注意缺陷多动障碍儿童的睡眠结构研究  

Study on the sleep structure of children with attention deficit hyperactivity disorder

作　　者：冯军坛[1] 朱彦丽[1] 王立文[1] 吕凌云[1] 崔雯[1] 李尔珍[1] 

机构地区：[1]首都儿科研究所,北京100020

出　　处：《中国实用儿科杂志》2007年第8期624-626,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨注意缺陷多动障碍(ADHD)儿童的睡眠结构。方法2005-06—2006-04用多导睡眠监护仪(PSG)对首都儿科研究所神经内科就诊的41例ADHD患儿及30例正常儿童进行全夜睡眠结构检测。结果41例ADHD儿童中混合型(ADHD-C)24例、注意缺陷型(ADHD-I)11例、多动/冲动型(ADHD-H)6例。其中男35例,女6例(ADHD-I3、ADHD-C2、ADHD-H1例)。与对照组比较ADHD组REM潜伏期短、睡眠潜伏期延长、睡眠效率降低,差异有显著性(P<0·05);ADHD-C儿童睡眠Ⅱ期百分比较ADHD-I增加,差异有显著性(P<0·05);ADHD组睡眠周期性肢体运动(PLMS)发生率为41·5%,正常组PLMS发生率为13·33%,差异有显著性(P<0·05);ADHD组及正常对照组脑电图未见疒间性放电。结论(1)ADHD儿童存在REM睡眠结构的改变、入睡困难及睡眠效率降低;(2)PLMS也是导致ADHD儿童睡眠质量下降的原因之一;(3)ADHD儿童以男孩为主,女孩以注意力缺陷型为主。对学习困难的女孩应注意是否患有ADHD。Objective To investigate the sleep structure of children with attention deficit hyperactivity disorder （ ADHD ）. Methods Forty-one children with ADHD and 30 normal control children underwent full overnight PSG assessment. Results Compared with normal controls,children with ADHD demonstrated decreased latency to REM, increased sleep latency and decreased sleep efficiency; these differences were all statistically significant （ P 〈 0. 05 ）. ,Compared with ADHD-I type,ADHD-C type demonstrated increased percentage of stage Ⅱ（ P 〈 0. 05 ）. The prevalence of PLMS was 41.46% in ADHD group and the prevalence of PLMS was 13.33% in normal control group, the difference of prevalence between the two groups was statistically significant （ P 〈 0. 05 ）. Epileptiform discharge had not been found in both ADHD group and normal control group. In the ADHD group there were 24 children with combined type ADHD （ ADHD-C ）, 11 children with predominant inattention type ADHD （ ADHD-I ） and 6 children with predominant hyperactivity impulsivity type ADHD（ADHD-H） ; 35 boys and 6 girls（3 children with ADHD-1,2 children with ADHD-C, 1 with ADHD-H）. Conclusion Children with ADHD display significantly more problems with sleep, which include decreased latency to REM, difficulty with falling asleep and decreased sleep efficiency. PLMS is one of the reasons which lead to the decrease of sleep quality of children with ADHD. More male children than female in ADHD group, and the most type is ADHD-I in female children. Girls with learning difficulties should be paid more attention to.

关 键 词：注意缺陷多动障碍 睡眠 ADHD 

分 类 号：R749.94[医药卫生—神经病学与精神病学]