目的 探讨注意缺陷多动障碍(ADHD)儿童的睡眠质量问题,为ADHD的综合评估干预提供理论依据。方法 选取2019年7-11月于上海市儿童医院确诊的ADHD儿童186人,同期儿童215人作为对照组,年龄均在5~12岁之间,采用睡眠质量问题调查问卷从主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物的应用和对日间功能的影响以及常见睡眠问题等方面对ADHD儿童进行评估,并与健康儿童进行比较。结果 ADHD组存在睡眠质量问题的儿童占8.60%(16/186),对照组占2.79%(6/215),差异有统计学意义(χ2=6.495,P＜0.05),主要表现在入睡时间延长及睡眠效率降低,ADHD组入睡时间和睡眠效率得分分别为1(1,2)及0(0,0),对照组得分0(0,1)及0(0,0),差异均有统计学意义(Z=-7.090,-3.504,P＜0.05)。睡眠问题中尿床发生率为17.7%(33/186),对照组4.7%(10/215)(χ2=17.852);睡眠呼吸紊乱发生率为7.0%(13/186),对照组2.3%(5/215)(χ2=5.059),睡眠中不随意抽动发生率为23.7%(44/186),对照组12.1%(26/215)(χ2=9.253),以上差异均有统计学意义(P＜0.05)。结论 ADHD儿童睡眠问题较多,睡眠中不随意抽动的发生率增高,临床诊治中需对ADHD儿童共患的睡眠问题予以评估和干预。
Abstract
Objective To investigate the sleep problems of children with attention deficit hyperactivity disorder (ADHD),in order to provide reference for the comprehensive assessment and intervention of ADHD.Methods A total of 186 children diagnosed with ADHD and 215 healthy children aged 5 to 12 years were enrolled in this study from July 2019 to November 2019 in Shanghai Children's Hospital.Sleep onset latency,sleep time,sleep efficiency,sleep disorders and common sleep problems were assessed by using a questionnaire in aspects of sleep quality and problems,and the results were compared with those of healthy children.Results Totally 8.60% (16/186) of the children in the ADHD group had sleep quality problems,and it was 2.79% (6/215) in healthy controls,the difference was significant(χ2=6.495,P<0.05).Sleep problems mainly manifested in prolonged sleep time and decreased sleep efficiency,which were scored as 1(1,2) and 0(0,0) in ADHD group,0(0,1) and 0(0,0) in control group,and the differences were significant (Z=-7.090,-3.504,P<0.05).As for common sleep problems,the incidence of bed-wetting was 17.7% (33/186) in ADHD group,4.7% (10/215) in the control group (χ2=17.852).The rate of sleep disordered breathing was 7.0% (13/186) in ADHD group,2.3% (5/215) in control group (χ2=5.059).The rate of involuntary twitching during sleep was 23.7% (44/186) in ADHD group,12.1% (26/215) in control group (χ2=9.253),and the differences on the above indicators were significant (P<0.05).Conclusions Sleep problems are common in ADHD children,and the prevalence of involuntary twitching during sleep is high.Thus the comorbidity of sleep problems in ADHD children need to be evaluated and intervened in clinical diagnosis and treatment.
关键词
注意缺陷多动障碍 /
睡眠质量 /
睡眠问题 /
儿童
Key words
attention deficit hyperactivity disorder /
sleep quality /
sleep problems /
children
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基金
上海市卫健委项目(2020YJZX0203);上海市公共卫生体系建设三年行动计划项目(GWV-10.1-XK19)
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