Sleep-Related Problems Among Children and Adolescents With Attention Deficit/Hyperactivity Disorder, Anxiety Disorders, or the Comorbidity of the Two

Abstract

Rannsóknir hafa sýnt fram á að ófullnægjandi svefn getur haft neikvæð áhrif á mikilvæga þætti í lífi ungmenna. Þessi rannsókn miðaði að því að auka vitneskju um svefnvanda ungmenna sem greinast með athyglisbrest/ofvirkni (ADHD), kvíðaraskanir (ADs) eða báðar raskanirnar (ADHD+ADs). Umfang svefnvanda var borinn saman á milli hópa auk einstakra atriða sem varða svefn. Auk þess voru áhrif almennrar kvíðaröskunnar (GAD) á svefnvanda borin saman við áhrif annarra kvíðaraskana. Að lokum var fylgni skoðið á milli umfangs svefnvanda og alvarleika kvíða annarsvegar og ADHD hinsvegar. Þátttakendur voru 103 ungmenni, sex til 18 ára, sem sóttu meðferð á þremur stofnunum. Greiningar voru gerðar með DSM-5 Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (DSM-5 K-SADS-PL). Svefnvandi var metinn með Child Behavior Checklist (CBCL) og Youth Self-Report (YSR). Alvarleiki kvíðaeinkenna var metinn með The Revised Child Anxiety and Depression Scale (RCADS) og alvarleiki ADHD einkenna með Ofvirknikvarðanum (ADHD-RS). Samkvæmt foreldrum var ADHD+ADs hópurinn með umfangsmeiri svefnvanda en bæði ADHD hópurinn (p = 0.031) og ADs hópurinn (p < 0.001). Einungis fannst munur milli hópa á einu svefnatriði: svefnerfðiðleikar. Foreldrar ungmenna í ADHD+ADs hópunum greindu oftast frá því atriði(X2 (2, 97) = 10.71, p = 0.011). Áhrif GAD sáust aðeins í ADHD+ADs hópnum samkvæmt sjálfsmati ungmenna (H (1) = 7.14, p = 0.008). Jákvæð fylgni fannst á milli alvarleika kvíða einkenna og umfangs svefnvanda samkvæmt foreldrum (r (55) = 0.38, p =0.004). Niðurstöður benda til þess að þörf sé á frekari rannsóknum á tengslum svefnvanda og geðraskana, sérstaklega út frá sjálfsmati ungmenna, og að það sé mikilvægt fyrir fagfólk að meta svefnvanda ungmenna sem greinast með ADHD, ADs eða bæði.

Insufficient sleep has been shown to negatively impact important functioning in youths. This study aimed to contribute to a growing body of research comparing sleep problems in children diagnosed with attention deficit/hyperactive disorder (ADHD), anxiety disorders (ADs) and the combination of the two (ADHD+AD), through the following methods: comparison of Sleep Composite Scores and independent sleep domains between groups; comparison of effects of generalized anxiety disorder (GAD) on sleep problems versus other ADs; and correlation of disorder severity to the degree of sleep problems. The study included 103 participants, six to 18 years old, seeking treatment at three different sites. Diagnostic assessment was conducted according to the DSM-5 Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (DSM-5 K-SADS-PL), sleep problems were assessed with the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR), the severity of anxiety was assessed with The Revised Child Anxiety and Depression Scale (RCADS), and ADHD severity assessed with the ADHD Rating Scale (ADHD-RS). The ADHD+ADs group exhibited a greater degree of parent-reported sleep problems than the ADHD group (p = 0.031) and the ADs group (p < 0.001). The item “trouble sleeping” was most often reported by parents of ADHD+ADs youths (X2 (2, 97) = 10.71, p = 0.011). A GAD diagnosis only modified degree of sleep problems reported by youths in the group diagnosed with ADHD+ADs (H (1) = 7.14, p = 0.008). Degree of parent-reported sleep problems was positively correlated with severity of anxiety (r (55) = 0.38, p =0.004). Results suggest that further research is needed on self-reported sleep problems in relation to ADHD and ADs, and that sleep problems should be assessed in treatment.