Bioulac Stéphanie, Sagaspe Patricia, Tron Eléonore, Benard Antoine, Berthomier Christian, Brandewinder Marie, Philip Pierre, Taillard Jacques
CHU Pellegrin, Service Universitaire de Médecine du Sommeil, Bordeaux, France.
Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, Bordeaux, France.
Front Psychiatry. 2021 Feb 19;12:586528. doi: 10.3389/fpsyt.2021.586528. eCollection 2021.
Excessive daytime sleepiness (EDS) is central in Attention deficit hyperactivity disorder (ADHD) but its causes remain unclear. The aim of this study was to explore objective EDS and homeostatic sleep pressure buildup, evaluated by power theta-alpha frequency (PTAF), in drug-free sleepy adults with ADHD and controls. Participants were placed during a 36-h period of extended wakefulness under constant routine protocol to strictly control sleep time, sleep duration, and circadian zeitgebers. Eight drug-free sleepy patients with ADHD and 7 matched controls were included. The ADHD group had significantly shorter sleep latency on the Maintenance of Wakefulness Test (MWT) throughout extended wakefulness than the control group. There was no significant difference between the groups in PTAF evolution during extended wakefulness and in kinetic sleep pressure buildup, evaluated by the time constant of saturating exponential function. The sample was small, so the findings cannot be generalized. Moreover, psychiatric comorbidities and circadian regulation should be taken into account in future studies. In very controlled conditions, mean sleep latency on the MWT during the whole extended wakefulness was significantly shorter in sleepy patients with ADHD than in control subjects. However, the difficulty to remain awake during soporific circumstances observed in these patients with ADHD cannot be explained by changes in the kinetic of sleep pressure buildup. www.clinicaltrials.gov/, Identifier: NCT02217371.
日间过度嗜睡（EDS）是注意力缺陷多动障碍（ADHD）的核心问题，但其病因尚不清楚。本研究的目的是通过功率θ-阿尔法频率（PTAF）评估，探索无药物治疗的ADHD嗜睡成年人及对照组的客观EDS和稳态睡眠压力积累情况。参与者在36小时的持续清醒期间，按照固定程序进行安排，以严格控制睡眠时间、睡眠时长和昼夜节律因素。纳入了8名无药物治疗的ADHD嗜睡患者和7名匹配的对照组。在整个持续清醒期间，ADHD组在清醒维持测试（MWT）中的睡眠潜伏期明显短于对照组。在持续清醒期间，两组在PTAF演变以及通过饱和指数函数的时间常数评估的动态睡眠压力积累方面没有显著差异。样本量较小，因此研究结果不能推广。此外，未来研究应考虑精神共病和昼夜节律调节因素。在非常受控的条件下，ADHD嗜睡患者在整个持续清醒期间MWT的平均睡眠潜伏期明显短于对照组。然而，这些ADHD患者在困倦情况下难以保持清醒的现象，无法通过睡眠压力积累动态变化来解释。www.clinicaltrials.gov/，标识符：NCT02217371。
