Durmuş Fatma Benk, Arman Ayşe Rodopman, Ayaz Ayşe Burcu
a Erenkoy Resarch and Training Hospital , Department of Child and Adolescent Psychiatry , Istanbul , Turkey.
b Marmara University School of Medicine , Department of Child and Adolescent Psychiatry , Istanbul , Turkey.
Chronobiol Int. 2017;34(7):886-894. doi: 10.1080/07420528.2017.1329207. Epub 2017 Jun 2.
Chronotype can be classified as morningness types, people who prefer morning hours for their physical and mental activities; eveningness types, people who prefer the afternoon or evening hours; and intermediate types, those who show characteristics of both morningness and eveningness types. Attention deficit hyperactivity disorder (ADHD) has been linked with disturbances in chronotype, particularly increased eveningness. Despite the possibility of an association between chronotypes, sleep disturbances and ADHD symptoms, there is little evidence of this association considering the child population. The purpose of this study was to examine chronotype preferences in children aged between 7 and 12 years who were diagnosed as having ADHD in the context of sleep disturbances. The Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version, Conner's Rating Scales, Children's Sleep Habit Questionnaire and Children's Chronotype Questionnaire were used for the evaluation of children with ADHD and healthy controls. The ADHD group was 73% combined-type, and the eveningness scores of the ADHD group (n = 52) were significantly higher than the control group (n = 52) (p < 0.01). There was a positive correlation between the higher scores of eveningness and total scores on resistance to sleep time (p < 0.09), respiratory problems during sleep and daytime sleepiness in the ADHD group. CSHQ total score was found to be a predictive factor for eveningness among children with ADHD (p < 0.01). These findings highlight possible reciprocal links between ADHD symptoms, sleep disturbances and chronotype in children aged 7-12 years, which might lead to individualized treatment options.
昼夜节律类型可分为晨型，即喜欢在上午进行身心活动的人；夜型，即喜欢下午或晚上时段的人；以及中间型，即兼具晨型和夜型特征的人。注意力缺陷多动障碍（ADHD）与昼夜节律紊乱有关，尤其是夜型特征增加。尽管昼夜节律类型、睡眠障碍和ADHD症状之间可能存在关联，但在儿童群体中，这方面的证据很少。本研究的目的是在睡眠障碍背景下，检查7至12岁被诊断患有ADHD的儿童的昼夜节律偏好。使用《学龄儿童情感障碍和精神分裂症量表-目前和终生版》、康纳评定量表、儿童睡眠习惯问卷和儿童昼夜节律问卷对ADHD儿童和健康对照组进行评估。ADHD组中73%为混合型，ADHD组（n = 52）的夜型得分显著高于对照组（n = 52）（p < 0.01）。ADHD组中，夜型得分较高与入睡抵抗时间总分（p < 0.09）、睡眠期间呼吸问题和白天嗜睡之间存在正相关。发现CSHQ总分是ADHD儿童夜型的预测因素（p < 0.01）。这些发现突出了7至12岁儿童ADHD症状、睡眠障碍和昼夜节律类型之间可能存在的相互联系，这可能会带来个性化的治疗选择。
