| ObjectiveAttention-deficit hyperactivity disorder(ADHD)is one of the most common childhood mental health problems,which is characterized by developmentally inappropriate symptoms of inattention,hyperactivity/impulsivity and always accompanied functional impairment,like learning disabilitiy and difficulties in interpersonal communication.Sleep problems/disorder is one of the most common comorbidities of ADHD.This study is to learn the prevalence and characteristics of the comorbidity of ADHD and sleep problems/sleep disorder,by surveyed the 6 to 12 years school-aged children in Chongqing,China.Subjects and MethodsIn the Jiulongpo District of Chongqing,China,6260 children from 5full-time public primary schools were surveyed by cluster randomly sampling and two-staged epidemiological survey.6035 voluntary childrenwith informed consent should complete the ADHD scales in primary screening.Children,whose ADHD scales were suspicious positive/positive in the recycling qualified questionnaires,should accomplish the Vanderbilt Parent Rating Scales(VADPRS)? Vanderbilt Teacher Rating Scales(VADTRS)and Children's Sleep Habits Questionnaire(CSHQ).Based on the diagnostic criteria of ADHD in American Psychiatric Association's?Diagnostic and Statistical Manual of Mental Disorders ? forth edition(DSM-IV),ADHD has three subtypes,predominant inattentive type(PI)? predominant hyperactivity-impulsive type(HI)and combined type(CT)respectively.It is positive for the result that the total score of CSHQ is equal or greater than forty one.All questionnaires should be filled in based on the typical behaviors(include the conduct and sleep manifestations)in nearly six months by the guardian or caregivers.Results1.In 5979 recycling qualified questionnaires,the prevalence rate of ADHD was 8.7%(519/5979).The prevalence rate of ADHD in boys was significantly higher than that of girls'(?2 =59.06,P=0.000).In the 519 subjects with ADHD,the rate of comorbidity of ADHD and sleep problems/disorder was 72.4%.There were no statistical differences between sex and ages in the prevalence rates of sleep problems/disorder(P>0.05).In the correlative symptoms of sleep problems/disorder,therates of “Go to bed not at the same time” and “Not sleeps the right amount”in ADHD girls were significantly higher than boys'(?2 =5.37,P=0.02;?2=4.25,P=0.039,respectively).The prevalence rates of “sleep onset latency”?“sleep duration”?“daytime sleepiness”?“bedtime habits”?“sleep anxiety”and parasomnias were significantly different in 6 to 8 years group,9 to 10 years group,and 11 to 12 years group(P<0.05).2.In the children's sleep habits questionnaire of 519 ADHD children,the top three stratifications were daytime sleepiness(55.7%),sleep onset latency(41.6%)and bedtime habits(41.2%).The three minimum occurrence of 33 questions in CSHQ were sleep walking(1.7%)? sleep apnea(3.9%)and bed-wetting(4.8%).3.The prevalence rates of sleep problems/disorder were different in ADHD subtypes,predominant inattentive type and combined type were higher than that of predominant hyperactivity-impulsive type,which had significantly statistical difference(?2 =21.53,P=0.000;?2 =10.82,P=0.001,respectively).Parts of correlative symptoms(like “Falls asleep in others bed”?“Struggles at bedtime”?“Talks during sleep”?“Restless and moves a lot” and “Takes long time to be alert”)in sleep problems/disorder exists significant difference distribution between the three clinical classifications of ADHD(P<0.05).Conclusion1.The prevalence rate of ADHD is very high and mainly among boysin Chongqing,China.2.The prevalence rate of comorbidity of ADHD and sleep problems/disorder is very high in school-aged children in Chongqing,China.And mainly is the sleep problems.3.The symptoms of sleep problems/disorder are closely associated with ages and developmental stages.4.In the three subtypes of ADHD,predominant inattentive type and combined type are more vulnerable to sleep problems/disorder. |
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