- 3 :

* , .

" )" ( EEG
. REM ) NREM
, (.
NREM 4 :

:1 , ,

, ,
,
.30 : 5.

:2 ," : "

" K , ,
. 25 5 :.

:3+4 , ,SWS .

. 30-45 :.

:REM = , : ,

, . +
. 5 :.

: .

5 " , 100 -90
" 1/3. 1/3
.

" 2 :

= " "

. 24
, '.
* 2 ) + " ( 2
) (.
* .
* .

.1 " 30 10 , ,
.
.2
.
, ,') ,
, , , , ( .
.3 , ,
, .
' .
.4 + " .11

Bonnet : Sleep Deprivation 1

: .
.
.1 .
.
.2 ," ,
.

.3 , "
.
: , , .
.4 .
:
,
, , .
. ,
: .
: , , ,
. :

2 :
(1 : - " " "
: , , ,
. .

.
, .REM : REM
. , "
. : .
(2 " 2
:

. 5

, 5 .REM " "

REM REM " ,
REM 60 40
.

".

(3 6 5 .
,
.

 : , '
.
.
:
.
(4 ,
, , .?
" - : REM " ,
. .
:
.
(5 :
.
.1 " , .
.2 ,
"" ) ( .
.3 ,

, , ,
.
.4 .
.5 : ) "
( ) (.
.
* REM .
* ,
.
' .

. " ,
.
"" , .
,
.

 (6. :
. .
. ,
.
* " ) (.
. .
(7 ?

" ,

,
.

"

,
,
.

" : ,

.
"
"" " ".

. ,
." .

" " : .

2 .:
.1

) 2 10 (.

.2

, .

, .
.
.3

,
) .(3+4
.4

" " ".

.5

. ,
.

) : , (

.

)( ,

5 ") EEG : () EMG , ( ) EOG

( ." .
: .
.1 :
.
.2 .
.3 .

. ,

, .
.

"

" .

, "
.
: ,
,' , , .
.1 : .
.2 .
: ,
.

:3 '
: -.

2 " " -
. 11 , ) 12-48( ) (monitored "
" . -
; .85.3% , / 63

 34 ) 9-27( . ) (monitored "

4.45 )" 482( "
. , "
5 , ' ) .(P<0.0001
.
. '
79.4% ,91.2%.

/ ,
. 3 , 10% 30%
. )
.(settling problems
.
/ / .
.
.
. , .

.
, , , .
)( , .
, , . "
. " ,
) ( .
-
. ,
.
, 80% 90%
.
.
,
.
2 .
. '
" .
1

 11 . ) 7 4( , 12 48 10 .
/ . . 4
, . ,"
7 .
. -
. , , ) .
( ,
. .
" .rechtschaffen and kales" 1.2.3 ,4 " ." 0
. . " "
" ) ( 10 . 0
) ( . "
/ .
" .
./
" . , - 2 ) 2(
/ .

/ " /
. ,94.8% /
.
,85.3% 87.7%
76.9% . 75.7% .92.5%
. "" "" 14.9% 1
2% ,2 3 ,4 17.3% .REM ""
) ( 5.9% ) ??(
" .
2

2 . . 63 ) 37 36(
.
, 9-24 ) .(SD=4.3 ,14.6-
.
34 ) 18 16,( , 733
.
,/ , , . 11
27 ) 17.8 -.(SD=5.6 ,

 ) ( .
. 97 " " "
.
.

7 )=.(SD=2.9 ,4.4

.482
, ,
.

2 ,
.
.
) PSG( .
ASA . , )
( , ) "
( , - , 5 , " "
) ( , " " )
( , .
,
. covariate
) (.
. .
) 28.7% .(P<0.05 ;34.8%
" . , .
' . ,
' ' .
' ) 4.3 ,2.1; ,(F=44.9 ; P<0.0001
) 82.2 ,(90.9 ) 50.7 ,(59.4
) 61.4 (46.6 - ) 92.1 133.5( .
, .
." , 2
) n=62 ,n=26' ' ,
( .
, ' ' ,
. 0.38'
' 0.79 ' . '
. 2 . '
) r=0.75 (r=0.59 ' ) r=0.50 ,r=0.23 ( . ,
' ) r=0.58 .(r=0.03

 . .' ,
) r=0.39 ,r=-0.51(
.' .
) (r=-0.30 ) r=-0.06 ( .'
).(r=0.27
. ,
. " .
, 41% .
)-( ,
7% / . ,
91.2% ' 79.4% ' . ,
20.6% ' )( , 8.8%
' .

- "
. .
85.3% - PSG
80% 90% , .
- '
) ( ' .
.
, .'
' . ,
, - ,
. 50% 60%
.
) ( ," -.

.
"
. ' ,
.
, , - .
) ( . ,
.' , ,
. "
.

 .'
. .'
, , .
, ' , .
.
.
.

.

.

. )
( .
.

:4 /

:

. 59 ) 5.5( 4-5
" )( " .
.
, ,
. " 41%
.
:
.
. DSM-4 , 50
,
. :
, ,
. .
, .
, .
' . ,
, .


-
.
.

. ,
" , 30%-20% ,
) ( .
, .
, 84%
3 . 41% , 8
3 . , 26% 8
, .3
) (4-6 . ,
.
- . ,
, .
, .
) ( 14% .4-6 34% 4
,
" .4-5 , 22% 5 "
"/" , 1.4% "" .
) (
, .,
66% 5 30 , 33%
30.

2 :
.1 , .
, ,
.
, , "
? , ?
. ,
: 2 ,
" , 4 . 19%
5 . ,

 ) 24( . , " 5-7

, , 3 .

3 . ,
, , . 30
" ?
.2 ) ( .
" ) ( "
. ,
, ,
.
' " . :
- - , , -
. ,
," .
,
. - ) ( -
. , 24
- , )
( . , ,
, .
" " 18%
. " " .
.
' ,
" .
,
" .

" . ,
) (
)' (.

59 29 , 30 , . 3 . 3.8 6.1 )
,5.5 - (0.6- 2 - -
, ) ' -1' 30( .
. 15 )

 "( . :
) 70% 66% ,47% : .(91%
,
, .

, .
4-5 . ,
. ,
.

" " -IBM - .PC

- - "" -
.90%
: . . . . . )
( . . )(
. . - ..
5 -.
,
.
: . .
. . . ) ( . . .
. , 4' ) 0 ( ) 3( . . ,
4' ) 0 5'( ) 3 30'( . . , 3' 0
) ( ) 2 ( . . , 3' ) 0 ( ) 2
(. . .

,
. : .
" . . .
.1 : .2 .
.3 . .4 .
"".

, ,
" .
, .

 4 1' ) .32
(.
" ) ( ' , )4-5
( . : ' .
) 2' .(31 ,
) (0.7 .
4-5 .
) 3' .(31

" , .
.
. , .
.
.

" ,
. ) 4' (33
"" :
,0.87 .0.81 , t
23.7'
34.2' .
, ) r=0.45 , .(2
) (0.45
).(2.66
"
.
. ,
, , , .
' ; 86% .'
" 2 " .
: 2.6% . , '
- ' )
( . "
. .

: , ) (0.41
) .(0.43- .0.34

 ,
) (r=-0.28 , ,
.
, ;r=0.30
.
" "
" , " "
:
. ) 90% 10% , , .
. 3 ) 5'(.
, ,
) ( .
41% , 29% .90%
41% , "
".
- , "" .
2 "" .
41% , , 18.6%
. .3
, " 5
) ( . 19% , ) ( ,
.

" .
- - ,
. ,
- , ) (motility .
, )
(.
, .

) (0.70 ) ,' ,
( .
) 12-60( ) " ( .
) , ( ,0.70
. " ,
.
"

 ' . '
- - ,
.

,
. "
, . ,
" .

.
, )' , ( ,
. ' '
" - , ' .,
' " ,2.7 0.5 .
, .
, ' " 2
- .
,
" . )" (
, .
"
.
, .
. ,
, , 41%
.
.


. , ) ( , /
, , .
.
, )" ( ,
. " ,
.
".


. , . ,

 " ,
" , . ,
,
" .
, . ,
3 " .
, , ,3 ) 5'( .
, .
) 3 5' /
,(90% ,
) ( . , 41% ,
. :
" ,
' ?

' / ,
.
, ' . , ,
' .
, ,
" , .

" , ,

- . ,
, / ' . ,
, ,
.
' .
"
. ,
.30%-20% .
, ' ,
, . , ,
' ) 2.66
( . ' .
, , ,
, .
,
.
, .

 , . ",
18% "" . 2 " ,
"
.' ,
" .
. , 37%
" .
" ,
. , 19% ,
.
.5 , )" 3-8
( 14% .34% ,
, .

.
.
, , , ,
.
, )
( .
,
. , ,
- .
.
, .

,
. , .
, ,
.
,
.
:5
EVELYN B. THOMAN and CHIRSTINE ACEBO
, .
. ""
, , , .

 , , ,
,- , . ,
,
.
, , ,
. , , ,
. ,
, , .
, )( .
.
.
, . ,
,Polysomnography , actigraphic .
. ,
.
.
" " .
,Polysomnography - .
, EEG ,
. ,
,Polysomnography .

5 , , .
. " " .
, .
. . . REM .
, . REM
.
. ,
, ) \ ( . .
, . .
. REM.
. . , .
, , .
, . NREM ,
.

 . .- , .
. . , ,
, .
6 , ,
,NREM . ,
- . ,
, , .
.
.

, . ,
).(CNS
, , :
. , , .
, .
. , . ,
. . .
. , .
. .

, ,
. ,
. 6 \ :
, , , , ,
\.
.
.
, . ,,
. ) (REM
, .
,REM .
: , , ,
, ,
. , , ,
. , ,
, . ,

 , , .CNS - ,
REM ) ,(REM 6 ,
.
, .
, .
.
\ , 10 ,
) ( , 6 -
. , ) - (
, .
, , .
. -
, .
, .
, 4 ,
.
10 , , ,
- . .
. ,- 10
, REM , ,
. , 10 ,
.
, , , .
, .
.
, . ,
. , 27,
.
.
, 50% ) ( ,
28% 2% , - 4% , 1%- -
. 6 ,
. , - , 60 , 90
.
. ,
, , .
, , , . -
, , , ,
.

 .
, , ,
Thoman . 7
, 2 , 3.5 . -?
, ,
. , ,
.
, ,
. ,
.
.
, , .
,
. . -
) , ( , ,
,REM- , ,
. , .
, ! ,

.
.Polygraphic
, , EEG ,
, ,EEG,
, . ,polygrapgically
, .
, , ,
.
.
,Anders, Emde and Parmelee ,1971 , "-
, , " ,
, polygraph
. , .
.
,
, , . ,
,

 .32-34c , " " ,

, ""

. ,
24.
,
.
.22-30c - - -
.polygraph
polygragh ,
. , , ,
. '
. , ,collodion
. , ,
11- . .mm/second 10
, .30mm/second 3.0
.
polygraphic , , ,
) ,([electro-oculogram [EOG ) ,(EEG ) (EMG )
.([electrocardiogram [ECG
. "
,polygraphic" ,
, ) (.
,polygraph - ,
.
. , ,
; ; ; plethysmography
; ;
, .
.
,- , - Dreyfus-Brisac .
, , .
. , )(
, . ) ,(Mastoid
, , .
REM .
, ) ( , .

 , - Mechanogram ,
.
EOG- , REM ,
REM . , ) 20-30 ,(
REM REM .
. :EEG -
) ,(C3-O1 ) .(C3-A1 ,
.
32- , EEG- ,
. EEG - . 32
, EEG- ) ( ,
) ( . ,
. , .
, .
: )
; (LVI ;) (TA ;) (HVS ) .(M 38
) ( .
EEG )( .
- ,
. , 2 NREM ,
4 8 . EEG
NREM K-complexes 2 , 6.
, 3-4 ,NREM
, , .
,EEG - .
- ) ( , 4
. . , EEG
.
. - ,
.
- , .
EMG-
. ,
.
, - ,-
- , .
.

 . EEG- , ,
, .
.
.
, polygraphic .
polygraphic ,
- ,polygraphic .
, ,
.
,
, ,
, .
REM . : , ,
REM , ) ,(SEMs , . EOG -
REM . EEG- LVI, M ) HVS LVI
( EMG . .
. , .
EEG- ) HVS, TA, M , TA ( . , EOG -
REM EMG-.
. .
, .
,polysomographic - ,
.
) , , ( ,
. , , polygraphic -
.
3-4 , EEG-
. . NREM
) (3-4 2 ,1
.
- , 20-30 ,
, , 15 . " ,
" . ,
. , , , , .
. -
,- 1 . ,
- Prechtl and O'Brien . 3.

.
, .
, ,
, , ,
\ , .
.
) power-spectral ( EEG- ,Fourier
EEG- .
.
Stefanski , ) ,(87.4% EEG
, 36- ) ( . ,
EPG- .REM
Hoppenbrouwers , , , 12 ,
2 6 . 80% ,
, , 20% ,
. .
) ( ,
.
.
. -
,polysomnographic , , - ,
. EEG polygraphic
, , .
Anders , polygraphic

, , , .
,Lombroso and Matsumiyava EEG, EMG ,EOG-
, Thoman ,- ,
, , . ,
, REM ,NREM polygraphic
.
6 , , ,
. .
polygraphic
, , .
. , ,

 ) , ( . , 2-6,
24 Kahn , " ,
."EMG
, . ,
. .
.

.
Anders ,
.
.
,
. ,
. , . -
, . ,
, - . ,
, .
, . , ,REM
" " )" .(Keystone Cops" effect
, .
5 ) ( , .
.
. ,
.
Anders 12:1 18:1 14-16 .
, 60:1 24 5) . = 5
( . ,
.
.
,
. , : , , ,
Anders , , .
) ,(LSP , . LSP - 4
, 7 5 ,
.

 LSP- 5:00
"" . 46% - 89%- 9
, 69%- 9 .
, Anders ,
. , .
, . Anders ,
. .(Anders (1985

Anders and Sostek 2-8 ,-
.polygraphic - Thoman , , -
. .

. ,
, . ,
, .
, ,
, ) ( , ,
.
, . Anders
and Sostek 2-8 . , ,
, ,
. , 3-6 , ,
- . , - ,
.
, ,
. , . ,
, .
\ Actigraphic-
,
wistogram- . actigraph- Sadeh -
- . - , 2-
,ounces .
. , . ,
, , .
Sadeh , , 1 ,-
. , .

 polysomnographic , 90%-80% 9 .
, .
) ,(83%-55% 3
) (92%-78% 6 ) .(98%-66%
3 . ,
.
Actigraph- - , ,
. , ,.
.Actigraph-
,
. , Actigraph - . ,
: , .
.
actigraph ,polysomnographic actigraph -
. ,
. ,
, . - ,
.
, actigraph - ,
. , . ,
.
, , .
,
. , , ,
, .

) ,(HMS , ,
. X 24 12 ,X 24 24 .
. .
24 60 . ,
.
, ,actigraph -
, . ,
.
. 6-1 4 . ,
; , ;
) ( , .

 , ) (samples/sec 10 .
, , , 30 , ,
, - , , ..
- .
. ) ( .

, , .
, ;
, , . , ,
,
.
) -( . , , ,
. 6-1 -,
.
.HMS-
,HMS- : ,
, , - , , ,
,
. , . ,
6 . 5 , ,
.
.
. ,
. , , .
, ; ,
; , ,actigraph
.
, , , ;
,polysomnographic - ,(NREM (1-4
; ,
, ; ,actigraph -
, , . HMS -
, ,actigraph-
. , , .
, . ,
, , .

 : ?
, : )
( , 7 -; polysomnographic , , , 12 -
; 16- ; ) ,(HMS-
24- ) ( ; actigraph - 8- )
(.
, ,actigraph- . ,
, , .
.
, ,
. , ) ,(HMS
. ,
, .polysomnographic ,
) ( ,
.

2


/ 16-17 ) (
13 :
,
.
* .
) (
/ 5-6 , .
3 . 6
9.
, 2 ) +(.
.
) (
* . ( (REM.
* REM .
* 60.
3 * - 4 .NREM

* REM.

.1 .
.
.
.
.2 :
.

6


. ,
. Aserinsky and kleitman / )
(REM . .
Kleitman / , ).(BRAC
)
(CNS . .1 :
.2
,
.
.
,
)( .
) 9( : )(EEG
, ,EMG , , / .
, .
.
,
. /
).( SIDS


Prechtl and Beintema
.
Parmelee and Coworkers .
8 .
.1 :

)REM ( .2

.3 . 400 -
, :

EMG EEG -

.1
,
.
3 .
.
.
, /
. , REM REM , .
10 ,
) 10-( ./
. , SWS -
/ . , .
,
) ( . 2 -
, ,
.Emde and Walker /
5% - 10% .
Bowe and Anders .
9 .
, ,
. Bowe and Anders good sleeper - poor sleeper - -
good sleeper poor sleeper .
)( 30 15
9 Anders and Keener .
. 44% 78% -
9 . ,
, ,
.

 / . , REM
. , ) ( -
.REM
: ???rem
.
60% - 3 90% - 6 .
.
6 - Roffwarg . 30%-
20%- ???rem 6 5- .
. 4 NREM 2 5- 14%-
18%- . 3 4-
NREM / .
) 3 4- NREM 24(
. 2 5- 35-
. , 3 " REM-
.

.
36 ,
-
. )( ,
, .
.
.
,
, 3 .
.
)( / .
)( )(
/ Prechtl .
/ )
( . .
.
)( . , ,
/ 3-.
.
, , ,

 . /

.
. -
.

:7 6
Susan Coons
(REM (rapid eye-movment ,,(NREM ( non rapid eye movment-
24 , 6 ,
) .(1,2 )( ,
, . ,
REM 24 . NREM
,1,2,3,4 , - 24
. , , , ,
, .

, 30 , 3 6 ,
24 , . 24 .
25 . . 3 )
n=10), 6 ) n=10), 3 ) n=9), 4.5 ) ,(n= 10 6- ) .(n=9electroencephalogram-
,((EEG; C3/A2, C4/A1), electrooculogram (EOG), electromyogram (EMG ,(electrocardiogram (ECG-
. - ,
. .Grass model 7 3 6- ,
30 , . 3
, ,NREM EEG-
. , .
NREM , .2
3 4- , 20%- , 30 .
NREM , 2 20% - 30 .
"" ) ,(epoch
) .(1,2, 10 , ,REM ,
REM- 10- , .90% ,
, , ' . ,
- , .
" " ) (orderd stage "" ,
, , . ,

 , . ,
, . -
, . ,
.
, , 30 , ,PDP 11/34 -
, . 24 ,
, . ,
, : , , 24 .

, 2/3 24 . 6 ,
. , 24 , ,REM
, . NREM ,
, 24 , , .
NREM , REM .1
REM - , 24 .
, , . 5% - , 3 , 2%
6 , 3.1% 3 0.3% - 6.

, , , 24
, . 3 , , , 211.7
23.2% . 6 , , , 358
48% . 3 6- , 6 3- ,
. 3 128 24%
. 6 3- 4.5 -
6.

6 , , , 24
) 8 8( . 6 , , . 3
, . \ ,
6 , , 3 , ,
. 4.5 ) 8 (.
, . 6 ,
) 8(.

. , REM
. 10 24 , 3 , 6.4

 .REM 6 REM 0.6- 3

. , REM 3
6- 4.5 6- . ,
, REM 3-6 6- . , 3,4.5 -
, , ,20% - .REM
REM
3 , ,2 REM 24 .
. , .REM
, ,REM , . , REM
.
NREM
,NREM 2, 3-4 , 3 , , -0%
40% , .2 , ,2 6
, ,2 MREM- ,35.6% .
) .(3
,3-6 3-4 , . 3 , ,3-4
,NREM 2
. 4.5-6 , 3-4 ,2 NREM , .
3-4 ,NREM , 3
.

, , ,
. ,
REM ,NREM , .
, REM NREM- ,
. , .
REM NREM- , NREM
.REM 24 , ,
. , .
. 3-6 ,
4.5-6 , , . ,
- , .

, . ,
. ,

 .
, .
, , REM 2 .NREM 2
,2 3 , .
REM , , 70%-.86%-
, REM , 70%- ,50%- ,
1 .NREM 3 , ,REM
REM . 2 NREM 65%- .81%- ,
NREM 1 ,3-4- 3 . 3-6 ,
.

, 3-6 , .
, REM , .
REM .hypercapnic
) ,(apnea
.
, ,
\ .
, REM NREM-
. , .NREM
8 , REM/NREM
3 . , \ ,
3.
REM REM . -
REM , , REM ,REM
.
3-6 , REM ,REM- . 4.5-
,6 REM - REM .
REM - , .
,REM ,3-4.5
.REM
,REM ,
. REM ,
. . ,
.
EEG- ,NREM- , "
" ) (""trace alternate ,

 , 8-12 . ,EEG- .
, NREM . 3-4 ,2
. ,
. REM/NREM , NREM
REM . 90-
REM . , ,
. , ,REM , 3.
, , 58 , 4.
- REM NREM
. ,
. , 4.5 ,
. ,
. , , , 24 , .
, - .
. 3
, , , ,
.
24 , ,
. , , ,.

- REM , ,NREM- .
, NREM , , .
, , ,
, .

:8 , :

Melissa M. Burnham, Beth L. Goodlin-Jones, Erika E. Gaylor, and Thomas F. Anders
: (1 : - ,
, 12 1 (2 . ,
(3 , 12 , ,
.
: 80 5 , ,
, Somnography- . : ,
,, ,
. ,

 . , 12 :
, , ,
, , 3 . :
, .
: , , , ,.
, ,
, - .
, ,
. ,
, , , .
,
. , , - ,
, .
- , , . ,
24 , . , 16-17 ,
3-4 24 . ,
) ( , , 24 , . ,
, , ,(REM (Rapid Eye Movment NREM
((Non REM Sleep , . - ,
40 , , ,
.
, , ,
, , .
, , , , .
. , 4-6 ,
, , - .
- ,
, . , ,
. ,(France and Blampied (1999 ,
, , . ,,
, .
, , , .
, , .
, . ,
, . 1 ,
, . , ,
\ , .
, ,

 , . .
, \ .
.
, , ,
. , , .
, , . , ,
. ,
,- (Minde (1993 . ,
. , )
(.
, (Seifer (1996 . ,
,(Benoite (1992 .
, , , .
, , .
, .
- , ,
, , ,
. , , " ,
. .
.
, , , . ,
, .,
, " " ) ,(double blind ,
. ,
12.

- . , .
87 ) 43( ,
. , . ,
." 4 , ,
. ,
, 80 ) 42(.
80 .1 ) ,(76% ;61
) (1% (4%) 3 , (19%) 15- 77% . ,
, . .
,
, .


, " " )
(RSA ) .(SC , , .
,- . , ,
10 , ,- . , ,RSA -
, , SC - ,
. , . ,
\ , .
, . ,
"" .
,RSA- , . 2
, , ,
, . ,
, . , 2-12 ,
.
. , ,
.
,SC- .
, , .
, RSA- ,
SC , - . ,
) ( ,
, , ,
.
, ,
, .
, . , ,
. ,3,6,9
12- , .
.
, , ,
.
-
.

, -

, . : , ,
. , ,
.
.

3 12- ,- Rothbart

.((IBQ, 1981 IBQ- 94- , 6 : ,

, , , .
7 ,Likert 1- "-" 7 "" .
" " . .
, , 3 12-.
- .

. 2- ,

5- , . . ,
- , ) ,(Panasonic
) ,(sanyo , ,
. " 18" .
, .,
, , . " 18" ,
. ""
.
, RSA/SC- 85%
, . :
) ,(LSP ) ,(TST ) REM ,(%AS ,
) NREM ,(%QS , ) ,(%AW ) .(%OOC
, ,
. , , ,
, ,
. , , ) ,(%SS
, , ,
.
.

) 1,3,6,9,12( ,

) , ,( , .
.

,(Beck (BDI

) 1,3,6,9,12( . ,BDI- 21- ,

. , ,0.81 . 0
,63- . , 10- ,,
.

2 : ) ,(PES

) ,(PSOCS ,1,6 12- . PES-

.(Cronic and Greenberg (1990 20- ,

. ) ,
, , ( ) =1 =5 , ( .
, .
) ,as=0.85, as=0.9( . PSOCS-
. 6 " " "-
" . 2 : .
, ,
.
.

,(Batholomew (1991 . Likert 1

) ( )7 ( . , ,
. : , , Batholomew .
,(and Horowitz (1991 ,
.

- ) ,(SPSS .10
2 , 1,3,6,9-
.12 .
, 2- .
, .
, , , ""
, " " .
,
) .(GLM , ,
) , ,'( , Q- .Cochran
, , , .
, , .
, .0-1
) Y- ( . ,
, .
, ,
, GLM - .,
) ,(ANOVA , ,
, .

 ) ,(Stepwise ,
, 12 . ,
12 , .
.

. , .2
) ,(GLM ) ,(LSP 1
3 .[F (4, 76) = 18.48, p<0.01 ] .
, 1 3
, .(F(4, 76) = 7.12, p < 0.01 ] , ,
, 1 3 F (4, 76) = 33.22,] .
.[p<0.01 , , ,
. ] ,[F(4,76)=158.28, p<0.01
] ,[F(4,76) = 173.97, p<0.01 1 . ,
] .[F(4,76)=28.38, p<0.01 .
, 24 , , ,.
, , ,
, . ,
.
. 1 12
] .[F(4,57) = 4.86, p<0.01 , , , 27.6%-.
, 12 , ) 46.4% - .(2
, .
, ,
.

, ,
) .(2 ,
, .
.3 , ,
, , ) - ( ,
, .
, ) ,(%ss 56.6%- 43.4% ,
. %SS GLM- ,
.


,
) ) (RSA )) .(SC 9 , RSA-
, ] ,[F(4,76) = 2.53, p<0.04 ],[F(4,76) = 2.53, p<0.04
.SC- , RSA- ,
, RSA- SC- .

. . , , 3 12-,
.4 6 , , , 0.27
0.53- .
. . (81%) 65 , (15%) 12 ,
(4%) 3 . 44 , ) (56% 35- )
(44% . .
.Beck BDI .5 BDI
12- ] .[F(5,73) = 7.63, p<0.0.1
, - .(Beck et al (1988
. PES .5
.
, 6 12
].[F(2,74) = 3.85, p<0.02 and F(2,74) = 5.99, p<0.01
. ,5 PSOCS
.[F(2,75) = 11.44, p< 0.00] 12 " " ]= )F(2,75
.[11.16, p<0.00 , .
. , 12 - .
] .[C=.57, p=0.0 76 , ,
(65%)49 " " (18%)14 , " " (5%)4 ,
" " (12%)9- " " . -
.(Bartholomew and Horowitz (1991
. . ,
) .(4 , , (8%) 6 , ,
, . 12 , .(32%) 25- , ) 47 ,
(60% , , 12 , ) 37-
.(47% , ,
, , . ,
, , ) 32%
21% 12(.

 . , ) .(4
, . ,
"" " " , , .
, , , Cochran's Q (4)=27.56, ] ,
.[p<0.00 , 43.4%- 26.3%- 12.
,- ""
. , ]
.[F(4,57) = 11.03, p<0.00 , 30% -
. 60%- 6 , 9 40%- .50%-
, , . ,
. 12 , ,
.
. ) .(4 78 ,
78% : , 24%- 12 ]Q(4) = 114.72,
p<0.00]. 61 19 , 12 . ,
12 . ,
, , ) ,(68% 6.
.

,4 ,

, . , , 1.58 3
] = ,,SD = 1.85]0-12 1.22- 12 ] = .,SD = 1.23]0-6 ,
.
, 6 ) = 0.5
,SD = 4.56 ,26.75 = )3.72 12 ) = ,SD = 3.77 ,23 0.5 =
.)2.91
: 12
, , 12 , .
, , 12,
.
. , 12
.
. 12 , ,
, 12 ,(M= 33.68, SD = 37.55). ) M = 50.37, SD = 34.39; t(70) = 1.96,
.(p<0.05
) ,(r(71) = 0.30, p<0.01 ) ,(r(69) = 0.29, p<0.01
) ,(r(69) = -0.28, p<0.02 ) ,(r(69) = - 0.32, p<0.00
, 12 .
, .

 . , , 9 )= )r(51
(-0.44, p<0.00 12 ) (r(56) = -0.32, p<0.02 12 .
, . )
( , 3 ) ,(r(72) = -0.31, p<0.00 6 ) ,(r(72) = -0.36, p<0.00 9
) ,(r(72) = -0.47, p<0.00 12 ) ,(r(72) = -0.56, p<0.00
, . ,
, 3 ) ,(r(64) = 0.33, p<0.01 6 )
,(r(58) = 0.30, p<0.02 9 ) ,(r(52) = 0.41, p<0.00
12 , , .
, , ,
12 ) .(r(72) = 0.33, p<0.01 , 12
, RSA SC , ,
.(r(72) = 0.45, p<0.00 ) .
, ,
) 12 , 3( ,
.
. ) ,(r(72) = 0.26, p<0.03
) ,(r(72) = 0.37, p<0.00 ) ,(r(72) = -0.49, p<0.00 )= )r(72
,(0.46, p<0.00 ) (r(72) = 0.312, p<0.01
) ,(r(72) = -0.35, p<0.00 12 . ,
.
\ , .
, ,
.
.

, 6 , , ,

.Stepwise : , 12 , 12 ,
, 3 , , ,
. 12 ,
, , 3 )
.(6 , , ,
, 22% , , . ,
, 3 , ] .[F(3,79) = 18.16, p<0.00 ,
40% 12 ) .(adjusted R = 0.395
, .

 , ,
, .
, ,
. ,
, " ".
,
. ,
. , ,
,
. )( , . ,
) (RSA ) ,(SC
. , , , RSA -
.
, ,
, , ,
. ,
, , 4-12
) .(Winnicot, 1953
, 12 , \ \ , .
, -,
. ,
, , , , .
. , ,
, 50% , , , ,
12 . ,
, . ,
, 6 12 .
, 12.
, . ,
, . Passman and
,(Halonen (1979 ,
. , , 6
, . , 6 ,
) ( . 6 ,
, , ,
.
, , ,

 . 80% , . ,
. , ,
, , . , ,
, 3-6 . ,
, . , -
, .
,
.
, ,
, , 12 . 40%
, . ,
, ,
, 12 . ,
. ,
, . ,
.
, .
, , .
, , , .
, , ,
.
.
, ,
. , ,Y - ) 0( .
. , ,
,
, 12.
, , ,
3 . , 3 ,
12 . ,
,
, ,
. " " .,
, ,
12.
, , 12,
, .stepwise- ,
, 12
. ,

 . 100%- )
, ( ,
, 12 .
. ,
. ,
, ,
. ,
, , ,
.
,
. , .
12 , .
, .
- , ,
, ,
, . ,
, , 12.
, ,
. , .
.
. ,
. ,
. , "" .
, .
, ,
12 . , ,
.
.
.

, .
. , ,
. , ,
. ,
. ,
, ,
.
, , ,
. , , , ,
, .

 .
, ,
. ,
, . , .
, , \
, . , , ,
. , ,
, .
.
, .
, . ,
, .
3 ,2 4- . , ,
, .
, , -
, , . ,
, .
.
9
Sleep Patterns and Sleep Disruptions in School Age Children
"
:
" ) -( .

.
. ,
.
' .
.
,
. ,
.

, , " .
140 ) 72 68 , : , ,(
) (Activity monitors .actigraph ,
. ,

 .
. 18% ) .(fragmented sleep
.
) .( , , -
.
.I
. -
:
) .(Dahl, 1996b; Sadeh, 1996; Sadeh & Gruber 1998
,
.
,PTSD ,
);American Psychiatric Association (APA), 1994; Dahl, 1996b;Dahl & Puig-Antich, 1990; Ford& Kamerow, 1989
(Sadeh & Gruber 1998; Sadeh, McGuire, et al, 1995; Wolfson & Carskadon, 1998
, :
) Carey, 1974; Novosad, Freudigman, & Thoman 1999; Owens et al, 1997, Sadeh, Lavie, & Scher, 1994; Shaefer,
.(1990; Van Tassel, 1985; Weissbluth & Liu, 1983; Zuckerman, Stevenson, & Bailey, 1987
.
) ADHD- ( ADHD :
)(Chervin, Dillon, Bassetti, Ganoczy, &Pituch, 1997; Corckum, Tannock, Moldofsky, 1998; Dahl, 1996b
:
) Dahl, 1996b; Epstein, Chillag& Lavie 1998; Hansen & Vanderberg 1997; Marcotte et al 1998; Randazzo,
(Muehlbach, Scweitzer & Walsh 1998; Wolfson & Carskadon, 1998
, .
. , ,
- " . -
) (1 ) (2 .
(1) : ) ( ) (2
.
: - "
.
.1
- - .
)(Sadeh & Anders 1993; Thoman 1975, 1990
: , , -
.

 Anders & Eiben 1997; Mindell 1993, Sadeh & Anders 1993; Sadeh & Gruber) .
(1998; Stores, 1996
- (1) : -
- (2) ,
. ,

). (Anders 1979; Sadeh & Anders 1993

- , , )(

) ,(Weissbluth, 1995 ,

).(Wolfson, 1996
) (1 , , ,
.
) ) .Mindell 1993, Richman 1987, Sadeh & Anders 1993 ,
, .
, ,
.
) .(Anders 1979; Sadeh 1994,1996
.

) ( (2 , ,
) .(Thorpy, Korman, Spielman&Glovinsky 1988
-

.;Carskadon, Viera & Acebo 1998) (Carskadon 1990 '

) .(puberty

.
;Carskadon, & Dement 1987; Wolfson& Carskadon 1998) (Carskadon 1990
- .
(1) : ) (circadian rhythm (2)- .
) (1 "
(2) . ,
) .(Borbely, 1994 , )(
.
.
)(Epstein et al 1998; Tynjala, Kannas,&Levalahti 1997; Wolfson& Carskadon 1998
) , (.
.2

 20-30% ) ( 3 .
)(Anders&Eiben 1997; Mindell 1993; Richman 1987; Sadeh & Anders 1993; Sadeh & Gruber 1998
" , .1-5% -
) .(Gass & Strauch 1984; Richman, Stevenson & Graham 1982 , -
,.
.Carskadon, Dement &Harvey, 1978) (Anders . '
1989 43% 8-10 .
" (DSM (1994 - " ) " " 14% .
, 11-33.4%
);Bearpark & Michie 1987; Kirmil-Gray, Eagleston, Gibson & Thorensen 1984; Morrison, McGee, & Stanton, 1992
(Price, Coates, Thorensen,& Grinstead 1978
) (Blader, Koplewicz, Abikoff & Foley 1997 ) "(:
27%
11% ) (
17%
6.5%
17%
, ) (Rona, Gulliford & Chin 1988 ).(5%
, ),
) Primary insomnia ( ( ,
.

".
.3 -
- .
-:
) (a : , ,
)(Morrell 1999; Rona et al 1998; Sadeh &Anders 1993; Van Tassel 1985
) (b - )(Moore 1989; Sadeh 1996
) (c , ,
)(Carskadon 1990; Wolfson 1996; Wolfson & Carskadon 1998
, . ,
.
)(Anders & Eiben 1997; Mindell 1993; Sadeh &Anders 1993; Sadeh & Gruber 1998; Stores 1996
.4
" 2 :

) (1 ,
.
) (2 .
) (1
) , ( )
.(polysomnographic) (Kahn, Dan, Groswasser, Franco & Sottiaux, 1996
).(Sadeh 1994,1996
,"
1-2 , .

, , ,
.(Ferber 1996; Sadeh 1994, 1996; Wolfson 1996) .
Actigraphy )( -
.
)Cole, Kripke, Gruen, Mullaney& Gillin 1992; Sadeh, Acebo, Seifer,Aytur & Carskadon 1995; Sadeh, Hauri, Kripke
.(& Lavie 1995; Sadeh, Lavie, Scher, Tirosh & Epstein, 1991; Sadeh, Sharkey, Carskadon, 1994
.
.
-
- ) (1 85-95%

)(Sadeh, Acebo et al 1995; Sadeh, Hauri, et al 1995; Sadeh, Sharkey, et al, 1994
-
.
) (2
: DSM-IV2 - ) (APA, 1994:
) (a ,
.
) (b ) ( , , .
)(APA, 1994
,
, : ,
.
,DSM-IV - :
" 2-4 " )(Richman 1987, p118
" 6 , , (Johnson, 1991,p109) .

 , ,
Minde et al 1993) (Kerr & Jowett ;1994
,
.
.5
.
.
:
) (a

" .

)(b

)(c

)(d

.II
.1

174 72 , 68.
3 :
' ) 7.2-8.6 , 7.9" = (50
' ) 9.3-10.4 , 9.7" = (37
' ) 9.9-12.7 , 11.8" = (53
2 - , .
. 15$ .

(The Child Behavior Checklist (Achenbach & Edelbrock 1983

, Zilber, Auerbach, & Lerner

((1994
.2

4-5 .
. " , - . Actigraphic Scoring -
(Analysis (ASA , :
) (a

: 15
.

)(b

: )" (

15 .
) (c

: .

)(d

: .

) (e

% : .

 : 5

)(f

.
)(g

)(h

:
) (a

: 1- -4

)(b

: 1- -4 .

, Sleep Habits Questionnaire ,

: , , .(Gruber, Sadeh & Raviv 1997) .
:
) (a

: ,

.
)(b

: .

. ) ( .0.72-0.82
.III

.1

,1 .2 .

.2

MANOVA .
ANOVA- " . :
) (1 , , ,
.
) (2 , ,
.

.3

" "

(a) : ) 90% - , 10% -

(b) . , ) 5 ( 3 25 .
, .
.4

MANOVA . ,
.

 "" :

.5

)( 1

)( 2

)( 3

)(.

: , , , - ,
. , ) , '( .
" .
.4 " : ,
.
.
. ,
.
.IV
- ".
- "
.
." , .
,
.
.1
. 12-60
.(Acebo et al (1999 ,
).
(Wolfson & Carskadon 1998 ,
-.
.2
, . '
' . , ) '(
" " " . " ,
- .

.

) Carskadon, 1990; Carskadon & Dement 1987; Carskadon et al 1993; Tynjala et al 1997; Wolfson & Carskadon
.(1998
. -
.
) Carskadon, 1990; Carskadon & Dement 1987; Carskadon et al 1993; Tynjala et al 1997; Wolfson & Carskadon
.(1998
"" )(
. "" - ) (
, .
,Dahlitz,Vignau &Parkes 1992; Thorpy et al, 1988) (Alvarez

.
, ,
.
.3
2 , " ,
.

) .(Sadeh et al, 1991

.
. ,(Minde et al (1993
1 5 .
, , , .

) ,(Blader et al 1997 .

. )( .

.
)(Sadeh, Horowitz, Wolach-Benodis & Wolach 1998
) (
.
.4
.
)(Epstein et al 1998
, ) .(Gau & Soong, 1995
.

 ) ,(Sadeh et al 1991
) .(Sadeh, Dark,& Vohr, 1996
.
) Anders, Halpern & Hua 1992; Cornwell 1993; Eaton & Enns 1986; Eaton & Yu 1989; Feldman, Brody & Miller
(1980
.5
" " , ,
) ( .
) ( . .
,
(Rona et al 1998) .

) (Sadeh 1996; Sadeh & Gruber
" " 3-5% ) (.
,
" . ,
.
) ( )(hyper-vigilance
)(Field & Reite,1984; Fisher & Rinehart,1990; Gunnar, Maone, & Fisch,1985;Selye, 1983
, ,
).(Fisher & Rinehart, 1990
,
" . ,
" )(Sameroff & Fiese, 1990; Sameroff et al, 1987
" , .
.
.6
:
.1

. "
' ' .
.2

.3

.4

,
, .
,
.1

"?

.2

- ?

.3

'

?
" ) (longitudinal study
.

.
) (1 (2) , (3) , .
: , ,
,
.

" , .
-

" ".

.
-

MSLT .

:
-

: , , '.
) (

MSLT .
. ,
.

- 10 : ,
Amy Wolfson

 :
2 ,
, .
,
. ,
) ( , .
.

, . ,
, .
" .
. , ""
. : ,
, .

.I

.
" " , .
2-:
-REM EEG- , ,.
NREM- 4:
-1

- "

, , .

-2

" ) (spindle k complex -) EEG- ( . "

-3

) Slow wave / delta sleep) 4 .

, NREM - ,REM-

90-110

7-10 . NREM_REM , 4
,NREM .REM-

.II

70%- " .50% -

50-

.
.a

: 6-7 ,REM .NREM ,8-

. " , .
: ,NREM, REM ,

 24 . .
: ) ,(REM ) (NREM .
NREM .REM- , " ,
, , . " ,
, "" . , NREM4-
. . )
.(1 . 3-6 .
, .
50 90 , . 3-6- REM-
. -3' ,REM 50% NREM 50% 20% .-REM
REM- .
.b

5 , 16-17- 11- ) (2
16-17 . 14-15 16 ,
6-8 13-14 . 4' , -1' . 16 ,
3-4'.
3 , .
6 3- . / ,
2-4 , 1-2' , .
. 3 ,
24' .

. 3' . 6-9'
.
. 4 . 4-'
8- . 3' , .

.c

)(settling

.
.
" " "".
, . , 95%
. -44% 78% ,
9' 60-70% , . ,
, , .,
, .
.d

"

2-5 .
" " . 4' ,

 2-3 . 6' 85-90% - , 15'50% -

- . 3 92% - 6 4 ,
57% 5 5 , 27% 4 6' 3.5
) 1-6'( . 9-12' 90% : 2-4' , 15-24' +90% : 1.5-
3.5'.
," .
. Weisbluth
,
Weisbluth . 3-6:
60% " 30% , 10% ,
, , . ,
.
1-2' , , ,,
, .
.
.e

. ,
.REM- .
. ,
. :
. , .
: , ) ,
] anoxia [ ( , ) , , (,
) , , , (.
.i
2 "" .
"" ) 14' ( ,
, .
,
, . ' /
. .
, .
, , .
. , ,
, ,
Guilleminault .

1-6' , ",

, ,REM , NREM
.

 .ii
. 10-15% -
, , .
3-4' , .
.iii
, 5-9'.
.
.
.iv ) (
.
Wolf and Lozoff .
,Scher-

20%- )6'4-(

80%,

) ,(

8.4% . ,

44%

) .57% - .(30%-
.
.
. .
. . . )
( -
.
.v
" / .
, ,
- . ,
. , " ,
, ,
.
) , /(
. , . , ,
. ,
" . ' - .' - ,50%-
,20% .10%- .
. ,
. 4
, , .

- , , '
.
.

 McKenna

" " .

)( )(
/
)( .
.vi - -
" ." , ,
. ,
, Paret .

9' " . " " " , ,

" . " ,
12 5- , 4 . ,
, .
, " " 9' ,
, .
, ) ( .
.
,
. , , ,
.

.III

. ,

Maccoby

.
, ".
.a

REM ,2-5 30-35% ) 20-25% - ( . 7-9

REM , NREMREM50-60 -' . REM- 10- 35-'
, REM- 20-25-' . 4 NREM
, , .
Roffwarg .

REM- 5

. 19-25% 3 NREM 4 .
3-4 NREM .
, NREM 4 5 .2 ,
2" , 4NREM .
, .
.b

Roffwarg . 5 2-3
, ".

 ," 14- 11-12- ) .(2 ,

.
' . 20- :
30% 14% ,1-2 ,3 5%- .8 :
Johnson : 6 , , 12' .
1-2 : 6 -5, , 18'.
: France and Hudson , .
" ,
.
, :
57% 65% ,1-2 61% ,3-4 5 . 21% ,5
. 5 -
. (1 ) :
(2) . ) , , ( (3 )-
. ,
.
"

.IV

) (6-11 , , ,
. , .
.a

" , 10-' 6-7 8-9' ) .(2

Carskadon .
15 10 .
, . " .
,3-6 7 " .
. , ,4 ,
" 30-40% " Guillford .'
" Szymczak .' 10 14
.
" " ' .
.
" 95-97% . REM - 140- 6-7 124-
.10-11 REM ) 6= 6-8 , 4-5= 10-12( . REM
26-28%- " " 22-25%- .
NREM

20-25%" . 90 .

.
.b

"

 , : ) ( ,
) , " , ( , ) ,( , .
5-6
. .
, " , .
) " ( ,
. . , 6' 5-'
.
.9-10 , " .
:
, .
, " .

.V

, , , -,
" .
.
.a

: ,
. ,20 slow wave 40% .10 , 4 3
NREM , .NREM 1-2 REM- %-
) REM .(1 .REM
.b

.
") . 10 -' 7.5-8 ,16 ..(2
60% "-" " " . , 54%
.. 45% '-" 90%-
. 30-60 10-
,14 .18
. .
, " ,
.
.c

" -

" .
.i
2 : 80-
. ,
, .
, ,

 .. , " ,
. - .
" .
/ ) (M\E 400 ' . (1) :
, , . : 3
(2) .
)17,25( .
.ii )(
" , ) ,
( . , "
," / . ,
, " .
, 65- 15
' ' . " ) ( .
) .(3
) " - ( Multiple Sleep Latency Test - .
- , )
( " .
, . ",
.
.iii "
." "
, , .
3000- ) -( )"( 59% ,
, 28%- 20 . -
+20 - 20 -
. )"( " )
( . , " ,
, . 10% .
+20 , 5%- +20 ,
. 20% , 20% ,
+20 35%- +20 20 +
. 20- "
, , , )
,(.

- .

 .
"
/ , , .
, , ,
, .
: : , , , ,
.
:" " , " ,
.
3

.
:
-

"

30% 20%
:
* .
*' .
* " 3 , ,'
.
* 50%.
* "
, .
* .
" , .
.1 )(
: , ,
, '.
: ) (
.

 . , ,

. , '.
" ,
, .
.
.
.2
" " : .
.
:
* '
.
* .
.3 ) (
.

.1 :
.
.2 " .
.3 ".
.4" .
:
.1 .:
.2 "
.

" , .

:
.

/ "

.
.4

 , " " " ,

.
: .
.
: .
, , ,
.
11 /

. ,
- . ,
.
.
, ,
,
, .
.
.
, .
.
.DSM-IV ,
,
. , . ,
.
.
, .

.
) .(ADHD -
ADHD .
ADHD ."
-
" " . ,
.

 ADHD - , ,
.
ADHD-
.ADHD .:
.
:

, ,
. ' .
: , , .
) ( ,
. , ,
.

(1

: .

. , .

, .
. -

. "
.
, , ,
.
. "
.
. , ,
. ,
. :
. ,
. , ,

.
:
.1
.2 .

 .3
.4 .
.5 .
, ,
.CRSD , ,
. ,
) ( ,
CRSD- .
:

. ) (1957
5 - , 4 5 , 4
. 3 70%
"" , 83% - 6 90%- 9 "" . )(1981
30- ,
4 .
30% 20%- .3 )(
, , . "
.
8-10 . 45%-
, , 14% .
- 33.4%-11% .

. , .
:
.
18- . 5-6 -
. .
22 - , 7-8 .
,
.
.
. " "
. .

.
.
. .

 ,
.


.
) ( : , ,
.
, .
, ,
.
, .
.
. ,
.
,
. :
.
. .
:
.1 : .

. , , .

.
.
.

.
" .

/ .

/ .
" "
, ,
": " ,
) " ,
(

* : "
.
, " ,
.
,
, .
.
.
:
.1

.2

90% - 73% .
. ) , ' (.
(2 : , .
.13
. ,
.
. ,
. .
,
. ,
.

(2

: . .

. .
-
. ,
, , , .
. " , .
:
,
, .
. -
DSM

) ( ,

.
. , , ,
. , DSM

 , . ,
.
.
:
, .
:
, . .
. BRSD -
.
:
) REM ( .
2- : - ,
, " ".
.(3 :
. ,
. ,
.
.
. ) ( ,
. , " "
. , ,
,
. , ,
.
:
,
.
BRSD- , "
, . BRST
.
:
.
:
. .
.
:
, , .
.

 , ,
.
.
(4 CRSD : .
) (.
.
. CRSD
. , , " ,
" .
.
:
, .
.

, . ,CRSD
-
. DSM , :
.
.CRSD -
:
, . 7% .
:
.
. 24
.
.
.
. '

.
.
:
,
" " ,
, .
" " , .
,

 . .
, .
,
.
.
.
.
. , . ,
.
. , . ,

.
.
. . .
.(5:
:
.
. ,
.
, ,
. , , .
. : .
. ,
.
.
,
, . ,
.
.
.
:

, .
)( .
. ,
. ,

 ,
.
:
50%-10%- 3-5 .
, .
,

. :
. ,
. ,
, ,,
, )( . .
, .
. 10 ,
.
:

, ,

REM EEG .
:
1-6%- .
. : . ,
.
. .

. , ,
, . .
, .
:
.
, .
.
:
. 15% 5-12
. 10%- 2 . 2 ,3-11
. .10
,6-16 .40% , 2-3% .
.11-12


. ,REM
) REM- ( ,
) ( , , .

DSM , .

. , , )
(50%- . , ,
.
: 2 :
.1

.2

.
'.
.
,
. .
,
. .
) (
.
.
" .
: ,
.

olysomlography

, . ,

ideosomnography

, ,

Ensitive mattress

)"" ,

""( .

, 24

. .

. "

,
,

 12
, / ,
Sleepwalking, confusional arousals and sleep terrors in the child / Rosen, Mahowald, Ferber
:
: ,
.
:
.
:
,
.
" ) (SWS
.
,
:
) ,(constitutional , ) , , (...
) ,(precipitating )( , .
:
, .
:
, .
.NREM
.
-
.
3:
.1 ) (
.2
.3
:
-

) (

60% ) 60%
(.

SWS ) ( .
90 ) 60-110(.
15 , 45-75
, : ,
,NREM ,REM (NREM ( SWS.
SWS ,
NREM .
EEG
" ,

:
) ( : / :
40% :
:


:
/
1-10
:

- - -1%
5-15%

1-5
5-40

:
:
.

.
,
, .
.
.
.
, ,
, ! .
"
.

 :
,
/ ,
.
.
, , .
:
, ".
:
" , ,
.
.
, , .
40 , 5 15.
)
, , (.
) , , (...
.
.
,
.
:
,
) (
.
, .
)
(.
, .
, " .
" " " )
(.
:
SWS 3:
(1 " .
(2 .

 (3 :
.
:
) : , () (1
, 60%
.
) (2
) SWS SWS
(.
) (3
SWS .
) (4
SWS SWS .
) (5
.
- :

(
) (1 :
( )sleep epnea (
(
(
(
(
) (2 :
( , ) ,.(...
(
,
, .
" " ,

) , .(...
.
.

 SWS
,
.
= ) : (14
.
- :
(1 - :: ) , ( , ...
: ) , ( ,/ , - - ...: ) ( , , , ...
(2 : , , ,
, .

.
(3 : , , ) (...
(4 - : : )
( , - ... : , ...
) = ( :
:
, ,sleep apnea , , , ,REM
- ).(PTSD
.
:
-

?
, :

,
:

"

:

:

"

"

"

?
:

: , .
- ) (. , .
. , . :
(1 :
, .

, .
(2 " :

 " ,
.

"

.
)" ( ,
:
) (,

.

:13 :\
.
: 1992
, 70% 20%

.40%

.
.
.

. ,
.
: , , , ,
, , 2 3

,

.
.
,
, ,
.

.1 : ,

.
.

,
.
.1: .2 , .3,
. 20%
.
, 20%
1 3 .
.

.
.2 :
. .
: , ,
.
, : .
.
. :3
, , .
, .
, , ,
. .

, .
.3 : .
,
.
,.
.
.4 : ,
: .
.
. .

 ,
.
.5 :
, .
.
,
.
. :

:
,
.
,
.
. ,
.
,
. ,
, .
.
, .
.1 :
.

. 162 in addition

.
.2 :
.
.
. ,
.
1% .10%
,
.
2 ,
.
.3 :
.

 , .
.
:
,
. , , , ,
.
.
.
,
.
,
, .
.
,
18 . .
, .
.
:
.

,
, ,
, .
, , .
.

, , .
, .
. , .
) (
.
.
163 ,
, (.
:
.
, .1992
, .

 . .
, .
.
.
,
.
,, , .
:, , , ,
.
.

. .
:
.
, , .
,
.
:
.
.
,
..
,
.

, .

.
,1992
, ) (.

, .
: , ,
.

.1

, .

, , ) ( , ,.

.2

: , ,
'.

' ,

) , ,(

.3

,
.

,
.
, , .
.4
) (
: , ,
,
14 !!!
4
) (
: "
.

, .
.1

 :
.
:
.
:
.
: .
:

.
. .

/ " 5"

."
. , '
: ,

. ."
.
.1 : .
.2 .

. "

.
: "" .
: .

, .
" ,
.

: .

. , .

6 3 .

: ) ,
( , .
: 80% .
:16 " " , ,
, .
"" , " ".
16
: ,
/ , &
Effects of parent training on infant sleeping patterns, parent's stress and perceived parental competence/
Wolfson, Lacks & Futterman
:
"
) (?


:
60 .
,
.
:
) 6-9 ( , 4-5 ,
.
:
60 .
29 ) ( 4 ,
31 - ) ( ) (

 ,
:
6-9 -

) ' (

'
:
.
" : ?"
.
" .
,
.
8 ,
.
:
30% 4 .
-

& ) (1957 10% 5

, & ) (1987 18% 8 29%

5%
.
26% , 61% , 6% .10

.
:
.
16-20 ,
,
.

 4 , 4
) 8(.
:
(1 ) (
(2 ) , (...
(3 ) , (...
(4 ) / , , (...
, )
, ,'(,
) ,
( .
- .
.

.
.
, , "" / .

.

.

,
3 :
(1 '
(2 ' , '
(3 '

:
( :
60 "" " .
)( :
-

 ) 21-40 :(28.7 : ' ,15.7 : ( :

.
, 4
) 2 2(,
.
) ( '
) (.

3.
) , ,
( 16-20.
'
.
( :
- :
- 24.
15 ) ,(....12:30 ,12:15 ,12:00
: , , .
24 , .
) (
, 16-20 .
?
(1 ,
.
(2 ) ( , 3
.
:
(1
(2
(3
(4 300
(5
(6
:
(1 ?

 (2 ?
:
:
)",("Hassles and Uplifts scale

.
3:
) 6-9( 16-20 :

.
: 16-20.
10 ) (0-100
.
10 :
- ( :
, "
' " ).(1985
) ' (
.
, , " "
.
.
: " , , .
:

 .
:
-
.
, " " ) 10 12
( , ) "
, , (.
:
.
4- ,
, ,
.
.
:
,
.
( :

.
.

,
16-20 '
' .
,

,
.
- .
6-9

 :
, -
.

.
, , :
9,

,
) (
.

) (.
: .
:
) ( ,
,
, ?
,
0-3 9-12,
0-3 .
,
.
,
)( .
:
.
: , ' ,
6-9.
) ,
4- ( , '
.
) ""(
.
"" , , ,
4-5
.

.

 ' ) '
(,
.
:

.
.
, ,
:
(1 '
) :
,
(.

.
.
, '
.
(2 :
,
) ,
(
) (.
(3 :
,
.

, .
,

.
:
,
:
, ,
.
)
(.

 : " " /
' & ),(1985
,
, ,
.

.
16 )(
** ) ( ,
) ( , stress- .
** + ) ( ,
) ( . 6-9 , 16-20.
:
.1 :
.1 . , .
, ,
5 , ,
) . , 6-9 .
, ?(.
.2 . , ,
.
.2 :
.1 . ) ( ,
.
.2 : ,
.
.3 :
.1 . , . ,
.
.2 . 2- .
:

stress .4 :
, ,
) (.
:

stress

.1 : ' '
. 2' .
.2 300 ) 6 5 (
.
.2 9 6 , '
' . . 2 .
.3 ,' ) (
' .
.4 , '
. 2' .
: / .
.
.
.1 : ' .
.2 .
.3 ' , .
.4 .
- 17 :

 , ,
. , 30%-10%
' .
. . ,
.
.
.
.

.
.
. , .
.
, .
50 9-24 .
8 - .
3 30-.
: , .
, 5 .
,self soothing ,
, , .
: , ,
. ,
. , .
, , " . ,
.
. .
, ,
) ( , , 4 .
, , .
' . '
.

 . . ,
.81.2%- ,
. .92.4%-
: .
, "
. ,
.
:
. ,
, ,
. .
, ,
, .

:
.
:

.
.
.3
.1 : ) (
.2 " .
.1 : , .
2 :' - .

19
* = ,
) : (3 .
:
. 28 : 30
, 12 36 , , ,

 , . : ,
, , . ,
. :

- .
,
.

" , , , 15%
20% . , 12
. . ' ) ,(1984
360 ) ( 6 12 . -
50% 70% 36 ,30 ,18 ,12 ,6
6- 12 .' ) (1982
) ( 3
5 . , ,
20 3 8 .
.

. ' ) (1982
45% 3 8- , 3 .
)( .
) .(1984
, , ) 85% (35%
) ( 46% .19% , ,
28 12 36 , 30
. ) (
/
* . ,
. ) 46% ,(13%
,
' '' , .
, , - ,
) (.
,
, ,3-8 1/3
. , ,

 . ,
, , .
,
.
,
. , ,
. ,
.
)( , .
" ) (1993
" 28 ,
12-36 . ,"
- 30 .
.
:
28 : 3 30 ,
, , 12-36 , .
) ( , " 6 2
. ') .(1981 : 3
4 , ./ .2 20-' , .3
.4 30'
. ,
" ' , . "
. 6 : ,
, , ,
.
, "
0-4 , .0-24
" ' 8-11.9 12 '
)(.
, ,'
9 .
, .
.6- ,
.
.

, . , 50% ,

 . , ,
, .
:
) : (. . ,
. ,
, , 77 .
" . 18 .
* .
24 ,
. 24 ,
" " " , " ' .
" " .
.
2 : , , .
, ,
3 , .
. .
12 ,
.
,
. ,
.
) (
. , 7 7
.
" , -.
65 )
, ,(... ) , , ,( .
1-5 ) 1 5 , (.
6 66 .
) ( 2 ) ( 2
) (.
- ,"
83.1% 93.9% .
, 6 ,
.
.)(
.
- .

 . : .
,
. ,
, ,
. , ,
, ,
. ,
. .
.
.
, "" ,
.
5 ,
"" . ,
.
3.75 3
. , 25 .
6 .
.
, 3 .
,
.
.
:
, , -,
.
2 3 6
. 6,
6-19 .
, , 6
, 3 . ,
, 21 ,
. 4
.
3 . , ""
, " " 30% ,
11 . 24
' " " . , " ",
.


6 . ,

. - . ,
66 6 , , .
. ,
6
- . , .
, ,
. ,
.
.
.1 :
.2 . 2
.3
.
,
, - ,
.
. , ,
- . , .
)(
.
.
. ,
.
.
, , .
,
, ," .
, 3 . 3 6
.
3 ,
.
4 -
3 .

.
' ' , , - )
( . , '-

 ) ( . 2
'
6 .
:
"
. ,
.
.
.
. , . ,
, - .
)( )
( .
, ,
, . ,
.
.
,
, . ,
.

? ,
, .
.
, ,
. "
.

.
,
.
, - .
,
.
, ,
.
" " ." " 60 " " ) ' (
8 .

 - . ,

. ,
.
,
.

- .
, ) (
.

: , , .

30 15 ,

.

: ""
.
.1 : ) 1(
) 3 (
.
.2 " .
.3 .
20 /
-
.
,
. :-
, .
.

 , , ,
.

) .(1-3
, .
. -
) ,(
.
, , .
1996- , .
"" .
. ""
" " " ".
" "
)( .
" " )(
"" .
. "".
:
.
.

, " " ,
" " .
,
.
, ,/
. "
.
) , , (
, .
"" , .
-
) ,( .
.
. . /
)( .

 ,
. 5 4
. " "
.

" . "
) ( .
,
" .
-
,
" ." - .
28 .
,
) 15 ,10 ,5( .

. " ,
.
,
" " " "
.
,
. .
,
. ) (
.
/ -
.
.
, , .
,
. " ,"
" ".
"" 268 2-3 )( ' ,
45 . 6
' 9 ' .


.

" " "
. , .
. 15-30
. ) , ,(
.
.
" . '"
, .


.

)( . .
.
. ' ,
" .
" " ,
. .
/ .
.

.

.

) ( .
,
.
3 .
.
, ) ( . '
.
. .

" " ,
. 30' . )
15-30'(
. .
, .
, .
.
" " ,
,
. ,

.
, ,
.

""
, . " ,

.
.
.
12
)(... .
) ( .
,
.
) , , , (
) , , , (.
, ) .(1
, , ,
D=1.58, 1.55, 1.35

. ,

) D = 0.80 (1 ) .(60
.
"" , Z=0.88 Z=0.53
. .
"'" 0.96 5 .
, .

 ) , ,( ,
.


. ) (
asps : dsps , ,
Asps . , . asps
, , .
asps . .
.
' dsps dsps
/ .
Dsps , .
dsps 3 : ,
,
. .
dsps ' ,
.
dsps
," . " ,dsps
, .
dsps .
" , "
3- .
.
, .
"" )( 10
dsps ) adhd( .
7.2 9- .
,
, adhd
. ,

.dsps

.1981
"'"
" . " 6-
" , , 90 -

 .
Dsps . .
.

"" ."
."
, , .
, " .
.
"" 11- .
.
xsps .
-
- 15-30' )( .
.
, .
.
.
.
)( ,
. "
. ,
" . "

.

.
. .
.
.

.

..
.
.


, ,
"" .
"" 25 6-14' , 11
, 11 )
( 3 3
. " " ,
., , ,
, , .
3' ' 5 1' ' ,2 ' .3
,
, , 3 ,3
,
.
" ""
19 . ) (13-18
6 ) ( irt
-1 : -2 , " " -3 , 20-
15 . 3 ,
. , ,
.
.

. , ,
, , ,
.

, , ,
.
,
. , ) (rem

) (

.
)( rmd
,
.
. , ) ,
( , , ,

 . rmd , .
rmd , . rmd
/ .
rmd ,
. rmd
. .
, rmd rmd
) ( , .
rmd -
.
. " ,
. rmd 8
, , ,
. ,
.
. rmd - .
,
rmd .
,"
, . ,
" ,"
, : ,
"" " ."
7
. ,
, .
"" ,
.
.
:
,,
.
. , . ,
.

. ,
. ) ,
( , ) , ,

 (
. . ) ,
,rmd , ( " , "
.
.
,
.

, , .

:-

Effects of sleep deprivation on performance

)June J. Pilcher & Allen I. Huffcutt (1996

, - ,
, 19 .
1,932 ,



143
. ,
, -
- . , -
, .

)( .
, .
(Krueger (1 ,
, ).(affect
. "-" )-
( , , ) .(2,3
, - . , -
) (
.
.
,
. , , , ,
.

 , - , , .,
- .
, ) , ( .
.
, ,
, )
(.
- , ) ,(4-6 ,
. , -
(Benca et al. (7 : (Hudson et al. (8 ,
(Knowles & MacLean (9 , - ,,
(Koslowsky & Babkoff (10 - -
.
, , -
.
,
. , :
, .
.
, .
(Johnson (11 ,
, ) , , ,
, ( . , ) (12 ,
.
, , .
(Martin (13 ,
. , ) ,(14-17 ,
) .(18 ,
(VanHelder & Radomski (19 , 72- ,
, .
.
,(Naiton (20 , 46 -
. ,
45- ) .(21 , )12,22- ,
,(24 .
-
. (Koslowsky & Babkoff (10
. , : ,

 , . ,
. ,
.

- 1984
.1992- ,
, 56 .

. ,
. , ,
? ,
?

: .
.

) ( / ) (.

)/( )/(.

.
, -
- ) , 1.37 (.
,

. , ,
, ).(55-59
-
. , . ,
,
. , ,
.
-
).(1,11,19,24
.
- ,

 . , ,
3- . -
, .
, . ,
- - . ,
- 2- ,
.
, - , - .
. ,

.
. ,
).(1,60
,
- ) .(12,24
- . , -
. , -
- ,
- .
. , -
,
.

. ,
) ( .
) ,(61,62
. ,
. )
,(63,64
. , .,
) ,(65
. ,
.
) ,(67 ,66 ,
. , ,
.
.
. -
,

 . ,
. -
) ,
( . , . ,
. , -
. ,

. .

.2
-

- .
) 77 (2003 .
: 3 . .
: ) (
.
: ) (
.BL
)( .BL
22
/ 10-14 ,,
&
Cognitive function following acute sleep restriction in children ages 10-14 / Randazzo, Muehlbach, Schweitzer
& Walsh

:

.
16 ,10-14 .
: : 11 : 5
:

= MSLT

.1

) '

(MSLT

.2

) (

.3

) (96% ' ) ,(84%

?

11 ,
.

.4

REM ) 1+2'

( , .SWS = 3+4 '

, ?
,SWS
SWS . ) (1+2
.
:

: .

16 : ) 7 9 ,( 10-14

: , :

' 11 ,' 5.

: ,

) .(MSLT
:
' ) (MSLT ' ' : ,

' ' : ) (
:
) ( :

: ) (.
,
.
.

.

 ,
.

, -
.
, .
-
,
.

,
) ( .
:
:
, : ) MSLT
( , - .
2:
(1 11 ) 21:00 (8:00
(2 5 ) 3:00 (8:00
* ' .
* ' ) ( ,
.
:
16 ) 7 9( , ,11.9 :
* ) ////( ,
) 9 (
: 3 5 , 11.6 : : 4 4 , 12.3 : :
10 3 ,
.
: ) 2100-0800
, 0300-0800 (.
EOG,EEG,ECG,EMG
- = MSLT :


' .
4 MSLT , ,14:00 ,12:00 ,10:00 : .16:00
- : 4 ) ( ),(14:45 ,12:45 ,10:30 ,8:45 :
- .
(1 -:
- " 2 : DSST .SC -
: DSST -
9 9 ).(& = 3 ,$ = 2 ,@ = 1 :
)
(.
.
DSST - 4 .
: , .
: CS -
""
. " .
" 2 4 ) ' 2 .(4
.
: .
(2 :
: , , .
= ) WRAML ( :
3 : , .
= ) TTCT ( :
.
: " ,
.
: " . : " . : " , , .
: .
: , , , .
: " . : " . - : " .

 : " . : " , .
, , ,
.
.
= ) CCT ( :
, ,
.
.
= ) WCST ( :
" 3 :
4
.
"" " " , "
3.

= ) CVLT ( :
" 14 . CVLT
.
.
:
:MSLT
" 287 : ' 548 , ' ) '
(
95.8% :' 83.9% ,' ) '
, 11 '
(.
) MSLT (:
) ( 14.4 : '
23.5 , ' .
' : 4.5 ' ,
MSLT '
) (
-:
- ,

 ) ' ( ,
.
' '
.12:45
) SC ( .
:
) TTCT ( : '
) (
) WCST ( : ' 15% ,
.
) CCT ( : .
) WRAML ( : ,
'
) - (.
:
:
)( 1

.
)( 2

.
:
, .
) MSLT ( :
, .
DSST ) SC - , (:
' ,
' '
.
: '
, .
:
) TTCT, CVLT, WRAML , , (

.
- ,
.

 " "
) , , (
.
) WCST- (:
.
, ,
, ,
.
WCST " " .
-.
) TTCT (
-:
, .
, ,
.
, TTCT
, .
, , .
, , .

.
:
TTCT , 30
.
,
.
:

(1

) (
) ( ,
.
.

(2

) 16 8 , ( ,

(3

) 10
3 (

(4

'

) 11(

(.

11

' .
'
.
(5 , .
(6 ) =
(

' : ' : 4
,2 ,3 ' :
,3 3 .3
' , )
( . , 2-3
. -
. '
' .
' .
!!!

50% .

.
,
.
. ) , (

/ :
, .

) : ,(
.

.
.

,
.
-23
:- /

) (sagea

.
:
:
297 : ' ) (.
: ,
.
. .
sagea: 54 ) (18.1% 24 .
30 .

. .sagea
sagea : '
. sagea
.

.
) (osas , 2% - 1%
, 12% ),(ps
. , osas
" -
.osas osas
" .osas osas ,
, , .
osas

 . 782 ,,
.
osas
,.osas osas

. sagea '
sagea ".
:
'
, . osas " .
) 0 : ( ) 1( )2( ) 3( 4
) ( . -1 : -2 .
? -3 ? -4
? -5 ? -6 ? -7
? 8 ? -8 ? .10
? .11 ? -12 " ? -13
?
, ,
).(tcco2 ,
. sagea
, . 3
,
" . "
.
. 0-4 2 , 2-2.5
.
:
4' :
.1 sagea ,co -
.2 ,ps
.3 sagea ,nt
.4 sagea .tr
' .spo2
:

 358 , 297 '

. 61
. .
32 . 66 PS
(22.2%), 54 ) (18.1% SAGEA - 24 ) TR) 30
) .(NT 4
: 2.43 2.87

.TR NT - 2.44 2.46-

. .
:
SAGEA .

SAGEA .' .
SAGEA OSAS
.
,
SAGEA . ,
. ,

. -
.
SAGEA . SAGEA

.
, SAGEA .
.
SAGEA OSAS

. , TR , 2 - .
SAGEA
.
. osas
,
14
. , .
osas .
" , ,
. ,

 . nt tr
.
. tr nt tr
-

sagea

.nt ' tr

.
.
:
, "
' .

sagea

. ,
, .

24 : .
: .
. ) , , ( ,
) , ,( . 3120
4 .
50 40 .19- 13
, .
. 25
40 ) (.
)
(.

.

) (
, , , 8

60

: .
: ,,,
, .
.
,, . ,
.

 ,,,,

,
10 -
7.5-8 .16
, 54% ) (

.
60% 11 12- .
45% 10 12 )
( , 90%- .
30 60- 10 ,14\13

)18

(.

.
) (
, ,

.
: , , .

.
10
.

11 ,10 12-

, , 7.5 8- .

9.2

.
.
,
.

MSLT ,
, .

, .
)
( ,

 ) ( \

.:
. 9.
) (
.
) \ ( 400
.

.


,
.
: .
" ,:
.
,
. " .
: 10 14
.
.
7.30 " ) (
.
40
) ,
( mslt 45 .

, " .
:
.
,
. )

. .:
) ,
, , ( .
, .
:

 ,, \ . .
" , ,
. , , "
, , .
.

, .
:
, ,
, , .

( ) (.
. ,
) , ,( ) ( ,
, , )
( )
(.
, , ,
.
,
, ,
) ( .
..
,
.

, , , .
.1 : ,, . 2.
) ( .3 .
.
:
: 7:10-7:30 .

.
" , ,

\ , .1 :
.2
" " . \

) ( , ,
, . :
) (" .
: , 10
, , , .
1 1) 4 4 ( . 10
):
, 3, (.
5 )=5
= 1, (.
10 50 - .0.75

.
): , , (.
, .
" .
. 6 5
.
:
3120- 395 , ' 1077 ' 745
' 903- ' ) 48% 52% ,(.
' -' 10-12 ' -' 9) .12- '+'+'+'
, ( , .88%
13 .19- 91% ' ,' ,' ,
. 81% , ,
46% , 63% - 86% .
.
:
.1: \ ,, .2 .
\ .3.
:" ,

,, ,
) ( :" , , ,
.
.1: .2 , .3,
.
: 311
.

:
.

" 40 13-14 17-

) 19 1 ( . 45
) 1(.
) ( 10) ( .
." 50- ) (.
)
(.
) = ( .
13 .19-
) 7:10 ,(7:30

) (
) (7:10 .
" , ,
. ,
" , ) = (
.

.
:
)
(.
" .
.
. "
,

(.

:
2 .
.
.
.

. " .

. 2.3
) ( 1.8 -

 .
. .
:
,
, ,
, .
.
:" :=8 15 , =
45 . , = 120 -
60.
:= 120 = 60- .
" , , ,
,. " ,
, .
). 3
: ,,
=

(.

) , ,
( :" ,
,

.
. "
, ,
. ,
.

,
) (.

.
,
.
) (,

:

.

 ) (88%
.
.
, ) : (
, 3000 " )
(.
.13-19
, " 7 42 7 4 . :
9 20- 8 38
.
,
. 7:10 7:30 ,
.
12 ) (
.
) ( " .
,
. .
9.2 .
, 87% -
\)() 9(40% .
11 , 91% 11
)67% ( . 26% 6.5
, 15% 8.5 ) 7.5(.
70% 60
, .
91% 6:30- , 72% 9:00

.1 :
.2 . .3 .
.
.
.
5.1%
80%

 ) (:

) ( , ,
) (
.
150,
.

.
) ( "
,

.
, .
.
, ,
, , ,
.
) (:

, ,
. ,

" \
.
.
. 4
13 :15 , ,
, .
,
, .
,
.
9 12 2 5 ,

.
.


.
.
.
:
, , .
,
.
.
,
, , .
, ,. , ,

. .
10 ,
6 53- .
, ,
.
, ,

) (.
) (
.
.1:
.2 ,, 13 19
.3 "
.
, .,
,
, , .

.
,,
.
, .
, , . , 7 - -
20

,, .

, , ,
.
.
, .
) , ,(
.
.
.
.
.
25
- "

/ , &

Sleep' neurobehavioral functioning and behavior problems in school-age children / Sadeh, Gruber & Raviv
:
- " ) ,,(
.
,
)
(.
! ) (,
.
:

- :

) (
:
-

?
:

,

 .
:
,
.

.
, , ) "
( .
-
".

) (
-.
,
- ) (NBF ".
5 :
(1 NBF
(2 NBF -
(3 NBF -
(4
(5 , , NBF
NBF , ,
,
"" " "
) , (.
, :

.NBF
:
(1

(
(2

) (.

:
-

) ,

-
(
:
- ) 4 ( )

,
.
, , ) (1998 5

11

(:

, ,
.
- ) (NBF
,
, .
, .
,
.
-.

.
NBF :
NBF.
- ,
.
,
" .
: -
, "" .
- -
.
NBF :
,
.

 ) (sleep apnea
.
) NBF
, , (.
- - -
:
) (ADHD
,ADHD
ADHD .
ADHD , '
.
ADHD
) (
-.
, ,PDD-
.
:

.
: .
: ,
/ - ) ,(PTSD.
: .
, : NBF -
NBF " , .
" , ,
.
,
4 .
, , -
, .NBF

.NBF

) ( , " .
:

 -,
- .
.

) ( ,
- ) " (.
.
- ",
" .
3 .
NBF NBF
.

-
) : NBF- NBF
(.

.
:
:
135 , 3 ) ' ,' ,'(.
.
.
:
.
2-4 " -
.
= ) NES -
( ",
.
NBF ) ,8:00-9:00 : ,(12:00-13:00 :
) ( .
NBF 3-4 , :
,.
,
.
:

( :
- .
,
.
5 ".
) 10
(.
-.
.
:
) (1
) (2
) (3"
) (4 = "
) (5 = "
) (6'
) (7 =
) (8 =
( - :
NES -
.
, " ,
".
NES :
) (1 : .
) (.
) (2 : .
) (.
) (3 ) :(CPT ,
.
) , = , = (
) (4 ) SDS): 9 9 ,
9 ) .
(.
) (5 : ,
) ( . 2
, - ) .
(.

) (6 : .
) . ,
2 (.
( :
CBCL " .
CBCL .
:
- :
-
- ) ,,
- (.
.
)
, , (.
-:
.
NBF .
NBF
) SDS (
) CPT (.
,NBF:
) '( .NBF
"" "" :
:
(1
(2
""
:
(1 3 ) 5(
(2 90% ) 10% (
25 "" ,
.
-:
NBF
.NBF
) (.
.

 NBF
"" "" .
- :
) (1 ) = (,
) ' ( ,
.
) (2 ,
"

":

)-( .
:
- ".
NBF
NBF .
: - ,

.
, ,
, - ,
.

.
) ,(ADHD ,
/ -,
NBF .
" " .
,NBF

.

"" .
- )
SDS ,(CPT- .
) , ( .
NBF , , , )
(,
NBF .
NBF -
) '(.

 ,
, -
.
) (
NBF- .
CPT
)(.
.
"" "" ,
:
"" 3- ,SDS, CPT : .
"" ,
"" "" .CPT
- "" ,
.

) ( .
"" , )"
(.
,
-,

:
) (1 " ?
) (2 - ,
' ?
) (3
?
:
, 3-:
(1 : , .
(2 : , .
(3 : .?
, / .
" " , : )
(.

 6

.
.1

. : , , , , .

PILCHER&HUFFCUTT
.

, .

TOTTERDELL
.
.

-

,
.

90% : , ,
,REM .REM

: , .

:
.

.REM

26
/
The regulation of sleep and arousal: development and psychology / Dahl
:
.

.
, .

 )
(.
, ' ,
.
) ""( - ,PFC
, , - ) ""(
,LOCUS COERULEUS .

.
:
.
,

.
" -.

- , :
) PFC -(

) (.

,
.

:

.
.

.
PFC .

.
:
,
.

, .

 -.
- , :
(1 .
(2 - , ,- .
(3 - ) (PFC
.
(4 - )
( )
( . .
(5 ) , (
- .
,
.
:

,

.
, ,

, .
,
.
, :
, ) (
90% ,
: ,
) , , (...
.
3 ) (2-5 ,
" ) /
/ .(...
: ?
, , , ,
?

!


:


.
,
. .
, ) (
?
:
,
"" ?
,
.
) = ( :
,
:
, .
:
, .
.
, .
: :
.
:
/ - , ,
.
: , .
)( - ) (.
,.
:
- ) (,
.
: ) ,
(.
,
)( -.
, ,


.
) ( ,
,
.
--
!
--
, !
)( :
""
.
" "
.
.
,
.
) = (,

.
--- :
/ "
, .
)
(,
" .
, .
"" -
.
:
-
?
,
:
?
, :
3 , :

 (1 :
, , .
(2 :
) : , , (.
(3- -

, , ---
- . , , , .
3 ":
(1 :
.
) , , '( .
:
.
.
.
: 75% 25%
) = ( .
,
,
. ? :
(1 ) (
(2 : ,
. -
- :
, ,(PTSD (post traumatic stress disorder , ,
... .
(2 :

) ,
( ." ,
, .""
:
"" = ,' . .
,
, , .


: REM "
. , /
.ADHD
,

-- ,
.
4 --:
(
( .
( )
/(
( ,
' .
(3- , :
, - .' -

.

, .
:
:1 16 , :
16 "
.
, .
.
,
. :
, , .
, ,
.
:2 :
14 , , ,
.
, 6 .

 9
.

) , , (,
.

,
, .
EEG :
EEG .
:
(1 .
(2 3 ) 4 100 (
(3 REM ) (?alerted pattern .
EEG ) (MDD :

EEG -
.
3 4 ,
, ' .
MDD : ,REM latency -
).(sleep latency
8 MDD , :
4 ,REM latency -
5 ),(sleep latency
3 .
,
.
:
)
( , .
?

.

,:

 REM latency -
,
-

.REM latency

) (
: - EEG
.

) / .(...
,
.
- - -

.
,
.
.

) - ( )
-(.

.
) ( -
-.

.

:

.
, ,
- .
: -
): (PFC
PFC , .
: PFC
' .
, .
PFC / - ,
) ( ) (.

:
, PFC ,
PFC .
PFC"" )
(.
: PFC ) , ,
( .
PFC - , ,
:
, - , " ",
" " ,
, .
.
PFC , - ,
.
PFC .
PFC ""
PFC , - ,
.
PFC .
PFC ""
PFC , , , ,
) (.
PFC )
(
- .
, ) (
) (.
PFC )
( ,
) (
) (.
PFC :
- ,PFC .
,
.
" , " ,
.

 " PFC" "

" , .
-
.

.
= PFC )
, , (.
: ,
) ( )
'(
, PFC
, .
/ :
,
.
:
(1 ,PFC .
(2 , ,
.
(3 ) ,
( .
(4 ) ( ,
:
- - )

(,

PFC .
(5 PFC .
:
- :
(1
(2 ) , , ,
, , ,(
-
: .
50-60%

) (.

 - -
:
(1
,
(2
(3 - )
"
(.
:
, , ,
.
,PFC , :
PFC
PFC ,
, , ?
?
" :
.
" , PFC )
( , ) ? ?
?(.
) (
) " '
(.
-
.
PFC
) (
.
:
PFC ) (,
.
PFC ,
PFC ,
PFC .
:

.

.
PFC
.

-- .

--.
, .
,
.
?
?
pfc.
- , pfc
,
, - .
, pfc
.
?
, -
.
, )
- -( , pfc
.
pfc - )
(.
pfc , -
.
-- :

)(1

- ) -(

,PFC

) (

)(2

).(PFC

, ,
-
.
)
(
.

)(3

PFC , :

, , .
PFC

PFC
PFC ,

.
:
: ?
"" ,
- .
:

NREM )

" ,
(

REM ) :

/ , (
: -
?
-
"" , .
) (

.

:
, .

 .

: , ,
, .
.1 : .2 . ADHD
.1
-

"".
-

.
ADHD 28

: .ADHD :
1970 ADHD . box-
score , .
: ADHD - ,
. ADHD
.
) ,
) REM ( , . :
ADHD .
. , ,
ADHD .
ADHD . 5% -
ADHD . ,
. ,
. ,
- ADHD - . ) (1990 ,ADHD -
" " . ;ADHD
, .
ADHD DSM-III - ,ADHD
) DSM - ( .
ADHD -
) , ( .
ADHD .ADHD

 , , , ,
ADHD
- , ADHD
.ADHD
ADHD , ,
ADHD .
ADHD , .1970
Medline .
. 16
ADHD . 16 8 ,
.ADHD ,
(1) : ADHD
ADHD (2) .
) , ( (3) .
.(ADHD. (4 .
box-score 16 , .
box-score ) ,
,ADHD , ( . ) meta-
(analysis )
( .
. ,
.
, .ADHD
" ,
.


- . ) , , ,(
, , , ,
,' . , ,
\ .
) ,polysomnographs, actigraphy ,( ,
,Polysomnographs . " " ,
Polysomnographs .
EEG - , ) , NREM - REM( non /rapid eye -

 .( (movement Actigraphy - -
Actigraphy . , , ,
,' . . ,
actigraphy EEG - .
ADHD
. 113
ADHD, 65 . . ,
14- ) 91 ADHD"(.

. " " .
6 14 \ .
ADHD , .
,ADHD .
, .
- . , .
.
) ,(methylphenidate, dextroamphetamine, pemoline .
.
. , (ADHD (90% - ,
. ,
6- .12 - ,
.
, , .
EEG -
.
, .
ADHD
. , Polysomnographic -
. ) (1984
, ) ,
(.
. ) ,(1983
ADHD . ,

 ) , ( .
- ) , ( .
. , ) ,(1996
) , , (.
Polysomnographic .
) , , (.
) , , ( . ,
) (1992
) , ( Actigraphy .Polysomnographs -
Polysomnographs .
, .
) (13/14 Polysomnographs - . ,
.
,
, ,
) , ( .
. ) , , (
. ,
\ .

ADHD
ADHD
.ADHD -
. ,
.ADHD 48 ADHD
) 56% (23% ) 55% (27% 30
.
) (1987
.
, 25% ADHD ,
, .
ADHD
ADHD .
14 ADHD 12 .2
,Polysomnographs - .Actigraphy -

) (parasomnia ADHD- ,
) (dyssomnia.
ADHD :
ADHD ;
; . .
, ADHD - .
ADHD - .
) ( . ADHD -
. ,
.
, ,actigraphy -
.polysomnographs - ADHD -
. .
ADHD - . ) (1992
; ,
ADHD "" ) , ADHD (.
" , " , ADHD -
) , (.
ADHD ,REM -
REM - . REM - ,
NREM- . REM - ADHD
. REM - .ADHD -
) (1990 REM ADHD -
, .ADHD -
REM - .ADHD -
.NREM - EEG (13 15(,
. ,
. .NREM -
. 2 , 3
.ADHD -
.
14 )
(methylphenidate .ADHD .
, .
' ) ,(1978 .methylphenidate
, ADHD ) methylphenidate (pemoline

 ADHD , .
- .ADHD ,
. .REM ' ) (1983
,REM REM .
REM-.

;ADHD , .
) b.i.d ( ) t.i.d - ( .ADHD ' ) (1995
) ( ,
) t.i.d ( . ' ) ,(1996 -
,actigraphy t.i.d .b.i.d ,
.t.i.d' ) (1983
. ) REM- -
.(REM
ADHD -
ADHD .
) ,(1991 10 ADHD
)) ( chronotherapy
( .
) ,
( . 4
" , v . ) (1976
7 .ADHD
, .
ADHD - " " ADHD
. , ) (1992
.ADHD - ) (1994 34% ADHD -
) (periodic leg movement disorder .
34 , 14- .PLMD PLMD (clonidine
( levodopa .
) (1996
) .(adenotonsillectomy ,
, . .

 . 18
,ADHD ) (1992 .
) ,(1996 62 ADHD
. , , ) 85%
(.
Box- Score
ADHD
. ADHD
) (113 25% 50% 7% .
.ADHD , ADHD
. ,
ADHD - ADHD .
ADHD

- .
.
, ) ,(33% ) (22% ) .(45%
, 90% ) (9/10
ADHD . ADHD - 38%-
) (3/7 67% . ) (4/6 ADHD -

. ADHD - REM-
NREM ) REM NREM: 55% - 50% - ,(.
, ) II
( .ADHD -
. , ADHD -
) 90% ( .
. , ADHD ) Actigraphy .(67%
,polysomnographs - -
actigraphy .polysomnographs -
75% - ) .(6/8
REM -; ,
"" .
. , -
"" .

 ADHD .
, .
, .
ADHD - ,
ADHD .

ADHD .
) (1 , ,
(ADHD; (2 ADHD
, ; ) (3 ),
( (ADHD; (4
. ,
,ADHD
.ADHD -
29 !!!

7 ,
3.1 : ,
.2 .3
.
/ 3:
.1 .
.2 ' .
.3 .
.1
SADEH ' 33 2
.
:Turn On
.
.
, .
: Shut off
,
.

.2
PTSD
.1 : : , .2
, , , .
* PTSD )
( ) (
?
* PTSD

. .

.REM

REM

, .

. .

) (.

.1 PTSD .
.2 ,
: .
.3 : .
.4 : PTSD , , .
.3

, .
,
.
.

.
, ,
.
31 !!

32 .

 , , ,
, .
- ,
, , ,
.
.
. REM 3 NONREM 4
, . .
, , , .
,
. ) . ,

4 .5 " (."
,
. .
) (5,4 ,
.
"" "
.
. , ,
, .
. , - ) (
,
.
"" ) " ("MARE
. /
) ( PTSD ,
) .(...
, , .
REM .NREM
REM ) NREM ,REM ,
/ ,
REM NREM .

, .
, . / ,
, , ,


. "" ,
, ) ( in utero " -' -"
"" ) ( ,
" "'" ) ( MOHAVES .
.
.
. ,
, " .
"". ' , ,
.
3-5
"" 1910-1911 ,
.
,
. -1900 " " ,
,
. ,
, . ,
" .
" , "" ) ,( PIAGETIAN"
.

. " ,
, . .
, ,
.
" / "
. ) ( . )
( .
- . .
"
)
( . "
" .
, " "
.
" . "
, ""

 .
, .
, ,
" .
""
.
"" 1970- , , ,
.

/ :
"" adultomorphic
) (. . 1919'

. " ,
) ( .
8 .
, , , .
" -
) -( - .
, .
"" , 13 " " ,
. "
" ) ( . ,
.

.
"" ") "Isakower phenomenon
, ,
( ," pavor nocturnes " ,
" " preimagic
. ""
) ""object permanency 15( ,
. "" "
.
"" , ,3-4
" ," preimagic ,
/ / , .

 15-30' " , , ,
, . " pavor nocturnus " - ,
3-4 . ,
.
.
" "imagic
, , 15-
30 , .
.
. , ,
)
.(.
) (
, .
, ,
, . .
" , , , .
,
, , .
. ) 19'(
) 22'( .
, , .
24' .
) REM ( .pavor nocturus -
" ." , .
"" 14 ) 9
8( .
. ,
2-5 ,
"
.
"" 190 ,

, 39

"

) (2-5 . " ,
, /.
"" , ,

. ","
," ,
. , :

 )( ,
. .
/ , " "" "" .
" .
" , " , , . 5-6
: , , , .
, .
" ) ( ) (2-3
.
) 6-7 (11-12
15-30' 4-6 . ,
, .
, , ,
.
.
.

. " . "
.
.
, 13' , .
, .
.
.
.
.
.
, )
" ( . . "
, , .
" .
, , / /
/ . .
, , , ,
.
.
. ' ,


.
(pts)-
" " ,
, . .
, . -
. , " .
" ,""
" ." ) - ( .
1945
.
1976 26 ," chowchilla " - .
27 .
4 5 . . CHOW -
, ,
, .
Chow / . ,
, . ,
. NREM )
( 4-5 .
,
, . , CHOW

: , .
.
. ,
,"
.
, .
,CHOW .
, .
, .
.
, .
,CHOW
. ,
.

 .
, .

?
CHOW " .
" / / / .
.
/
, .
. /.
. ,
.
" " " " " " "
,

, , . ,
/ .
. . "
.
,CHOW 3 ,
" . , " , . , ,
, .
"
- . .
/ ,
. , .
.
' = 3-5
' = 5,6

,, ). (33
.
,

 , ,
.
.
:
, ,

, . ,
.
,
.
) ( .1 :

.2 .
.3.
,, .
,. ),,(,
,
. , , . 3
9
.
,, . ,
.
.
:
, ,
.
.
,
. ,

.
.

.
.

.

 )( ,
, ).

, (.
, .
0
, ( ,
.

, .
:
.
.
: ,,)(,, ,
, boelby .
, 1 :\-
, ,\ ) (
.
.2- .
.3 -
.
, .
.
, , ,
.
, .
.
) ( , ,
, , , .
, .
, , , , , .
.
: .
) (,
)=( .
,
. ,
.

 \ ), ,(
)" ( .

. " \
,
.
.
,
.
: ,

.
,

, ,
, , .
, ,

.
)( ,
.
,, .
.
: ,16 .
4 5 . ,
.
30 40-
. 4 5-
20 40 .
. ,
. , ,
.
.
: .

.

\, . , ,
.
, .
"
. 5
. 3.5
.
.
: :
. ,, .
.
, .
. .
. .
, .
. )( ,
.
. \
.
. ,
, , , , , ,.

) ( , , .
.
.
.1 :
, ,
, .
.2
.
.3 \
.
:
, .
, :,,
. "

 .
. ,
, , .
\
:,, .

.
: , .
. "
.
.

.
.
.
. ,
,,,
\ .

, .
, .

.
.

.
:
.

.
, , .
) ( .


.

. , ,
. ) (, ,
, , .

 .
.
,
, ) , ,
(.
:

.
:
,
.
)
(.
.
, .
.
.
, .
86 16 22 60
. ,
, .
.

) ( . )
( .
. , 61
. .
55 .
,
.

).
,(.
:

.

 29 .

,, , , , .
,
,.

, , ) 50%
(,

,

.
159 .
13, .
.
77.1%-

62.9%

, 55.6%
.
, , , ,
.

. , .
) ( ,
.
:

.
:
.1
), (.
.2 , ,), (
, .
, , .
.3 .
.4 ):
(, .
.5 " .
.
.6 " .

 :
, : , , ,

turn on

,
, ,
.
SHUT off
\
.


" ,, ,,, ,
,
,

. , :
, )(, .

.TURN ON
2 , .SHUT OFF

, ,

.
.
.

.
) (
.
) (
.
.
, .
.
.

 33 , /
:
.
. ,
.

.


,
.
. .
,
.
:
.1

.
.2

.3

, '.
, , , ,
)( .

) , , ( ,
, .
" . 3
9
.
, ,
.
DSM .
, .

" "

 .
, .
.
- ,
) ( . "" "
-
.
,
. " .
-
.
,
.
.
" )" (
, .
PTSD ,
.
. PTSD .
,REM
.

" 2 .
:
-

.
-

. "
. , , ,
.
,
:
.1

, ,

.
.2

.3

""

.
.
. ,
/ , ,
.REM
, .
, .
, , / ,
, .

.

' , ,

.
,
: .
,
. , .
/ , /
.

.

.
) , '(
)" ( .

.
,
" .
) ( ,
. .
,' ,
.

, "
) ( .
.


.
, ,
, , ,
, .
- , ,
.
) ( . -
, .
, .
)( ,
"".

, .
, .
.
: , ,16
. , 4:00 5:00 ,
.

.
) / (
30 40 , .
, , 4:00 5:00
20 40 .
. ,
,
. ) (
.
, , .

.
.

.
.



, .
, ,
.
/ ,
.

.
' , 5
. 3.5
.
, 6 ,
.
.
, : , ,
. , , .
.
, " .
.
. .
, .
.
.
.
, .
/.
,DSM-IV .
, ,
, .
, : ,
. ,
, ,
.
, .
:

 .1 ,
.
.2
.
.3 - .

.

, ,
, .
, , .
,
. ,
. :,
, , .
, ) (
: , , .

' . ,
, .
.
.
.,
, ,
, .
.
,
) , " ( .
" ".
.
, , ,
.
,
.
,
. ,
." ,

 . , ,
, . , ,

.
.
, ,
, .
) (
, .
.
) ( .
,
, .
, ,
, )( .
, .
, , , .
,

.
)
, (
. , ,
.
,
.
:

.
.
: , '
.
.
.
.

.

. 86
16 . 22 60 .
, .
"
.
.
5 , "
. , .
. 61
' ," .
. 55
.
.
.
:
. 29
. :
, , , .
,
. ,
.
) 50%( " LOMA
.PRIETA
) " ( .
, "
" .
, 159
. 13 .
.
77.1% , 62.9%
, 55.6%
.
, ,
,
.
5687 ,
.

 ) 5% ,(3.7% ) (20% .
) ( ,
.

/
.
.
:
.1

) :
, (.
.2

, ) (

, .
.
.3

.4

" ,

.
.5

.
.6

'
. "" : , ,

. ,
"" , "

.
"" ""
. ,
, - "" -
, , .
" -.
" ," "" , .
.
. , ,
: ,
.

 "" , , ,
"".

" . ,
/.
-
) ( ,
) .
" .
.

. .
, ,
, .
,
. ) (
.
) ( ) (
" .
. ,
) ( . ,

.
. ,
, .
- ,

.
-
. ,
.
, ) :
( .

.
8

 " ,
.
, ,
.
.1 : .
.2 , " .
.3 "
, ,
.
.4 : " ,
.
.5 : .
134 !!!137

" " 35

: .
,
, )" ,(
.

2 3 ' , 3
" . 517" ) (1-5
494 .4 )
(CSHQ .
.CSHQ

. " ) ,(1-4 )(9:02VS8:27
) ,(6:55VS6:28 )
.(10:15VS9:25 ,CSHQ
.
, , , ,
. , ,
, ,
,
.



" .
.
" .

, ,

, , .
20% .30%
, ,
. , "
.
.
" .

,, ,
.
" 18.2% 55%
.7 73.5%
.3-6 " " , "
" .
." ) , (
. "
1993-2000 9.2% ,

, , .
, .
40,303 11-16 ,
. "
, .
.12:00-14:00 ,
.
, " .
" " (1), ) ,
, ( , (2).
(3). ,
" .
" , " .

 "
) ( . .

" " .
.CSHQ
) (1
(2). ,
(3) . "
(CSHQ.(4 , , ,
,
" (5). ,
" ,
(6).
" .
" ,
. "
, , :
- .
. ,
30'
. "
. . ,

. " ,
" ,

" . "

. . 60%
2 4 , 40% 30% , " ",
30%-26% ) "( 23% 22%
10% . ,
,
" .
) ( . " ,
, , 12%
" ,

) "(.

 ,
.
.
" 3
. " .VS 47% 92%
.


.
!!!138-141

McKenna : Infant parent co sleeping in an evolutionary perspective: Implications for 36

understanding infant sleep development and the sudden infant death syndrom
McKenna :
.1 "" , .
.2 ) ( .
.3 ,
, .
.4 ,
.SIDS
.5
.
.6
,
, ,
.
.7
.
.
.
,

.

2 .
.

""
.

, .
. " "
.

.

2
.
.
.

,

' .

.

,

.

: .
: .