DEHB Bulguları ve Uyku Problemleri Arasındaki İlişkide Bilişsel Kopma Sendromu Bulgularının Rolü: Epidemiyolojik Bir Çalışmadan Bulgular

Year 2025, Volume: 12 Issue: 2, 83 - 90, 28.08.2025

Akın Tahıllıoğlu , Burcu Kardaş , Ömer Kardaş , Nagihan Saday Duman , Emel Sarı Gökten , Merve Çıkılı Uytun , Özlem Kahraman , Esra Özdemir , Ayşe Irmak Taşdemir , Zeyneb Şan , Funda Dönder Şen , Elif Kurt Yılmaz , Gamze Yilmaz Türkel , Merve Ergüven Demirtaş , Eyüp Sabri Ercan

https://doi.org/10.47572/muskutd.1602215

Abstract

Yavaşlık ve gündüz düşleriyle karakterize bir tanılararası yapı olan Bilişsel Kopma Sendromu (BKS) Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) ile ilişkilidir. Çalışmamızda bir Türkiye epidemiyoloji örnekleminde DEHB ve uyku bozuklukları arasındaki ilişkide BKS’nin aracı rolünün araştırılması amaçlanmıştır. Örneklemi Türkiye’deki dört şehirden 7-11 yaşları arasındaki 268 olgu oluşturmuştur. Ebeveynler DEHB bulguları için Turgay DEHB Ölçeği’nin dikkat eksikliği (DE) ve hiperaktivite/impulsivite (HI) alt ölçeklerini, BKS bulguları için Barkley Çocuk Dikkat Anketini (BÇDA) ve uyku problemleri için Çocuk Uyku Alışkanlıkları Anketini (ÇUAA) doldurmuşlardır. Korelasyon analizlerinde DE ve ÇUAA skorları arasında (r=0.406, p=0.001), HI ve ÇUAA skorları arasında (r=0.381, p<0.001) ve BÇDA ve ÇUAA skorları arasında (r=0.404, p<0.001) anlamlı ilişkiler saptandı. Regresyon modelleri BKS’nin DE bulguları ve uyku sorunları arasındaki ilişkiye tümüyle aracılık ettiğini ortaya koydu. BKS modele dahil edildiğinde DE’nin uyku problemleri üzerindeki etkisi anlamsızlaştı (β=0.094, p=0.284); ancak BKS anlamlı bir yordayıcı olarak kalmaya devam etti (β=0.249, p=0.001). Ancak HI bulguları uyku bozukluklarıyla doğrudan ilişkisini BKS’den bağımsız olarak sürdürdü (β=0.304, p<0.001). Anne yaşı ise ÇUAA skorlarıyla ters ilişkiyle koreleydi (r=−0.148, p=0.033); ancak bu ilişki regresyon analizinde anlamlı düzeyde değildi (β=−0.092, p=0.144). Bu bulgular, BKS'nin DE bulgularının uyku bozukluklarını nasıl etkilediği konusunda kritik bir mekanizma olarak işlev görebileceğini vurgulamaktadır. BKS'nin aracı rolü, dikkat güçlüklerinin uyku bozukluklarına nasıl katkıda bulunduğunu anlamak için tanı ötesi bir çerçeve sağlamakta ve DEHB'li çocuklarda uyku kalitesini iyileştirmeyi amaçlayan müdahalelerde BKS belirtilerini ele almanın kritik bir hedef olduğunu ortaya koymaktadır.

Keywords

Bilişsel Kopma Sendromu , Dikkat Eksikliği/ Hiperaktivite Bozukluğu , Epidemiyoloji , Uyku Bozuklukları , Yavaş Bilişsel Tempo

The Role of Cognitive Disengagement Syndrome Symptoms in the Association Between ADHD Symptoms and Sleep Problems: Findings from An Epidemiological Survey

Abstract

Cognitive Disengagement Syndrome (CDS), a transdiagnostic construct characterized by sluggishness and daydreaming, was associated with Attention-Deficit/ Hyperactivity Disorder (ADHD). Our study investigated the mediating role of CDS in the relationship between ADHD and sleep disturbances in a Turkish epidemiological sample. The sample consisted of 268 children aged 7-11 from four Turkish cities. Parents completed inattention (IN) and hyperactivity/impulsivity (HI) subscales of Turgay’s ADHD Rating Scale IV for ADHD symptoms, Barkley’s Child Attention Scale (BCAS) for CDS symptoms, and Children’s Sleep Habits Questionnaire (CSHQ) for sleep problems. Correlation analyses revealed significant associations between IN and CSHQ scores (r=0.406, p=0.001), HI and CSHQ scores (r=0.381, p<0.001), and BCAS and CSHQ scores (r=0.404, p<0.001). Regression models demonstrated that CDS fully mediated the relationship between IN symptoms and sleep disturbances. When CDS was included in the model, the direct effect of IN on sleep problems became non-significant (β=0.094, p=0.284), whereas CDS remained a significant predictor (β=0.249, p=0.001). HI symptoms, however, retained a direct association with sleep disturbances (β=0.304, p<0.001), independent of CDS. Maternal age was inversely correlated with CSHQ scores (r=−0.148, p=0.033), but the relationship was not significant in regression analysis (β=−0.092, p=0.144). These findings emphasize that CDS may serve as a critical mechanism through which IN symptoms influence sleep disturbances. The mediating role of CDS provides a transdiagnostic framework for understanding how attentional difficulties contribute to sleep disturbances and underlines the importance of addressing CDS symptoms as a critical target for interventions aimed at improving sleep quality in children with ADHD.

Keywords

Cognitive Disengagement Syndrome , Attention-Deficit/Hyperactivity Disorder , Epidemiology , Sleep Disorders , Sluggish Cognitive Tempo

Ethical Statement

Ethical approval was obtained from the Ege University Ethical Committee of Clinical Research (decision no: 15-11/3, date: 04.12.2015).

Supporting Institution

No funding was received to assist with the preparation of this manuscript.

Thanks

The authors acknowledge all the participating children and adolescents and their parents who were involved in the study.

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