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成人注意力缺陷多动障碍(ADHD)与认知脱离综合征症状与睡眠问题和昼夜偏好的独特关联。

Unique associations of ADHD and cognitive disengagement syndrome symptoms with sleep problems and circadian preference in adults.

作者信息

Knouse Laura E, Becker Stephen P

机构信息

University of Richmond, USA.

University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, USA.

出版信息

Sleep Med. 2025 Jul;131:106531. doi: 10.1016/j.sleep.2025.106531. Epub 2025 Apr 21.

Abstract

People with attention-deficit/hyperactivity disorder (ADHD) experience higher rates of sleep difficulties coupled with greater circadian preference for eveningness. Emerging evidence suggests that symptoms of cognitive disengagement syndrome (CDS) may be associated with sleep difficulties and eveningness preference independently of ADHD symptoms. However, most studies have been conducted with children, adolescents, or college students. This study examined unique associations between ADHD and CDS symptom dimensions and sleep problems and circadian preference in a non-referred sample of adults. 106 adults (ages 18-75 years; Mage = 38.69 years) completed self-report assessments of ADHD and CDS symptoms, sleep quality and functioning, and circadian preference. ADHD inattentive (ADHD-IN), ADHD hyperactive-impulsive (ADHD-HI), and CDS symptoms evinced differential unique associations in regression analyses. Only ADHD-IN symptoms were uniquely associated with more frequent sleep medication use. Only ADHD-HI symptoms were uniquely associated with shorter sleep duration and greater nighttime sleep disturbance. Only CDS symptoms were uniquely associated with poorer sleep quality, longer sleep onset latency, greater daytime dysfunction, greater global sleep impairment, and greater eveningness preference. Findings support the importance of considering the role of CDS in sleep disturbance and circadian preference in adults with ADHD and point to the need for careful assessment of these dimensions in research and clinical care.

摘要

患有注意力缺陷多动障碍(ADHD)的人睡眠困难发生率更高,且昼夜节律更倾向于晚睡。新出现的证据表明,认知脱离综合征(CDS)的症状可能与睡眠困难和晚睡偏好有关,且独立于ADHD症状。然而,大多数研究是在儿童、青少年或大学生中进行的。本研究在一个未被转诊的成年样本中,考察了ADHD与CDS症状维度、睡眠问题和昼夜节律偏好之间的独特关联。106名成年人(年龄在18 - 75岁之间;平均年龄Mage = 38.69岁)完成了关于ADHD和CDS症状、睡眠质量与功能以及昼夜节律偏好的自我报告评估。在回归分析中,ADHD注意力不集中型(ADHD-IN)、ADHD多动冲动型(ADHD-HI)和CDS症状表现出不同的独特关联。只有ADHD-IN症状与更频繁使用助眠药物有独特关联。只有ADHD-HI症状与较短的睡眠时间和更严重的夜间睡眠干扰有独特关联。只有CDS症状与较差的睡眠质量、较长的入睡潜伏期、更严重的日间功能障碍、更严重的整体睡眠损害以及更强的晚睡偏好有独特关联。研究结果支持了考虑CDS在ADHD成年人睡眠障碍和昼夜节律偏好中所起作用的重要性,并指出在研究和临床护理中需要仔细评估这些维度。

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ADHD and sleep: recent advances and future directions.注意缺陷多动障碍与睡眠:最新进展与未来方向。
Curr Opin Psychol. 2020 Aug;34:50-56. doi: 10.1016/j.copsyc.2019.09.006. Epub 2019 Sep 20.

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