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. 2022 Dec 15;24(12):1365-1370.
doi: 10.7499/j.issn.1008-8830.2206147.

[Influence of sleep quality on symptoms in children with attention deficit hyperactivity disorder: the mediating role of working memory]

[Article in Chinese]
Lin Zhong  1 , Jing Zhang  1 , Xiao-Yan Gao  1 , Hong-Yao He  1 , Peng-Xiang Zuo  1 , Ran-Ran Song
Affiliations

[Influence of sleep quality on symptoms in children with attention deficit hyperactivity disorder: the mediating role of working memory]

[Article in Chinese]
Lin Zhong et al. Zhongguo Dang Dai Er Ke Za Zhi. .

Abstract
in English, Chinese

Objectives: To study the mediating role of working memory between sleep quality and symptoms in children with attention deficit hyperactivity disorder (ADHD).

Methods: The cluster random sampling method was used to select 110 ADHD children and 124 normal children as subjects from grade 3-5 students in two primary schools in Kashgar, Xinjiang Uygur Autonomous Region, China. SNAP-IV, Pittsburgh Sleep Quality Index (PSQI), and visual-spatial working memory paradigm were used for investigation and comparison.

Results: Compared with the normal group, the ADHD group had a significantly higher total score of PSQI and scores of subjective sleep quality, sleep latency, sleep efficiency, sleep disturbance, and a higher incidence of sleep quality problems (P<0.001). The working memory score in the ADHD group was significantly lower than that in the normal group (P<0.001). In the ADHD group, the working memory score was negatively correlated with the total score of PSQI (rs=-0.271, P<0.001) and the score of symptoms (rs=-0.439, P<0.001), and the total score of PSQI was positively correlated with the score of symptoms (rs=0.540, P<0.001). Working memory had a partial mediating effect in the influence of sleep quality on symptoms in children with ADHD, accounting for 18.10% of the total effect.

Conclusions: Sleep quality issues are observed in some children with ADHD, and working memory plays a mediating role between sleep quality and symptoms in ADHD children.

目的: 探讨注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）儿童工作记忆在睡眠质量与症状之间的中介作用。方法: 采用随机整群抽样法从新疆维吾尔自治区喀什市2所小学3~5年级学生中筛选出符合条件的ADHD儿童（110例）及正常对照儿童（124例）为研究对象，采用SNAP-Ⅳ评估量表、匹兹堡睡眠质量指数量表（Pittsburgh Sleep Quality Index，PSQI）、工作记忆任务测试进行调查并比较。结果: ADHD组儿童主观睡眠质量、入睡时间、睡眠效率、睡眠障碍评分及PSQI总分高于正常对照组（P<0.001），睡眠质量问题的发生率也高于正常对照组（P<0.001）；ADHD儿童工作记忆得分低于正常对照组（P<0.001）。ADHD组工作记忆得分与PSQI总分呈负相关（rs=-0.271，P<0.001），与症状得分呈负相关（rs=-0.439，P<0.001）；ADHD组PSQI总分与症状得分呈正相关（rs=0.540，P<0.001）。工作记忆在睡眠质量对ADHD儿童症状影响中起部分中介效应，占总效应的18.10%。结论: 部分ADHD儿童存在睡眠质量问题，且工作记忆在ADHD儿童睡眠质量与症状之间起中介作用。.

Keywords: Attention deficit hyperactivity disorder; Child; Sleep quality; Symptom; Working memory.

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Conflict of interest statement

本研究无经济利益或其他因素导致的利益冲突。

Figures

图1
图1. ADHD组儿童睡眠质量、工作记忆及症状的相关性分析图 A为ADHD儿童PSQI总分（睡眠质量）与工作记忆的相关性；B为ADHD儿童PSQI总分（睡眠质量）与症状的相关性；C为ADHD儿童工作记忆与症状的相关性。
图2
图2. 工作记忆在睡眠质量及症状间的中介模型图 图中数字代表各路径回归系数β，即代表预测变量和结果变量的相关性。* P<0.05。
See this image and copyright information in PMC

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