New York University Child Study Center and Verona University, USA.
J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):784-96. doi: 10.1016/j.jaac.2013.06.001.
To provide evidence- or consensus-based recommendations concerning the assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder (ADHD).
PubMed, Ovid, EMBASE, and Web of Knowledge were searched through October 31, 2012. When no evidence was available, consensus of the authors was achieved. The evidence-level of the recommendations on the management of sleep disturbances was based on the Scottish Intercollegiate Guidelines Network (SIGN) system.
A total of 139 original articles on sleep and childhood ADHD were retrieved, including 22 on treatment of sleep disturbances. This review focuses on behaviorally based insomnia, circadian rhythm disorder, sleep-disordered breathing, restless legs syndrome/periodic limb movement disorder, and sleep disturbances due to comorbid psychiatric disorders or ADHD medications. Healthy sleep practices are recommended as the foundation of management strategies. Behavioral interventions should be considered as first-line treatment of insomnia, although further evidence from randomized controlled trials (RCTs) is needed to prove their efficacy in ADHD. Among pharmacological treatments, RCTs support the use of melatonin to reduce sleep-onset delay, whereas there is more limited evidence for other medications.
Growing empirical evidence is informing assessment/management strategies of sleep problems in youths with ADHD. However, further RCTs are warranted to support current recommendations.
为评估和治疗注意缺陷多动障碍（ADHD）青少年的睡眠问题提供基于证据或共识的建议。
通过 2012 年 10 月 31 日检索 PubMed、Ovid、EMBASE 和 Web of Knowledge。当没有证据时，作者达成共识。关于睡眠障碍管理的建议的证据水平是基于苏格兰校际指南网络（SIGN）系统。
共检索到 139 篇关于睡眠和儿童 ADHD 的原始文章，其中 22 篇关于治疗睡眠障碍。本综述重点介绍基于行为的失眠、昼夜节律障碍、睡眠呼吸障碍、不宁腿综合征/周期性肢体运动障碍以及共病精神障碍或 ADHD 药物引起的睡眠障碍。健康的睡眠习惯被推荐作为管理策略的基础。行为干预应被视为失眠的一线治疗方法，尽管需要更多的随机对照试验（RCT）来证明其在 ADHD 中的疗效。在药物治疗方面，RCT 支持使用褪黑素来减少入睡潜伏期，而其他药物的证据则更为有限。
越来越多的经验证据为 ADHD 青少年睡眠问题的评估/管理策略提供了信息。然而，需要进一步的 RCT 来支持当前的建议。
