Sleep Characteristics Of Children With Attention Deficit Hyperactivity Disorder

Objective To explore the association between symptoms of attention-deficit /hyperactivity disorder and sleep problems in children. To further explore the changes of sleep structure in children with ADHD by Polysomnography, and reveals a more comprehensive sleep characteristics of the children with attention deficit hyperactivity disorder by both subjective and objective measures.Methods A total of 3463 children(grade 1 to grade 6) in five primary schools of Guangzhou were sampled by random cluster sampling. They were investigated by Conners Abbreviated Symptom Questionnaire(ASQ) and The Sleep Questionnaire of The Chinese University of Hong Kong. A total of 3463 questionnaires were distributed, and 3346 questionnaires (96.6%) were returned. Then remove the questionnaires suggest there are significant other mental illness and physical disease and other void volumes (data loss>30%). 3252 valid questionnaires (93.9%) were finally obtained. According to ASQ≥15 points or not, all of the children were divided into ADHD-related symptoms group(130) and non-ADHD-related symptoms group(3122). According to the principle of informed and consent, in strictly accordance with the selection and exclusion criteria, 40 volunteers (ADHD children, 20; healthy control subjects, 20) were collected in our clinic and the above primary schools, they were investigated by SNAP-IV(Swanson, Nolan, and Pelham, Version IV) and monitored with polysomnography for a whole night .Results All of the 3252 children, ASQ score≥15 were 130 persons (4.0 %). The average time of nighttime sleep was 9.12±0.63 hours. Comparison among these groups showed: The ADHD–related symptoms groups were significantly higher in gender proportion of men(χ2=4.439,P<0.05), ramp duration(χ2=24.733, P<0.01), daytime sleepiness(Z=-6.170,P<0.01), and the incidence rate of snoring(χ~2=17.954, P<0.01) and night terrors (χ~2=47.426, P<0.01)than that of non-ADHD–related symptoms groups. While less in the time of nighttime sleep(t=-3.760, P<0.01) than that of non-ADHD groups. Correlation analysis indicated that:The ASQ score has a negative correlation with the time of nighttime sleep(r = -0.080, P <0.01), and has a significant positive correlation with ramp duration(r = 0.138, P <0.01), daytime sleepiness(r = 0.230, P <0.01), snoring(r = 0.150, P <0.01), night terrors(r = 0.119, P <0.01) and sleepwalking (r = 0.044, P <0.05). Logistic regression analysis showed that: All the six factors into the regression equation according to the influence of size were: daytime sleepiness, ramp duration, the time of nighttime sleep, gender proportion, snoring, night terrors. Nighttime sleep and the ASQ score showed a negative relationship. ramp duration﹑men'proportion﹑daytime sleepiness﹑snoring and night terrors all have a positive relationship with the ASQ score. 40 volunteers (20 ADHD children and 20 healthy control subjects) polysomnography date showed: Compared to the healthy control subjects, the ADHD group experienced shorter nighttime sleep (from sleep onset to final morning awakening, and including"wake"time) (t = 2.288, P <0.05)﹑ actual sleep time (from sleep onset to final morning awakening, and excluding"wake"time) (t = 2.759, P < 0.01)﹑ non-rapid eye movement sleep- stageⅡ(t = 2.492, P <0.05) and rapid eye movement sleep (t = 2.132, P <0.05), but longer awakening time (t =- 2.300, P <0.05), the ADHD group also showed decreased sleep efficiency (Z =- 2.208, P <0.05).Conclusions The children with ADHD-related symptoms were often accompanied by sleep problems, and these symptoms of ADHD are closely related to their sleep problems. The children with ADHD have some changes in sleep structure.