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共病过敏性疾病对注意缺陷多动障碍症状及睡眠的影响:一项横断面研究。

Effect of comorbid allergic diseases on attention-deficit hyperactivity disorder symptoms and sleep: A cross-sectional study.

作者信息

Panpan Zhang, Yang Liu, Tao Ma, Chong Tian, Fan Cao, Hao Sun, Xuwu Xiao

机构信息

Dalian Medical University, Dalian, Liaoning, China; Department of Child Health, Dalian Municipal Women and Children's Medical Center (Group), Dalian, Liaoning, China.

Department of Intensive Care Unit, The First Hospital of Yulin, Yulin, Shannxi, China.

出版信息

Res Dev Disabil. 2025 Feb;157:104907. doi: 10.1016/j.ridd.2024.104907. Epub 2025 Jan 9.

Abstract

INTRODUCTION

Recent studies have shown a close relationship between attention-deficit hyperactivity disorder (ADHD) and allergic diseases in children. Regrettably, few studies have investigated the effect of comorbid allergies on ADHD symptoms and sleep, in particular, it is unclear whether comorbid allergic conditions further exacerbate sleep problems in children with ADHD.

OBJECTIVE

To investigate the effect of comorbid allergic on symptoms and sleep in children with ADHD.

METHODS

This was a cross-sectional study, 222 ADHD children (aged 6-14 years) were enrolled in, of whom 93 had allergic diseases and 129 without allergic diseases. Collected all ADHD symptom severity and functional impairment scales, including: Swanson, Nolan and Pelham (SNAP) scale, Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Conners Parents Symptom questionnaire (PSQ) and Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P). Every guardian of children diagnosed with ADHD is required to complete the Children's Sleep Habits Questionnaire (CSHQ).

RESULTS

Compared to ADHD children without allergic diseases, we observed significantly higher hyperactivity and impulsivity scores on the SNAP-IV, higher hyperactivity index and impulsivity index on the PSQ, and higher risky activities on the WFIRS-P in ADHD children with comorbid allergic diseases (all p < 0.05). CSHQ total score and sleep disordered breathing were particularly prominent in ADHD children with comorbid allergic diseases (all p < 0.05), and changes in CSHQ correlate with ADHD symptoms and functional impairment. Further analyses revealed that ADHD symptoms and sleep did not worsen with increasing number of comorbid allergic diseases (all p > 0.05). The primary influence on ADHD symptoms and sleep was the type of allergic diseases, where food allergies predominantly influence ADHD symptoms, including attention deficit disorder and hyperactivity disorder (all p < 0.05); allergic rhinitis notably impacts parasomnias, sleep disordered breathing (all p < 0.05); and allergic asthma significantly affects sleep anxiety, daytime sleepiness, and sleep disordered breathing in children with ADHD (all p < 0.05).

CONCLUSION

The presence of comorbid allergic diseases affects both the hyperactivity and impulsivity symptoms of ADHD and sleep disordered breathing, predominantly influenced by the type of the allergic diseases.

摘要

引言

最近的研究表明儿童注意力缺陷多动障碍(ADHD)与过敏性疾病之间存在密切关系。遗憾的是,很少有研究调查共病过敏对ADHD症状和睡眠的影响,尤其是尚不清楚共病过敏状况是否会进一步加重ADHD儿童的睡眠问题。

目的

研究共病过敏对ADHD儿童症状和睡眠的影响。

方法

这是一项横断面研究,纳入了222名6至14岁的ADHD儿童,其中93名患有过敏性疾病,129名没有过敏性疾病。收集了所有ADHD症状严重程度和功能损害量表,包括:斯旺森、诺兰和佩勒姆(SNAP)量表、综合视觉和听觉持续注意力测试(IVA-CPT)、康纳斯父母症状问卷(PSQ)和韦斯功能损害评定量表-家长版(WFIRS-P)。要求每位被诊断为ADHD的儿童监护人完成儿童睡眠习惯问卷(CSHQ)。

结果

与无过敏性疾病的ADHD儿童相比,我们观察到共病过敏性疾病的ADHD儿童在SNAP-IV上的多动和冲动得分显著更高,在PSQ上的多动指数和冲动指数更高,在WFIRS-P上的危险活动得分更高(所有p<0.05)。CSHQ总分和睡眠呼吸障碍在共病过敏性疾病的ADHD儿童中尤为突出(所有p<0.05),并且CSHQ的变化与ADHD症状和功能损害相关。进一步分析显示,ADHD症状和睡眠并未随着共病过敏性疾病数量的增加而恶化(所有p>0.05)。对ADHD症状和睡眠的主要影响是过敏性疾病的类型,其中食物过敏主要影响ADHD症状,包括注意力缺陷障碍和多动障碍(所有p<0.05);过敏性鼻炎显著影响异态睡眠、睡眠呼吸障碍(所有p<0.05);过敏性哮喘显著影响ADHD儿童的睡眠焦虑、日间嗜睡和睡眠呼吸障碍(所有p<0.05)。

结论

共病过敏性疾病的存在会影响ADHD的多动和冲动症状以及睡眠呼吸障碍,主要受过敏性疾病类型的影响。

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