Interpretation of Clinical Practice Guidelines for Sleep Disorders in Children with Autism Spectrum Disorder

doi:10.12114/j.issn.1007-9572.2022.0267

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (21): 2563-2568.DOI: 10.12114/j.issn.1007-9572.2022.0267

Special Issue: 指南/共识最新文章合集；儿科最新文章合集；睡眠研究最新文章合集；睡眠问题专题研究

• Guideline Interpretation • Next Articles

Interpretation of Clinical Practice Guidelines for Sleep Disorders in Children with Autism Spectrum Disorder

1. Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
2. Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
3. MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
4. Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai 201602, China

Received:2022-02-20 Revised:2022-05-17 Published:2022-07-20 Online:2022-05-24
Contact: Fan JIANG, Guanghai WANG
About author:
TANG Y J, WANG Z J, JIANG Y R, et al. Interpretation of clinical practice guidelines for sleep disorders in children with autism spectrum disorder[J]. Chinese General Practice, 2022, 25 (21) : 2563-2568.

孤独症谱系障碍儿童睡眠障碍临床实践相关指南解读

1．200127　上海市，上海交通大学医学院附属上海儿童医学中心发育行为儿科
2．200127　上海市，上海交通大学医学院附属上海儿童医学中心儿科转化医学研究所
3．200092　上海市，上海交通大学医学院附属新华医院环境与儿童健康教育部和上海市重点实验室
4．201602　上海市，上海脑科学与类脑研究中心

通讯作者: 江帆, 王广海
作者简介:
唐艺嘉，王紫惊，姜艳蕊，等.孤独症谱系障碍儿童睡眠障碍临床实践相关指南解读[J].中国全科医学，2022，25（21）：2563-2568. [www.chinagp.net] 作者贡献：唐艺嘉负责论文相关资料/文献收集，论文的撰写及修订；王紫惊、姜艳蕊负责论文修订；江帆、王广海负责论文构思、修订，质量控制及审校并对文章整体负责、监督管理。
基金资助:
国家自然科学基金面上项目(82071493); 上海市科学技术委员会启明星计划A类项目(19QA1405800); 上海市科学技术委员会引导类项目(19411968800); 上海市科学技术委员会重大项目(18JC1420305，2018SHZDZX05)

Abstract

Abstract:

Sleep disorders, especially insomnia and sleep behavior disorders, are highly prevalent in children with autism spectrum disorder (ASD) , which cause a wide range of detrimental effects on the children and their families. Several international professional organizations have highlighted integrating sleep disorders into the comprehensive evaluation and treatment in children with ASD, and developed relevant clinical guidelines or expert consensuses, such as the A Practice Pathway for the Identification, Evaluation, and Management of Insomnia in Children and Adolescents with Autism Spectrum Disorders by the Autism Treatment Network (ATN) , Autism: the Management and Support of Children and Young People on the Autism Spectrum by the National Institute for Health and care Excellence (NICE) , and Practice Guideline: Treatment for Insomnia and Disrupted Sleep Behavior in Children and Adolescents with Autism Spectrum Disorder by the American Academy of Neurology (AAN) . However, there is no applicable clinical guideline or expert consensus for sleep disorders among Chinese children with ASD, which greatly restricts the development of relevant clinical practice. We interpreted the above-mentioned two guidelines and one consensus, focusing mainly on several aspects, such as the levels of evidence and strength of recommendations, the definition of sleep disorders and associated factors, and behavioral treatments and melatonin-based therapies. It is hoped that our endeavors will contribute to the diagnosis and management of sleep disorders in Chinese children with ASD and the development of relevant clinical guidelines or expert consensuses.

Key words: Autism spectrum disorder, Sleep disorders, Insomnia, Child, Guidebooks, Behavioral treatment

摘要：

睡眠障碍，尤其是失眠和睡眠行为紊乱在孤独症谱系障碍（ASD）儿童中极为常见，对ASD儿童及其家庭造成多方面损害。国际上多个专业组织强调将睡眠障碍纳入ASD儿童的综合诊疗之中，并发布了相关临床指南或专家共识，如美国孤独症治疗联盟（ATN）共识、英国国家卫生与临床优化研究所（NICE）指南、美国神经病学学会（AAN）指南等。然而，目前仍缺乏适用于我国ASD儿童睡眠障碍的临床指南或专家共识，极大限制了相关临床工作的开展。本文重点对上述3个临床指南或专家共识涉及的证据等级和推荐强度、睡眠障碍界定和相关因素评估，以及睡眠障碍行为治疗和褪黑素治疗等进行解读，以期为我国ASD儿童睡眠障碍的诊治，以及临床指南或专家共识的制订提供参考。

关键词: 孤独症谱系障碍, 睡眠障碍, 失眠, 儿童, 指南, 行为治疗

Yijia TANG,Zijing WANG,Yanrui JIANG, et al. Interpretation of Clinical Practice Guidelines for Sleep Disorders in Children with Autism Spectrum Disorder[J]. Chinese General Practice, 2022, 25(21): 2563-2568. DOI: 10.12114/j.issn.1007-9572.2022.0267.
唐艺嘉,王紫惊,姜艳蕊等. 孤独症谱系障碍儿童睡眠障碍临床实践相关指南解读[J]. 中国全科医学, 2022, 25(21): 2563-2568. DOI: 10.12114/j.issn.1007-9572.2022.0267.

Figures/Tables 2

References 28

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行为治疗方法	实施内容
消退法	父母设置固定的就寝和起床时间，忽视孩子在这之间的不适应睡眠行为
逐渐消退法	父母等待固定或逐渐延长的时间间隔后，对孩子进行简短安抚，避免强化就寝抵抗行为
积极就寝程序	父母为孩子制订规律的、安静的就寝常规活动，并严格遵守
渐变就寝时间	父母暂时推迟孩子的就寝时间，使其接近孩子实际入睡的时间

行为治疗方法	实施内容
消退法	父母设置固定的就寝和起床时间，忽视孩子在这之间的不适应睡眠行为
逐渐消退法	父母等待固定或逐渐延长的时间间隔后，对孩子进行简短安抚，避免强化就寝抵抗行为
积极就寝程序	父母为孩子制订规律的、安静的就寝常规活动，并严格遵守
渐变就寝时间	父母暂时推迟孩子的就寝时间，使其接近孩子实际入睡的时间

Interpretation of Clinical Practice Guidelines for Sleep Disorders in Children with Autism Spectrum Disorder

孤独症谱系障碍儿童睡眠障碍临床实践相关指南解读

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