Abstract

Introduction

Executive functioning (EF) deficits are a key feature of ADHD, and sleep disturbances may be an important contributor. Specifically, disturbed sleep is prevalent in ADHD and similar EF deficits are observed in ADHD and sleep disorders. Associations between disrupted sleep and EF in ADHD are poorly understood, particularly during adolescence. This study is among the first to examine relationships between sleep and EF using polysomnography (PSG) among adolescents across the ADHD symptom continuum.

Methods

In this ongoing study, 42 adolescents aged 13 to 17 (mean age = 14.86, 20 females) completed 3 nights of at-home PSG recording (total sleep time; TST) and self-reports of sleep quality, daytime sleepiness, and chronotype. Seventeen had ADHD and 25 were healthy controls (HC). Participants and parents also completed a measure of EF (BRIEF-2; global and behavioral, emotional, and cognitive subscales). Linear regressions controlling for age and sex evaluated associations between sleep and EF.

Results

Self-reported poorer sleep quality and greater daytime sleepiness and eveningness tendency (p’s<.05), but not TST, were associated with poorer self-reported global EF among adolescents. Shorter TST and greater eveningness were correlated with poorer parent-reported global EF (p’s<.05). Follow up analyses examine differential relationships between sleep and behavioral, emotional, and cognitive domains of EF and between ADHD and HC groups.

Conclusion

This study is among the first to examine relationships between sleep and EF across the ADHD continuum in an adolescent-specific sample using PSG. Objectively-measured TST as well as subjective measures of sleep were associated with poorer EF in adolescents across the ADHD continuum. Prevention/intervention strategies focused on sleep may support EF among adolescents, and future studies should examine this possibility. In addition, given variability in EF among individuals with ADHD, future studies should investigate whether sleep disturbances identify a phenotypic subgroup within ADHD at risk for EF deficits.

Support

This work was supported by NIMH K23 MH108704 (Dr. Lunsford-Avery)

中文翻译：

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0983整个Adhd Continuum青少年与执行功能相关的睡眠

摘要

介绍

执行功能（EF）缺陷是ADHD的关键特征，睡眠障碍可能是重要的促成因素。具体而言，多动症多见于睡眠障碍，而多动症和睡眠障碍也观察到类似的EF缺乏。人们对ADHD中睡眠中断与EF之间的关联了解甚少，尤其是在青春期。这项研究是第一个使用多导睡眠图（PSG）在整个ADHD症状连续体中的青少年中检查睡眠与EF之间关系的研究。

方法

在这项正在进行的研究中，有42位13至17岁的青少年（平均年龄= 14.86，20位女性）完成了3个晚上的在家PSG记录（总睡眠时间； TST），并自我报告了睡眠质量，白天嗜睡和表型。17名患有ADHD，25名是健康对照（HC）。参与者和父母还完成了一项EF测量（BRIEF-2；整体和行为，情感和认知分量表）。控制年龄和性别的线性回归评估了睡眠与EF之间的关联。

结果

自我报告的较差的睡眠质量和白天的嗜睡和夜间睡眠倾向（p's <.05）（而非TST）与青少年自我报告的较差的全球EF相关。较短的TST和较大的晚间睡眠时间与较差的父母报告的全球EF相关（p's <.05）。后续分析检查了睡眠与EF的行为，情感和认知域之间以及ADHD和HC组之间的差异关系。

结论

这项研究是第一个使用PSG在特定于青少年的样本中检查ADHD连续体中睡眠与EF之间关系的研究。客观测量的TST以及主观睡眠与ADHD连续谱中青少年EF较差有关。以睡眠为重点的预防/干预策略可能支持青少年的EF，未来的研究应探讨这种可能性。此外，鉴于多动症患者的EF存在差异，未来的研究应调查睡眠障碍是否能确定ADHD内有EF缺乏风险的表型亚群。

支持

这项工作得到NIMH K23 MH108704（Lunsford-Avery博士）的支持