The Study About Sleep Quality And Problems In Children With Attention Deficit Hyperactivity Disorder

[Purpose]To explore the sleep quality and problems of children with attention deficit hyperactivity disorder,and to provide a theoretical basis for comprehensive assessment and intervention of ADHD.[Methods]A case-control study（n=186 in the ADHD group,n=215 in the control group,aged 5-12 years）was used to conduct a questionnaire survey of sleep quality problems in children with attention deficit hyperactivity disorder and normal children,comparing the differences in the occurrence of sleep quality problems between the two groups of children.The fifth edition of the Manual of Diagnostic and Statistical Manual of Mental Disorders（DSM-V）was used as the diagnostic standard to diagnose children with ADHD;a questionnaire for sleep quality of children was compiled based on the Pittsburgh Sleep Quality Index（PSQI）and children’s common sleep disorders.The score of sleep quality is divided into 7 components:subjective sleep quality,sleep onset latency,sleep time,sleep efficiency,sleep disorders,application of hypnotic drugs,and effects on daytime function.When PSQI<8,it is regarded as good sleep quality;When PSQI≥8,it is considered that there is a problem of sleep quality.Sleep problems includedmolar,bed-wetting,sleep disordered breathing,involuntary twitching,and sleepwalking.Self-made personal questionnaires were made for school-age children to understand the basic health of children,including children individual factors（gender,age）and family environmental factors,etc.A self-contrast study（n=42,aged7-12 years）was used to conduct questionnaire surveys of children with attention deficit hyperactivity disorder before and after the use of central nervous system stimulants medication for 2 months to compare the differences in the occurrence of sleep quality problems before and after medication.Statistical analysis was performed with SPSS 21.0 software.Qualitative data was described by example and rate（%）.The measurement data conforming to the normal distribution was described by x±s,while being described by M(P₂₅,P₇₅)not conforming to the normal distribution.On the test level ofα=0.05,the Independent sample t test,Kruskal-Wallis test and Chi-square test were used for comparing the data.[Results]There were 8.60%of the children in the ADHD group with sleep quality problems,2.79%of which in the control group,the difference of which was statistically significant（X2=6.495,p<0.05）,mainly manifested in prolonged sleep time and decreased sleep efficiency,which were scored as 1（1,2）and 0（0,0）,compared with 0（0,1）and 0（0,0）in the control group,the difference of which was statistically significant（Z=-7.090,-3.504,p<0.05）.As for common sleep problems,the incidence of bed-wetting in the ADHD group was 17.7%,compared with4.7%in the control group（X2=17.852）;that of sleep disordered breathing in ADHD was 7.0%,compared with 2.3%in the control group（X2=5.059）;that of involuntary twitching during sleep in ADHD was23.7%,compared with 12.1%in the control group（X2=9.253）,the difference of which were all statistically significant（p<0.05）.There was no significant difference in sleep quality scores and incidence of sleep problems among ADHD children of different genders and ages（all p>0.05）.After 2 months of treatment with ADHD children with central stimulant medicine,thescores of sleep onset latency and total scores（1（0,2）and 4（2,6））were higher than before administration（0（0,1）and 3（2,4））,the difference was statistically significant（Z=-2.623,-2.236,p<0.05）.No significant change existed in sleep problems after medication（all p>0.05）[Conclusions]The proportion of children with ADHD who have sleep quality problems is higher than that of healthy children,the main problems of which are prolonged sleep latency and decreased sleep efficiency.The incidence of sleep problems in children with ADHD is higher than that in healthy children,such as bed-wetting,sleep disordered breathing and involuntary twitching during sleep.There was no significant difference in sleep quality scores and incidence of sleep problems among children with ADHD of different genders and ages.After 2 months of treatment with central stimulant drugs,the incidence of sleep quality problems in children with ADHD increased,the main problems of which was sleep onset latency,and there was no significant change in the incidence of sleep problems.In the clinical diagnosis and treatment of ADHD children,sleep quality problems should be paid attention to and we should intervene the situation and adjust the treatment plan in time.