了解ASD睡眠障碍的复杂性：从机制到管理
Understanding the Complexity of Sleep Disturbances in ASD: From Mechanisms to Management.
摘要(中文译文)
睡眠障碍是孤独症谱系障碍（ASD）儿童中最常见且具有重要临床意义的共病之一，影响约50%～80%的个体。临床上，这些障碍涵盖广泛的一系列疾病，包括失眠、异态睡眠、睡眠相关运动障碍和睡眠相关呼吸障碍，通常表现为入睡潜伏期延长、夜间频繁觉醒、总睡眠时间减少以及睡眠结构改变。昼夜节律失调、γ-氨基丁酸（GABA）和5-羟色胺等神经递质系统异常以及褪黑素信号传导改变已被反复证实与此相关。这些过程可能反映了影响生物钟调控和突触功能的潜在遗传和代谢因素。ASD睡眠障碍的管理需要采取综合性方法，结合行为策略、照护者教育和睡眠卫生干预，而当非药物措施不足时，可考虑药物治疗，尤其是褪黑素。理解ASD睡眠障碍背后的多因素机制对于改善早期识别和制定个体化治疗策略至关重要。本综述综合了当前关于ASD睡眠障碍的患病率、生物学机制、临床表现和管理方面的证据，为临床医生和研究人员提供整合性视角。
Abstract
Sleep disturbances represent one of the most frequent and clinically significant comorbidities in children with autism spectrum disorder (ASD), affecting approximately 50-80% of individuals. Clinically, these disturbances encompass a broad spectrum of disorders, including insomnia, parasomnias, sleep-related movement disorders, and sleep-related breathing disorders, commonly presenting with prolonged sleep latency, frequent nocturnal awakenings, reduced total sleep time, and alterations in sleep architecture. Circadian rhythm dysregulation, abnormalities in neurotransmitter systems such as GABA and serotonin, and altered melatonin signaling have been consistently implicated. These processes may reflect underlying genetic and metabolic influences affecting circadian clock regulation and synaptic function. The management of sleep disturbances in ASD requires a comprehensive approach combining behavioral strategies, caregiver education, and sleep hygiene interventions, while pharmacological options, particularly melatonin, may be considered when non-pharmacological measures are insufficient. Understanding the multifactorial mechanisms underlying sleep disturbances in ASD is essential for improving early recognition and developing individualized therapeutic strategies. This review synthesizes current evidence on the prevalence, biological mechanisms, clinical manifestations, and management of sleep disturbances in ASD, providing an integrated perspective for both clinicians and researchers.
如何引用
AMA
Adelina Glangher, Ina-Ofelia Focsa, Vanda Roxana Nimigean, Florentina Ionela Linca, Doina Ioana, Sorina Mihaela Papuc, et al. Understanding the Complexity of Sleep Disturbances in ASD: From Mechanisms to Management.. Diagnostics (Basel, Switzerland). 2026; doi:10.3390/diagnostics16111727.
APA
Adelina Glangher, Ina-Ofelia Focsa, Vanda Roxana Nimigean, Florentina Ionela Linca, Doina Ioana, Sorina Mihaela Papuc, et al (2026). Understanding the Complexity of Sleep Disturbances in ASD: From Mechanisms to Management.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics16111727
GB/T 7714
Adelina Glangher, Ina-Ofelia Focsa, Vanda Roxana Nimigean, Florentina Ionela Linca, Doina Ioana, Sorina Mihaela Papuc, et al. Understanding the Complexity of Sleep Disturbances in ASD: From Mechanisms to Management.[J]. Diagnostics (Basel, Switzerland), 2026 doi:10.3390/diagnostics16111727.
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