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Sleep and alertness in children with ADHD.
M Lecendreux1, E Konofal, M Bouvard
1Service de Psychopathologie de I'Enfant et de I'Adolescent, Hôpital Robert Debré, Paris, France. Marie-Christine.Mouren-Siméoni@rdb.ap-hp-Paris.fr
Journal of Child Psychology and Psychiatry, and Allied Disciplines
|October 20, 2000
Summary
Children with attention-deficit/hyperactivity disorder (ADHD) exhibit increased daytime sleepiness and slower reaction times, indicating an alertness deficit not linked to nocturnal sleep quality. These findings highlight potential physiological markers for ADHD subtypes.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Neurodevelopmental Disorders
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
- Sleep disturbances and alertness issues are frequently reported in children with ADHD, but underlying mechanisms require clarification.
Purpose of the Study:
- To evaluate sleep patterns and alertness levels in children diagnosed with ADHD.
- To investigate potential sleep-wake disorders contributing to ADHD symptoms.
- To explore the relationship between sleep/alertness measures and ADHD subtypes.
Main Methods:
- Polysomnography (PSG), Multiple Sleep Latency Test (MSLT), and reaction time (RT) tests were administered to 30 boys with ADHD (ages 5-10) and 22 controls.
- Participants were medication-free and had no clinical signs of sleep problems prior to the study.
- Sleep studies included 3 adaptation nights followed by daytime testing.
Main Results:
- No significant differences in nocturnal sleep variables were observed between children with ADHD and controls.
- Children with ADHD showed significantly shorter mean sleep latency on the MSLT (MSLT 1, 2, and 3; p < .05), indicating increased daytime sleepiness.
- Mean reaction times were significantly longer in children with ADHD across all tests (p < .05).
- MSLT sleep onset number and duration correlated significantly with hyperactivity-impulsivity and inattentive-passivity indices.
Conclusions:
- Children with ADHD demonstrate greater daytime sleepiness and prolonged reaction times, suggesting an alertness deficit.
- These findings are independent of alterations in nocturnal sleep quality.
- MSLT measures of daytime sleep onset are relevant physiological indices for differentiating ADHD subtypes.
- The results suggest a primary alertness deficit in ADHD, warranting further investigation.