抽动障碍儿童睡眠情况调查分析

doi:10.20274/j.cnki.issn.2025.04.003

摘要/Abstract

摘要：

目的探讨抽动障碍儿童的睡眠情况及其与抽动障碍类型的关系。方法选择2024年1～12月泉州市第一医院儿科门诊收治的抽动障碍患儿86例作为观察组，同期招募于本院健康体检的健康儿童70例作为对照组。收集两组儿童的人口学特征和临床资料，采用儿童睡眠习惯问卷（CSHQ）进行睡眠评估。观察组同时采用耶鲁全球抽动严重程度量表（YGTSS）进行抽动障碍程度评估。结果抽动障碍患儿CSHQ总分（48.32±7.64）分，显著高于对照组（42.17±5.92）分，差异有统计学意义(P<0.001)。根据YGTSS评分，轻度抽动障碍CSHQ总分（44.86±6.32）分、中度（50.37±7.15）分和重度（56.75±8.24）分，3组比较差异有统计学意义(P<0.001)。慢性抽动障碍组CSHQ总分最高，其次为抽动-秽语综合征组，暂时性抽动障碍组最低，3组比较差异有统计学意义(P<0.001)。结论抽动障碍儿童睡眠问题明显高于正常儿童，不同类型抽动障碍儿童睡眠问题存在差异，随着抽动障碍的严重程度增加而升高。临床工作中，应注意评估抽动障碍儿童的睡眠问题。

关键词: 抽动障碍, 睡眠问题, 儿童睡眠习惯问卷, YGTSS评分, 儿童

Abstract:

Objective To investigate the sleep quality of children with tic disorders and their association with the types of tic disorders. Methods A total of 86 children with tic disorders admitted to the First Hospital of Quanzhou City from January to December 2024 were selected as the observation group, and 70 healthy children who underwent physical examinations at the same hospital during the same period were recruited as the control group. Demographic characteristics and clinical data of the two groups of children were collected, and sleep assessment was conducted using the children's sleep habits questionnaire(CSHQ). The observation group was evaluated using the Yale global tic severity scale(YGTSS). Results The CSHQ total score in the tic disorders group was 48.32±7.64, which was significantly higher than that of the control group (42.17±5.92， P<0.001). Based on YGTSS scores, the tic disorders group was further categorized into mild, moderate, and severe subgroups, with CSHQ total scores being 44.86±6.32,50.37±7.15, and 56.75±8.24, respectively. Significant differences were observed among these 3 subgroups(P<0.001). CSHQ total score was the highest in chronic tic disorders group, followed by Tourette syndrome group, and the score was the lowest in temporary tic disorders group. There were statistical differences among the 3 groups(P<0.001). Conclusion Children with tic disorders have significantly more sleep issues compared to healthy controls. Furthermore, sleep issues vary across different types of tic disorders, with greater severity associated with poorer sleep quality. Clinical practitioners should pay attention to the assessment of sleep issues in children with tic disorders.

Key words: Tic disorder, Sleep issues, Children's sleep habits questionnaire, YGTSS score, Child

中图分类号:

R277.7

张情梅, 许白叶, 王海岛, 陈真, 陈婷婷. 抽动障碍儿童睡眠情况调查分析[J]. 中国中西医结合儿科学, 2025, 17(4): 287-291.

Qingmei ZHANG, Baiye XU, Haidao WANG, Zhen CHEN, Tingting CHEN. Investigation and analysis of sleep quality in children with tic disorders[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(4): 287-291.

图/表 4

表1

表2

表3

表4

参考文献 21

[1]	American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders(DSM-5)[M].Washington DC: American Psychiatric Publishing，2013:81-85.
[2]	辛莹莹, 孙丹, 刘智胜. 儿童抽动障碍及其共患病治疗进展[J]. 中华儿科杂志, 2022, 60(3): 263-266.
[3]	Hirschtritt ME, Lee PC, Pauls DL, et al. Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome[J]. JAMA Psychiatry, 2015, 72(4): 325-333.
[4]	Quist JF, Barr CL, Schachar R, et al. The serotonin 5-HT1B receptor gene and attention deficit hyperactivity disorder[J]. Mol Psychiatry, 2003, 8(1): 98-102.
[5]	Sukhodolsky DG, do Rosario-Campos MC, Scahill L, et al. Adaptive, emotional, and family functioning of children with obsessive-compulsive disorder and comorbid attention deficit hyperactivity disorder[J]. Am J Psychiatry, 2005, 162(6): 1125-1132.
[6]	Owens JA, Spirito A, McGuinn M. The children's sleep habits questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children[J]. Sleep, 2000, 23(8): 1043-1051.
[7]	卢青, 孙丹, 刘智胜.中国抽动障碍诊断和治疗专家共识解读[J]. 中华实用儿科临床杂志, 2021, 36(9): 647-653.
[8]	张情梅, 许白叶, 王海岛, 等. 神经递质失衡在儿童抽动障碍共患睡眠障碍中的研究进展[J]. 中国现代医生, 2025, 63(8): 106-109.
[9]	姜玲, 张迪, 刘英. 神经递质失衡在抽动障碍中的研究进展[J]. 中国中西医结合儿科学, 2025, 17(2): 132-136.
[10]	刘万超, 王荣.儿童抽动障碍共患睡眠障碍类型的研究进展[J]. 中国现代医生, 2025, 63(1): 116-118.
[11]	Li Q, Wang SP, Wang YP, et al. The prevalence of sleep problems in patients with Tourette syndrome or chronic tic disorder: A systematic review and meta-analysis[J]. J Psychiatr Res,2024,171:371-378.
[12]	Ricketts EJ, Rozenman M, Choy C, et al. Sleep sufficiency in pediatric and adolescent Tourette’s disorder: national survey of children's health[J]. J Dev Behav Pediatr, 2018, 39(1): 72-76.
[13]	郭徵艺, 阳柯佳, 雷静, 等. 中国儿童抽动障碍预后影响因素的系统评价[J]. 中国中西医结合儿科学, 2023, 15(4): 283-290.
[14]	Mi Y, Zhao R, Sun X, et al. Sleep disturbances and sleep patterns in children with tic disorder: a case-control study[J]. Front Pediatr, 2022, 10: 911343.
[15]	Li N, Hong X, Cui Y, et al. Clinical tics and quality of life in children and adolescents with tic disorders: the mediating role of sleep[J]. Sleep Med, 2024, 124: 217-222.
[16]	Leckman JF, Bloch MH, Smith ME, et al. Neurobiological substrates of Tourette's disorder[J]. J Child Adolesc Psycho-pharmacol, 2010, 20(4): 237-247.
[17]	McGuire JF, Ricketts EJ, Piacentini J, et al. Behavior therapy for tic disorders: an evidenced-based review and new directions for treatment research[J]. Curr Dev Disord Rep, 2015, 2(4): 309-317.
[18]	Ghosh D, Rajan PV, Das D, et al. Sleep disorders in children with Tourette syndrome[J]. Pediatr Neurol, 2014, 51(1): 31-35.
[19]	Keenan L, Bramham J, Downes M. Parent-report sleep disturbances and everyday executive functioning difficulties in children with Tourette syndrome[J]. Dev Neuropsychol, 2024, 49(1): 39-60.
[20]	Swisher VS, Liu S, Ricketts EJ. Bedtime regularity and sleep sufficiency in children with Tourette syndrome[J]. Pediatr Neurol, 2024, 158: 26-34.
[21]	Murphy TK, Lewin AB, Storch EA, et al. Practice parameter for the assessment and treatment of children and adolescents with tic disorders[J]. J Am Acad Child Adolesc Psychiatry, 2013, 52(12): 1341-1359.

组别	n	性别(男/女)	年龄(x±s,岁)	出生方式		胎次
组别	n	性别(男/女)	年龄(x±s,岁)	顺产	剖宫产	第1胎	第2胎	≥第3胎
对照组	70	45(64.29)/25(35.71)	7.48±2.25	40(57.14)	30(42.86)	44(62.86)	21(30.00)	5(7.14)
观察组	86	58(67.44)/28(32.56)	7.62±2.31	46(53.49)	40(46.51)	52(60.47)	28(32.56)	6(6.98)
组别	n	高龄产妇	父亲教育水平			母亲教育水平
组别	n	高龄产妇	高中及以下	本科	研究生及以上	高中及以下	本科	研究生及以上
对照组	70	11(15.71)	23(32.86)	37(52.86)	10(14.29)	25(35.71)	35(50.00)	10(14.29)
观察组	86	15(17.44)	31(36.05)	42(48.84)	13(15.12)	34(39.53)	40(46.51)	12(13.95)

项目	观察组(n=86)	对照组(n=70)	t值	P值
CSHQ总分	48.32±7.64	42.17±5.92	5.693	<0.001
就寝时间抵抗	10.23±2.56	8.42±1.93	4.916	<0.001
入睡延迟	2.38±0.75	1.86±0.68	4.628	<0.001
睡眠时间	4.12±1.37	3.86±1.24	1.264	0.208
睡眠焦虑	7.35±2.14	5.94±1.82	4.452	<0.001
夜醒	4.86±1.53	4.12±1.28	3.256	0.001
异态睡眠行为	9.42±2.87	8.15±2.36	3.018	0.003
睡眠呼吸障碍	3.54±1.26	3.32±1.18	1.147	0.253
日间嗜睡	13.28±3.15	11.64±2.74	3.465	0.001

项目	轻度(n=42)	中度(n=36)	重度(n=8)	F值	P值
YGTSS评分	19.72±2.51	33.47±4.36	55.87±2.42	10.361	<0.001
CSHQ总分	44.86±6.32	50.37±7.15	56.75±8.24	13.642	<0.001
就寝时间抵抗	9.12±2.28	10.86±2.45	12.75±2.66	11.352	<0.001
入睡延迟	2.07±0.68	2.53±0.70	3.25±0.71	12.245	<0.001
睡眠时间	3.95±1.27	4.22±1.42	4.50±1.60	0.982	0.378
睡眠焦虑	6.45±1.96	7.92±1.84	9.38±1.92	13.764	<0.001
夜醒	4.38±1.43	5.14±1.48	6.00±1.51	6.458	0.002
异态睡眠行为	8.26±2.36	10.19±2.68	12.13±3.04	12.687	<0.001
睡眠呼吸障碍	3.40±1.19	3.64±1.31	3.88±1.36	0.862	0.426
日间嗜睡	12.17±2.85	13.97±2.92	15.75±3.45	8.457	<0.001

项目	暂时性抽动障碍(n=53)	抽动-秽语综合征(n=5)	慢性抽动障碍(n=28)	F值	P值
YGTSS评分	26.48±11.28	29.80±10.72	38.75±12.64	12.357	<0.001
CSHQ总分	45.92±6.75	47.60±6.84	52.64±8.13	8.753	<0.001
就寝时间抵抗	9.58±2.33	10.20±2.49	11.46±2.72	6.325	0.003
入睡延迟	2.21±0.72	2.40±0.55	2.71±0.76	4.387	0.015
睡眠时间	4.02±1.35	4.00±1.22	4.32±1.42	0.564	0.571
睡眠焦虑	6.77±1.98	7.20±2.05	8.46±2.13	7.563	0.001
夜醒	4.64±1.47	4.80±1.30	5.25±1.60	1.688	0.191
异态睡眠行为	8.62±2.54	9.20±2.59	10.96±2.98	8.243	<0.001
睡眠呼吸障碍	3.45±1.21	3.60±1.14	3.68±1.36	0.394	0.676
日间嗜睡	12.51±2.86	13.00±3.00	14.75±3.26	6.042	0.004