自闭症谱系障碍儿童和青少年的睡眠障碍：临床特征、影响和干预的范围综述。

文献信息

中文摘要

综述目的： 自闭症谱系障碍（ASD）是一种神经发育状况，以社交沟通缺陷、受限重复行为和感觉异常为特征。据报道，睡眠障碍会显著恶化ASD的行为、认知和家庭功能。本范围综述旨在梳理关于ASD儿童睡眠障碍的临床特征、影响和干预措施的现有证据。
数据收集与分析： 根据PRISM-ScR指南进行了全面的文献综述，并在PubMed、开放获取期刊目录（DOAJ）、Cochrane、Scopus和Embase中进行了检索。使用“睡眠障碍”、“ASD”、“患病率”、“病因学”、“类型”和“干预”等术语的组合，识别了2015年至2025年8月31日发表的研究。符合条件的研究包括系统综述、荟萃分析、叙述性综述、随机对照试验、观察性研究和病例系列，这些研究发表在同行评审的英文期刊上，涉及ASD儿童和青少年。
结果： 所综述的文献表明，ASD中睡眠障碍的原因是多因素的，包括医学/精神科共病以及感觉敏感性和就寝抵抗等行为因素。常见的睡眠问题包括失眠、昼夜节律障碍、异态睡眠、睡眠呼吸障碍和睡眠相关运动障碍（SRMDs）。这些障碍会加剧ASD核心症状，损害适应功能，导致攻击行为，并增加父母压力。报告的干预措施包括照顾者教育、行为策略、药理学方法以及共病睡眠相关状况的管理。
结论： ASD儿童的睡眠障碍非常普遍、多面且具有临床意义。早期识别和基于证据的综合干预可能会改善睡眠质量、行为结果和整体家庭福祉。未来的研究应侧重于纵向设计和客观睡眠评估方法，以加强证据基础。

英文摘要

PURPOSE OF THE REVIEW: Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by social-communication deficits, restricted-repetitive behaviors, and sensory anomalies. Sleep disturbances are reported to significantly worsen behavioral, cognitive, and family functioning in ASD. This scoping review aims to map existing evidence on the clinical features, impact, and interventions for sleep disturbances in children with ASD.
COLLECTION AND ANALYSIS OF DATA: A comprehensive literature review was conducted in accordance with PRISM-ScR guidelines, and searches were performed in PubMed, Directory of Open Access Journals (DOAJ), Cochrane, Scopus, and Embase. Studies published from 2015 to August 31, 2025, were identified using combinations of the terms "Sleep disturbances," "ASD," "Prevalence," "Etiology," "Types," and "Intervention." Eligible studies included systematic reviews, meta-analyses, narrative reviews, randomized controlled trials, observational studies, and case series published in peer-reviewed English-language journals involving children and adolescents with ASD.
RESULTS: The reviewed literature indicates multifactorial causes for sleep disturbances in ASD, including medical/psychiatric comorbidities and behavioral factors like sensory sensitivities and bedtime resistance. Common sleep problems include insomnia, circadian rhythm disorders, parasomnias, sleep-disordered breathing, and sleep-related movement disorders (SRMDs). These disturbances exacerbate core ASD symptoms, impair adaptive functioning, contribute to aggression, and increase parental stress. Reported interventions include caregiver education, behavioral strategies, pharmacological approaches, and management of comorbid sleep-related conditions.
CONCLUSIONS: Sleep disturbances in children with ASD are highly prevalent, multifaceted, and clinically significant. Early identification and evidence-based, integrative interventions may improve sleep quality, behavioral outcomes, and overall family well-being. Future research should focus on longitudinal designs and objective sleep assessment methods to strengthen the evidence base.