Sleep and daytime sleepiness in adolescents with and without ADHD: differences across ratings, daily diary, and actigraphy
Sleep and daytime sleepiness in adolescents with and without ADHD: differences across ratings, daily diary, and actigraphy
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DOI：
10.1111/jcpp.13061
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发表时间：
2019-09-01
影响因子：
7.6
通讯作者：
Bourchtein, Elizaveta
中科院分区：
文献类型：
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作者：
Becker, Stephen P.;Langberg, Joshua M.;Bourchtein, Elizaveta
背景注意力缺陷多动障碍（ADHD）儿童比同龄人经历更大的睡眠问题。虽然青春期通常是一个以睡眠不足为特征的发育期，但很少有研究使用多信息提供者，多方法设计来检查患有和不患有ADHD的青少年的睡眠是否不同。方法采用定向招募方法，招募大约相同数量的八年级青少年（平均年龄= 13岁），有ADHD（n = 162）和无ADHD（n = 140）。青少年和父母完成了睡眠问题的全球评级;青少年，父母和教师完成了白天嗜睡的评级。青少年佩戴活动记录仪并完成约2周的每日睡眠日记。结果ADHD青少年比非ADHD青少年更容易在上学日（根据日记）和周末（根据日记和活动记录）获得睡眠不足。患有ADHD的青少年也更有可能报告在课堂上睡着，并且在过去的两周内至少有两次整夜不睡（分别有14%和5%的人报告ADHD和对照组的通宵）。在回归分析中，控制了一些已知会影响睡眠的变量（例如青春期发育，性别，药物使用，具有外化，焦虑或抑郁诊断），ADHD仍然与较短的日记和活动记录学校夜间睡眠时间，青少年和父母报告的白天嗜睡，以及父母报告的启动和维持睡眠困难和总睡眠障碍相关。在控制其他变量的情况下，ADHD青少年被归类为临床上父母报告的睡眠障碍升高的几率是6.20倍。研究结果提供了一些最明确的证据，ADHD青少年比没有ADHD的同龄人经历更多的睡眠问题和嗜睡。评估ADHD青少年的睡眠问题，并评估现有的睡眠干预措施是否有效，或者可以优化，用于也有睡眠问题的ADHD青少年，这可能特别重要。
Background Children with attention-deficit/hyperactivity disorder (ADHD) experience greater sleep problems than their peers. Although adolescence is generally a developmental period characterized by insufficient sleep, few studies have used a multi-informant, multi-method design, to examine whether sleep differs in adolescents with and without ADHD. Methods Targeted recruitment was used to enroll an approximately equal number of eighth-grade adolescents (mean age = 13 years) with (n = 162) and without ADHD (n = 140). Adolescents and parents completed global ratings of sleep problems; adolescents, parents, and teachers completed ratings of daytime sleepiness. Adolescents wore actigraphs and completed a daily sleep diary for approximately 2 weeks. Results Adolescents with ADHD were more likely than adolescents without ADHD to obtain insufficient sleep on school days (per diary) and weekends (per diary and actigraphy). Adolescents with ADHD were also more likely to report falling asleep in class and to have stayed up all night at least twice in the previous 2 weeks (14% and 5% reported all-nighters for ADHD and comparison, respectively). In regression analyses controlling for a number of variables known to impact sleep (e.g. pubertal development, sex, medication use, having an externalizing, anxiety, or depression diagnosis), ADHD remained associated with shorter diary and actigraphy school night sleep duration, adolescent- and parent-reported daytime sleepiness, and parent-reported difficulties initiating and maintaining sleep and total sleep disturbance. Controlling for other variables, the odds of being classified with clinically elevated parent-reported sleep disturbance were 6.20 times greater for adolescents with ADHD. Conclusions Findings provide some of the clearest evidence yet that adolescents with ADHD experience more sleep problems and sleepiness than their peers without ADHD. It may be especially important to assess for sleep problems in adolescents with ADHD and to evaluate whether existing sleep interventions are effective, or can be optimized, for use in adolescents with ADHD who also have sleep problems.