Comportamento e sono em crianças com transtorno do déficit de atenção com hiperatividade
Carregando...
Arquivos
Data
2019-04-18
Autores
Souza, Ana Luiza Decanini Miranda de [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
O Transtorno do Déficit de Atenção com Hiperatividade (TDAH), cuja patogênese é multifatorial, apresenta a tríade de sintomas: hiperatividade, desatenção e impulsividade. Queixa frequente nessa população, os distúrbios do sono podem ser indicativos de problemas na ritmicidade circadiana e decorrer em problemas comportamentais, de cognição e de humor. Com o intuito de contribuir para o conhecimento das bases biológicas e das características clínicas no TDAH o objetivo deste estudo foi investigar possíveis correlações entre o comportamento, parâmetros do ritmo atividade/repouso, sono/vigília e a presença de distúrbios de sono em crianças com TDAH. Os dados comportamentais foram avaliados por meio do Questionário de Capacidades e Dificuldades (SDQ); os parâmetros de atividade/repouso e sono/vigília por meio da actigrafia e a presença de distúrbios de sono por meio da Escala de Distúrbios de Sono para Crianças (EDSC). Participaram do estudo 27 crianças de sete a 12 anos de idade sendo 15 delas com diagnóstico de TDAH e 12 crianças com desenvolvimento típico. Os resultados mostraram que no escore total do SDQ 13,4% das crianças do grupo TDAH obtiveram pontuação para classificação normal, 33,3% limítrofe e 53,3% anormal enquanto 75% das crianças do grupo controle apresentaram pontuação total para classificação normal, 8,4% limítrofe e 16,6% anormal. No escore total da EDSC 66,6% das crianças com TDAH apresentaram distúrbios do sono. No grupo controle as crianças não apresentaram indicativo de distúrbio de sono. Nas subescalas da EDSC 40% das crianças do grupo TDAH apresentaram indicativo de Distúrbio de início e manutenção do sono, 20% de Distúrbio respiratório de sono, 13,3% de Distúrbio do despertar, 13,3% de Distúrbio de transição sono-vigília, 20% de Sonolência excessiva diurna, 33,3% de Hiperidrose de sono. Não houve diferença nos parâmetros analisados entre crianças TDAH do tipo desatento e TDAH do tipo combinado. As subescalas da ESDC e SDQ mostraram correlações entre o distúrbio de início e manutenção do sono e as subescalas de comportamento: escala de sintomas emocionais, hiperatividade, problemas de relacionamento com colegas e comportamento pró-social. O distúrbio do despertar apresentou correlações com as subescalas de comportamento: sintomas emocionais, hiperatividade, problemas de relacionamento com colegas e comportamento pró-social. Os distúrbios respiratórios do sono apresentaram correlações com a escala de comportamento pró-social. O distúrbio de transição sono-vigília apresentou correlações com as subescalas de comportamento: sintomas emocionais, hiperatividade, comportamento pró-social; sonolência excessiva diurna e problemas de relacionamento com colegas. A Hiperidrose de sono apresentou correlação apenas com a subescala de sintomas emocionais. O escore total da EDSC apresentou correlações com as subescalas de comportamento: sintomas emocionais, hiperatividade e problemas de relacionamento com colegas. Conclusão: Os resultados do presente estudo permitem concluir que crianças com TDAH apresentam maior índice de problemas comportamentais e de distúrbios de sono do que crianças com desenvolvimento típico. Além disso, quanto mais grave os distúrbios de inicio e manutenção de sono e hiperhidrose de sono, mais grave os problemas comportamentais representados por sintomas emocionais, problemas de conduta, hiperatividade e problemas de relacionamento com os colegas.
Attention Deficit Hyperactivity Disorder (ADHD), pathogenesis is multifactorial, presents a triad of symptoms: hyperactivity, inattention and impulsivity. The frequencies in this population, sleep disorders may be indicative of problems in rhythmicity and behavioral, cognitive and mood behaviors. In order to contribute to the knowledge of the biological bases and clinical characteristics in ADHD, the objective of this study were to investigate correlations between behaviors, activity / rest cycle, sleep / wake cycle and sleep disorder in children with ADHD. Strengths and Difficulties Questionnaire (SDQ); The parameters rhythm of activity / sleep / sleep-wake through the Sleep Disturbance Scale for Children (SDSC). Twenty-seven children, seven to 12 years of age, 15 of them with a diagnosis of ADHD and 12 children with typical development participated in the study. The results of the total SDQ score were 13.3% of the children in the ADHD group were classified as normal, 33.3% and the percentage of abnormal children were 53.3% of the children in the total control group for the normal classification , 8.4% borderline and 16.6% abnormal. The total score EDSC 66.6% of children with ADHD sleep disorders. In the control group, children are not indicative of sleep disorders. In SDSC subscales, 40% of the children in the ADHD group the indicative of disorders of initiating and maintaining sleep, 20% sleep disordered breathing, 13.3% of the disorders of the awakening, 13.3% of the disturbance of sleep-wake, 20% disorders of excessive somnolence, 33.3% sleep hyperhidrosis. There was no difference in the parameters analyzed between ADHD children of the inattentive type and ADHD of the combined type. The SDSC and SDQ subscales showed correlations between sleep onset and maintenance disorder and behavior subscales: emotional problems scale, hyperactivity, peer problems scale, and prosocial scale. The disorders of arousal presented correlations with behavior subscales: emotional problems, hyperactivity, peer problems and prosocial. Sleep disordered breathing had correlations with the scale of prosocial. The sleep-wake transition disorder presented correlations with behavioral subscales: emotional problems, hyperactivity, pro-social; disorders of excessive somnolence and peer problems. Sleep hyperhidrosis presented correlation only with the subscale of emotional problems. SDSC total score correlated with behavioral subscales: emotional symptoms, hyperactivity, and peer problems scale. Conclusion: The results of the present study allow us to conclude that children with ADHD present a greater index of behavioral problems and of sleep disorders than children with typical development. In addition, the more severe the disorders of initiating and maintaining sleep and sleep hyperhidrosis, the more severe the behavioral problems represented by problems of conduct, hyperactivity and peer problems.
Attention Deficit Hyperactivity Disorder (ADHD), pathogenesis is multifactorial, presents a triad of symptoms: hyperactivity, inattention and impulsivity. The frequencies in this population, sleep disorders may be indicative of problems in rhythmicity and behavioral, cognitive and mood behaviors. In order to contribute to the knowledge of the biological bases and clinical characteristics in ADHD, the objective of this study were to investigate correlations between behaviors, activity / rest cycle, sleep / wake cycle and sleep disorder in children with ADHD. Strengths and Difficulties Questionnaire (SDQ); The parameters rhythm of activity / sleep / sleep-wake through the Sleep Disturbance Scale for Children (SDSC). Twenty-seven children, seven to 12 years of age, 15 of them with a diagnosis of ADHD and 12 children with typical development participated in the study. The results of the total SDQ score were 13.3% of the children in the ADHD group were classified as normal, 33.3% and the percentage of abnormal children were 53.3% of the children in the total control group for the normal classification , 8.4% borderline and 16.6% abnormal. The total score EDSC 66.6% of children with ADHD sleep disorders. In the control group, children are not indicative of sleep disorders. In SDSC subscales, 40% of the children in the ADHD group the indicative of disorders of initiating and maintaining sleep, 20% sleep disordered breathing, 13.3% of the disorders of the awakening, 13.3% of the disturbance of sleep-wake, 20% disorders of excessive somnolence, 33.3% sleep hyperhidrosis. There was no difference in the parameters analyzed between ADHD children of the inattentive type and ADHD of the combined type. The SDSC and SDQ subscales showed correlations between sleep onset and maintenance disorder and behavior subscales: emotional problems scale, hyperactivity, peer problems scale, and prosocial scale. The disorders of arousal presented correlations with behavior subscales: emotional problems, hyperactivity, peer problems and prosocial. Sleep disordered breathing had correlations with the scale of prosocial. The sleep-wake transition disorder presented correlations with behavioral subscales: emotional problems, hyperactivity, pro-social; disorders of excessive somnolence and peer problems. Sleep hyperhidrosis presented correlation only with the subscale of emotional problems. SDSC total score correlated with behavioral subscales: emotional symptoms, hyperactivity, and peer problems scale. Conclusion: The results of the present study allow us to conclude that children with ADHD present a greater index of behavioral problems and of sleep disorders than children with typical development. In addition, the more severe the disorders of initiating and maintaining sleep and sleep hyperhidrosis, the more severe the behavioral problems represented by problems of conduct, hyperactivity and peer problems.
Descrição
Palavras-chave
Transtorno do déficit de atenção com hiperatividade, Ciclo sono-vigília, Neurodesenvolvimento, Comportamento, Attention-deficit hyperactivity disorder, Sleep-wake cycle, Neurodevelopment, Behavior