Department of Psychiatry, Dankook University College of Medicine, Cheonan, Republic of Korea; Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea.
Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea; Department of Psychology, College of Health Science, Dankook University, Cheonan, Republic of Korea.
J Acad Consult Liaison Psychiatry. 2022 May-Jun;63(3):234-243. doi: 10.1016/j.jaclp.2021.10.002. Epub 2021 Oct 13.
Sleep-related problems are highly prevalent comorbidities in Attention-Deficit/Hyperactivity Disorder (ADHD).
This study aimed to investigate the associations between sleep-disordered breathing (SDB) and behavioral and cognitive functions in children with and without ADHD.
A total of 341 children were included (ADHD group: 155, control group: 186; age: 6-10 years). The participants' sleep-related symptoms were assessed using a parent-rated questionnaire, and they were categorized into low- and high-risk SDB groups based on their scores. Behavioral symptoms were assessed using the Behavioral Assessment System for Children, Second Edition (BASC-2), and cognitive sustained attention and inhibitory control were assessed using a computer-based continuous performance test.
In the ADHD group, the high-risk SDB children showed significantly higher scores than the low-risk SDB group in externalizing problems (F = 4.22; P = 0.042), including hyperactivity (F = 4.65; P = 0.033) and attention problems (F = 8.19; P = 0.005), but not internalizing problems. Meanwhile, in the control group, the high-risk SDB children showed significantly higher scores than the low-risk SDB group in internalizing problems (F = 9.89; P = 0.002), depression (F = 9.45; P = 0.002), and somatization (F = 7.83; P = 0.006), as well as in externalizing problems (F = 7.72; P = 0.006), including hyperactivity (F = 6.23; P = 0.013), aggression (F = 5.00; P = 0.027), and conduct problems (F = 6.79; P = 0.010). Contrary to the behavioral outcomes, none of the attention performance subscale scores showed significant differences between the high- and low-risk SDB groups in either the ADHD or control group.
The present findings suggest that SDB is associated with behavioral problems in children with ADHD and controls, with stronger associations in control children. On the contrary, SDB has no association with cognitive attention performance. This study extends our understanding of the associations of SDB with behavioral symptoms and cognitive functions in children.
睡眠相关问题是注意力缺陷多动障碍（ADHD）的高度普遍共病。
本研究旨在探讨睡眠呼吸障碍（SDB）与伴有和不伴有 ADHD 的儿童的行为和认知功能之间的关系。
共纳入 341 名儿童（ADHD 组：155 名，对照组：186 名；年龄：6-10 岁）。使用父母评定问卷评估参与者的睡眠相关症状，并根据得分将其分为低风险和高风险 SDB 组。使用行为评估系统第二版（BASC-2）评估行为症状，使用基于计算机的连续表现测试评估认知持续注意力和抑制控制。
在 ADHD 组中，高风险 SDB 儿童的多动（F=4.65；P=0.033）和注意力问题（F=8.19；P=0.005）等外部问题的得分显著高于低风险 SDB 组，而内部问题的得分没有差异。同时，在对照组中，高风险 SDB 儿童的内部问题（F=9.89；P=0.002）、抑郁（F=9.45；P=0.002）和躯体化（F=7.83；P=0.006）以及外部问题（F=7.72；P=0.006）的得分显著高于低风险 SDB 组，包括多动（F=6.23；P=0.013）、攻击（F=5.00；P=0.027）和行为问题（F=6.79；P=0.010）。与行为结果相反，在 ADHD 或对照组中，高风险和低风险 SDB 组之间的注意力表现亚量表得分均无显著差异。
本研究结果表明，SDB 与 ADHD 儿童和对照组儿童的行为问题相关，在对照组儿童中相关性更强。相反，SDB 与认知注意力表现无关。本研究扩展了我们对 SDB 与儿童行为症状和认知功能关系的理解。
