Lin Chien-Heng, Wu Po-Yen, Hong Syuan-Yu, Chang Yu-Tzu, Lin Sheng-Shing, Chou I-Ching
Division of Pediatric Pulmonology and Critical Care Medicine, China Medical University Children's Hospital, Taichung 404327, Taiwan.
Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung 404327, Taiwan.
Life (Basel). 2025 Apr 21;15(4):678. doi: 10.3390/life15040678.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsive behavior. In recent years, studies have shown that patients with ADHD often experience sleep problems, raising clinical interest in the potential role of polysomnography (PSG) in the diagnosis and management of ADHD. This study examines polysomnographic findings in children with ADHD who present with diverse sleep complaints. A cohort of children aged younger than 18 years, diagnosed with ADHD based on DSM-5 criteria, underwent overnight polysomnography. The study assessed various sleep parameters, including sleep latency, sleep efficiency, total sleep time, and the presence of sleep-disordered breathing. A retrospective analysis was conducted on 36 children (29 boys and 7 girls) aged 6 to 14 years, diagnosed with ADHD, who underwent polysomnography between 2021 and 2024. Polysomnographic findings revealed that 77.78% of the children demonstrated significant snoring. Furthermore, 50.0% were diagnosed with obstructive sleep apnea syndrome (OSAS). In addition, eight children exhibited parasomnias. Among them, six had bruxism, three were diagnosed with periodic limb movement disorder (PLMD), and two experienced sleep talking. Other notable sleep-related conditions included two cases of narcolepsy, one case of prolonged sleep onset latency, and one case of central apnea syndrome. Total sleep time (TST) was significantly longer in females compared to males (400.71 ± 32.68 min vs. 361.24 ± 41.20 min, = 0.0215), whereas rapid eye movement (REM) latency was longer in males compared to females (118.62 ± 55.60 min vs. 78.57 ± 27.82 min, = 0.0194). These findings highlight the high prevalence of sleep-disordered breathing (SDB) in children with ADHD who present with sleep disturbances. Furthermore, sleep quality, as indicated by longer TST and shorter REM latency, appears to be better in females with ADHD. The findings of this study underscore the critical role of polysomnography (PSG) in the assessment of children with ADHD. PSG provides an objective evaluation of sleep abnormalities commonly associated with ADHD, which may influence symptom manifestation and treatment outcomes. Notably, the results suggest that females with ADHD exhibit better sleep quality, as indicated by longer total sleep time (TST) and shorter rapid eye movement (REM) latency compared to males. We recommend incorporating polysomnography (PSG) into the comprehensive assessment of children with ADHD who present with significant sleep disturbances. Further research is warranted to investigate the impact of targeted interventions for sleep abnormalities on ADHD symptoms, prognosis, and potential sex-specific differences.
注意缺陷多动障碍（ADHD）是儿童常见的神经发育障碍，其特征为注意力不集中、多动和冲动行为。近年来，研究表明ADHD患者常伴有睡眠问题，这引发了临床上对多导睡眠图（PSG）在ADHD诊断和管理中潜在作用的兴趣。本研究调查了有各种睡眠主诉的ADHD儿童的多导睡眠图结果。一组年龄小于18岁、根据《精神疾病诊断与统计手册》第5版（DSM - 5）标准诊断为ADHD的儿童接受了整夜多导睡眠图检查。该研究评估了各种睡眠参数，包括入睡潜伏期、睡眠效率、总睡眠时间以及睡眠呼吸紊乱的存在情况。对2021年至2024年间接受多导睡眠图检查的36名年龄在6至14岁、诊断为ADHD的儿童（29名男孩和7名女孩）进行了回顾性分析。多导睡眠图结果显示，77.78%的儿童有明显打鼾。此外，50.0%被诊断为阻塞性睡眠呼吸暂停综合征（OSAS）。另外，8名儿童出现了异态睡眠。其中，6名有磨牙症，3名被诊断为周期性肢体运动障碍（PLMD），2名有说梦话。其他值得注意的与睡眠相关的情况包括2例发作性睡病、1例入睡潜伏期延长和1例中枢性呼吸暂停综合征。女性的总睡眠时间（TST）显著长于男性（400.71±32.68分钟 vs. 361.24±41.20分钟，P = 0.0215），而男性的快速眼动（REM）潜伏期长于女性（118.62±55.60分钟 vs. 78.57±27.82分钟，P = 0.0194）。这些发现突出了有睡眠障碍的ADHD儿童中睡眠呼吸紊乱（SDB）的高患病率。此外，ADHD女性的睡眠质量似乎更好，表现为TST更长和REM潜伏期更短。本研究结果强调了多导睡眠图（PSG）在评估ADHD儿童中的关键作用。PSG对通常与ADHD相关的睡眠异常提供了客观评估，这可能影响症状表现和治疗结果。值得注意的是，结果表明与男性相比，ADHD女性表现出更好的睡眠质量，表现为总睡眠时间（TST）更长和快速眼动（REM）潜伏期更短。我们建议将多导睡眠图（PSG）纳入对有明显睡眠障碍的ADHD儿童的综合评估中。有必要进一步研究针对睡眠异常的靶向干预对ADHD症状、预后以及潜在性别差异的影响。
