Vélez-Galarraga Rosario, Guillén-Grima Francisco, Crespo-Eguílaz Nerea, Sánchez-Carpintero Rocío
Pediatric Neurology Unit, Clínica Universidad de Navarra, Pamplona, Spain.
Department of Preventive Medicine, Clínica Universidad de Navarra, Pamplona, Spain; Navarra's Health Research Institute (IDISNA), Pamplona, Spain; Department of Health Sciences, Public University of Navarra, Pamplona, Spain.
Eur J Paediatr Neurol. 2016 Nov;20(6):925-937. doi: 10.1016/j.ejpn.2016.07.004. Epub 2016 Jul 14.
To determine the prevalence of sleep disorders in children with attention-deficit/hyperactivity disorder (ADHD) and in a control population. To examine the relationship between sleep disorders and symptoms of inattention, hyperactivity/impulsiveness and executive dysfunction.
We studied 126 children with ADHD and 1036 control children aged between 5 and 18 years old. Caregivers completed the Pediatric Sleep Questionnaire and the ADHD Rating Scale (ADHD-RS). Children with ADHD were subsequently assessed for executive function with the Conner's Continuous Performance Test (CPT) or with AULA Nesplora.
Children with ADHD slept less at night and were more likely to display sleep-related rhythmic movements. Children in the ADHD group who were under 12 years old and who had total ADHD-RS scores over the 90th percentile had more difficulty falling asleep than other children; there was also a relationship between total ADHD-RS scores over the 90th percentile and certain parasomnias in the control population. There was a correlation between shorter duration of night-time sleep and omission errors in children who were 12 or older and who were under pharmacological treatment for ADHD. Bedtime resistance and difficulty falling sleep were more frequent in children with ADHD whose symptoms were not treated pharmacologically, than in children receiving treatment.
Symptoms of inattention and hyperactivity are correlated with impaired sleep duration and quality; specifically, there is an association between ADHD symptoms and problems falling asleep and parasomnias, however, the current study does not address the nature and direction of causality. Children with ADHD and receiving methylphenidate had fewer sleep disorders, suggesting that, at least in some children, stimulant treatment is associated with improvement of some aspects of sleep. Shorter sleep duration in adolescents under pharmacological treatment for ADHD tended to result in more errors of omission, suggesting that it is important to promote good sleep habits in this population.
确定注意力缺陷多动障碍（ADHD）儿童及对照人群中睡眠障碍的患病率。研究睡眠障碍与注意力不集中、多动/冲动及执行功能障碍症状之间的关系。
我们研究了126名ADHD儿童和1036名5至18岁的对照儿童。照料者完成了儿童睡眠问卷和ADHD评定量表（ADHD-RS）。随后，使用康纳斯连续操作测验（CPT）或AULA Nesplora对ADHD儿童进行执行功能评估。
ADHD儿童夜间睡眠较少，且更易出现与睡眠相关的节律性运动。ADHD组中12岁以下且ADHD-RS总分超过第90百分位数的儿童比其他儿童入睡困难更多；在对照人群中，ADHD-RS总分超过第90百分位数与某些异态睡眠之间也存在关联。12岁及以上且正在接受ADHD药物治疗的儿童，夜间睡眠时间较短与漏报错误之间存在相关性。未接受药物治疗的ADHD儿童比接受治疗的儿童更常出现就寝抵抗和入睡困难。
注意力不集中和多动症状与睡眠时间和质量受损相关；具体而言，ADHD症状与入睡困难和异态睡眠之间存在关联，然而，目前的研究并未探讨因果关系的性质和方向。接受哌甲酯治疗的ADHD儿童睡眠障碍较少，这表明至少在一些儿童中，兴奋剂治疗与睡眠某些方面的改善有关。接受ADHD药物治疗的青少年睡眠时间较短往往会导致更多漏报错误，这表明在这一人群中促进良好的睡眠习惯很重要。
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