摘要
目的:探讨哌甲酯(methylphenidate,MPH)缓释片对注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童睡眠特征的影响。方法:纳入23例ADHD儿童作为MPH组,予持续处方可变剂量的哌甲酯缓释片,并分别于基线、治疗2周和治疗6周进行3次整夜多导睡眠监测(polysomnogram,PSG)。同时招募相匹配的正常儿童21例作为对照组进行PSG。采用SPSS 22.0进行统计分析,根据资料类型分别采用均数±标准差,均数(四分位数)[M(P25,P75)]和百分比进行统计描述,对睡眠参数间的比较采用配对t检验或方差分析。结果:与对照组比较,基线时MPH组儿童睡眠效率[SE(%)]降低[(86.7±12.4)%,(90.9±7.5)%]、睡眠潜伏期(SOL)延长[(21.1±12.4)min,(18.1±13.0)min]、REM潜伏期(ROL)缩短[(145.2±35.2)min,(155.6±57.7)min],均差异有统计学意义(均P<0.05)。与同组基线比较,MPH组儿童治疗2周SOL延长[(27.2±6.4)min,(21.1±12.4)min],ROL[(127.2±32.1)min,(145.2±35.2)min]及REM期[(70.5±13.8)min,(79.8±15.3)min]时间缩短及SE(%)变差[(83.1±15.4)%,(86.7±12.4)%],均差异有统计学意义(均P<0.05)。与同组基线比较,MPH组儿童治疗6周SOL、ROL、REM期时间及SE(%)睡眠参数,均差异无统计学意义(均P>0.05)。MPH组儿童N1期、N2期、N3期及R期的总睡眠时间百分比(%TST),唤醒次数及唤醒时间等睡眠参数,在基线、治疗2周和治疗6周时,均差异无统计学意义(均P>0.05)。结论:ADHD儿童存在睡眠效率降低、入睡困难及REM潜伏期缩短;MPH对ADHD儿童的睡眠,在前2周具有一定的负面影响,恶化ADHD儿童患者本身的睡眠问题。当持续治疗6周后,MPH对睡眠的影响逐渐好转。
Objective:To explore the effect of methylphenidate(MPH)sustained-release tablets on the sleep characteristics of children with attention deficit hyperactivity disorder(ADHD).Methods:A total of 23 children with ADHD were included in the MPH group,and treated with sustained variable doses of methylphenidate sustained-release tablets,and overnight polysomnograms(PSG)were performed at baseline,2 weeks of treatment,and 6 weeks of treatment.At the same time,21 matched normal children were recruited as control group for PSG.SPSS 22.0 was used for statistical analysis,and the mean±standard deviation,M(P25,P75)and percentage were used for statistical description according to the type of data.Paired t test or analysis of variance was used for comparison of sleep parameters.Results:At baseline,children in MPH group had lower sleep efficiency(SE(%))((86.7±12.4)%,(90.9±7.5)%),longer sleep latency(SOL)((21.1±12.4)min,(18.1±13.0)min),shorter rapid eye movement onset latency(ROL)((145.2±35.2)min,(155.6±57.7)min),and the differences were statistically significant(all P<0.05).Compared with baseline,children in MPH group after 2 weeks of treatment had prolonged SOL((27.2±6.4)min,(21.1±12.4)min),shortened ROL((127.2±32.1)min,(145.2±35.2)min)and REM phase time((70.5±13.8)min,(79.8±15.3)min)and significantly lower SE(%)((83.1±15.4)%,(86.7±12.4)%),and the differences were statistically significant(all P<0.05).There was no significant difference in the SOL,ROL,REM phase time,and SE(%)sleep parameters of children in the MPH group after 6 weeks of treatment and baseline(all P>0.05).The sleep parameters such as%TST,number of awakenings and time of awakening of WASO in N1,N2,N3 and R phase of MPH group were not statistically significant among baseline,2 weeks of treatment and 6 weeks of treatment(all P>0.05).Conclusion:Children with ADHD present lower sleep efficiency,more difficulty to fall asleep,and shortened REM latency.MPH has a certain negative effect on the sleep of ADHD children in the first 2 weeks,which worsens the
作者
吴为阁
王文强
李宗磊
韦璇
Wu Weige;Wang Wenqiang;Li Zonglei;Wei Xuan(Department of Child and Adolescent Psychology,Affiliated Xianyue Hospital,Xiamen Medical College,Xiamen 361012,China;Department of Sleep Medicine,Affiliated Xianyue Hospital,Xiamen Medical College,Xiamen 361012,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2020年第7期624-628,共5页
Chinese Journal of Behavioral Medicine and Brain Science
基金
厦门市科学技术局科技惠民项目(3502Z20174027)。
关键词
哌甲酯缓释片
注意缺陷多动障碍
多导睡眠监测
儿童
Methylphenidate sustained-release tablets
Attention deficit hyperactivity disorder
Polysomnography
Children
