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刘之旺, 包盈晶, 程芳, 禹海航, 张文武. 青少年ADHD共患睡眠障碍影响因素分析[J]. 中国公共卫生, 2020, 36(7): 1039-1042. DOI: 10.11847/zgggws1120019
引用本文: 刘之旺, 包盈晶, 程芳, 禹海航, 张文武. 青少年ADHD共患睡眠障碍影响因素分析[J]. 中国公共卫生, 2020, 36(7): 1039-1042. DOI: 10.11847/zgggws1120019
Zhi-wang LIU, Ying-jing BAO, Fang CHENG, . Influencing factors for comorbidity of attention-deficit/hyperactivity disorder and sleep disorder among adolescents: a cross-sectional survey[J]. Chinese Journal of Public Health, 2020, 36(7): 1039-1042. DOI: 10.11847/zgggws1120019
Citation: Zhi-wang LIU, Ying-jing BAO, Fang CHENG, . Influencing factors for comorbidity of attention-deficit/hyperactivity disorder and sleep disorder among adolescents: a cross-sectional survey[J]. Chinese Journal of Public Health, 2020, 36(7): 1039-1042. DOI: 10.11847/zgggws1120019

青少年ADHD共患睡眠障碍影响因素分析

Influencing factors for comorbidity of attention-deficit/hyperactivity disorder and sleep disorder among adolescents: a cross-sectional survey

  • 摘要:
      目的  了解注意缺陷多动障碍(ADHD)青少年患者共患睡眠障碍的影响因素。
      方法  于2015年5 — 6月,在浙江省宁波市分层随机整群抽取2 133名中学生进行ADHD共患睡眠障碍评估,通过诊断性面谈确定符合ADHD诊断的青少年272例,以中文版注意缺陷多动障碍评定量表 – 父母版(SNAP-IV)、失眠严重程度指数量表(ISI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和自编一般情况表进行问卷调查,按有无睡眠障碍分为无睡眠障碍组(181例)及伴睡眠障碍组(91例),比较两组一般情况、ADHD症状评分及焦虑抑郁评分,并进行logistic回归分析。
      结果  无睡眠障碍组平均年龄(14.27 ± 1.15)岁,低于伴睡眠障碍组的(14.62 ± 1.10)岁;睡眠障碍组中学习压力应对困难占13.2 %,明显高于无睡眠障碍组的5.0 %;无睡眠障碍组的母亲文化水平大学以上的占22.1 %,高于睡眠障碍组的14.3 %;无睡眠障碍组与睡眠障碍组的注意缺陷评分(14.88 ± 3.95 vs 16.21 ± 4.25)、焦虑评分(31.67 ± 7.56 vs 38.31 ± 9.20)及抑郁评分(11.42 ± 8.23 vs 21.41 ± 9.83)比较,无睡眠障碍组均低于睡眠障碍组,两组多动障碍及对立违抗评分差异无统计学意义;logistic回归分析结果显示,年龄大、高注意缺陷评分、高焦虑、抑郁评分是ADHD青少年共患睡眠障碍的危险因素。
      结论  ADHD共患睡眠障碍与注意缺陷症状及焦虑、抑郁等其他共患症状有关,对睡眠障碍的干预应采取综合干预的策略。

     

    Abstract:
      Objective  To investigate influencing factors for comobidity of attention-deficit/hyperactivity disorder (ADHD) and sleep disorder among adolescents.
      Methods  We a conducted survey on ADHD and sleep disorder among 2 133 students selected with stratified random cluster sampling from 6 high schools in 3 county-level regions in Ningbo city of Zhejiang province during May and June 2015. The Chinese Version Swanson, Nolan, and Pelham Scale-Version IV (SNAP-IV) was used for the diagnosis of ADHD; the Insomnia Severity Index (ISI) was used to assess sleep status of the students; and the Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , and a self-designed questionnaire were adopted to collected relevant information in the students. Then the 272 students identified with ADHD were assigned into a non-sleep disorder (NSD) group (n = 181) and a sleep disorder (SD) group (n = 91) for comparison analysis. Logistic regression analysis was performed to explore influencing factors of comobidity of ADHD and sleep disorder.
      Results  For all the 272 students with ADHD, the average age of the NSD group was younger than that of SD group (14.27 ± 1.15 vs. 14.62 ± 1.10) ; the proportion of the students with difficulty in coping with learning stress was higher for the SD group than that for the NSD group (13.2% vs. 5.0%) ; the ratio of the students with maternal education of undergraduate or above was higher in NSD group than that in SD group (22.1% vs. 14.3%) . Compared to those in the SD group, lower scores for attention deficit (14.88 ± 3.95 vs. 16.21 ± 4.25) , anxiety (31.67 ± 7.56 vs. 38.31 ± 9.20) , and depression (11.42 ± 8.23 vs. 21.41 ± 9.83) were observed in NSD group; whereas there were significant differences in scores for hyperactivity disorder and oppositional disobedience between the two groups. The results of logistic regression analysis indicated that age and high scores for attention deficit, anxiety, and depression were risk factors for the comobidity of ADHD and sleep disorder among the adolescents.
      Conclusion  The comobidity of ADHD and sleep disorder are correlated with symptoms of attention deficit, anxiety and depression among high school adolescents and comprehensive strategies should be developed in interventions on sleep disorder among the adolescents.

     

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