Deakin University, School of Psychology, Geelong, Vic, Australia.
Deakin University, School of Psychology, Geelong, Vic, Australia; Murdoch Children's Research Institute, Parkville, Vic, Australia.
Sleep Med. 2021 Nov;87:174-182. doi: 10.1016/j.sleep.2021.08.021. Epub 2021 Aug 28.
OBJECTIVE/BACKGROUND: Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience greater difficulties in the domains of sleep, daytime sleepiness, and functioning compared to their peers. However, the relationship between these domains has not been fully elucidated. This study aimed to examine the relationship between sleep problems (including daytime sleepiness), ADHD severity, and functional outcomes (irritability, sluggish cognitive tempo, homework difficulties, and substance use) in a sample of adolescents with ADHD.
PATIENTS/METHODS: Eighty-two adolescents (13-17 years) and their families participated in the study. Sleep was measured by both adolescent and parent-report. Adolescent irritability and sluggish cognitive tempo were reported by both adolescents and parents, while other variables were reported by a single reporter (homework difficulties - parent; ADHD severity - parent; substance use - adolescent). Analyses controlled for demographic factors and internalising and externalising comorbidities.
A weak relationship was found between adolescent-reported sleep problems and daytime sleepiness, which became non-significant in adjusted analyses (β = -0.19, p = 0.115). In adjusted analyses, there was an association between adolescent-reported sleep problems and adolescent-reported irritability (β = -0.27, p = 0.023) as well as between adolescent-reported daytime sleepiness and parent-reported sluggish cognitive tempo (β = 0.28, p = 0.033). In adjusted analyses, parent-reported adolescent sleep problems were associated with ADHD severity (β = 0.54, p = <0.001), parent-reported sluggish cognitive tempo (β = 0.64, p = <0.001), both reporters of irritability (parent-report: β = 0.32, p = 0.004; adolescent-report: β = 0.29, p = 0.022), and homework problems (β = 0.37, p = 0.003). Parent-reported daytime sleepiness was associated with parent-reported sluggish cognitive tempo (β = 0.34, p = 0.024).
This study demonstrates the importance of a holistic assessment of adolescents with ADHD, not only focusing on symptomatology but also on sleep problems and functional outcomes. The importance of multi-informant assessment of sleep problems is also reinforced.
目的/背景：与同龄人相比，患有注意缺陷多动障碍（ADHD）的青少年在睡眠、日间嗜睡和功能领域面临更大的困难。然而，这些领域之间的关系尚未完全阐明。本研究旨在检查 ADHD 青少年样本中睡眠问题（包括日间嗜睡）、ADHD 严重程度与功能结果（易怒、认知迟钝、家庭作业困难和物质使用）之间的关系。
患者/方法：82 名青少年（13-17 岁）及其家属参与了这项研究。通过青少年和家长报告来测量睡眠。青少年的易怒和认知迟钝由青少年和家长报告，而其他变量则由单一报告者报告（家庭作业困难-家长；ADHD 严重程度-家长；物质使用-青少年）。分析控制了人口统计学因素以及内化和外化的共病。
青少年报告的睡眠问题与日间嗜睡之间存在弱相关关系，但在调整后的分析中变得不显著（β=-0.19，p=0.115）。在调整后的分析中，青少年报告的睡眠问题与青少年报告的易怒之间存在关联（β=-0.27，p=0.023），以及青少年报告的日间嗜睡与家长报告的认知迟钝之间存在关联（β=0.28，p=0.033）。在调整后的分析中，家长报告的青少年睡眠问题与 ADHD 严重程度（β=0.54，p<0.001）、家长报告的认知迟钝（β=0.64，p<0.001）、易怒的两个报告者（家长报告：β=0.32，p=0.004；青少年报告：β=0.29，p=0.022）和家庭作业问题（β=0.37，p=0.003）相关。家长报告的日间嗜睡与家长报告的认知迟钝有关（β=0.34，p=0.024）。
本研究表明，对 ADHD 青少年进行全面评估非常重要，不仅要关注症状，还要关注睡眠问题和功能结果。多报告者评估睡眠问题的重要性也得到了加强。
