Brevik E J, Lundervold A J, Halmøy A, Posserud M-B, Instanes J T, Bjorvatn B, Haavik J
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway.
Acta Psychiatr Scand. 2017 Aug;136(2):220-227. doi: 10.1111/acps.12756. Epub 2017 May 26.
To investigate the prevalence of insomnia in adults with Attention-deficit hyperactivity disorder (ADHD) and its association with clinical subtypes, current ADHD symptoms, and stimulant treatment.
We obtained diagnostic information, symptom rating scales and treatment history from clinically ascertained adult ADHD patients diagnosed according to DSM-IV criteria (n = 268, mean age 38.1 years) and randomly selected population controls (n = 202, mean age 36.5 years). The Bergen Insomnia Scale (BIS) was used to measure insomnia. ADHD symptom domains were self-rated using the Adult ADHD Self-Rating Scale.
Insomnia was far more frequent among adults with ADHD (66.8%) than in the population controls (28.8%) (P < 0.001). Insomnia was more common in adults with the combined subtype than in those with the inattentive subtype (79.7% and 55.6%, respectively) (P = 0.003). For self-reported current ADHD symptoms, inattention was strongly correlated to insomnia. Patients currently using stimulant treatment for ADHD reported a lower total insomnia score compared to patients without medication (P < 0.05).
Insomnia was highly prevalent among adults with ADHD. The lower insomnia score in patients on current stimulant treatment suggests that stimulant treatment is not associated with worsening of insomnia symptoms in adult ADHD patients.
调查注意缺陷多动障碍(ADHD)成人患者中失眠症的患病率及其与临床亚型、当前ADHD症状和兴奋剂治疗的关联。
我们从根据《精神疾病诊断与统计手册》第四版(DSM-IV)标准确诊的临床确诊成人ADHD患者(n = 268,平均年龄38.1岁)和随机选择的人群对照(n = 202,平均年龄36.5岁)中获取诊断信息、症状评定量表和治疗史。使用卑尔根失眠量表(BIS)测量失眠。ADHD症状领域使用成人ADHD自评量表进行自评。
ADHD成人患者中失眠症的发生率(66.8%)远高于人群对照(28.8%)(P < 0.001)。合并型亚型的成人患者失眠症比注意力不集中型亚型更常见(分别为79.7%和55.6%)(P = 0.003)。对于自我报告的当前ADHD症状,注意力不集中与失眠症密切相关。与未用药的患者相比,目前正在使用兴奋剂治疗ADHD的患者报告的失眠总分较低(P < 0.05)。
失眠症在ADHD成人患者中非常普遍。目前接受兴奋剂治疗的患者失眠得分较低,这表明兴奋剂治疗与成人ADHD患者失眠症状的恶化无关。