标题：学龄前儿童睡眠问题对心理行为发育的影响及干预措施

      作者：曾宏 1，陈小燕 1，徐晓清 2    1.深圳市龙岗区坪地预防保健所，广东 深圳 518117；2.中国科学院大学深圳医院儿童保健科，广东 深圳 510170

      卷次： 2020年31卷4期

      【摘要】 目的 调查学龄前儿童睡眠问题对心理行为发育的影响，并探究有效的睡眠干预措施。方法 选择2018年6~11月深圳市龙岗区坪地预防保健所合作幼儿园的200名3~6岁学龄前儿童作为调查对象，采用儿童睡眠习惯问卷(CSHQ)、长处和困难问卷(SDQ)调查儿童睡眠问题。选择存在睡眠问题的36名学龄前儿童按照随机数表法分为实验组和对照组各18例，试验组实施儿童睡眠矫正干预，对照组不实施任何干预，持续6个月。采用比奈西蒙量表、韦氏儿童智力量表(WSIC-CR)、Luria成套神经心理测验以及伊利诺斯言语能力测验(ITPA)对两组儿童睡眠、智力、神经心理及言语能力状况进行评估分析。结果 (1)睡床方式：受试儿童合睡与分房睡发生率比较(84.50% vs 15.50%)差异有统计学意义(P<0.05)，同床睡与同房分睡、分房睡的发生率比较(64.00% vs 20.50%；64.00% vs 15.50%)差异均具有统计学意义(P<0.05)；Logistic回归分析结果显示，性别、年龄、独生子女、家庭经济情况、父母学历、养育方式和养育观念分歧是影响睡床方式的相关因素(P<0.05)。(2)睡眠模式：学龄前儿童平时全天、夜间、午睡午休睡眠时间与周末比较差异均有统计学意义(P<0.05)；Logistic回归分析结果显示，睡眠不足受独生子女、父母学历、家庭经济、睡眠环境等因素影响(P<0.05)。(3)睡眠问题：每日、平时及周末全天睡眠不足发生率比较差异均无统计学意义(P>0.05)；Logistic回归分析结果显示，性别、母亲学历、教养方式、养育观念分歧等因素对总体睡眠问题影响显著(P<0.05)。(4)睡眠干预效果：试验组儿童的CSHQ得分为(38.27±5.39)分，明显低于对照组的(48.29 ±6.43)分，SDQ困难得分总分为(9.27±4.11)分，明显低于对照组的(14.83±5.26)分，亲社会行为得分为(8.78±2.53)分，明显高于对照组的(5.25±2.42)分，差异均有统计学意义(P<0.05)；试验组儿童的比奈西蒙量表得分和言语智商(VIQ)、操作智商(PIQ)和总智商(FIQ)明显高于对照组[(38.24±1.08)分 vs (41.23±1.15)分；(83.25±27.67) 分 vs(95.12±27.93)分；(115.27±28.11)分 vs (143.13±25.67)分；(102.25±24.18)分 vs (128.12±24.31)分]，差异均有统计学意义(P<0.05)；试验组儿童的LNNB量表得分明显低于对照组[(241.28±12.39)分 vs (251.25±13.34)分]，ITPA得分为(123.27±14.16)分，明显高于对照组的(90.87±16.40)分，差异均有统计学意义(P<0.05)。结论 学龄前儿童睡床方式、睡眠模式和睡眠问题受到家庭以及环境等多种因素影响；睡眠问题与情绪行为问题关系显著；睡眠矫正干预能够通过家长教育的方式，家庭、学校和社会三位一体的密切合作综合干预，有助于儿童培养良好睡眠习惯，提高睡眠质量。
      【关键词】 学龄前儿童；睡眠问题；睡眠模式；睡床方式；情绪行为问题；行为干预
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2020）04—0470—06

Influence of sleep problems of preschool children on the development of psychological behavior and interventionmeasures.
ZENG Hong 1, CHEN Xiao-yan 1, XU Xiao-qing 2. 1. Pingdi Preventive Health Center of Longgang District,Shenzhen 518117, Guangdong, CHINA; 2. Department of Child Health Care, Shenzhen Hospital of Chinese Academy ofSciences, Shenzhen 510170, Guangdong, CHINA
【Abstract】 Objective To investigate the effect of sleep problems on preschool children on psychological andbehavioral development, and to explore the effective sleep interventions. Methods A total of 200 preschoolers aged3-6 years were selected from the cooperative kindergarten of Pingdi Preventive Health Center, Longgang District, Shen-zhen from June 2018 to November 2018. The children's sleep habits questionnaire (CSHQ), strengths and difficultiesquestionnaire (SDQ) were used to investigate children's sleep problem. Thirty-six preschool children with sleep prob-lems were selected and divided into the experiment group and the control group according to random number table meth-od, with 18 cases each group. The experiment group received children's sleep correction intervention, and the controlgroup did not perform any intervention for 6 months. The Benai Simon Scale, Webster's Intelligence Scale for Children(WSIC-CR), Luria Complete Neuropsychological Test, and Illinois Speech Ability Test (ITPA) were used to evaluate andanalyze the sleep, intelligence, neuropsychological, and speech ability of the two groups of children. Results (1) Bedmode: There was statistically significant difference between the incidence rate of sleeping in the same bed and sleepingin different rooms (84.50% vs 15.50%, P<0.05); there were statistically significant differences in the incidence rate of