Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain.
Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, UK.
Neurosci Biobehav Rev. 2018 Jun;89:61-71. doi: 10.1016/j.neubiorev.2018.02.014. Epub 2018 Mar 2.
Sleep alterations associated with adulthood ADHD are poorly understood. Here, we conducted the first meta-analysis of sleep studies in adults with ADHD. Based on a pre-registered protocol (PROSPERO-CRD42017065407), we searched Pubmed, Ovid and Web of Knowledge databases through August 3rd, 2017, with no language or publication type restrictions, and contacted study authors for unpublished data/information. From a pool of 8812 references, we retained 13 studies. Random-effects models were performed and study quality was rated using the Newcastle-Ottawa Scale. Compared to adults without ADHD, those with ADHD significantly differed in seven out of nine subjective parameters (Standardized Mean Difference, SMD, ranging from 0.56 to 1.55) and two out of five actigraphic parameters [SMD (95% CI): sleep onset latency: 0.80 (0.46-1.14); sleep efficiency: -0.68 (-1.03, -0.34)]. No significant differences were detected for polysomnographic parameters. We conclude that, whereas subjectively reported sleep problems are significantly associated with ADHD in adults and should be systematically screened during the clinical interview, additional research is needed to understand if they are underpinned by objective sleep alterations.
成人 ADHD 相关的睡眠改变尚未被充分理解。在此，我们对成人 ADHD 的睡眠研究进行了首次荟萃分析。基于预先注册的方案（PROSPERO-CRD42017065407），我们检索了 Pubmed、Ovid 和 Web of Knowledge 数据库，时间截至 2017 年 8 月 3 日，不限制语言和出版类型，并联系了研究作者以获取未发表的数据/信息。从 8812 篇参考文献中，我们保留了 13 项研究。使用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对随机效应模型和研究质量进行了评价。与无 ADHD 的成人相比，ADHD 成人在九个主观参数中的七个（标准化均数差，SMD，范围从 0.56 到 1.55）和五个活动记录仪参数中的两个[SMD（95% CI）：入睡潜伏期：0.80（0.46-1.14）；睡眠效率：-0.68（-1.03，-0.34）]上存在显著差异。多导睡眠图参数无显著差异。我们的结论是，尽管主观报告的睡眠问题与成人 ADHD 显著相关，并且在临床访谈中应系统筛查，但需要进一步研究以了解它们是否由客观的睡眠改变引起。
