Impact of sleep restriction on affective functioning in adolescents with attention-deficit/hyperactivity disorder
Impact of sleep restriction on affective functioning in adolescents with attention-deficit/hyperactivity disorder
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DOI：
10.1111/jcpp.13235
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发表时间：
2020-03-10
影响因子：
7.6
通讯作者：
Beebe, Dean W.
中科院分区：
文献类型：
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作者：
Becker, Stephen P.;Tamm, Leanne;Beebe, Dean W.
背景 睡眠时间缩短和情感障碍在患有注意力缺陷/多动障碍 (ADHD) 的青少年中都很普遍，但这些领域之间的因果关系尚未得到检验。这项研究调查了睡眠时间缩短是否与患有多动症的青少年的情感功能存在因果关系。方法 参与者是 48 名患有 ADHD 的 14-17 岁青少年（75% 男性），他们使用实验交叉设计成功完成了为期三周的睡眠方案。该方案包括阶段稳定周，然后以随机平衡顺序进行一周的睡眠限制（床上 6.5 小时）和延长睡眠一周（床上 9.5 小时）。通过客观体动记录仪监测睡眠，与限制相比，本研究中的所有参与者在延长期间获得了≥1小时的体动记录仪测量的睡眠持续时间。父母和青少年在延长和限制条件下每天提供积极和消极影响的评级。情感、内化症状和情绪调节的评分是在每周结束时进行的实验室访问中收集的。结果 与延长限制期间相比，父母和青少年都报告了更大的抑郁症状和更低的积极影响。父母还报告说，青少年在睡眠限制期间的负面影响和情绪失调比延长睡眠期间更大。没有发现对父母或青少年报告的焦虑症状或青少年报告的情绪调节或负面影响有影响。结论 这项研究的结果提供了第一个证据，证明睡眠时间缩短是 ADHD 青少年经常经历的情感和情绪障碍的一个原因，尤其是父母观察到的。针对睡眠对于减少多动症青少年的情感障碍可能很重要。
Background Shortened sleep and affective disturbances are both prevalent in adolescents with attention-deficit/hyperactivity disorder (ADHD), yet the causal link between these domains has not been examined. This study investigated whether shortened sleep duration is causally linked to affective functioning in adolescents with ADHD. Methods Participants were 48 adolescents (75% male) aged 14-17 years with ADHD who successfully completed a three-week sleep protocol using an experimental crossover design. The protocol included a phase stabilization week, followed, in randomized counterbalanced order, by one week of sleep restriction (6.5 hr in bed) and one week of sleep extension (9.5 hr in bed). Sleep was monitored with objective actigraphy, and all participants included in this study obtained >= 1 hr actigraphy-measured sleep duration during extension compared to restriction. Parents and adolescents provided daily ratings of positive and negative affect during the extension and restriction conditions. Ratings of affect, internalizing symptoms, and emotion regulation were collected at laboratory visits conducted at the end of each week. Results Both parents and adolescents reported greater depressive symptoms and lower positive affect during restriction compared to extension. Parents also reported greater negative affect and emotion dysregulation among adolescents during sleep restriction than extension. No effects were found for parent- or adolescent-reported anxiety symptoms or for adolescent-reported emotion regulation or negative affect. Conclusions Findings from this study provide the first evidence that shortened sleep duration is a causal contributor to the affect and mood disturbances frequently experienced by adolescents with ADHD, particularly as observed by parents. Targeting sleep may be important to reduce affective disturbances in adolescents with ADHD.