Department of Neurology, Charles University in Prague, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic.
Sleep Med. 2010 Oct;11(9):922-8. doi: 10.1016/j.sleep.2010.03.017.
To evaluate sleep macrostructure, sleep disorders incidence and daytime sleepiness in attention-deficit/hyperactivity disorder (ADHD) affected children compared with controls.
Thirty-one patients (26 boys, 5 girls, mean age 9.3±1.7, age range 6-12 years) with ADHD diagnosed according to DSM-IV criteria, without comorbid psychiatric or other disorders, as never before pharmacologically treated for ADHD. The controls were 26 age- and sex-matched children (22 boys, 4 girls, age range 6-12 years, mean age 9.2±1.5). Nocturnal polysomnography (PSG) was performed for two nights followed by the multiple sleep latency test (MSLT).
No differences between the two groups comparing both nights were found in the basic sleep macrostructure parameters or in the time (duration) of sleep onset. A first-night effect on sleep variables was apparent in the ADHD group. Occurrence of sleep disorders (sleep-disordered breathing [SDB], periodic limb movements in sleep [PLMS], parasomnias) did not show any significant differences between the investigated groups. A statistically significant difference (p=0.015) was found in the trend of the periodic limb movement index (PLMI) between two nights (a decrease of PLMI in the ADHD group and an increase of PLMI in the control group during the second night). While the mean sleep latency in the MSLT was comparable in both groups, children with ADHD showed significant (sleep latency) inter-test differences (between tests 1 and 2, 1 and 4, 1 and 5, p<0.01).
After the inclusion of adaptation night and exclusion of psychiatric comorbidities, PSG showed no changes in basic sleep parameters or sleep timing, or in the frequency of sleep disorders (SDB, PLMS) in children with ADHD compared with controls, thus not supporting the hypothesis that specific changes in the sleep macrostructure and sleep disturbances are connected with ADHD. A first-night effect on sleep variables was apparent only in the ADHD group. Though we found no proof of increased daytime sleepiness in children with ADHD against the controls, we did find significant vigilance variability during MSLT in the ADHD group, possibly a sign of dysregulated arousal.
评估注意力缺陷多动障碍（ADHD）患儿的睡眠宏观结构、睡眠障碍发生率和日间嗜睡与对照组相比的情况。
31 名患者（26 名男孩，5 名女孩，平均年龄 9.3±1.7 岁，年龄 6-12 岁）根据 DSM-IV 标准诊断为 ADHD，无共患精神或其他疾病，且以前从未接受过 ADHD 的药物治疗。对照组为 26 名年龄和性别匹配的儿童（22 名男孩，4 名女孩，年龄 6-12 岁，平均年龄 9.2±1.5 岁）。进行了两晚的夜间多导睡眠图（PSG）检查，然后进行多次睡眠潜伏期试验（MSLT）。
两组比较，两晚的基本睡眠宏观结构参数或入睡时间（持续时间）无差异。ADHD 组存在睡眠变量的第一晚效应。睡眠障碍（睡眠呼吸障碍[SDB]、睡眠周期性肢体运动[PLMS]、睡眠障碍）的发生率在两组之间无显著差异。两组之间的周期性肢体运动指数（PLMI）存在统计学上的显著差异（p=0.015）（ADHD 组的 PLMI 下降，对照组的 PLMI 在第二晚增加）。虽然 MSLT 的平均睡眠潜伏期在两组之间相似，但 ADHD 患儿的睡眠潜伏期存在显著的（睡眠潜伏期）组间差异（第 1 次和第 2 次、第 1 次和第 4 次、第 1 次和第 5 次测试之间，p<0.01）。
在纳入适应夜和排除精神共病后，与对照组相比，ADHD 患儿的 PSG 基本睡眠参数或睡眠时间、睡眠障碍（SDB、PLMS）的频率无变化，因此不支持特定的睡眠宏观结构和睡眠障碍与 ADHD 有关的假设。仅在 ADHD 组中出现睡眠变量的第一晚效应。虽然我们没有发现 ADHD 患儿比对照组日间嗜睡增加的证据，但我们确实发现 ADHD 组在 MSLT 期间警觉性变化显著，可能是觉醒调节失调的迹象。
