Malmborg Julia S, Tuvesson Josefine, Larsson Ingrid, Svedberg Petra, Nygren Jens, Jarbin Håkan, Lindholm Annelie
School of Health and Welfare, Halmstad University, Halmstad, Sweden.
Faculty of Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.
BMC Pediatr. 2025 Sep 9;25(1):678. doi: 10.1186/s12887-025-06051-3.
Adequate sleep is crucial for children's health, especially for children with ADHD and concurrent sleep problems. There is a need for more studies focusing on sleep problems in children with ADHD as these problems may exacerbate ADHD symptoms and vice versa, impacting negatively on everyday life. The aim of this study was to investigate the differences in health-related factors between children with ADHD without clinically relevant sleep problems and those with clinically relevant sleep problems after a sleep intervention.
This cross-sectional study involved 83 children diagnosed with ADHD and sleep problems, 46 boys and 37 girls; aged 6-14 years, divided into two groups after a sleep intervention according to the parent-reported Children's Sleep Habits Questionnaire (CSHQ) and a cut-off for clinically relevant sleep problems. Data from a 16-week follow-up of the sleep intervention were analysed in terms of the following health-related measures: The Insomnia Severity Index (ISI), The short form of State-Trait Anxiety Inventory (Short-STAI), The Child Outcome Rating Scale (CORS), The EQ-5D-Y-3L (child-reported), and The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) (parent-reported). The Mann-Whitney u-test, Independent samples t-test, and Chi-square/Fisher's exact test were used for the analysis.
Forty-two of the 83 children (50.6%) were grouped as having clinically relevant sleep problems and 41 (49.4%) as being without the same. The results indicated that the group without clinically relevant sleep problems reported less insomnia (ISI, total score p = 0.011), less tension in the anxiety scale (Short-STAI, tense p = 0.047), and their parents reported less ADHD symptoms (SNAP-IV, total score for attention deficit, p < 0.001). No group differences were observed for life functioning (CORS) or health-related quality of life (EQ-5D-Y-3 L).
This study showed that children with ADHD without parent-reported clinically relevant sleep problems had fewer health-related issues after a sleep intervention, including self-reported insomnia, tension, and parent-reported ADHD symptoms, compared to children with clinically relevant sleep problems. Longitudinal studies are necessary to fully comprehend the long-term impact of sleep problems and various health-related factors in this cohort.
充足的睡眠对儿童健康至关重要，尤其是对患有注意力缺陷多动障碍（ADHD）及并发睡眠问题的儿童。需要开展更多针对ADHD儿童睡眠问题的研究，因为这些问题可能会加重ADHD症状，反之亦然，会对日常生活产生负面影响。本研究的目的是调查在进行睡眠干预后，无临床相关睡眠问题的ADHD儿童与有临床相关睡眠问题的ADHD儿童在健康相关因素方面的差异。
这项横断面研究纳入了83名被诊断患有ADHD和睡眠问题的儿童，其中46名男孩和37名女孩；年龄在6至14岁之间，根据家长报告的儿童睡眠习惯问卷（CSHQ）以及临床相关睡眠问题的临界值，在睡眠干预后分为两组。对睡眠干预16周随访的数据，依据以下健康相关指标进行分析：失眠严重程度指数（ISI）、状态-特质焦虑量表简表（Short-STAI）、儿童结果评定量表（CORS）、EQ-5D-Y-3L（儿童报告）以及斯旺森、诺兰和佩勒姆评定量表（SNAP-IV）（家长报告）。采用曼-惠特尼U检验、独立样本t检验和卡方/费舍尔精确检验进行分析。
83名儿童中有42名（50.6%）被归为有临床相关睡眠问题，41名（49.4%）被归为无临床相关睡眠问题。结果表明，无临床相关睡眠问题的组报告的失眠情况较少（ISI，总分p = 0.011），焦虑量表中的紧张程度较低（Short-STAI，紧张p = 0.047），且他们的父母报告的ADHD症状较少（SNAP-IV，注意力缺陷总分，p < 0.001）。在生活功能（CORS）或健康相关生活质量（EQ-5D-Y-3L）方面未观察到组间差异。
本研究表明，与有临床相关睡眠问题的儿童相比，在进行睡眠干预后，家长报告无临床相关睡眠问题的ADHD儿童在健康相关问题上较少，包括自我报告的失眠、紧张以及家长报告的ADHD症状。有必要开展纵向研究以全面了解该队列中睡眠问题和各种健康相关因素的长期影响。
