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Attention Deficit Hyperactivity Disorder, otherwise known as ADHD, is a complex condition.
注意力缺陷多动障碍，又称为ADHD，是一种复杂的疾病。
The inability to pay sustained attention to things can really cause problems when you're trying to go about your day to day.
你每天都在努力工作的时候，无法持续地关注事情真的会造成问题。
But it's not just focusing that's an issue.
但问题不只是集中注意力。
It's really common for those with ADHD to have trouble sleeping, too.
多动症患者睡眠困难也很常见。
And that's actually created a chicken-and-egg question among researchers.
这实际上让研究人员产生了一个“先有鸡还是先有蛋”的问题。
Does ADHD lead to sleep problems in some people, or do sleep problems lead to ADHD symptoms?
多动症会导致一些人出现睡眠问题，还是睡眠问题会导致多动症症状？
Or a bit of both?
或者两者兼而有之？
The relationship between ADHD and sleep has been a feature of ADHD research for years.
多动症与睡眠的关系一直是多动症研究的一个特点。
Scientists and doctors have long received complaints from patients
科学家和医生长期以来都听到病人的抱怨，
that they are just not able to get to sleep at the right time.
说他们不能在正确的时间入睡。
And research has backed this up.
研究证实了这一点。
For example, a study from 2008 found that up to 70% of kids with an ADHD diagnosis have issues falling and staying asleep.
例如，2008年的一项研究发现，高达70%的多动症的患儿在入睡和保持睡眠方面存在问题。
That's a way bigger chunk than in the general population.
这比普通人群的数量要多很多。
And in adults with ADHD, studies have shown that 78% have delayed circadian rhythm --
在患有多动症的成年人中，研究表明，78%的人的昼夜节律发生了延迟，
something that happens in just 20% of the population without ADHD.
这种情况在没有多动症的人群中只占20%。
Circadian rhythms are the hormonal cycles that keep our body clock in tune with the natural cycle of night and day.
昼夜节律是使我们的生物钟与昼夜自然周期保持一致的荷尔蒙循环。
And if this rhythm is delayed, it means that events that would happen at a certain time of day --
如果这种节律延迟，就意味着在一天中的某个特定时间发生的事情，
like getting sleepy --start to happen later on.
比如犯困，会在之后发生。
That means that many adults with ADHD are falling asleep later, and sleeping for shorter amounts of time.
这意味着许多患有多动症的成年人入睡晚，睡眠时间短。
As anyone that's ever pulled an all-nighter can tell you,
任何一个熬夜者都会告诉你，
a night without enough sleep can make things a whole lot harder the next day.
一个晚上没有足够的睡眠会让第二天变得更加困难。
A 2008 study showed that in kids with ADHD, moderate to severe sleep issues were associated with poorer outcomes,
一项2008年的研究表明，在患有多动症的孩子中，中度到重度的睡眠问题会导致较差的结果，
as well as causing problems for their family's day-to-day -- like getting to work and school on time.
同时也会给他们的家庭日常生活带来麻烦，比如准时上班和上学。
It's not always just falling asleep late, either.
也不总是睡得很晚。
Many of those with ADHD also experience sleep disorders, such as sleep apnea or restless leg syndrome,
许多多动症患者也会出现睡眠障碍，如睡眠呼吸暂停或不宁腿综合征，
which interrupt and reduce the quality of sleep that they do get.
这会中断和降低他们的睡眠质量。
And, especially in kids, this can cause some behavioral issues.
而且，尤其是在孩子身上，这会导致一些行为问题。
Some might be sleepy during the day, but sleep deprived children are especially prone to acting hyperactive and impulsive,
有些孩子白天可能会犯困，但睡眠不足的孩子特别容易表现得过于活跃和冲动，
or have trouble focusing, when they're tired out.
或者在疲劳时注意力不集中。
And some researchers suggest that even in adults with ADHD,
一些研究人员认为，即使是患有多动症的成年人，
hyperactivity is a strategy the brain might use to try keep itself awake.
多动也是大脑保持清醒的一种策略。
Thus our chicken-and-egg question:
我们的鸡和蛋的问题：
Is it ADHD that's causing these sleep issues, or could those sleep issues be causing ADHD symptoms?
是多动症导致了这些睡眠问题，还是这些睡眠问题导致了多动症症状？
Well, as with many things in psychology, so far there's no consensus.
就像心理学中的很多东西一样，到目前为止还没有达成共识。
The most likely explanation seems to be that ADHD and sleep interact with each other as bilateral comorbidities.
最有可能的解释似乎是多动症和睡眠相互作用的双边合并症。
That means they may share a common underlying cause, with symptoms of one exacerbating symptoms of the other.
这意味着它们可能有共同的潜在原因，一个症状加重另一个。
A 2010 study of adults with ADHD looked at the symptoms and sleep patterns of forty patients.
2010年一项针对ADHD成年人的研究，考察了40名患者的症状和睡眠模式。
The researchers found that the presence of sleep onset insomnia -- that delay in falling asleep --
研究人员发现，睡眠引发失眠，即睡眠延迟，
was more present in those who had ADHD with hyperactivity, as opposed to those who were primarily inattentive.
在多动症多动症患者中更为常见，而不是那些主要注意力不集中的人。
This suggests that there may be some weight to the idea that hyperactivity is,
这表明，至少在某些人中，
at least in some people, the result of poor sleep.
多动症是睡眠不足的结果。
But it's not as simple as just going to bed later.
但这并不像晚点睡觉那么简单。
In another study from, researchers measured levels of melatonin -- a hormone that regulates our circadian rhythm -- throughout the day.
在另一项研究中，研究人员测量了褪黑激素的水平。褪黑激素是一种调节我们昼夜节律的激素。
They found that the circadian rhythms of those with ADHD was delayed by about a 105 minutes, compared to non-ADHD controls.
他们发现，与非多动症对照组相比，患有多动症的人的昼夜节律延迟了大约105分钟。
That means that they aren't getting that same melatonin-induced sleepiness when daylight started to dim.
这意味着，当日光开始变暗时，它们不会像褪黑素一样引起嗜睡。
Instead, they were feeling it almost two hours later, pushing back their whole sleep cycle.
相反，他们在两个小时后才会有这种感觉，即把整个睡眠周期往后推。
These researchers have said the next step is to figure out why that is.
这些研究人员说，下一步是找出原因。
It may be that at least some people with ADHD may be insensitive to melatonin,
可能是至少有一些患有ADHD的人对褪黑激素不敏感，
or maybe even that the receptors in their eyes designed to pick up changes in light may be working atypically.
或者甚至是他们眼睛中旨在吸收光线变化的受体，可能运作异常。
Fortunately, there are treatment options.
幸运的是，有治疗选择。
And therapies that help correct circadian rhythms have already been shown to be effective in addressing symptoms of ADHD.
有助于纠正昼夜节律的疗法，已经证明能有效地解决多动症的症状。
A long-term study of 101 children with ADHD and sleep onset insomnia looked at the effect
一项针对101名多动症和睡眠失眠症儿童的长期研究，
taking melatonin supplements had on both their symptoms of ADHD and their sleep patterns.
考察了服用褪黑素补充剂对多动症症状和睡眠模式的影响。
After participating in a randomized control trial, the participants were contacted about three and a half years down the line
在参与了一项随机对照试验后，研究人员在三年半后联系了受试者，
to see whether melatonin was still proving helpful for them.
看看褪黑激素是否仍然对他们有帮助。
They found that 65% of the children still used melatonin daily, and that in 88% of cases,
他们发现，65%的儿童仍然每天使用褪黑激素，88%的病例中，
it was effective in inducing and maintaining better sleep.
褪黑激素能有效地诱导和维持更好的睡眠。
71% reported improvements in behavior, while 61% also saw improvements to their mood.
71%的人表示行为有所改善，而61%的人的情绪也有所改善。
What's more, this study found that 92% of those who stopped taking melatonin saw their delayed sleep onset come back.
更重要的是，这项研究发现92%停止服用褪黑激素的人，他们延迟的睡眠得到恢复。
Which adds even more weight to the idea that there's something biologically predisposing those with ADHD towards this altered circadian rhythm.
这更增强了一种观点，即ADHD患者在生理上倾向于出现昼夜节律的这种变化。
As we mentioned up top, ADHD is a really complex condition, and there are other theories as to what might be going on,
正如我们前面所提，多动症是一种非常复杂的疾病，关于可能发生的情况还有其他的理论，
and even other approaches to correcting these kind of sleep patterns beyond just taking melatonin.
甚至还有其他方法来纠正这种睡眠模式，而不仅仅是服用褪黑激素。
But research like this shows us that sometimes it's not always a simple case of cause and effect,
但这样的研究告诉我们，有时这并不总是一个简单的因果关系，
and that different cognitive and biological functions can play off each other, both for better and for worse.
不同的认知和生物功能会相互影响，无论它们是好是坏。
We hope you've enjoyed this episode of SciShow Psych, and maybe even learned why you're watching it at 3 am.
我们希望你喜欢这一集的《心理科学秀》，甚至可能知道你为什么要在凌晨3点时看它。
All our SciShow channels are made possible by the support of our generous, amazing patrons.
我们所有的《科学秀》频道都是在慷慨的赞助人的支持下制作出来的。
If you want to join our community of awesome humans, and get access to neat perks like bloopers and our patron-only Discord,
如果你想加入我们优秀的社区，并获得像花絮和赞助人专有福利，
check out patreon.com/scishow.
请登陆patreon.com/scishow查询。
