海原县6～12岁儿童睡眠障碍流行病学调查
【摘要】
目的：掌握海原县城乡6～12岁儿童睡眠障碍的流行病学特征，为有针对性地了解儿童睡眠障碍，制订相应的诊疗方案提供一定理论依据。
方法：采用多阶段整群随机抽样的方法在海原县城、海原新区、关桥乡、七营乡随机抽取4所小学1320名6～12岁小学生。应用儿童睡眠习惯调查问卷中文版（CSHQ），对其进行问卷调查。使用SPSS 19.0软件对数据进行统计分析。
结果：
1.海原地区不同年龄睡眠障碍情况
得分方面：低年级组与中年级组各维度及总分差异均无统计学意义（P>0.05）；在入睡潜伏期及睡眠呼吸障碍层面中，高年级组学生得分高于低年级组，其结果有统计学意义（P<0.05）；在睡眠呼吸障碍层面中，高年级组高于中年级组，结果有统计学意义（P<0.01）。
发生率方面：就寝习惯层面低年级组（49.82%）的发生率要高于中年级组（36.68%）及高年级组（32.18%），差异有统计学意义（P<0.0125）；在睡眠焦虑层面，低年级组（38.35%）发生率要高于中年级组（14.78%）及高年级组（16.83%），差异有统计学意义（P<0.0125）；在睡眠呼吸障碍层面中，高年级组的睡眠呼吸障碍发生率（27.48%）要高于中年级组（13.69%）及低年级组（11.47%），差异有统计学意义（P<0.0125）；在白天嗜睡层面，高年级组（13.86%）的发生率要高于中年级组（7.48%）及低年级组（5.01%），差异有统计学意义（P<0.0125）；睡眠障碍发生率低年级组（86.36%）要高于高年级组（73.85%），差异有统计学意义（P<0.0125）。其余各组发生率差异均无统计学意义。
2.海原地区不同性别睡眠障碍情况
得分方面：在入睡潜伏期层面，男性儿童的得分要低于女性儿童，其差异有统计学意义（P<0.05），其余各项均无显著性差异（P>0.05）。
发生率方面：男性睡眠障碍发生率在就寝习惯层面、入睡潜伏期层面、睡眠持续时间层面、睡眠呼吸障碍层面、白天嗜睡层面及总的发生率高于女性，其中仅有睡眠持续时间层面差异有统计学意义（P<0.01），其余各维度睡眠障碍发生率女性高于男性，但男女之间睡眠障碍发生率的差异并无统计学意义（P>0.05）。
3.海原地区城镇与乡村睡眠障碍情况
得分方面：在入睡潜伏期层面、夜醒层面、异态睡眠层面、睡眠呼吸障碍层面及总得分，城镇儿童的得分均低于乡村儿童，其差异有统计学意义（P<0.01），其余各维度，两地区儿童得分无明显差异（P>0.05）。
发生率方面：在入睡潜伏期层面，乡村儿童（37.18%）高于城镇儿童（26.52%），其差异具有统计学意义（P<0.01）；在睡眠持续时间层面，乡村儿童（42.31%）高于城镇儿童（14.39%），其差异具有统计学意义（P<0.01）；在夜醒层面，乡村儿童（21.79%）高于城镇儿童（8.33%），其差异具有统计学意义（P<0.01）；在异态睡眠层面，乡村儿童（35.90%）高于城镇儿童（15.91%），其差异具有统计学意义（P<0.01）；在睡眠呼吸障碍层面，乡村儿童（29.49%）高于城镇儿童（12.88%），其差异具有统计学意义（P<0.01）；总睡眠障碍，乡村儿童（89.74%）高于城镇儿童（76.52%），其差异具有统计学意义（P<0.01）；其余维度无统计学差异。
4.睡眠障碍组与非睡眠障碍组不同症状的发生率
睡眠障碍组与非睡眠障碍组在上课打瞌睡、注意力不集中、学习成绩下降及白天嗜睡方面，差异有统计学意义（P<0.05）；在食欲、白天精神状态、记忆力差、多动方面，差异无统计学意义（P>0.05）。
5.影响该地区儿童睡眠呼吸障碍的因素
近一年常发扁桃体炎及鼻炎是儿童睡眠呼吸障碍的危险因素，且差异有统计学意义（P<0.05，B>0、OR>1）。
6.海原地区家长对睡眠障碍认知度：该地区儿童家长在8个维度的主观评分均低于该儿童的客观得分，且差异均有统计学意义（P<0.01）。
结论：
1.海原城乡6～12岁儿童睡眠障碍发生率高，具有城乡差异，且随年龄的增长而降低，性别间发生率无差异。
2.海原城乡家长缺乏对儿童睡眠障碍的了解。
3.存在睡眠障碍的患儿会出现上课打瞌睡、学习成绩下降、注意力不集中、白天嗜睡的症状。
4.扁桃体炎及鼻炎是该地区儿童睡眠障碍的危险因素。
【关键词】儿童；睡眠障碍；睡眠呼吸障碍；流行病学调查(https://www.daowen.com)
The epidemiological survey of 6-12 years old children sleep disorders in Haiyuan
ABSTRACT
Objective：Master the epidemiological characteristics of Haiyuan county urban and rural children aged between 6 and 12 years of sleep disorder，is aimed at understanding of children with sleep disorder，formulate corresponding diagnosis and treatment to provide certain theoretical basis.
Methods：In Haiyuan County，Haiyuan area，GuanQiao xiang village，Qi Ying village by multi-stage cluster random sampling method randomly selected from 4 primary schools，including 6-12 years old students，a total of 1320.Using The Children’s Sleep Habits Questionnaire to carry out a questionnaire survey.Using SPSS19.0 software for statistical analysis of data.
Result：
1.Different age the prevalence of sleep disorders in Haiyuan area：
Score aspect：There was no significant statistical significance（P>0.05）in each dimension and total score of the lower grades and middle grades.In the sleep latency and sleep apnea level，high grade students scored higher than the low grade group，the result was statistically significant（P<0.05）.In the aspect of sleep disordered breathing in high grade group scored higher than in medium grade group，the results were statistically significant（P<0.01）.
Prevalence rate aspect：Sleeping habits level low grade group（49.82%）higher than medium grade group（36.68%）and high grade group（32.18%），the difference was statistically significant（P<0.0125）.In the sleep anxiety level，the incidence of the lower grade group（38.35%）was higher than that in the medium grade group（14.78%）and the higher grade group（16.83%），the difference was statistically significant（P<0.0125）.In the aspect of sleep apnea，the incidence of sleep disordered breathing in high grade group（27.48%）was higher than that medium grade group（13.69%）and low grade group（11.47%），the difference was statistically significant（P<0.0125）.In the daytime sleepiness level，the incidence of higher grade group（13.86%）was higher than that in the medium grade group（7.48%）and the lower grade group（5.01%），the difference was statistically significant（P<0.0125）.The incidence of sleep disorder was lower in grade group（86.36%）higher than in high grade group（73.85%），the difference was statistically significant（P<0.0125）.The incidence of the other groups were not statistically significant.
2.The prevalence of sleep disorder in different gender：
Score aspect：In the sleep latency level，the male children’s scores were lower than female children，the results were statistically significant（P<0.05），and the rest were no difference（P>0.05）.
Prevalence rate aspect：Boys Sleep Disorder incidence lasted in the level of sleep habits，sleep latency and sleep and time level，sleep disordered breathing level，daytime sleepiness level and total occurred than girls，which only sleep continued time level difference was statistically significant（P<0.01），while the rest of the dimension sleep disorder occurrence rate of girls was higher than boys，but men and women between sleep disorders occurred rate difference was not statistically significant（P>0.05）.
3.The urban and rural areas the prevalence of sleep disorders in Haiyuan：
Score aspect：In sleep latency level，night waking level，abnormal sleep level，sleep disordered breathing level，and the total score and scores of children in towns were lower than children in rural areas，the result is statistically significant（P<0.01），while the rest of the dimension，the two children score no significant difference（P>0.05）.
Prevalence rate aspect：The prevalence of sleep disorders，sleep latency in the level of rural children（37.18%）was higher than that of urban children（26.52%），the results were statistically significant（P<0.01）.In the duration of sleep level，children in rural areas（42.31%）was higher than that of urban children（14.39%），the results were statistically significant（P<0.01）.In the wake of the night，rural children（21.79%）were higher than those of urban children（8.33%），and the results were statistically significant（P<0.01）.At the level of abnormal sleep，rural children（35.90%）were higher than urban children（15.91%），and the results were statistically significant（P<0.01）.At the level of sleep disordered breathing，rural children（29.49%）were significantly higher than urban children（12.88%），and the results were statistically significant（P<0.01）.Total sleep disorder，rural children（89.74%）was higher than that of urban children（76.52%），and the results were statistically significant（P<0.01）；the other dimensions were not statistically different.
4.The incidence of different symptoms in patients with sleep disorder and non-sleep disorder：Sleep disorder and the non-sleep disorder group in doze off in class，inattention，poor academic performance and daytime sleepiness，the difference was statistically significant（P<0.05）.
On the mental state，poor memory，appetite，hyperactivity，there was no statistically significant difference（P>0.05）.
5.Nearly a year recurrent tonsillitis and children rhinitis is a risk factor for sleep apnea，with statistical significance（P<0.05，B>0，OR>1）.
6.Haiyuan parents awareness of sleep disorders：Children’s parents in the area of the 8 dimensions of subjective ratings were lower than the children’s objective score，and the results were statistically significant（P<0.01）.
Conclusion
1.The urban and rural children aged 6-12 the incidence of sleep disorder is high，With differences between urban and rural areas，and decreased with the increase of age，there was no difference between the sexes.
2.The parents of the children sleep disorders in urban and rural areas lack of understanding.
3.Children with sleep disorder have asleep in class，decline in academic performance and symptoms of daytime sleepiness.
4.Tonsillitis and rhinitis were risk factors of sleep disorders in children.
Key words：Children；Sleep disorder；Sleep disordered breathing；epidemiological investigation