台北市某區域教學醫院健兒門診兩歲以下嬰幼兒睡眠障礙統計分析

背景：在成人臨床研究中證實，睡眠障礙問題會影響睡眠時間及品質，與一些慢性病的形成有密切的關聯性；而與睡眠習慣及行為形成最重要的嬰幼兒時期，尚無國內的研究，因此本研究之目的是要了解國內嬰幼兒的睡眠問題相關因子。對象：台北市某區域教學醫院小兒科健兒門診2歲以下嬰幼兒，以其照護者為受訪對象，收集2歲以下嬰幼兒睡眠狀況及問題症狀的問卷，而問卷填寫方式以照顧者直接填寫或以訪談人員口述兩方式記錄。研究方法：綜合國外成人睡眠障礙問題與美國兒童睡眠障礙問題的研究項目，設計一套適合國內嬰幼兒評估表，以瞭解目前國內的嬰幼兒睡眠問題的相關因素。以嬰幼兒性別、出生體重、懷孕週數、懷孕胎數、產前檢查、雙親教育程度、雙親婚姻狀態、睡眠環境、異位性皮膚炎等九個嬰幼兒本身狀況進行分析，並與15項睡眠問題觀察( 睡覺時呼吸困難、睡覺時呼吸停止、睡覺時打鼾、睡不安穩、睡覺時流汗、白天不睡覺、食慾不好、夢饜、睡覺時尖叫、睡覺時踢腳、半夜醒來、醒來後離開床不睡自己的床、該睡覺時間拒絕上床、磨牙) 予以統計分析。結果：本研究共收納685名嬰幼兒問卷，納入分析之問卷數是605份，國內嬰幼兒常見的睡眠問題包括踢腳75%、半夜醒來75%、睡不安穩50%、睡覺時流汗50%、打鼾35%。在統計資料得知，女嬰睡眠時間長於男嬰，而出生體重、懷孕週數、懷孕胎數、產前檢查、雙親教育程度、婚姻狀態及患有異位性皮膚炎都會對睡眠障礙造成一些影響；而在睡覺的外在環境的因素中，在男、女嬰幼兒睡眠問題中，以不願意睡自己的床這一項最具統計差異。結論：研究結果顯示，在懷孕週數、產前檢查及父母教育、婚姻與2歲以下嬰幼兒睡眠品質沒有明顯相關性，但性別、出生體重與外在環境對嬰幼兒的睡眠品質具有明顯統計相關性，值得進一步研究，以了解並改善外在環境增進改善嬰幼兒睡眠品質及健康。 Key ward：「嬰幼兒睡眠障礙問題」、「性別」、「出生時體重」、「懷孕週數及胎數」、「父母親教育及婚姻」、「睡覺環境」、「異性性皮膚炎」。

關鍵字

嬰幼兒睡眠障礙問題；性別；出生時體重；懷孕週數及胎數；父母親教育及婚姻；睡覺環境；異性性皮膚炎

並列摘要

Abstract Background: In recent years, clinical studies of adults have revealed that sleeping disorders affect sleep duration and quality, which are closely related to the causes of certain chronic diseases. Sleep habits and behavior are the most important during early childhood. Currently, no research in this area has been carried out in Taiwan; therefore, this study aims to explore the factors related to sleep-related problems in young children in Taiwan. Subjects: Young children aged up to two years old from the pediatric clinics at Taipei regional teaching hospitals were the subjects. The carers were interviewed to collect data from questionnaires about problems and symptoms of young children. The questionnaires were filled in by the carers directly or from oral reports of the interviewers. Methods: An evaluation form was designed that was appropriate for young Taiwanese children by referencing the research items relating to sleep disorders in overseas adults and American children. The form helped us to understand the factors that currently cause sleep problems in young Taiwanese children. The data were analyzed using 9 characteristics of young children, including gender, birth weight, duration of pregnancy, number of pregnancies, pregnancy examination, the parents’ education level, the parents’ marital status, the sleeping environment, and atopic dermatitis. Also, 15 observations related to sleep problems (breathing difficulty when asleep, breathing disruption when asleep, snoring, unstable sleep, sweating when asleep, sleeping difficulty in the daytime, poor appetite, nightmares, screaming when asleep, kicking when asleep, waking in the middle of the night, waking from sleep and refusing to sleep in one’s own bed, refusing to go to sleep at bedtime, and grinding one’s teeth while asleep) were used for the statistical analysis. Results: This study collected 685 questionnaires from young children, and 605 were used for the analysis. The most common sleep problems among young children in Taiwan include: 75% kicking, 75% waking in the middle of the night, 50% unstable sleeping, 50% sweating while asleep, and 35% snoring. The statistical data showed that female babies sleep for longer than male babies; no significant effect on sleep was found related to birth weight, duration of pregnancy, number of pregnancies, pregnancy examination, the parents’ education level, the parents’ marital status and atopic dermatitis. Among the factors related to the external sleeping environment of young children, the most statistically significant outcome was found in relation to the event of refusing to sleep in one’s own bed. Conclusion: The results show that the duration of pregnancy (weeks), pregnancy examination, the parents’ education level and marital status were not significantly related to the sleep quality of young children. However, statistically significant effects were found on the sleep quality for the factors related to the gender, the birth weight, and the external environment in young children, which would be worth studying to improve the external environment and thus their sleep quality and health. Keywords: “young children’s sleep disorders”, “gender”, “duration and number of pregnancies”, “parent education and marital status”, “sleep environment”, “atopic dermatitis”

並列關鍵字

young children’s sleep disorders ； gender ； duration and number of pregnancies ； parent education and marital status ； sleep environment ； atopic dermatitis