摘要
目的探讨注意缺陷多动障碍(ADHD)综合征患儿的睡眠结构,睡眠中癎性放电及睡眠周期性肢体运动(PLMS)的情况;比较ADHD各亚型间睡眠结构的差异。方法利用多导睡眠监护仪对2005年6月至2006年11月在首都儿科研究所神经科门诊就诊的符合DSM-Ⅳ诊断标准的58例ADHD患儿及30名正常儿童进行整夜睡眠结构监测。结果ADHD组58例,其中4例睡眠监测未完成,实际完成54例。ADHD组中混合型(ADHD-C)31例(57.4%,31/54),注意缺陷型(ADHD-I)15例(27.8%,15/54),多动/冲动型(ADHD-H)8例(14.8%,8/54)。①与对照组比较,ADHD组快速动眼期(REM)潜伏期短、睡眠潜伏期延长和睡眠效率降低,差异有统计学意义(P<0.05);②ADHD-C患儿睡眠Ⅱ期百分比较ADHD-I增加,差异有统计学意义(P<0.05);③ADHD组PLMS发生率为37.0%(20/54),对照组PLMS发生率为13.3%(4/30),差异有统计学意义(P<0.05);④ADHD组和对照组EEG未见癎性放电。结论①ADHD患儿存在REM睡眠结构的改变、入睡困难及睡眠效率降低;②睡眠Ⅱ期百分比的增多可使ADHD-C较ADHD-I有更多和更重的症状;③ADHD患儿睡眠过程中PLMS发生率较对照组显著升高,PLMS也是导致ADHD患儿睡眠质量下降的原因之一。
Objective The purpose of this study was to investigate the sleep structure, epileptiform discharge, and periodiclimb movement during sleep （PLMS） in children with attention deficit hyperactivity disorder （ADHD） , and the difference in sleep structure among ADHD subtypes. Methods A total 54 children who were diagnosed as ADHD in the Capital Institute of Pediatrics clinics from 2005.6 to 2006.11 in accord with DSM-Ⅳ criteria （7 females and 47 males with a mean age of 9.5± 2.4 years old）and 30 normal control children （6 females and 24 males with a mean age of 9.2 ± 2. 3 ）underwent comprehensive overnight PSC assessment. In the ADHD group, 31 children were classified as combined type ADHD （ADHD-C） ; 15 children as predominant inattention type ADHD （ADHD-Ⅰ） ; and 8 children as predominant hyperactivity/impulsivity type ADHD （ADHD-H）. Analytic parameters included percentage of stage Ⅰ ,stage Ⅱ ,stage Ⅲ ,stageⅣand stage REM, latency to REM, sleep latency, total sleep time, sleep efficiency, number of arouses, and time of arouse. Results ①Compared with normal control, children with ADHD showed decreased latency to REM, increased sleep latency, and decreased sleep efficiency（ P 〈 0.05 ）. There was no significant difference in the percentage of stage Ⅰ , stage Ⅱ , stage Ⅲ ,stage Ⅳ and stage REM, total sleep time, number of arouses, and time of arouse between the two groups（P 〉0.05）. ②Compared with the subgroup of ADHD-Ⅰ, ADHD-C showed increased percentage of stage Ⅱ （P 〈 0.05 ）. There were no significant differences in the data between the ADHD-Ⅰ subgroup and ADHD-C subgroup（P 〉0.05） . ③The prevalence of PLMS was 37.0% in ADHD group versus 13.3% in normal control. The difference of prevalence rate was statistically significant between the two groups（ P 〈0.05 ）. The prevalence rate of PLMS with an index higher than 5 was 24.1% in ADHD group, and the prevalence of PLMS was 10.0% in matched normal control group. The observed difference
出处
《中国循证儿科杂志》
CSCD
2007年第4期271-275,共5页
Chinese Journal of Evidence Based Pediatrics
关键词
儿童
注意缺陷多动障碍
睡眠
Children
Attention deficit hyperactivity disorder
Sleep
