Artículo empírico que examina la asociación entre los subtipos de trastorno de déficit de atención e hiperactividad (TDAH), trastornos del sueño y calidad de vida en niños. Con una muestra de 72 niños con síntomas de TDAH (edades 6–13 años; 79,2% varones) diagnosticados según el DSM-5 y la Clasificación Internacional de Trastornos del Sueño, tercera edición, se evaluaron mediante cuestionarios estandarizados la calidad del sueño (CSHQ-DE), insomnia, pesadillas y calidad de vida. Los resultados muestran una prevalencia aumentada de trastornos del sueño en la muestra total y una asociación significativa entre el TDAH subtipo hiperactividad-impulsividad y mayores puntuaciones de trastornos del sueño. Se encontró impacto elevado de insomnia en este subtipo y carga comórbida alta de coocurrencia de insomnia y pesadillas. La calidad de vida fue reducida en toda la muestra, intensificándose en niños con insomnia y pesadillas comórbidas.
Puntos clave
Los niños con TDAH presentan una prevalencia clínicamente elevada de trastornos del sueño según el CSHQ-DE, con especial impacto en el subtipo hiperactividad-impulsividad.
La coocurrencia comórbida de insomnia y pesadillas en niños con TDAH se asocia con una reducción significativa de la calidad de vida.
El estudio verificó la validez de un modelo hipotético que vincula síntomas específicos de ambos trastornos a través de mecanismos neurobiológicos compartidos y disfunción de la regulación de la activación.
Para quién: Psicólogos clínicos, investigadores y profesionales de la salud mental infantil que atienden niños con TDAH y necesitan considerar el impacto de los trastornos del sueño en el tratamiento y la calidad de vida de este grupo.
Resumen de los autores
Julia Grünwald,1 Angelika Anita Schlarb2 1Department of Psychology, Faculty of Science, University of Tübingen, Tübingen, 2Department of Clinical Psychology and Psychotherapy, Faculty of Psychology and Sports Science, University of Bielefeld, Bielefeld, Germany Objectives: This study examined the links between sleep disorders and subtypes of attention deficit-hyperactivity disorder (ADHD-inattention, ADHD-combined, ADHD-hyperactive/impulsive) in childhood. We set up a hypothetical model linking different symptoms of both disorders to construct the underlying and shared pathways. By examining a sample of children with ADHD we firstly tested parts of the model.Methods: A total of 72 children with symptoms of ADHD (aged 6–13 years; 79.2% boys) were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and the International Classification of Sleep Disorders, third edition in regards to ADHD and sleep disorders via standardized parent-rated questionnaires. Additionally, quality of life (QoL) was assessed. Overall, 46 children fulfilled the criteria of ADHD and were medication-naive.Results: On average, the whole sample had clinically elevated total scores of the Children’s Sleep Habits Questionnaire in the validated German version (CSHQ-DE), indicating an increased prevalence of sleep disorders in children with ADHD. In accordance to our hypothetical model, children with primarily hyperactive–impulsive ADHD showed the highest CSHQ-DE scores. Moreover, we found a high impact for insomnia in this subgroup and a high comorbid load for the mutual occurrence of insomnia and nightmares. Furthermore, QoL was reduced in our whole sample, and again intensified in children with comorbid insomnia and nightmares.Conclusion: We verified an elevated occurrence of sleep disorders in children with ADHD and were able to link them to specific subtypes of ADHD. These results were in line with our hypothetical model. Moreover, we found a clinically reduced QoL in mean for the whole sample, indicating the strong impact of ADHD in the lives of affected children, even intensified if children exhibited comorbid insomnia and nightmares. These results should be kept in mind regarding the treatment and therapy of this subgroup of children. Specific treatment strategies should be considered for these children. Keywords: impulsivity, hyperactivity, inattention, sleep disorders, childhood
J, G., & AA, S. (2017). Relationship between subtypes and symptoms of ADHD, insomnia, and nightmares in connection with quality of life in children.Neuropsychiatric Disease and Treatment. https://www.dovepress.com/relationship--between-subtypes-and-symptoms-of-adhd-insomnia-and-night-peer-reviewed-article-NDT
