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Sleep disorders in Taiwanese children with attention deficit/hyperactivity disorder

Yu-Shu Huang1, Ning-Hung Chen, Hsueh-Yu Li

  • 1Department of Child Psychiatry, Chang Gung Memorial Hospital, Tao-yuan, Taiwan.

Journal of Sleep Research
|September 2, 2004
PubMed

Insights

Children with attention deficit/hyperactivity disorder (ADHD) have higher rates of sleep disorders like obstructive sleep apnea syndrome (OSAS) and periodic limb movement disorder (PLMD). Early evaluation of sleep issues is recommended before ADHD treatment.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Child Psychiatry

Background:

  • Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
  • Sleep disorders, including obstructive sleep apnea syndrome (OSAS) and periodic limb movement disorder (PLMD), may coexist with ADHD.
  • The relationship between ADHD and specific sleep disturbances requires further investigation.

Purpose of the Study:

  • To compare the prevalence of OSAS and PLMD in children diagnosed with ADHD versus a control group.
  • To investigate the impact of sleep disorders on cognitive and behavioral measures in children with ADHD.
  • To inform clinical practice regarding the assessment of sleep disorders in pediatric ADHD.

Main Methods:

  • Recruitment of elementary school children (6-12 years) with suspected ADHD and age-matched controls.
  • Diagnosis of ADHD based on DSM-IV criteria using standardized interviews (Kiddie-SADS-E), parent/teacher questionnaires, and neuropsychological testing.
  • Nocturnal polysomnography was performed to assess for OSAS (apnea-hypopnea index, AHI) and PLMD (periodic limb movement index, PLMI).

Main Results:

  • A significantly higher prevalence of abnormal AHI (>1 event/h) and PLMI (>5 events/h) was observed in the ADHD group compared to controls.
  • Children with ADHD and sleep disorders exhibited significantly worse response times on the Test of Variables of Attention (TOVA).
  • The Child Behavior Checklist (CBCL) indicated significant differences in hyperactivity subscales between ADHD children with and without sleep disorders.

Conclusions:

  • Sleep disorders, particularly OSAS and PLMD, are more prevalent in children with ADHD.
  • Sleep disturbances negatively impact attention and hyperactivity in children with ADHD.
  • Screening for sleep disorders is crucial before initiating pharmacological treatment for ADHD in children.

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