Loram George, Silk Tim, Ling Mathew, Sciberras Emma
School of Psychology, Deakin University, Burwood, Victoria, Australia.
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
J Sleep Res. 2024 Apr;33(2):e13830. doi: 10.1111/jsr.13830. Epub 2023 Mar 12.
Adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience greater sleep difficulties compared to those without. However, findings are mixed, and other mental health conditions are often overlooked. This study aimed to examine the relationship between sleep problems, ADHD, and other mental health conditions in a sample of adolescents. Data from 373 adolescents aged 10-19 years was used as part of the wider 'Healthy Brain Network' study, which targets children and adolescents experiencing mental health and neurodevelopmental difficulties. Mental health conditions were assessed via a comprehensive assessment. Sleep was measured by self- and parent-report, as well as via up to a month of actigraphy data. Actigraphy data were analysed using mixed-methods modelling, while subjective sleep data were analysed using multiple regression. Subjectively-reported sleep was generally worse in adolescents who had ADHD and other mental health conditions compared to those with ADHD but no other conditions. There were no associations between ADHD status and objective sleep measures or self-reported measures, but a significant association was found between ADHD status and parent-reported sleep difficulties, even when accounting for other conditions. Parent-reported sleep problems were associated not only with ADHD, but also with anxiety, depression, and externalising disorders. The strength of association between ADHD and sleep problems is potentially not as strong as previously thought when considering the role of other mental health conditions. Clinicians should consider the role of other mental health conditions when sleep problems are present, and vice versa. The study also highlights the importance of comprehensive, multi-informant assessment of mental health conditions, including sleep.
与没有注意力缺陷多动障碍（ADHD）的青少年相比，患有该障碍的青少年通常睡眠困难更多。然而，研究结果不一，且其他心理健康状况常常被忽视。本研究旨在调查青少年样本中睡眠问题、ADHD与其他心理健康状况之间的关系。来自373名10至19岁青少年的数据被用作更广泛的“健康大脑网络”研究的一部分，该研究针对有心理健康和神经发育困难的儿童和青少年。通过全面评估来评估心理健康状况。睡眠通过自我报告和家长报告进行测量，同时还通过长达一个月的活动记录仪数据进行测量。活动记录仪数据采用混合方法建模进行分析，而主观睡眠数据采用多元回归进行分析。与仅有ADHD但无其他状况的青少年相比，患有ADHD和其他心理健康状况的青少年主观报告的睡眠通常更差。ADHD状态与客观睡眠指标或自我报告指标之间没有关联，但即使考虑到其他状况，也发现ADHD状态与家长报告的睡眠困难之间存在显著关联。家长报告的睡眠问题不仅与ADHD有关，还与焦虑、抑郁和外化障碍有关。考虑到其他心理健康状况的作用时，ADHD与睡眠问题之间的关联强度可能不如之前认为的那么强。当存在睡眠问题时，临床医生应考虑其他心理健康状况的作用，反之亦然。该研究还强调了对心理健康状况进行全面、多信息评估（包括睡眠）的重要性。
