Montgomery P, Wiggs L
Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK; Centre for Evidence Based Intervention, University of Oxford, Oxford, UK.
Child Care Health Dev. 2015 Jan;41(1):139-46. doi: 10.1111/cch.12165. Epub 2014 Jun 12.
Sleep disturbances are common in children with attention-deficit hyperactivity disorder (ADHD). Sleeplessness is frequently reported although results are inconsistent perhaps because different definitions for it are applied. This study looked at maternal functioning and child objective sleep patterns in relation to different definitions of sleeplessness in children with ADHD.
The study included 45 children (aged 3-14 years) with ADHD and their mothers. Sleeplessness was defined according to: (i) yes/no report of whether mothers thought their children had a problem with sleeplessness (Maternal definition MD) and (ii) mothers' responses to a quantitative standardized questionnaire (Quantitative definition QD) designed to detect the frequency and duration of parent-reported problems with settling, night waking and early waking. Objective sleep patterns were also assessed by means of actigraphy. Maternal mental health, daytime sleepiness and cognitions related to child sleep were assessed by questionnaire.
Both definitions appeared to tap similar although slightly different constructs. There were no group differences in objective sleep patterns. Maternal mental health was found to be significantly worse in the mothers who considered their child to be sleepless (MD) (P < 0.025), but not in those mothers whose child was found to be sleepless according to the standardized criteria (QD). Maternal sleepiness did not differ between groups. For both categories of sleepless children (MD and QD), the mothers had significantly more doubts about their competency as a parent (P < 0.01 and P < 0.025, respectively) compared to mothers of children without sleeplessness.
Two different maternal assessments of child sleeplessness in children with ADHD may assess subtly different constructs, but both may provide useful information about potential problems across the family.
注意力缺陷多动障碍（ADHD）患儿中睡眠障碍很常见。尽管研究结果不一致，但失眠的情况经常被报道，这可能是因为对失眠采用了不同的定义。本研究探讨了ADHD患儿失眠的不同定义与母亲的功能以及儿童客观睡眠模式之间的关系。
该研究纳入了45名患有ADHD的儿童（3至14岁）及其母亲。失眠的定义如下：（i）母亲是否认为自己的孩子存在失眠问题的是/否报告（母亲定义MD），以及（ii）母亲对一份旨在检测家长报告的入睡困难、夜间醒来和早醒问题的频率和持续时间的定量标准化问卷的回答（定量定义QD）。还通过活动记录仪评估客观睡眠模式。通过问卷调查评估母亲的心理健康、日间嗜睡情况以及与孩子睡眠相关的认知。
两种定义似乎都涉及相似但略有不同的概念。客观睡眠模式在各组之间没有差异。发现认为自己孩子失眠的母亲（MD）的心理健康状况明显更差（P < 0.025），但根据标准化标准（QD）被认定孩子失眠的母亲则并非如此。各组之间母亲的嗜睡情况没有差异。与孩子没有失眠问题的母亲相比，两类失眠儿童（MD和QD）的母亲对自己作为家长的能力明显更缺乏信心（分别为P < 0.01和P < 0.025）。
对ADHD患儿失眠的两种不同的母亲评估可能评估的是略有不同的概念，但两者都可能提供有关整个家庭潜在问题的有用信息。
