Cosleeping en consultation de pédopsychiatrie : spécificités sociodémographiques et cliniques

• Published in: Annales médico psychologiques Vol. 178; no. 4; pp. 378 - 383
• Main Authors: Taleb, Sana, Bourgou, Soumaya, Ben Mustapha, Hajer, Hamza, Meriem, Charfi, Fatma, Belhadj, Ahlem
• Format: Journal Article
• Language: French
• Published: Elsevier Masson SAS 01.04.2020
• Subjects: Anxiety; Anxiété; Child; Child psychiatry; Consultation; Enfant; Parent relationship child; Pédopsychiatrie; Relation parent-enfant; Sleep; Sleep disorder; Sommeil; Trouble du sommeil; Child psychiatry; Sleep disorder; Trouble du sommeil; Sommeil; Sleep; Enfant; Consultation; Pédopsychiatrie; Relation parent-enfant; Anxiété; Parent relationship child; Anxiety; Child
• ISSN: 0003-4487; 1769-6631
• DOI: 10.1016/j.amp.2019.04.012

L’objectif de notre étude était de déterminer les particularités sociodémographiques et cliniques des enfants et de leurs parents pratiquant un cosleeping au cours du sommeil. Il s’agit d’une étude prospective descriptive qui s’est déroulée dans un service universitaire de pédopsychiatrie à Tunis (Tunisie) de juillet à novembre 2017. Elle a porté sur tous les nouveaux consultants âgés entre 2 et 18 ans, qui (a) ou dont les parents ont rapporté l’existence d’un cosleeping. Les données sociodémographiques et cliniques ont été relevées à partir des dossiers. Le(s) parent(s) a (ont) répondu à un hétéro-questionnaire, étudiant les modalités du cosleeping. La population était constituée de 70 patients. La moyenne d’âge était de 6,82 ans. Le sex-ratio était de 1,69. Les enfants étaient des benjamins dans 49 % et des enfants uniques dans 14 %. Un antécédent somatique pathologique a été noté chez 37 enfants. Aucun antécédent médical n’a été noté chez la mère dans 74 % et chez le père dans 80 %. Le trouble du spectre de l’autisme et l’anxiété de séparation étaient les deux diagnostics les plus fréquemment répertoriés chez les patients. Le cosleeping consistait en un partage du même lit dans 87 % des cas. L’enfant dormait avec sa mère seule dans 63 % et avec ses deux parents dans 22 % des cas. Le cosleeping, en consultation de pédopsychiatrie, ne représente certes pas un trouble du sommeil, mais peut traduire une situation particulière nécessitant une exploration minutieuse. The aim of our study is to determine the socio-demographic and clinical characteristics of Tunisian children and parents who cosleep. A descriptive and prospective study was conducted between July and November 2017 in the Child Psychiatric Department at Mongi Slim Hospital (Tunisia). We included all new patients who, or whose parents, reported a cosleeping. Cosleeping was defined as the practice of parent and child sharing a sleeping surface that includes room-sharing or bed-sharing. Socio-demographic and clinical data were collected from medical files, namely: age, sex, somatic personal history, rank in the siblings, and the psychiatric diagnosis according to fifth edition of the Diagnostic and Statistical Manual of Mental Disorders criteria. Information on parents’ marital status, educational attainment and personal history were noted. An hetero-questionnaire for the parent(s) explored the modalities of cosleeping: the beginning of this practice, the place: bed or room, the person sharing the sleep, the existence or not of sleep disorders. In case of bed-sharing, physical proximity between parent and child has been classified, subjectively, as: absent, close and very close. So when the child slept holding the hand or any other part of his parent's body but not on the same pillow as him, the contact was considered close. Sleeping on the same pillow, or sleeping in his parent's arm was considered a very close contact. 70 patients were included. There were more boys (63%, n=44) than girls (37%, n=26). The prevalence of cosleeping was 17%. The median age was at 6, 82 years with extremes between 2 and 16 years. Benjamin were widely represented in our population (49%, n=34), while ten were the only child of their families. Thirty-seven of them have personal history of somatic disease. Autism Spectrum Disorder and Separation Anxiety Disorder were the two most common diagnoses respectively in fourteen cases and nine cases. Early mother-infant interactions were considered good in 37 mother-child dyads while they were limited to purely “mechanical” exchanges in the remaining 33. Sleep sharing existed since birth in 57% of cases. For the rest of the children (n=13), cosleeping started after a remarkable event (road accident, physical violence, separation of parents, parasomnias…) Psychiatric follow-up was reported in 16% of mothers and 7% of fathers. 46% of families have an average socio-economic level while 24% have a good socio-economic level and their children had their own bedrooms. Children shared their sleep with their mothers in 63%, and with their both parents in 21%. They shared only the room in 13% and shared bed in 87%. The child in half of the cases requested this practice. Physical contact while sleeping among those who shared the same bed was considered close in almost two-thirds of the cases. Nine mothers described a very close contact. A child nocturnal awakening was reported in 21% (n=15). The average of wake-up number was 2.2 times per night with extremes from one to seven. The search for contact was the pattern reported in six of the 15 children, three woke up for nightmares. The reason could not be specified in the remaining cases. Cosleeping isn’t a sleep disorder, it is rather a symptom that reflects a particular situation who needs to be explored especially when it persists beyond a certain age of the child.