Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Department of Educational Administration and Policy, The Chinese University of Hong Kong, Hong Kong SAR, China.
Psychiatry Res. 2023 Oct;328:115447. doi: 10.1016/j.psychres.2023.115447. Epub 2023 Aug 28.
Sleep disturbances are often linked to attention-deficit/hyperactivity disorder (ADHD). Consistent findings document that children and adolescents with ADHD report more sleep problems than their typically developing (TD) peers across subjective sleep domains. However, few differences between these groups were observed in objectively measured sleep parameters, such as polysomnography (PSG) and actigraphy. This study synthesized empirical studies to identify objectively measured sleep continuity differences between children and adolescents with ADHD and TD. We included observational research and baseline data from intervention studies between 5- to 18-year-old individuals with ADHD and their TD peers at five databases from inception and September 2022. This systematic review and meta-analysis of 45 articles, including 1622 children and adolescents with ADHD and 2013 TD, found that compared with TD, children and adolescents with ADHD have higher sleep latency and moderately decreased sleep efficiency measured by actigraphy. Polysomnography-measured differences between ADHD and TD were not significant. Medication status and comorbid psychiatric status significantly moderated the group differences in sleep efficiency between ADHD and TD. Also, the group differences in sleep latency between ADHD and TD were moderated by actigraphy recorded nights. These findings highlight the importance of reducing disparities in sleep parameters among children and adolescents with and without ADHD.
睡眠障碍常与注意力缺陷多动障碍（ADHD）有关。一致的研究结果表明，ADHD 儿童和青少年在主观睡眠领域比其正常发育（TD）同龄人报告更多的睡眠问题。然而，在客观测量的睡眠参数（如多导睡眠图（PSG）和活动记录仪）方面，这些组之间观察到的差异很少。本研究综合了实证研究，以确定 ADHD 和 TD 儿童和青少年之间客观测量的睡眠连续性差异。我们纳入了 ADHD 儿童和青少年及其 TD 同龄人在五个数据库中从开始到 2022 年 9 月的 5 至 18 岁之间的观察性研究和干预研究的基线数据。对 45 篇文章的系统评价和荟萃分析，包括 1622 名 ADHD 儿童和青少年和 2013 名 TD，发现与 TD 相比，ADHD 儿童和青少年的睡眠潜伏期更长，活动记录仪测量的睡眠效率略低。PSG 测量的 ADHD 和 TD 之间的差异不显著。药物状态和合并的精神疾病状态显著调节了 ADHD 和 TD 之间睡眠效率的组间差异。此外，ADHD 和 TD 之间的睡眠潜伏期的组间差异也受到活动记录仪记录的夜晚的调节。这些发现强调了减少 ADHD 和非 ADHD 儿童和青少年之间睡眠参数差异的重要性。
