PDF(Pubmed)
Abstract：
Although the importance of sleep problems has been increasingly emphasized due to the effects on children\'s development and children\'s and families\' daytime behaviors, physical health, and quality of life, they have been overlooked in clinical practice. However, there have been few studies on the effects of rehabilitation on sleep problems. Therefore, in this study, we investigated the effects of an intensive rehabilitation program on sleep problems in children with developmental delays (DD).
We included 36 children with DD (30 outpatients, 6 inpatients) and their caregivers who completed all items on the Sleep Disturbance Scale for Children. Of the children with DD, 19 (59.3%) had cerebral palsy (CP) and 13 (40.7%) had DD of non-CP origins, of which 6 (18.8%) had prematurity, 4 (12.5%) had genetic causes, and 3 (9.4%) had an unknown origin. Changes in sleep problems after the intensive rehabilitation program were evaluated using a paired or unpaired t-test, depending on the distribution of the continuous variables.
After the intensive rehabilitation program, in 36 children with DD, there was a significant improvement in the difficulty in initiating and maintaining sleep (DIMS) sub-score (p < 0.05). However, there was no significant improvement in the total score or other sub-scores, such as those for sleep breathing disorders (SBD), disorders of arousal (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DOES), and sleep hyperhidrosis (SH). In the subgroup analysis according to the cause of DD, children with CP had a significant improvement in DIMS and DOES sub-scores (p < 0.05).
The intensive rehabilitation program, consisting of more than two sessions per day, effectively alleviated sleep problems in children with DD, especially in those with CP. Among the sleep problems, the intensive rehabilitative program was most effective at improving the DIMS. However, further prospective studies with a larger number of patients with DD and a more standardized protocol are necessary to generalize this effect.
We included 36 children with DD (30 outpatients, 6 inpatients) and their caregivers who completed all items on the Sleep Disturbance Scale for Children. Of the children with DD, 19 (59.3%) had cerebral palsy (CP) and 13 (40.7%) had DD of non-CP origins, of which 6 (18.8%) had prematurity, 4 (12.5%) had genetic causes, and 3 (9.4%) had an unknown origin. Changes in sleep problems after the intensive rehabilitation program were evaluated using a paired or unpaired t-test, depending on the distribution of the continuous variables.
After the intensive rehabilitation program, in 36 children with DD, there was a significant improvement in the difficulty in initiating and maintaining sleep (DIMS) sub-score (p < 0.05). However, there was no significant improvement in the total score or other sub-scores, such as those for sleep breathing disorders (SBD), disorders of arousal (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DOES), and sleep hyperhidrosis (SH). In the subgroup analysis according to the cause of DD, children with CP had a significant improvement in DIMS and DOES sub-scores (p < 0.05).
The intensive rehabilitation program, consisting of more than two sessions per day, effectively alleviated sleep problems in children with DD, especially in those with CP. Among the sleep problems, the intensive rehabilitative program was most effective at improving the DIMS. However, further prospective studies with a larger number of patients with DD and a more standardized protocol are necessary to generalize this effect.
摘要：
背景：尽管由于睡眠问题对儿童的发展以及儿童和家庭的白天行为的影响，人们越来越强调睡眠问题的重要性，身体健康,和生活质量，它们在临床实践中被忽视。然而,关于康复对睡眠问题的影响的研究很少。因此,在这项研究中，我们调查了强化康复计划对发育迟缓(DD)儿童睡眠问题的影响.
方法：我们纳入了36例DD患儿（30例门诊患者，6名住院患者）及其护理人员完成了儿童睡眠障碍量表上的所有项目。在有DD的孩子中，19（59.3％）患有脑瘫（CP），13（40.7％）患有非CP起源的DD，其中6人(18.8%)早产，4（12.5％）有遗传原因，3人(9.4%)的来历不明。采用配对或非配对t检验评估强化康复计划后睡眠问题的变化，取决于连续变量的分布。
结果：在强化康复计划之后，在36名患有DD的儿童中，启动和维持睡眠难度(DIMS)子评分显著改善(p<0.05).然而,总分或其他子分数没有显着改善，例如睡眠呼吸障碍（SBD），唤醒障碍（DA），睡眠-觉醒转换障碍（SWTD），过度嗜睡的障碍（DOES），和睡眠多汗症（SH）。在根据DD的原因进行亚组分析中，CP患儿的DIMS和DOES子评分有显著改善(p<0.05).
结论：强化康复计划，包括每天两次以上的会议，有效缓解DD儿童的睡眠问题，尤其是那些有CP的。在睡眠问题中，强化康复计划在改善DIMS方面最有效。然而,需要对更多DD患者进行进一步的前瞻性研究和更标准化的方案来推广这种效应.
方法：我们纳入了36例DD患儿（30例门诊患者，6名住院患者）及其护理人员完成了儿童睡眠障碍量表上的所有项目。在有DD的孩子中，19（59.3％）患有脑瘫（CP），13（40.7％）患有非CP起源的DD，其中6人(18.8%)早产，4（12.5％）有遗传原因，3人(9.4%)的来历不明。采用配对或非配对t检验评估强化康复计划后睡眠问题的变化，取决于连续变量的分布。
结果：在强化康复计划之后，在36名患有DD的儿童中，启动和维持睡眠难度(DIMS)子评分显著改善(p<0.05).然而,总分或其他子分数没有显着改善，例如睡眠呼吸障碍（SBD），唤醒障碍（DA），睡眠-觉醒转换障碍（SWTD），过度嗜睡的障碍（DOES），和睡眠多汗症（SH）。在根据DD的原因进行亚组分析中，CP患儿的DIMS和DOES子评分有显著改善(p<0.05).
结论：强化康复计划，包括每天两次以上的会议，有效缓解DD儿童的睡眠问题，尤其是那些有CP的。在睡眠问题中，强化康复计划在改善DIMS方面最有效。然而,需要对更多DD患者进行进一步的前瞻性研究和更标准化的方案来推广这种效应.
