407,P=0.000)。结论孤独症儿童睡眠障碍发生多于正常儿童,睡眠障碍是孤独症儿童主要症状之一。