Williams Kate E, Sciberras Emma
*School of Early Childhood and †Child & Youth Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia; ‡School of Psychology, Deakin University, Burwood, Australia; §Murdoch Childrens Research Institute, Melbourne, Australia; ‖The Royal Children Hospital, Melbourne, Australia; ¶Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
J Dev Behav Pediatr. 2016 Jun;37(5):385-94. doi: 10.1097/DBP.0000000000000281.
To examine mean level differences and longitudinal and reciprocal relations among behavioral sleep problems, emotional dysregulation, and attentional regulation across early childhood for children with and without attention-deficit hyperactivity disorder (ADHD) at 8 to 9 years.
This study used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC)-Infant Cohort (n = 4,109 analyzed). Children with and without ADHD were identified at age 8 to 9 years via parent report of ADHD diagnosis and the 5-item Inattention-Hyperactivity subscale from the Strengths and Difficulties Questionnaire. Maternal report of child sleep problems and self-regulation was collected at 0 to 1, 2 to 3, 4 to 5, and 6 to 7 years of age. Analysis of variance was used to compare mean level differences in sleep problems and emotional and attentional regulation by ADHD group. Longitudinal structural equation modeling examined the relations among sleep and self-regulation across time in children with and without ADHD.
Children with ADHD had persistently elevated levels of sleep problems (from infancy) and emotional and attentional dysregulation compared to controls (from 2 to 3 years of age). Sleep problems, emotional dysregulation, and attentional regulation were stable over time for both groups. Sleep problems were associated with greater emotional dysregulation 2 years later from 2 to 3 years of age for both groups, which in turn was associated with poorer attentional regulation. There was no direct relationship between sleep problems and later attentional regulation.
Sleep problems in children with and without ADHD are associated with emotional dysregulation, which in turn contributes to poorer attentional functioning. This study highlights the importance of assessing and managing sleep problems in young children.
研究8至9岁患有和未患有注意力缺陷多动障碍（ADHD）的儿童在幼儿期行为睡眠问题、情绪调节障碍和注意力调节之间的平均水平差异、纵向关系和相互关系。
本研究使用了来自澳大利亚儿童成长研究：澳大利亚儿童纵向研究（LSAC）-婴儿队列（分析样本量n = 4109）的数据。通过家长报告的ADHD诊断以及优势与困难问卷中的5项注意力不集中-多动分量表，在8至9岁时确定患有和未患有ADHD的儿童。在儿童0至1岁、2至3岁、4至5岁和6至7岁时收集母亲报告的儿童睡眠问题和自我调节情况。使用方差分析比较ADHD组在睡眠问题、情绪和注意力调节方面的平均水平差异。纵向结构方程模型研究了患有和未患有ADHD的儿童睡眠与自我调节随时间的关系。
与对照组（从2至3岁起）相比，患有ADHD的儿童睡眠问题（从婴儿期起）以及情绪和注意力调节障碍水平持续升高。两组的睡眠问题、情绪调节障碍和注意力调节随时间均保持稳定。从2至3岁起，两组儿童睡眠问题在2年后均与更大的情绪调节障碍相关，而情绪调节障碍又与更差的注意力调节相关。睡眠问题与后期注意力调节之间没有直接关系。
患有和未患有ADHD的儿童的睡眠问题均与情绪调节障碍相关，而情绪调节障碍反过来又导致注意力功能较差。本研究强调了评估和管理幼儿睡眠问题的重要性。
