上海市松江区学龄前儿童睡眠状况和睡眠问题的横断面调查

目的调查学龄前儿童的睡眠情况，分析不同特征学龄前儿童的常见睡眠问题。方法在普遍动员、自愿参与的原则下，以上海市松江区幼儿园作为问卷调查现场，以《儿童家族社会环境与睡眠健康问卷》作为调查工具，以年龄和性别分层分析。睡眠问题包括睡眠不足，就寝延迟，睡眠中发生每周＞2次的以下情况：害怕就寝、打鼾、白天嗜睡、磨牙、夜惊、梦魇、入睡困难和梦游。先对幼儿园保健老师集中统一培训，保健老师再对幼儿园班主任进行培训。问卷填写人为幼儿父或母或抚养人且近１年与幼儿一起生活。当场发放问卷、填写和回收。结果2018年5~6月22所幼儿园参与问卷调查，向儿童家长发放问卷8 624份，有效问卷8 586份，男孩4 595名(53.5%)，女孩3 991名； 3~岁占17.8%、4~岁占34.1%、5~岁占32.0%、6~岁占16.1%。平均晚上就寝时间为21∶43，平均晨醒时间为7∶01，随年龄增长，白天、夜间和全天睡眠时间总量在减少，晚上就寝时间点延迟，平均晨醒时间点提前，差异有统计学意义（P＜0.01）。不同性别学龄前儿童白天、夜间、全天睡眠总量和就寝时间，差异均无统计学意义（P＞0.05）。睡眠不足的发生率为12.2%，就寝延迟的发生率为75.7%。随年龄增长，睡眠不足和就寝延迟的发生率逐渐增加，差异有统计意义(P＜0.05)。害怕就寝72.4%，打鼾62.5%，白天嗜睡51.2%，磨牙50.4%，夜惊49.2%，梦魇41.2%，入睡困难33.4%，梦游4.4%。打鼾和磨牙的发生率男童高于女童（P＜0.05），夜惊、梦魇、入睡困难和梦游的发生率女童高于男童（P＜0.05）。结论上海市松江区学龄前儿童睡眠时间不足，就寝延迟，睡眠问题发生率高，应引起社会及家长的重视。

Cross-sectional survey on sleep status and sleep problems of preschool children in Songjiang District of Shanghai

ObjectiveTo investigate the sleep status of preschool children in Shanghai, and analyze the common sleep problems of preschool children with different characteristics. MethodsAccording to the principle of universal mobilization and voluntary participation, kindergartens in Songjiang district of Shanghai were chosen as the scene of questionnaire survey, and the questionnaire of children's family social environment and sleep health was used as a survey tool. Analysis was by age and stratified gender. Sleep problems include sleep deficiency，sleep delay，and the occurrence of sleep disorder more than twice a week during sleep like fear of going to bed, snoring, excessive daytime sleepiness, molars, night terrors, nightmare, difficulty falling asleep and sleepwalking. First of all, the kindergarten health care teachers received the centralized and unified training, and then the kindergarten health care teachers trained the class teachers. The questionnaire was filled in by the father or mother of the child, or the relatives who raised the child and lived with the child for nearly one year. The class teachers sent out questionnaires, which filled in and collected on the spot. ResultsFrom May to June 2018, 22 kindergartens participated in the questionnaire survey, 8,624 questionnaires were sent to parents and 8,586 valid questionnaires include 4 595 boys(53.5%) and 3 991 girls(46.5) with 17.8% in the 3-year-old group, 34.1% in the 4-year-old group, 32.0% in the 5-year-old group and 16.1% in the 6-year-old group. The average time of going to bed at night was 21∶43, and the average time of waking up in the morning was 7∶01. The total sleep time, daytime sleep time and nighttime sleep time decreased with the growing age, and the average time of going to bed at night was delayed, and the average time of waking up in the morning was advanced. The difference was statistically significant (P<0.01). There were no significant differences in the daytime sleep time, nighttime sleep time, total sleep time and bedtime in preschool children of different genders (P>0.05). The incidence of sleep deprivation was 12.2%, and the incidence of sleep delay was 75.7%. The incidence of sleep deprivation and sleep delay were decreasing with the growing age, and the difference was statistically significant (P<0.01). The incidence of fear of going to bed was 72.4%, snoring was 62.5%, excessive daytime sleepiness was 51.2%, molars was 50.4%, night terrors was 49.2%, nightmare was 41.2%, difficulty falling asleep was 33.4% and sleepwalking was 4.4%. The incidence of snoring and molars in boys was significantly higher than that in girls (P＜0.05), while the incidence of night terrors, nightmares, difficulty of falling asleep and sleepwalking in girls was significantly higher than that in boys (P＜0.05). ConclusionThe incidence of sleep deficiencies, sleep delay and sleep problems are higher of preschool children in Songjiang district of Shanghai, which should be paid attention to by the society and parents.