Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK.
Expert Rev Neurother. 2024 Jun;24(6):585-596. doi: 10.1080/14737175.2024.2353692. Epub 2024 May 13.
Sleep disorders represent an important comorbidity in individuals with ADHD. While the links between ADHD and sleep disturbances have been extensively investigated, research on the management of sleep disorders in individuals with ADHD is relatively limited, albeit expanding.
The authors searched PubMed, Medline, PsycInfo, Embase+Embase Classic, Web of Sciences databases, and clinicaltrials.gov up to 4 January 2024, for randomized controlled trials (RCTs) of any intervention for sleep disorders associated with ADHD. They retained 16 RCTs (eight on pharmacological and eight on non-pharmacological interventions), supporting behavioral intervention and melatonin, and nine ongoing RCTs registered on clinicaltrials.gov.
The pool of RCTs testing interventions for sleep disorders in individuals with ADHD is expanding. However, to inform clinical guidelines, there is a need for additional research in several areas, including 1) RCTs based on a precise phenotyping of sleep disorders; 2) pragmatic RCTs recruiting neurodevelopmental populations representative of those seen in clinical services; 3) trials testing alternative interventions (e.g. suvorexant or light therapy) or ways to deliver them (e.g. online); 4) sequential and longer-term RCTs; 5) studies testing the impact of sleep interventions on outcomes other than sleep; 6) and implementation of advanced evidence synthesis and precision medicine approaches.
睡眠障碍是 ADHD 患者的重要共病。虽然 ADHD 与睡眠障碍之间的联系已被广泛研究，但 ADHD 患者睡眠障碍管理方面的研究相对较少，尽管正在不断扩展。
作者检索了 PubMed、Medline、PsycInfo、Embase+Embase Classic、Web of Sciences 数据库和 clinicaltrials.gov，截至 2024 年 1 月 4 日，以查找与 ADHD 相关的睡眠障碍的任何干预措施的随机对照试验（RCT）。他们保留了 16 项 RCT（8 项药理学干预，8 项非药理学干预），支持行为干预和褪黑素，以及 9 项在 clinicaltrials.gov 上注册的正在进行的 RCT。
正在扩大针对 ADHD 患者睡眠障碍的干预措施的 RCT 库。然而，为了为临床指南提供信息，仍需要在几个领域开展额外的研究，包括 1）基于睡眠障碍精确表型的 RCT；2）招募具有代表性的神经发育人群的实用 RCT；3）测试替代干预措施（例如，苏沃雷生或光照疗法）或提供方式（例如，在线）的试验；4）序贯和更长期的 RCT；5）测试睡眠干预对睡眠以外的其他结果的影响的研究；6）以及实施高级证据综合和精准医学方法。
