SLEEP IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS

患有幼年类风湿性关节炎的儿童的睡眠

• 批准号: 6618644
• 负责人: CAROL A LANDIS
• 金额: $ 35.55万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6618644
• 关键词: actigraphy; anxiety; behavior test; behavioral /social science research tag; child (0-11); clinical research; emotions; human subject; inflammation; juvenile rheumatoid arthritis; neuropsychology; pain; polysomnography; questionnaires; remission /regression; sleep disorders; wakefulness

DESCRIPTION (provided by applicant): Approximately 285,000 of America's children have been diagnosed with arthritis, and juvenile rheumatoid arthritis (JRA) is the most prevalent form. Children with JRA, regardless of disease severity, report poor sleep quality, excessive daytime sleepiness, anxiety, and altered mood. Adequate sleep is essential for health and normal growth and development in children. Insufficient sleep in healthy children has been associated with hyperactivity, decreased attention span, distractibility, impulsivity, excessive daytime sleepiness, poor neurobehavioral performance, decrements in school performance, and increased school absenteeism. Disturbed sleep in children with JRA is likely to have similar negative impact on the child's behavior, mood, school performance, ability to carry out daily physical and social activities, as well as disease symptom (pain, stiffness, fatigue) severity. Sleep quality may be an important predictor of symptom severity, school performance, and how well children with JRA adjust to living with this chronic illness. In our preliminary studies, we have begun to document the extent of disturbed sleep by self-report and behavioral and physiological indicators in a small sample of children with JRA. These data show for the first time that sleep is most disrupted during periods when inflammation and joint swelling are most acute, yet children complain of poor sleep quality and excessive daytime sleepiness even during periods of disease remission. The extent of disrupted sleep and its impact on daytime functioning has not been studied in children with JRA. The proposed study builds on our pilot studies findings and is unique in that it will use a within-subject, repeated-measures design to determine the extent of poor nighttime sleep and evaluate the impact of poor sleep on daytime sleepiness, neurobehavioral performance, academic performance, and emotional/affective indicators during both periods of arthritic flare and disease remission. The results of this study will provide key information about sleep quality and daytime functioning in children with JRA; thus setting directions for the development of clinical therapies to enhance sleep quality during periods of arthritic flare as well as disease remission as different treatment strategies likely will be required.

描述（由申请人提供）：大约285,000名美国儿童被诊断出患有关节炎，而少年类风湿关节炎（JRA）是最普遍的形式。患有JRA的儿童，无论疾病严重程度如何，都报告睡眠质量不佳，白天嗜睡，焦虑和情绪改变。足够的睡眠对于儿童的健康，正常的成长和发展至关重要。健康儿童的睡眠不足与多动症，注意力范围降低，干扰性，冲动性，白天过度嗜睡，神经行为的表现不佳，学校表现降低以及学校旷工的增加有关。患有JRA儿童的睡眠干扰可能会对孩子的行为，情绪，学校表现，进行日常身体和社交活动以及疾病症状（疼痛，僵硬，疲劳）严重程度产生类似的负面影响。睡眠质量可能是症状严重程度，学校表现以及JRA儿童适应这种慢性病的重要预测指标。在我们的初步研究中，我们已经开始记录一小部分JRA样本中的自我报告以及行为和生理指标的睡眠程度。这些数据表明，在炎症和关节肿胀最为严重的时期，睡眠首次受到干扰，但孩子们也抱怨睡眠质量差和白天过度嗜睡，即使在疾病缓解期间也是如此。在JRA儿童中，尚未研究睡眠中断及其对白天功能的影响的程度。拟议的研究以我们的试点研究发现为基础，并且是独一无二的，因为它将使用受试者内部的重复测量设计来确定夜间睡眠不佳的程度，并评估睡眠不良对白天嗜睡，神经行为的表现，学术表现以及情感/情感指标的影响，在关节炎和疾病的两种时期。这项研究的结果将提供有关JRA儿童的睡眠质量和白天功能的关键信息；因此，设定了开发临床疗法的发展方向，以提高关节炎时期的睡眠质量以及疾病缓解，因为可能需要不同的治疗策略。