Lazzaro Giulia, Galassi Paolo, Bacaro Valeria, Vicari Stefano, Menghini Deny
Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Department of Psychology Renzo Canestrari, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Eur Arch Psychiatry Clin Neurosci. 2024 Oct 3. doi: 10.1007/s00406-024-01921-w.
Sleep disturbances (SD) are commonly reported concerns among parents and caregivers of children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). While it is widely acknowledged that SD can worsen various aspects of children and adolescents' well-being (e.g., academic performance and emotional/behavioral state), a comprehensive clinical characterization of ADHD and SD is currently lacking. To address this gap, 136 children and adolescents diagnosed with ADHD (aged 6 to 14 years) were retrospectively selected by reviewing electronic health records of hundreds of patients with neuropsychiatric disorders referred to the children's hospital. Participants were divided into two groups based on the presence of SD, assessed via a parent-report questionnaire (94 ADHD without SD and 42 ADHD with SD). Standardized measures of adaptive behavior, academic performance, ADHD-related and emotional/behavioral symptoms were collected. Results documented that the group of ADHD with SD obtained worse scores in specific aspects of adaptive behavior (conceptual and practical domains), academic performance (text comprehension, writing), ADHD symptoms (inattention) and emotional/behavioral difficulties (especially, mood/emotional regulation and stress) compared to those with ADHD without SD. In addition, our results established a relationship between sleep problems and diverse clinical aspects of children and adolescents with ADHD, while controlling for age, cognitive level, gender, ADHD symptoms severity, and Body Mass Index. From a clinical perspective, our study suggests that the presence of SD in patients with ADHD may serve as an indicator for strengths and weaknesses in this population, even demonstrating an independent relationship with specific clinical dimensions. Implications to improve clinical diagnostic and therapeutic interventions are discussed.
睡眠障碍（SD）是患有注意力缺陷多动障碍（ADHD）的儿童和青少年的家长及照顾者普遍报告的问题。虽然人们普遍认识到睡眠障碍会使儿童和青少年幸福的各个方面恶化（例如学业成绩和情绪/行为状态），但目前缺乏对ADHD和SD的全面临床特征描述。为了填补这一空白，通过回顾数百名转诊至儿童医院的神经精神疾病患者的电子健康记录，回顾性选取了136名被诊断为ADHD的儿童和青少年（年龄在6至14岁之间）。根据是否存在睡眠障碍，通过家长报告问卷将参与者分为两组（94名无睡眠障碍的ADHD患者和42名有睡眠障碍的ADHD患者）。收集了适应性行为、学业成绩、ADHD相关症状以及情绪/行为症状的标准化测量数据。结果表明，与无睡眠障碍的ADHD患者相比，有睡眠障碍的ADHD患者在适应性行为（概念和实践领域）、学业成绩（文本理解、写作）、ADHD症状（注意力不集中）和情绪/行为困难（特别是情绪/情感调节和压力）的特定方面得分更低。此外，我们的研究结果在控制年龄、认知水平、性别、ADHD症状严重程度和体重指数的同时，确立了睡眠问题与ADHD儿童和青少年不同临床方面之间的关系。从临床角度来看，我们的研究表明，ADHD患者中睡眠障碍的存在可能是该人群优势和劣势的一个指标，甚至与特定临床维度呈现独立关系。文中还讨论了对改善临床诊断和治疗干预措施的启示。
