癲癇兒童日間活動與睡眠型態相關性之探討

癲癇兒童普遍有睡眠障礙及身體活動程度較低的問題，其身體活動與睡眠皆與健康息息相關，研究發現無論是兒童、青少年或成年人，規律和適度身體活動都有助於睡眠的量和品質，但目前尚不清楚幼兒及學齡前期癲癇兒童身體活動與睡眠型態之關係，故本研究探討此族群身體活動與睡眠型態之相關，並將夜間睡眠光照環境納入考量，研究目的：（1）描述一歲半至六歲的癲癇兒童日間身體活動及日夜睡眠型態；（2）分析活動記錄器所測得一歲半至六歲的癲癇兒童日間身體活動之活動量計數；（3）探討一歲半至六歲的癲癇兒童日間身體活動及睡眠型態之關係。本橫斷性研究於北部某醫學中心兒童神經科門診收案，共有98位癲癇兒童完成配戴活動記錄器七日，其父母完成癲癇兒童基本健康資料表、兒童睡眠習慣問卷（Children’s Sleep Habits Questionnaire, CSHQ）及癲癇兒童睡眠活動日誌。研究結果發現癲癇兒童中高度身體活動時數為0.60±0.82小時，夜間睡眠環境共有51人（52.0%）開夜燈，夜間睡眠效率＞85%僅23人（23.5%），CSHQ總分（56.00±5.69）顯示有中度至重度的睡眠問題。相關性分析發現較多的中高度身體活動時數、百分比與較短的夜間睡眠時數（rp = -0.23，p < 0.05；rp = -0.21，p < 0.05）及較短的整日睡眠時數（rp = -0.23，p < 0.05；rp = -0.21，p < 0.05）相關。每日觀看電視、電腦或手機螢幕時間愈多與整日總身體活動量愈多（r = 0.50，p < 0.01）、夜間入睡時間愈晚（r = 0.23，p < 0.05）及日間起床時間愈晚（r =0.21，p < 0.05）相關。總結本研究結果顯示一歲半至六歲的癲癇兒童日間身體活動與睡眠型態具有相關性，期望研究結果能增進對癲癇兒童身體活動及睡眠型態的認識，以提供及改善未來癲癇兒童身體活動與睡眠指引介入措施之參考。

關鍵字

癲癇兒童；身體活動；睡眠型態

並列摘要

Sleep disturbances and lower physical activity levels are common among children with epilepsy. Both sleep and physical activity are closely related to health, and research has found that regular and moderate physical activity can improve the quantity and quality of sleep for children, adolescents, and adults. However, the links between the physical activity levels and sleep patterns of toddlers and preschool-age children with epilepsy are still unclear. For this reason, this study aimed to examine the correlation between physical activity levels and sleep patterns in this population. The amount of light in the nighttime sleep environment was also taken into consideration. The objectives of this study were as follows: (1) describe the daytime physical activity levels and sleep patterns of children with epilepsy between the ages of 18 months and 6 years, (2) analyze the daytime physical activity data obtained from actigraphs worn by children with epilepsy between the ages of 18 months and 6 years, and (3) examine the relationship between the daytime physical activity levels and sleep patterns of children with epilepsy between the ages of 18 months and 6 years. Participants for this cross-section study were recruited at a pediatric neurology clinic of a medical center in northern Taiwan. A total of 98 children with epilepsy wore an actigraph for 7 days, and their parents provided the children’s health information, completed the Children’s Sleep Habits Questionnaire (CSHQ) and a sleep diary. The results showed that the amounts of time spent by children with epilepsy on moderate-to-vigorous physical activities during the day was 0.60±0.82 hours. Among the participants, 51 children (52.0%) had nightlights, and only 23 children (23.5%) had a nighttime sleep efficiency greater than 85%. The overall CSHQ score (56.00±5.69) indicated moderate to severe sleep disturbances. Correlation analyses found that more hours and a higher percentage of time spent on moderate-to-vigorous physical activities were correlated with shorter nighttime sleep duration (rp = -0.23, p < 0.05；rp = -0.21, p < 0.05) and shorter total sleep duration (rp = -0.23, p < 0.05；rp = -0.21, p < 0.05). Correlation analyses also revealed that more daily screen time was correlated with higher daily total physical activity (r = 0.50, p < 0.01), later bedtime at night (r = 0.23, p < 0.05), and later wake-up time in the morning (r = 0.21, p < 0.05). Findings from our study are expected to improve the current understanding of the association between physical activity and sleep patterns in children with epilepsy, and to provide the basis to guide future interventions.