Kronik Hastalığı Olan Çocuk ve Ergenlerde Uyku Sorunları
Özet
Bu makale, kronik hastalığı olan çocuk ve ergenlerde uyku sorunlarının yaygınlığını, nedenlerini ve etkilerini kapsamlı bir şekilde ele almaktadır. Kronik hastalıklar, çocuklarda fiziksel ve psikososyal gelişim zorluklarına yol açarken, uyku bozuklukları bu sürecin en kritik bileşenlerinden biri olarak öne çıkmaktadır. Çalışma; astım, Tip 1 Diyabet, epilepsi, kronik böbrek yetmezliği ve kanser gibi hastalıkların uyku mimarisini nasıl bozduğunu detaylandırmaktadır. Örneğin, astımlı çocuklarda gece öksürükleri uykuyu bölerken; diyabetli çocuklarda glukoz ölçümleri ve hipoglisemi riski uyku kalitesini düşürmektedir. Kanser hastalarında ise hem tedavi yan etkileri hem de merkezi sinir sistemi tümörleri aşırı uykululuğa veya insomniaya neden olabilmektedir. Makale, yetersiz uykunun bağışıklık sistemini zayıflattığını, bilişsel fonksiyonları gerilettiğini ve duygusal sorunları tetiklediğini vurgulamaktadır. Sonuç olarak, kronik hastalık takibinde BEARS ölçeği gibi araçlarla uyku değerlendirmesinin rutin hale getirilmesi ve tedavi planlarının çocuğun uyku hijyenini koruyacak şekilde optimize edilmesi gerektiği savunulmaktadır.
This article comprehensively examines the prevalence, causes, and effects of sleep problems in children and adolescents with chronic illnesses. Chronic diseases lead to physical and psychosocial developmental challenges in children, while sleep disorders emerge as one of the most critical components of this process. The study details how diseases such as asthma, Type 1 Diabetes, epilepsy, chronic kidney failure, and cancer disrupt sleep architecture. For instance, nocturnal coughing interrupts sleep in children with asthma, whereas glucose measurements and hypoglycemia risks reduce sleep quality in children with diabetes. In cancer patients, both treatment side effects and central nervous system tumors can cause excessive sleepiness or insomnia. The article emphasizes that inadequate sleep weakens the immune system, impairs cognitive functions, and triggers emotional problems. Consequently, it is argued that sleep assessment using tools such as the BEARS scale should be made routine in the follow-up of chronic diseases, and treatment plans should be optimized to protect the child's sleep hygiene.
Referanslar
WHOQOL GROUP. The World Health Organization Quality of Life Assessment (WHOQOL): Development and General Psychometric Properties. Social Science and Medicine 1998;46:1569–1585.
Çavuşoğlu H. Çocuk sağlığı hemşireliği Cilt I-II. Genişletilmiş 11. Baskı. Ankara: Sistem Ofset Basımevi, 2013.
Boekearts M, Roder I. Stress, coping and adjustment in children with a chronic disease: A review of the literature. Disabil Rehabil 1999;21:311-37.
Türkiye özürlüler araştırması. Ankara: Devlet İstatistik Enstitüsü Matbaası, 2004:51.
Hampel P, Rudolph H, Stachow R, et al. Coping among children and adolescents with chronic illness. Anxiety, Stress & Coping 2005;18:145-155.
Fettahoğlu EÇ, Koparan C, Özatalay E, Türkkahraman D. İnsüline bağımlı diabetes mellitus tanılı çocuk ve ergenlerde gözlenen ruhsal güçlükler. Psychiatry in Turkey 2007;9:32-6.
Öztürk Y, Akay A. Kronik pediatrik hastalıklar ve hastaneye yatış. Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kitabı s:594-604 Türkiye Çocuk ve Genç Psikiyatri Derneği Ankara 2016 s:594-604
Carno M, Hoffman LA, Carcillo JA ve ark. Develeopmental stages of sleep from birth to adolescence, common childhood sleep disorders:overview and nursing implications. Journal of Pediatric Nursing 2003;1:8274-8283
Pıçak R, İsmailoğulları S, Mazıcıoğlu M, ve ark. Birinci basamakta uyku bozukluklarına yaklaşım ve öneriler. Turkish Journal Of Family Medicine And Primary Care 2010; 4 (3):12-22.
Törüner EK, Büyükgönenç L. Çocuk Sağlığı Temel Hemşirelik Yaklaşımları. 1. Baskı. Ankara: Göktuğ Yayıncılık; 2012. p.40-45.
Davis KF, Parker KP, Montgomery GL. Sleep in infants and young children: part one: normal sleep. Journal Of Pediatric Health Care 2004;18(2):65-71.
Walker, MP, van der Helm E. Overnight therapy? The role of sleep in emotional brain processing. Psychological Bulletin 2009;135(5): 731-748.
Beebe DW. Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatric Clinics of North America2011; 58(3): 649-665.
Kılınçaslan A, Fiş NP. Çocuklarda Uyku ve Uyanıklık Bozuklukları Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kitabı Türkiye Çocuk ve Genç Psikiyatri Derneği Ankara 2016 s:418-441
Owens JA, Dalzell V Use of the ‘BEARS’ sleep screening tool in a pediatricc residents’ continuity clinic: a pilot study Sleep Medicine 2005;6:63-69
Fiş NP, Arman A, Ay P ve ark. Çocuk Uyku Alışkanlıkları Anketinin Türkçe geçerliliği ve güveniliriliği. Anadolu Psikiyatri Dergisi 2010;11:151-160
Ağargün MY, Kara H, Anlar O. Pittsburg Uyku Kalitesi İndeksinin geçerliliği ve güveniliriliği 1996;7:107-115
Başbakkal Z, Sönmez S, Celasin NŞ, ve ark. 3-6 Yaş grubu çocuğun akut bir hastalık nedeniyle hastaneye yatışa karşı davranışsal tepkilerinin belirlenmesi. Uluslararası İnsan Bilimleri Dergisi 2010 ; 7(1): 456-468.
Dodds D, Koch K, Buitrago-Mogollon T, et al. Successful Implementation of the Eat Sleep Console Model of Care for Infants With NAS in a Community Hospital. Hosp Pediatr. 2019 Aug;9(8):632-638. doi: 10.1542/hpeds.2019-0086.
Leong T, Roome K, Miller T, et al. Expansion of a multi-pronged safe sleep quality improvement initiative to three children's hospital campuses. Inj Epidemiol. 2020 Jun 12;7(Suppl 1):32. doi: 10.1186/s40621-020-00256-z.
Nunes MDR, Jacob E, Bomfim EO, et al. Fatigue and health related quality of life in children and adolescents with cancer. Eur J Oncol Nurs. 2017 Aug;29:39-46. doi: 10.1016/j.ejon.2017.05.001.
Ward TM, Rankin S, Lee KA. Caring for children with sleep problems. J Pediatr Nurs. 2007; 22(4):283-296
Labyak SE, Bourguignon C, Docherty S. Sleep quality in children with juvenile rheumatoid arthritis. Holist Nurs Pract. 2003; 17(4): 193– 200.
Davis ID, Greenbaum LA, Gipson D &et al. Prevalence of sleep disturbances in children and adolescents with chronic kidney disease. Pediatr Nephrol. 2011; DOI 10.1007/s00467-011-2010-y
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2017. Available from: www.ginasthma.org
Fitzpatrick MF, Engleman H, Whyte KF, et al. Morbidity in nocturnal asthma: sleep quality and daytime cognitive performance. Thorax 1991;46:569-73.
Diette GB, Markson L, Skinner EA, et al. Nocturnal asthma in children affects school attendance, school performance and parents’ work attendance. Arch Pediatr Adolesc Med 2000;154:923-8
Türkiye Ulusal Allerji ve Klinik İmmünoloji Derneği Allerjik Rinit Tanı ve Tedavi Rehberi 2012: http://www.aid.org.tr/aid/images/download_arsiv/rehberler/Allerjik_Rinit_Tani_ ve_Tedavi_Rehberi_2012.p
Vehik K, Hamman RF, Lezotte D, Norris JM, et al. Increasing incidence of type 1 diabetes in 0- to 17-year-old Colorado youth. Diabetes Care. 2007 Mar;30(3):503-9. doi: 10.2337/dc06-1837.
Monaghan MC, Hilliard ME, Cogen FR, et al. Nighttime caregiving behaviors among parents of young children with Type 1 diabetes: associations with illness characteristics and parent functioning. Fam Syst Health. 2009 Mar;27(1):28-38. doi: 10.1037/a0014770.
Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, et al. American Academy of Sleep Medicine. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006 Oct;29(10):1263-76.
Miller KM, Foster NC, Beck RW, et al. T1D Exchange Clinic Network. Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry. Diabetes Care. 2015 Jun;38(6):971-8. doi: 10.2337/dc15-0078..
Smaldone A, Ritholz MD. Perceptions of parenting children with type 1 diabetes diagnosed in early childhood. J Pediatr Health Care. 2011 Mar-Apr;25(2):87-95. doi: 10.1016/j.pedhc.2009.09.003.
Borel AL, Pepin JL, Nasse L. Short sleep duration measured by wrist actimetry is associated with deteriorated glycemic control in type 1 diabetes. Diabetes Care; 36(10): 2902-8, 2013.
Reutrakul S, Thakkinstian A, Anothaisintawee T. Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis. Sleep Med; 23: 26-45, 2016.
Perfect MM, Patel PG, Scott RE. Sleep, Glucose, and Daytime Functioning in Youth with Type 1 Diabetes. Sleep; 35(1): 81-8, 2012.
Jaser SS, Lord JH, Simmons JH, Malow BA. Brief report: Sleep disturbances in young children with type 1 diabetes. Diabetes Res Clin Pract. 2016 Oct;120:232-4. doi: 10.1016/j.diabres.2016.08.012.
Farabi SS, Carley DW, Quinn L. EEG power and glucose fluctuations are coupled during sleep in young adults with type 1 diabetes. Clin Neurophysiol; 127(8): 2739-2746, 2016.
Farabi SS. Type 1 Diabetes and Sleep, Diabetes Spectrum; 29(1): 10-13, 2016.
Surani S, Brito V, Surani A, Surani A. Effect of diabetes mellitus on sleep quality World J Diabetes; 6(6): 868-873, 2015.
Banarer S, Cryer PE. Sleep-related hypoglycemia-associated autonomic failure in type 1 diabetes reduced awakening from sleep during hypoglycemia. Diabetes; 52(5): 1195 –203, 2003.
Kothare SV, Kaleyias J. Sleep and epilepsy in children and adolescents. Sleep Med. 2010 Aug;11(7):674-85. doi: 10.1016/j.sleep.2010.01.012.
van Golde EG, Gutter T, de Weerd AW. Sleep disturbances in people with epilepsy: prevalence, impact and treatment. Sleep Med Rev 2011;15:357–68.
Stores G. Sleep disturbance in childhood epilepsy: clinical implications, assessment and treatment. Arch Dis Child 2013;98:548–51. 45. Derry CP, Duncan S. Sleep and epilepsy. Epilepsy Behav 2013;26:394–404. 46.
Reilly C, Kent E, Neville BGR. Review: psychopathology in childhood epilepsy. Child Adolesc Mental Health 2013;18:66–75.
Zambrelli E, Turner K, Vignoli A, et al. Sleep disturbances in Italian children and adolescents with epilepsy: A questionnaire study. Epilepsy Behav. 2020 May;106:107014. doi: 10.1016/j.yebeh.2020.107014.
Tsai SY, Lee WT, Jeng SF, Lee CC, Weng WC. Sleep and Behavior Problems in Children With Epilepsy. J Pediatr Health Care. 2019 Mar-Apr;33(2):138-145. doi: 10.1016/j.pedhc.2018.07.004.
Stabouli S, Papadimitriou E, Printza N, et al. Sleep disorders in pediatric chronic kidney disease patients. Pediatr Nephrol. 2016 Aug;31(8):1221-9. doi: 10.1007/s00467-015-3237-9.
Olson K. Sleep-related disturbances among adolescents with cancer: a systematic review. Sleep Med. 2014 May;15(5):496-501. doi: 10.1016/j.sleep.2014.01.006.
Rosen G, Brand SR. Sleep in children with cancer: case review of 70 children evaluated in a comprehensive pediatric sleep center. Support Care Cancer. 2011 Jul;19(7):985-94. doi: 10.1007/s00520-010-0921-y
