癲癇兒童日間活動與睡眠型態相關性之探討

Associations Between Daytime Physical Activity and Sleep Patterns in Children With Epilepsy

"背景：癲癇症是兒童最常見的慢性神經系統疾病之一，睡眠障礙易使癲癇發作機會增加，成人研究顯示適度身體活動有益睡眠，但目前不清楚幼兒及學齡前癲癇兒身體活動與睡眠型態之關係。目的：探討幼兒期及學齡前期癲癇兒身體活動與睡眠型態之相關性。方法：採橫斷式描述相關性設計，共98位1.5－6歲癲癇兒連續七日佩戴活動記錄器，其父母完成癲癇兒童基本健康資料表、兒童睡眠習慣問卷（Children’s Sleep Habits Questionnaire, CSHQ）及癲癇兒童睡眠活動日誌。結果：癲癇兒平均每日中高度身體活動時數為36.00±49.20分鐘，夜間睡眠效率＞85％僅23人（23.5％），CSHQ總分（56.00±5.69）顯示有中至重度睡眠問題。多元迴歸分析在控制干擾因子後，中高度身體活動時數、百分比與夜間睡眠效率呈顯著正相關（β＝.54, p＜.01；β＝.51, p＜.01）；與夜間睡眠時數呈顯著負相關（β＝-.55, p＜.01；β＝-.52, p＜.01）。結論／實務應用：依研究結果建議常規評估癲癇兒身體活動與睡眠，適度增加中高度身體活動進而提升睡眠效率及避免縮短夜間睡眠時數。"

Background: Epilepsy is one of the most common chronic neurological diseases in children. Sleep disorders tend to increase the risk of seizures, and research has found that moderate physical activity may improve the quantity and quality of sleep in adults. However, the link between physical activity level and sleep patterns in toddlers and preschool-age children with epilepsy remains unclear. Purpose: To explore the association between level of physical activity and sleep patterns in toddlers and preschool-age children with epilepsy. Methods: A cross-sectional, descriptive, correlational study was conducted. Ninety-eight children with epilepsy (1.5-6 years old) wore an actigraph for seven days. Additional data were collected using a health information datasheet, Children's Sleep Habits Questionnaire (CSHQ), and sleep diary, all of which were completed by the parents of each child. Results: The results showed that the mean amount of time spent in moderate-to-vigorous physical activity per day was 36.00 ± 49.20 minutes and that only 23 children (23.5%) had a nighttime sleep efficiency greater than 85%. The overall CSHQ score (56.00 ± 5.69) indicated the presence of moderate to severe sleep disturbances. Multiple regression analysis showed the hours and percentage of moderate-to-vigorous physical activity to be positively associated with night sleep efficiency (β = .54, p < .01; β = .51, p < .01) and negatively associated with nighttime sleep hours (β = -.55, p < .01; β = -.52, p < .01), even after controlling for potential confounders. Conclusions/ Implications for Practice: Based on the findings, the sleep patterns and physical activity of children with epilepsy should be regularly assessed. Furthermore, appropriately increasing the duration of moderate-to-vigorous physical activity may improve sleep efficiency and prevent reductions in the duration of night sleep.