全国多中心学龄前儿童睡眠问题与手部精细动作能力的相关性

Correlation between sleep problems and manual dexterity ability in a national multicenter study of preschool children

摘要

目的 分析学龄前儿童睡眠问题与手部精细动作能力的现状及两者之间的关联关系,为改善我国学龄前儿童睡眠问题并提高手部精细动作能力提供依据。方法 2023年4—7月及2024年1月间,以多阶段分层整群抽样法,按照全国四大经济区划(东部、中部、西部、东北部)选取代表性省份中等及以上经济水平的城市,分城镇和农村招募49家幼儿园(城镇幼儿园26家,农村幼儿园23家),按照性别、3岁组和4岁组各1∶1的比例,每个园儿童总数控制在25~30名,共招募在园儿童1 316名。采用儿童睡眠习惯问卷(CSHQ)获得儿童睡眠问题检出率,使用美国国立卫生研究院神经和行为功能评估工具箱(NIH Toolbox)中的九孔板(9-hole pegboard test)测量儿童手部精细动作能力。构建多元线性回归模型分析儿童睡眠问题与精细动作能力之间的关系。结果 共收集1 255名儿童(男童50.04%),平均年龄(4.10±0.45)岁。儿童睡眠习惯问卷平均得分(47.05±6.14)分,整体睡眠问题检出率78.6%。九孔板测试用时为(36.30±8.45)秒,达标率93.8%。在调整混杂因素后,CSHQ总分与九孔板用时无显著关联(P＞0.05),但入睡潜伏期、睡眠呼吸障碍得分每增加1分,九孔板耗时分别延长0.808秒(95%CI:0.203~1.413)和1.003秒(95%CI:0.183~1.822)(P＜0.05)。结论 学龄前儿童手部精细动作能力减弱与入睡潜伏期延长、存在睡眠呼吸障碍有关,提示在学龄前儿童睡眠问题的预防和干预中,应同时纳入手部精细动作能力的针对性训练,以提升干预策略的全面性和有效性。

Abstract

Objective To describe sleep problems and manual dexterity among preschool children, and to examine their correlation, so as to provide reference for improving preschool children's sleep problems and manual dexterity ability in China. Methods From April to July 2023 and in January 2024, a multistage stratified cluster sampling strategy was applied to select cities with medium or above economic level in representative provinces across four major economic regions in China (eastern, central, western and northeastern China).A total of 49 kindergartens were recruited, including 26 urban kindergartens and 23 rural kindergartens.Within each kindergarten, children were enrolled with a 1:1 allocation by sex and by age group (3-year-olds vs. 4-year-olds), with 25–30 children recruited per kindergarten, for a total of 1 316 participants.Children's Sleep Habits Questionnaire (CSHQ) was used to obtain the detection rate of children's sleep problems, and the 9-hole pegboard test in the National Institutes of Health Neurological and Behavioral Function Assessment Toolbox (NIH Toolbox) was used to measure children's manual dexterity ability.Multiple linear regression models were constructed to analyze the relationship between children's sleep problems and manual dexterity ability. Results A total of 1 255 children were included (50.04% were boys), with a mean age of (4.10±0.45) years.The mean CSHQ total score was 47.05±6.14, and the overall detection rate of sleep problems was 78.6%.The mean 9-hole pegboard completion time was (36.30±8.45) seconds, with a pass rate of 93.8%.After adjustment for confounders, the CSHQ total score was not significantly associated with 9-hole pegboard time (P＞0.05).For each 1-point increase in the sleep onset delay and sleep-disordered breathing domain scores, the 9-hole pegboard completion time increased by 0.808 s (95% CI: 0.203–1.413) and 1.003 s (95% CI: 0.183–1.822), respectively (P<0.05). Conclusions Reduced manual dexterity was associated with prolonged sleep latency and the presence of sleep-disordered breathing in preschool children, suggesting that targeted manual dexterity ability training should be integrated into sleep intervention and prevention to optimize strategy comprehensiveness and efficacy.

关键词

睡眠问题 / 精细动作 / 手部 / 学龄前儿童

Key words

sleep problem / manual dexterity / hand / preschool children

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基金资助

北京市卫生健康委员会北京医学研究院公共服务发展与改革试点项目(BMR2021-3);北京市卫生健康委员会公共卫生高层次人才培养项目(领军人才-02-07)(学科带头人-01-17)