본문 바로가기
KERD
논문KCI 등재후보

36개월 미만의 철결핍성 빈혈 환자들에서 수면장애에 대한 연구

Sleep Disturbances in Children Younger than 36 Months of Age with Iron Deficiency Anemia

이선경|김문규|조희승|채규영|김해정
대한소아신경학회 (the Korean Child Neurology Society)|2013.06|대한소아신경학회지 (Journal of the korean child neurology society)|제21권 제2호|pp. 59-67|DOI 10.26815/jkcns.2013.21.2.59

1

조회

0

다운로드

0

인용

0

참고문헌

주제분류신경과학

초록

목 적 : 철결핍성 빈혈과 수면 문제는 영유아기에 흔히 나타나며 인지, 운동, 정서 및 사회성 발달의 나쁜 예후와 연관되어 있다. 저자들은 한국의 36개월미만 영유아에서 철결핍성 빈혈과 수면 장애의 관계를 조사하였다. 방 법 : 2011년 3월부터 2012년 3월까지 본 병원 소아청소년과에 정기검진차 방문한 아동 중 총 196명을 대상으로 하였다. 보호자들이 영유아 수면 설문지에 답하도록 하였고 수면질환성 호흡이 의심되는 93명을 제외한 103명 중 혈액 검사 결과에 따라 철결핍성 빈혈군(n=23)과 정상대조군(n=80)으로 구분하였다. 양 군간 수면-각성주기 변수들(sleepwake parameters) 및 수면 장애의 유병률을 비교분석 하였고, 다변량 분석을 하여 아동의 수면 문제에 대한 독립적인 위험 인자를 알아보았다. 결 과 : 철결핍성 빈혈군에서 정상대조군에 비해 밤에 더 자주 깨고 수면 중 더 뒤척이며 자다가 깨어서 달래지지 않고 우는 증상을 더 많이 보였고 부적절한 수면개시 연관들 또한 많은 것으로 나타났다. 수면-각성 주기 변수들은 양 군간 큰 차이가 없었다. 아동의 철결핍성 빈혈과 임신 중 산모의 빈혈 여부가 영유아의 수면 장애에 대해 유의한 독립인자로나타났다. 결 론 : 영유아기의 철결핍성 빈혈을 예방하거나 조기에 발견 및 치료하는 것이 적절한 수면을 위하여 중요하다.

Abstract

Purpose : Iron deficiency anemia (IDA) and sleep problems are prevalent in infancy and early childhood and are more associated with poor cognitive, motor, and social-emotional development. The aim of this study was to access the relationship between IDA and sleep disorders in a population of Korean children <36 months. Methods : One hundred and ninety six children, who visited the outpatient clinic for a routine check-up were consecutively enrolled from March 2011 to March 2012. All parents answered a questionnaire about sleep patterns of their children using a modified expanded version of the Brief Infant Sleep Questionnaire. Among the subjects, 93 children with strong evidence of sleep disordered breathing were excluded. Hundred three children were then divided into the IDA group (n=23) and the control group (n=80). Sleep-wake parameters and prevalence of sleep disturbances were compared between the two groups. A multivariate analysis was performed to determine the independent risk factors for sleep disturbances in children. Results : Children with IDA had more frequent nocturnal waking, restless sleep, and inconsolable crying during sleep than those in the control. Children with IDA also had more inappropriate sleep onset associations. No difference in sleep-wake parameters was observed between the two groups. The presence of IDA in children and maternal anemia were significant independent risk factors for sleep disturbances in children <36 months. Conclusion : The results suggest that prevention, early detection, and treatment of IDA would be important for good sleep in young children <36 months.

참고문헌 (41)

  1. Stoltzfus RJ, "Iron-deficiency anemia: reexamining the nature and magnitude of the public health problem. Summary: implications for research and programs", J Nutr, 131, pp.697~700 (2001)
  2. Brotanek JM, "Iron deficiency, prolonged bottle-feeding, and racial", ethnic disparities in young children, 2005, pp.159, 1038~1042
  3. Lozoff B, "Long-lasting neural and behavioral effects of iron deficiency in infancy", Nutr Rev, 64, pp.34~43 (2006)
  4. Carter RC, "Iron deficiency anemia and cognitive function in infancy", Pediatrics, 126, pp.427~434 (2010)
  5. Lozoff B., "Iron deficiency and child development", Food Nutr Bull, 28, pp.560~571 (2007)
  6. McCann JC, "An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function", Am J Clin Nutr, 85, pp.931~945 (2007)
  7. O'Brien LM, "Neurocognitive dysfunction and sleep in children : from human to rodent", Pediatr Clin North Am, 51, pp.187~202 (2004)
  8. Peirano PD, "Sleep alterations and iron deficiency anemia in infancy", Sleep Med, 11, pp.637~642 (2010)
  9. Dahl RE, "The impact of inadequate sleep on children's daytime cognitive function", Semin Pediatr Neurol, 3, pp.44~50 (1996)
  10. Peirano PD, "Sleep and neurofunctions throughout child development: lasting effects of early iron deficiency", J Pediatr Gastroenterol Nutr, 48(Suppl 1), pp.8~15 (2009)
  11. Peirano PD, "Iron deficiency anemia in infancy is associated with altered temporal organization of sleep states in childhood", Pediatr Res, 62, pp.715~719 (2007)
  12. Mindell JA, "American Academy of Sleep M. Behavioral treatment of bedtime problems and night wakings in infants and young children", Sleep, 29, pp.1263~1276 (2006)
  13. Bayer JK, "Sleep problems in young infants and maternal mental and physical health", J Paediatr Child Health, 43, pp.66~73 (2007)
  14. Kordas K, "Maternal reports of sleep in 6-18 month-old infants from Nepal and Zanzibar : association with iron deficiency anemia and stunting", Early Hum Dev, 84, pp.389~398 (2008)
  15. Morris S, "Economic evaluation of strategies for managing crying and sleeping problems", Arch Dis Child, 84, pp.15~19 (2001)
  16. 윤정원, "Prevalence and risk factors for vitamin D deficiency in children with iron deficiency anemia", Korean Journal of Pediatrics, 55(6), pp.206~211 (2012), 대한소아과학회[DOI]
  17. Hiscock H, "Adverse associations of sleep problems in Australian preschoolers : national population study", Pediatrics, 119, pp.86~93 (2007)
  18. Quach J, "Outcomes of child sleep problems over the school-transition period : Australian population longitudinal study", Pediatrics, 123, pp.1287~1292 (2009)
  19. Meijer AM, "Time in bed, quality of sleep and school functioning of children", J Sleep Res, 9, pp.145~153 (2000)
  20. Sadeh A, "The effects of sleep restriction and extension on school-age children : what a difference an hour makes", Child Dev, 74, pp.444~455 (2003)
  21. Mindell JA, "A clinical guide to pediatric sleep : diagnosis and management of sleep problems", pp.2010, Wolters Kluwer Health
  22. Armstrong KL, "Sleep deprivation or postnatal depression in later infancy : separating the chicken from the egg", J Paediatr Child Health, 34, pp.260~262 (1998)
  23. World Health Organization. Dept. of Nutrition for Health and Development, "Iron deficiency anaemia : assessment, prevention and control : a guide for programme managers", World Health Organization, ~ (2001)
  24. Lozoff B, "Iron deficiency and brain development", Semin Pediatr Neurol, 13, pp.158~165 (2006)
  25. Angulo-Kinzler RM, "Spontaneous motor activity in human infants with iron-deficiency anemia", Early Hum Dev, 66, pp.67~79 (2002)
  26. Algarin C, "Iron deficiency anemia in infancy : long-lasting effects on auditory and visual system functioning", Pediatr Res, 53, pp.217~223 (2003)
  27. Peirano P, "Iron-deficiency anemia is associated with altered characteristics of sleep spindles in NREM sleep in infancy", Neurochem Res, 32, pp.1665~1672 (2007)
  28. Sun ER, "Iron and the restless legs syndrome", Sleep, 21, pp.371~377 (1998)
  29. Simakajornboon N, "Periodic limb movements in sleep and iron status in children", Sleep, 26, pp.735~738 (2003)
  30. Dzirasa K, "Dopaminergic control of sleep-wake states", J Neurosci, 26, pp.10577~10589 (2006)
  31. Fuller PM, "Neurobiology of the sleep-wake cycle: sleep architecture, circadian regulation, and regulatory feedback", J Biol Rhythms, 21, pp.482~493 (2006)
  32. Mindell JA, "A clinical guide to pediatric sleep : diagnosis and management of sleep problems" (2003), Lippincott Williams & Wilkins
  33. Beard JL, "Altered monamine metabolism in caudate-putamen of iron-deficient rats", Pharmacol Biochem Behav, 48, pp.621~624 (1994)
  34. Angulo-Kinzler RM, "Twenty-four-hour motor activity in human infants with and without iron deficiency anemia", Hum Dev, 70, pp.85~101 (2002)
  35. Sadeh A, "Sleep and sleep ecology in the first 3 years : a web-based study", J Sleep Res, 18, pp.60~73 (2009)
  36. Benhamou I, "Sleep disorders of early childhood : a review", J Psychiatry Relat Sci, 37, pp.190~196 (2000)
  37. Viteri FE, "Importance of pre-pregnancy and pregnancy iron status: can long-term weekly preventive iron and folic acid supplementation achieve desirable and safe status?", Nutr Rev, 63, pp.65~76 (2005)
  38. Idjradinata P, "Reversal of developmental delays in iron-deficient anaemic infants treated with iron", Lancet, 341, pp.1~4 (1993)
  39. Lozoff B, "Behavioral and developmental effects of preventing iron-deficiency anemia in healthy full-term infants", Pediatrics, 112, pp.846~854 (2003)
  40. Sadeh A., "A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample", Pediatrics, 113, pp.570~577 (2004)
  41. Mindell JA, "Efficacy of an internetbased intervention for infant and toddler sleep disturbances", Sleep, 34, pp.451~458 (2011)

관련 논문AI추천

한국인 소아에서의 하지 불안 증후군의 임상적 양상에 대한 연구권순학, 김세윤, 서혜은대한소아신경학회 · 대한소아신경학회지2011 · 제19권 제3호철 결핍 빈혈 영ㆍ유아의 수유 형태 및 이유 지식 평가강성길, 김부영, 김순기, 전용훈, 최은혜, 홍영진대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2009 · 제12권 제2호소아청소년의 새로운 일차성 수면장애로서의 불안수면장애김은희대한수면연구학회 · Journal of sleep medicine2023 · 제20권 제3호모유 수유아의 철 결핍과 조기 저용량 철분보충요법의 효과에 대한 연구김미정, 나보미, 노소정대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2008 · 제11권 제2호모유수유아에서의 철결핍 빈혈과 비타민 D 결핍김순기, 박지연, 유정순, 이유진, 장경자, 전용훈, 정수호, 최은혜대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2010 · 제13권 제2호소아의 수면이 성장에 미치는 영향김덕곤, 이진용, 최민형대한한방소아과학회 · 대한한방소아과학회지2012 · 제26권 제4호

이 간행물의 다른 논문 (4건)

우리나라 학생들에서 두통과 생활 습관과의 관계이건희, 심지윤, 은소희, 김원섭, 남상욱, 은백린, 노영일, 정희정, 김영옥pp. 39-45Clinical Presentations and the Bacterial Meningitis Score in Children with Cerebrospinal Fluid (CSF) Pleocytosis이준수, 강훈철, 김흥동, 이영목, 권혜은pp. 46-52소아 만성 매일 두통의 임상 양상과 예방 치료에 대한 반응임병찬, 황희, 김헌민, 김기중, 최지은, 이정호, 황용승, 채종희pp. 53-58A Case of Thyrotoxic Periodic Paralysis in 17-Year-Old Adolescent김선준, 조태희, 김순철pp. 68-72
원문 보기