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ADHD 患者的睡眠障碍:研究 ADHD 多基因风险和与睡眠相关表型的贡献。

Sleep disturbances in ADHD: investigating the contribution of polygenic liability for ADHD and sleep-related phenotypes.

机构信息

MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.

Department of Psychology, Goldsmiths, University of London, London, UK.

出版信息

Eur Child Adolesc Psychiatry. 2023 Jul;32(7):1253-1261. doi: 10.1007/s00787-021-01931-2. Epub 2022 Jan 7.

Abstract

Sleep disturbances are common in attention deficit hyperactivity disorder (ADHD) and associated with poor outcomes. We tested whether, in children with ADHD, (1) polygenic liability for sleep phenotypes is over- or under-transmitted from parents, (2) this liability is linked to comorbid sleep disturbances, and (3) ADHD genetic risk is associated with comorbid sleep disturbances. We derived polygenic scores (PGS) for insomnia, chronotype, sleep duration, and ADHD, in 758 children (5-18 years old) diagnosed with ADHD and their parents. We conducted polygenic transmission disequilibrium tests for each sleep PGS in complete parent-offspring ADHD trios (N = 328) and an independent replication sample of ADHD trios (N = 844). Next, we tested whether insomnia, sleep duration, and ADHD PGS were associated with co-occurring sleep phenotypes (hypersomnia, insomnia, restless sleep, poor sleep quality, and nightmares) in children with ADHD. Children's insomnia and chronotype PGS did not differ from mid-parent average PGS but long sleep duration PGS were significantly over-transmitted to children with ADHD. This was supported by a combined analysis using the replication sample. Insomnia, sleep duration, and ADHD PGS were not associated with comorbid sleep disturbances. There is weak evidence that children with ADHD over-inherit polygenic liability for longer sleep duration and do not differentially inherit polygenic liability for insomnia or chronotype. There was insufficient evidence that childhood sleep disturbances were driven by polygenic liability for ADHD or sleep traits, suggesting that sleep disturbances in ADHD may be aetiologically different to general population sleep phenotypes and do not index greater ADHD genetic risk burden.

摘要

睡眠障碍在注意缺陷多动障碍(ADHD)中很常见,并且与不良结局有关。我们测试了在患有 ADHD 的儿童中,(1)睡眠表型的多基因易感性是否从父母过度或不足传递,(2)这种易感性是否与共患睡眠障碍有关,以及(3)ADHD 遗传风险是否与共患睡眠障碍有关。我们在 758 名被诊断为 ADHD 的儿童(5-18 岁)及其父母中得出了失眠、昼夜节律、睡眠时间和 ADHD 的多基因评分(PGS)。我们对每个睡眠 PGS 进行了完全父母-子女 ADHD 三胞胎(N=328)和 ADHD 三胞胎的独立复制样本(N=844)的多基因传递不平衡测试。接下来,我们测试了失眠、睡眠时间和 ADHD PGS 是否与 ADHD 儿童共患的睡眠表型(嗜睡、失眠、不安睡眠、睡眠质量差和噩梦)有关。儿童的失眠和昼夜节律 PGS 与中亲平均 PGS 没有差异,但长睡眠时间 PGS 显著传递给 ADHD 儿童。这得到了使用复制样本的综合分析的支持。失眠、睡眠时间和 ADHD PGS 与共患睡眠障碍无关。有微弱的证据表明,ADHD 儿童过度继承了较长睡眠时间的多基因易感性,并且对失眠或昼夜节律的多基因易感性没有差异继承。没有足够的证据表明儿童睡眠障碍是由 ADHD 或睡眠特征的多基因易感性驱动的,这表明 ADHD 中的睡眠障碍在病因上与一般人群的睡眠表型不同,并且不能说明 ADHD 遗传风险负担更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8188/10276090/dd2c2a166262/787_2021_1931_Fig1_HTML.jpg

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