수면다원검사를 이용한 주의력결핍 과잉행동장애 아동의 수면 양상

Sleep Patterns in Children with Attention-Deficit/Hyperactivity Disorder by Polysomnography

본 연구는 ADHD 환자의 야간 수면 양상을 객관적 검사 도구 중 하나인 수면다원검사를 통하여 확인해 보고자 하였다. ADHD 환자군이 적절하게 선별되었는지 확인하기 위하여 정신과 전문의의 임상면담과 신경인지 기능검사를 시행하였으며, 대조군에서는 임상면담만 시행하였다. 수면 양상을 평가하기 위해 두 군 모두 수면다원검사를 시행한 후 수면 변수를 산출하고 두 군 간의 차이를 비교하였다. 또한 ADHD 환자군 내에서 수면 변수들 사이의 연관성을 평가하였다. 평가 결과 ADHD를 가진 환자는 다양한 수면 문제를 보이고 있었는데 본 연구에서는 대조군에 비해 유의하게 취침시간과 입면잠복기가 길고, 서파수면분율이 낮았으며, 기상을 동반한 사지 운동이 유의하게 자주 나타나는 것으로 측정되었다. 하지만 추후 표본 크기, 성별 분포, 수면다원검사로 인해 유발된 낯선 환경 효과 등의 제한점을 보완하여 추가적인 연구들을 시행해 일관성 있는 결과들을 밝혀내야 할 것으로 생각된다.

Objective Sleep problems are a prominent feature in children with attention-deficit/hyperactivity disorder (ADHD) and about 25–43% of ADHD patients were reported to have sleep problems including higher level of nocturnal activity, longer sleep latency, lower sleep efficiency, more frequent night awakenings and shorter total sleep time. However, the association between sleep and ADHD is poorly understood and their relationships to sleep structure are not consistent across studies. The aims of our study were to ascertain the nocturnal sleep disturbances in patients with ADHD by objective measure, polysomnography. Methods The subjects were 20 patients with ADHD and 21 control children (6–12 years). We tested them by polysomnography to get sleep variables and compare sleep disturbances. In addition, we tested ADHD group by neurocognitive function test and assessed the correlation between sleep variables and neurocognitive functions in ADHD group. Results In sleep variables by polysomnography, the total time in bed (509.73±24.56 min vs. 490.51±20.71 min, p=0.01), sleep latency (21.30±19.33 min vs. 10.72±7.26 min, p=0.031) and limb movement arousal (6.56±2.19 /hr vs. 5.98±1.38 /hr, p=0.043) were significantly increased in patients with ADHD compared with controls. And the slow wave sleep (24.59±4.73% vs. 28.45±5.63%, p=0.023) were significantly decreased in patients with ADHD compared with controls. There were no significant differences in sleep period time and sleep efficiency test. Conclusion The patients with ADHD had more sleep problems and results of this study suggested that they have significantly increased the total time in bed, sleep latency and Limb movement arousal. And in the patients with ADHD, some sleep variables indicated poor sleep quality. However, further studies should repeatedly suggest consistent results about sleep problems in children with ADHD.