The Study On The Sleep Characteristics In Children With Autism Spectrum Disorders And Case Intervention Of Repetitive Transcranial Magnetic Stimulation

ObjectiveThe prevalence of ASD is increasing,and it has become a serious public health problems in the world.The purpose is to know the characteristics of sleep disorders in children with ASD,and to explore the relationship between sleep disorders and behavioral problems.The rTMS is to evaluate whether sleep disorders and core symptoms of ASD are improved.Providing a new entry point for the intervention and rehabilitation of children with ASD in China,which has practical significance.Methods1.The sleep disorders of 231 typically developing(TD)children from one kindergartens and 237 children with ASD from six special education institutions and the ASD children's community rehabilitation project in Tianjin which were investigated by using CSHQ with cross-sectional study.The CSHQ>41 points for sleep disorders.2.The sleep disorders and behavioral problems of 107 children with ASD from a special education school and the ASD children's community rehabilitation projects in Tianjin which were investigated by using CSHQ,self-injurious behavior questionnaire,SDQ,SCQ and RBQ-2 with the methods of cross-sectional study.3.The rTMS intervention was conducted in 5 children with ASD conforming to the inclusion criteria using Wuhan based on Reed CCY-I instrument.4.All data were input by EpiData 3.1 and analyzed by SPSS 20.0.Chosing analysis of variance,rank sum test,chi square test,pearson correlation,multiple linear regression analysis and logistic regression analysis.The test level is ?=0.05.Results1.The score of CSHQ and detection rate of sleep disorder in ASD(75.9%)were higher than TD children(49.4%)(P<0.05).The score and detection rate of bedtime resistance,sleep anxiety,irregular sleep duration and sleep onset delay were higher than TD.Stratified with gender and age,ASD were higher than TD(P<0.05).The ASD had longer sleep latency than TD,and detection rate of sleep onset delay in ASD with sleep disorders was higher than TD(P<0.05).2.The score of SDQ,emotional symptoms,SCQ,social interaction,communication and repeated stereotyped behavior patterns,RBQ-2,repetitive activity,narrow interest and abnormal sensation were higher than normal(P<0.05).There was a positive correlation between CSHQ and SDQ,self injurious behavior,hyperactivity,emotional symptoms,SCQ,social interaction,communication,repetitive behavior,RBQ-2,repetitive activities,narrow interests and abnormal sensation(P<0.05).Emotional problems,social disorders and repetitive activities had predictive effects on sleep disorders(P<0.05).Emotional symptoms and repeated stereotypes were risk factors for sleep onset delay in children with ASD(P<0.05).3.Compared with 1 of the course of treatment,the length of sleep was longer and the duration of sleep latency was shorter in ASDC3 and ASDC4 when 2 of the course of treatment(P<0.05).The score of CSHQ and behavior problems were reduced in 5 cases at the end of the intervention,and there are 3 cases of CSHQ<41.Conclusion1.The sleep disorders of 3-6 year old in children with ASD and TD were not optimistic.The ASD was more serious and showed longer sleep latency than TD.2.There was a positive correlation between sleep disorders and self injurious behavior,emotional problems,social and repetitive stereotyped behavior in ASD.Emotional problems,social and repetitive activities had predictive effects on sleep disorders,and emotional symptoms and repeated stereotypes were risk factors for sleep onset delay in ASD.In the future,the improvement of sleep disorders in children with ASD can be considered from emotional symptoms.3.The rTMS intervention improved sleep disorders in children with ASD,at the same time,the behavioral problems had also improved.Future studies can intervene the ASD with sleep intervention as a breakthrough point.