PsyQ Psycho-Medical Programs, Program Adult ADHD, The Hague, The Netherlands.
Biol Psychiatry. 2010 Jun 1;67(11):1091-6. doi: 10.1016/j.biopsych.2009.12.032. Epub 2010 Feb 16.
Previous studies suggest circadian rhythm disturbances in children with attention-deficit/hyperactivity disorder (ADHD) and sleep-onset insomnia (SOI). We investigate here sleep and rhythms in activity and melatonin in adults with ADHD.
Sleep logs and actigraphy data were collected during 1 week in 40 adults with ADHD, of whom 31 reported SOI. Salivary melatonin levels were assessed during 1 night. Sleep measures, circadian activity variables, and dim light melatonin onset were compared between groups of ADHD adults with and without SOI and with matched healthy control subjects.
Compared with control subjects, both groups of ADHD adults had longer sleep-onset latency and lower sleep efficiency. Adults with ADHD and SOI showed a delayed start and end of their sleep period and a delayed melatonin onset compared with adults with ADHD without SOI (p = .006; p = .023; p = .02) and compared with healthy control subjects (p = .014; p = .019; p = .000). Adults with ADHD and SOI also showed an attenuated 24-hour amplitude in their rest-activity pattern, in contrast to those without SOI, who showed a higher day-to-day stability.
These findings demonstrate diurnal rhythm deviations during everyday life in the majority of adults with ADHD that have SOI and suggest that potential benefits of rhythm-improving measures should be evaluated.
先前的研究表明，注意力缺陷/多动障碍（ADHD）和入睡困难（SOI）儿童存在昼夜节律紊乱。我们在此研究了成年 ADHD 患者的睡眠和活动节律以及褪黑素。
在 1 周内，40 名成年 ADHD 患者（其中 31 名报告 SOI）记录了睡眠日志和活动记录仪数据。在 1 晚评估唾液褪黑素水平。比较有和无 SOI 的 ADHD 成年组与匹配的健康对照组之间的睡眠测量、昼夜活动变量和暗光褪黑素起始时间。
与对照组相比，两组 ADHD 成年患者的入睡潜伏期和睡眠效率均较长。与无 SOI 的 ADHD 成年患者（p =.006；p =.023；p =.02）和健康对照组（p =.014；p =.019；p =.000）相比，有 SOI 的 ADHD 成年患者的睡眠期开始和结束时间以及褪黑素起始时间均延迟。与无 SOI 的 ADHD 成年患者相比，有 SOI 的 ADHD 成年患者的昼夜节律模式 24 小时振幅也减弱，而无 SOI 的患者则表现出更高的日间稳定性。
这些发现表明，大多数患有 SOI 的 ADHD 成年患者在日常生活中存在昼夜节律偏差，并表明应评估改善节律的措施的潜在益处。
