Sleep Structure in Children With Attention-Deficit/Hyperactivity Disorder.

Area of Science:

• Neuroscience
• Pediatrics
• Sleep Medicine

Background:

• Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
• Sleep disturbances are frequently reported in children with ADHD, but objective data on sleep architecture are limited.
• Previous studies often included children with comorbidities or on medication, confounding results.

Purpose of the Study:

• To investigate basic sleep architecture and non-rapid eye movement (NREM) sleep alterations in drug-naïve children with ADHD without comorbidities.
• To compare sleep microstructure between children with ADHD and healthy controls using polysomnography.

Main Methods:

• Cross-sectional case-control study involving 28 drug-naïve children with ADHD and 15 healthy controls.
• Subjective sleep quality and daytime sleepiness assessed.
• Objective sleep analysis using polysomnography, focusing on sleep macrostructure and microstructure (Cyclic Alternating Pattern - CAP).

Main Results:

• Children with ADHD reported worse subjective sleep quality and increased daytime sleepiness.
• No significant differences in sleep macrostructure were observed between groups.
• Significant alterations in sleep microstructure were found in ADHD children, including reduced total CAP rate and duration, and a decreased A1 index during NREM stage 2.
• Slightly decreased SpO2 and no significant difference in sleep-disordered breathing incidence.

Conclusions:

• Sleep microstructure, particularly CAP, is altered in drug-naïve children with ADHD, suggesting a potential objective marker for sleep disturbances.
• Cyclic Alternating Pattern scoring offers valuable insights into the complex sleep structure of children with ADHD.
• These findings highlight the importance of evaluating sleep microstructure in ADHD management.