Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Sleep. 2021 Aug 13;44(8). doi: 10.1093/sleep/zsab054.
To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD.
Participants were 122 adolescents (ages 15-17; 61% male; 48% with ADHD). Parents reported on adolescents' sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019 to February 2020) and during (May-June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19.
Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19.
COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.
前瞻性研究 COVID-19 大流行前后青少年 ADHD 患者和非 ADHD 患者的睡眠变化。
共纳入 122 名青少年（年龄 15-17 岁；61%为男性；48%患有 ADHD）。家长报告青少年的睡眠时间和入睡及维持睡眠困难（DIMS）；青少年报告睡眠模式、睡眠时间、睡眠推迟/觉醒行为以及 COVID-19 大流行前后（2019 年 9 月至 2020 年 2 月；2020 年 5-6 月）白天困倦情况。青少年还报告了他们的健康行为、与 COVID-19 相关的负性情绪和因 COVID-19 而难以集中注意力的情况。
家长报告青少年在 COVID-19 大流行期间 DIMS 较 COVID-19 大流行前增加，临床显著增加率从 24%增加至 36%。COVID-19 大流行期间，青少年入睡和醒来时间均明显推迟，且报告更多的睡眠推迟/觉醒行为。青少年也报告 COVID-19 大流行期间白天困倦减少，学校日睡眠延长。考虑 ADHD 青少年和非 ADHD 青少年之间的差异，患有 ADHD 的青少年学校日睡眠时长未增加，且在 COVID-19 大流行期间更难以获得推荐的睡眠时间。在全样本中，控制 ADHD 状态，与 COVID-19 相关的悲伤/孤独与 DIMS 增加相关，而户外活动时间减少和与 COVID-19 相关的担忧/恐惧增加与 COVID-19 大流行期间睡眠推迟/觉醒行为增加相关。
COVID-19 对青少年睡眠产生了负面影响和积极影响。患有 ADHD 的青少年在 COVID-19 大流行期间并未像非 ADHD 青少年那样增加学校日睡眠时间。负性情绪和健康行为可能是减少 COVID-19 对青少年睡眠负面影响的有效干预靶点。
