学龄前儿童睡眠状况与情绪和行为问题的关联性研究

目的 分析学龄前儿童睡眠质量及夜间睡眠时间与情绪和行为问题的关联及其影响因素。方法 资料源自2015年3-6月中国长江中下游4个城市部分3~6岁学龄前儿童问卷调查。采用自编的"学龄前儿童发育问卷"调查学龄前儿童夜间睡眠时间和质量,通过长处与困难量表（SDQ）了解学龄前儿童情绪和行为问题发生情况,有效问卷共8 900份。采用多分类logistic回归模型分析夜间睡眠时间及睡眠质量与情绪和行为问题之间的关联。结果 学龄前儿童情绪症状、品行问题、多动、同伴交往、SDQ困难总分、亲社会行为异常率分别为9.0%、13.9%、18.9%、25.5%、13.6%和16.2%,除情绪症状异常率女童高于男童,其余各项异常率男童全部高于女童。睡眠质量好、较好和较差/很差分别为3.9%、52.9%和43.2%。多因素logistic回归模型分析显示,控制性别、年龄、分娩方式、出生体重、出生身长和父母文化程度等混杂因素后,与夜间睡眠较短的儿童相比,夜间睡眠较长的儿童发生情绪症状、品行问题、多动、同伴交往、SDQ困难总分、亲社会行为异常的风险较低,OR值（95%CI）分别为0.86（0.77~0.95）、0.85（0.78~0.93）、0.85（0.79~0.92）、0.87（0.81~0.93）、0.83（0.76~0.91）和0.82（0.76~0.89）;与睡眠质量好的儿童相比,睡眠质量较差/很差的儿童发生情绪症状、品行问题、多动、同伴交往、SDQ困难总分、亲社会行为异常的风险升高,OR值（95%CI）分别为3.26（2.40~4.42）、2.86（2.16~3.78）、2.60（2.00~3.38）、1.96（1.52~2.54）、4.02（3.06~5.27）和2.56（1.96~3.35）。结论 夜间睡眠时间短和睡眠质量差对学龄前儿童情绪和行为问题产生负面影响。

Emotional and behavioral problems associated with sleep problems in preschool aged children

Objective To examine whether sleep problems are related to both emotional and behavioral problems in children aged 3-6 years. Methods A large cross-sectional study was conducted in Anqing, Wuhu, Tongling and Yangzhou from March to June 2015. A total of 8 900 preschool aged children were included. Sleep problems were obtained by using adapted BISQ completed by the parents or the people who took care of children. Emotional and behavioral problems of the children were accessed by using Strengths and Difficulties Questionnaire (SDQ), and multivariate logistic regression model was used for statistical analyses. Results The detected rates of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior in preschool aged children were 9.0%, 13.9%, 18.9%, 25.5%, 13.6% and 16.2% respectively. All the detected rates were higher in boys than in girls except the higher rate of emotional symptoms. The proportions of children with high sleep quality, moderate sleep quality and poor or worse sleep quality were 3.9%, 52.9% and 43.2% respectively. After controlling the confounding factors of demographic variables, including gender, age, delivery mode, birth weight, birth height and patent''s educational level, multinomial logistic regression analysis showed that the risk of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior in children with longer sleep duration was lower than that in children with shorter sleep duration, the ORs were 0.86 (95%CI:0.77-0.95), 0.85 (95%CI:0.78-0.93), 0.85 (95%CI:0.79-0.92), 0.87(95%CI:0.81-0.93), 0.83 (95%CI:0.76-0.91) and 0.82 (95%CI:0.76-0.89) respectively. Compared with the children with good sleep quality, the risk of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior were higher in children with poor or worse sleep quality, the ORs were 3.26 (95%CI:2.40-4.42), 2.86 (95%CI:2.16-3.78), 2.60 (95%CI:2.00-3.38), 1.96 (95%CI:1.52-2.54), 4.02 (95%CI:3.06-5.27) and 2.56 (95%CI:1.96-3.35) respectively. Conclusion There was a negative impact of shorter sleep and poor or worse sleep on emotional and behavioral problems of preschool aged children.