CAJ | 학술논문

目的应用Actiwatch评估城市婴儿生后第一年夜晚睡眠-觉醒模式发展变化轨迹,为临床实施婴儿早期睡眠评估指导提供参考依据.方法选择北京市、西安市、青岛市、武汉市、长沙市、重庆市、湖州市、厦门市、柳州市9个城市的10家医疗保健机构为研究现场.调查时间为2009年10月7日至2011年10月30日.采用Actiwatch在家庭自然环境状态下前瞻性追踪婴儿0～12个月的夜晚睡眠-觉醒模式的发展轨迹,监测年龄点包括生后10 d、28 d各1次,第2～6个月每月1次,第9、12个月各1次,共9次.Actiwatch的监测观察时间为每次60 h.采用二水平随机效应模型对婴儿夜晚入睡能力、连续睡眠能力和睡眠效率等睡眠-觉醒模式核心参数的变化趋势进行统计描述.结果本研究共纳入473例健康足月婴儿,其中男246例(52.0％),女227例(48.0％).355例(75.1％)婴儿完成为期12个月的随访.随着年龄的增长,婴儿夜晚入睡潜伏期逐渐缩短,从生后10 d的平均66.8min减少为6～12月龄的15.5～18.7 min;夜晚连续睡眠能力增强,最长连续睡眠时间逐步延长,从最初的平均227.6 min延长至12月龄的350.9 min,相应的夜醒次数从每晚3.0次减少为1.6次;整个婴儿期夜晚睡眠效率从新生儿期的66.3％增长至12月龄86.3％.男童夜晚最长连续睡眠时间、睡眠效率平均较女童短19 min(266.6比285.6 min)、低2.2％(74.2％比76.4％),且随着年龄的增长男女童之间睡眠效率的差异呈缩小趋势.结论我国城市婴儿夜晚睡眠-觉醒模式在生后6个月内变化发展最为迅速,随年龄增长婴儿夜晚入睡能力和连续睡眠能力增强,睡眠效率提高.
목적 응용Actiwatch평고성시영인생후제일년야만수면-각성모식발전변화궤적,위림상실시영인조기수면평고지도제공삼고의거.방법 선택북경시、서안시、청도시、무한시、장사시、중경시、호주시、하문시、류주시9개성시적10가의료보건궤구위연구현장.조사시간위2009년10월7일지2011년10월30일.채용Actiwatch재가정자연배경상태하전첨성추종영인0～12개월적야만수면-각성모식적발전궤적,감측년령점포괄생후10 d、28 d각1차,제2～6개월매월1차,제9、12개월각1차,공9차.Actiwatch적감측관찰시간위매차60 h.채용이수평수궤효응모형대영인야만입수능력、련속수면능력화수면효솔등수면-각성모식핵심삼수적변화추세진행통계묘술.결과본연구공납입473례건강족월영인,기중남246례(52.0％),녀227례(48.0％).355례(75.1％)영인완성위기12개월적수방.수착년령적증장,영인야만입수잠복기축점축단,종생후10 d적평균66.8min감소위6～12월령적15.5～18.7 min;야만련속수면능력증강,최장련속수면시간축보연장,종최초적평균227.6 min연장지12월령적350.9 min,상응적야성차수종매만3.0차감소위1.6차;정개영인기야만수면효솔종신생인기적66.3％증장지12월령86.3％.남동야만최장련속수면시간、수면효솔평균교녀동단19 min(266.6비285.6 min)、저2.2％(74.2％비76.4％),차수착년령적증장남녀동지간수면효솔적차이정축소추세.결론 아국성시영인야만수면-각성모식재생후6개월내변화발전최위신속,수년령증장영인야만입수능력화련속수면능력증강,수면효솔제고.
Objective To understand the infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch,which would benefit the clinical assessment of infantile sleep.Method This study was a longitudinal study conducted between 7 Oct,2009-30 Oct,2011 in 10 hospitals of 9 cities of China (Beijing,Xi'an,Qingdao,Wuhan,Changsha,Chongqing,Huzhou,Xiamen and Liuzhou).Actiwatch was used to track the sleep-wake pattern development trajectory of healthy infants in the first year of life in the home setting.Participating infants were followed up at 10th day and 28th day during the first month,and then monthly from the second to the sixth month after birth,and then at ninth and twelve months of age respectively.Meanwhile,infantile sleep was observed continuously for about 60 hours at each visit.According to the characteristics of repeated measurement data of this study,two-level random effect model was adopted to analyze the trend of infantile nocturnal sleep-wake parameters changing with age,and the gender difference.Result A total of 473 healthy infants were included in this study,among whom 246 (52.0％) were boys,and 227 (48.0％) were girls;355 (75.1％) infants completed the whole year follow-up survey.With infants' age increasing,the latency of infants' nighttime sleep onset decreased from 66.8 minutes on 10th day to 15.5-18.7 minutes at 6-12 months of age.The number of night wakes also decreased with age,while uninterrupted sleep periods lengthened with age.On the 10th day,there were 3.0 times of nightwaking on average,and the longest continuous sleeping interval lasted for 227.6 minutes on average.At 12-month of age,infants could sleep continuously for 350.9 minutes at most on average,while the number of nightwaking decreased to 1.6 times per night on average.Generally,nighttime sleep efficiency increased from 66.3％ on the 10th day to 86.3％ at 12-month of age.The differences of sleep-wake patterns between boys and girls presented as boys' nocturnal longest uninterrupted sleep period was 19 minutes shorter (266.6 vs.285.6 min),and the average nighttime sleep efficiency was 2.2％ lower (74.2％ vs.76.4％)compared with girls respectively.And the differences of sleep efficiency between boys and girls reduced gradually along with the growth.Conclusion During the first 6 months after birth,infantile sleep-wake pattern undergo obvious change.The capability of sleep-onset and uninterrupted sleep improved with age,and the sleep efficiency increased.