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Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
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Sleep-Related Disorders in Children with Attention-Deficit Hyperactivity Disorder: Preliminary Results of a Full

Silvia Miano1, Maria Esposito2, Giuseppe Foderaro3

  • 1Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland. silvia.miano@gmail.com.

CNS Neuroscience & Therapeutics
|June 4, 2016
PubMed

Insights

Children with attention-deficit hyperactivity disorder (ADHD) exhibit diverse sleep phenotypes, including narcolepsy-like, insomnia, sleep apnea, and epilepsy. Identifying these sleep issues aids in tailored treatment for ADHD.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Neurodevelopmental Disorders

Background:

  • Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
  • Sleep disturbances are frequently reported in children with ADHD, but their specific phenotypes are not well-characterized.
  • A comprehensive sleep assessment is crucial for understanding the heterogeneity of sleep issues in ADHD.

Purpose of the Study:

  • To investigate and classify distinct sleep phenotypes in children diagnosed with ADHD.
  • To explore the potential for a "primary" form of ADHD related to a hypoarousal sleep state, similar to narcolepsy.
  • To determine if specific sleep phenotypes correlate with different treatment approaches.

Main Methods:

  • Prospective case-control study involving 15 children with ADHD (mean age 10.6 years).
  • In-depth sleep assessment including questionnaires, sleep habits, video-polysomnography with high-density EEG, cardiorespiratory polygraphy, multiple sleep latency test, and actigraphy.
  • Phenotypic classification based on identified sleep disorders: hypoarousal, delayed sleep onset insomnia, sleep-disordered breathing, restless legs syndrome/periodic limb movements, and sleep epilepsy/interictal epileptiform discharges.

Main Results:

  • Five distinct sleep phenotypes were observed among the 15 participants.
  • Narcolepsy-like hypoarousal phenotype: 3 children.
  • Sleep onset insomnia phenotype: 1 child.
  • Mild obstructive sleep apnea: 3 children.
  • Sleep hyperkinesia and/or periodic limb movements (PLMs): 5 children.
  • Interictal epileptiform discharges (IEDs) and/or nocturnal epilepsy: 3 children.
  • Treatments included melatonin, iron, antiepileptic drugs, or stimulants based on phenotype.

Conclusions:

  • Children with ADHD present with a wide spectrum of sleep phenotypes.
  • The findings underscore the necessity of a structured sleep diagnostic algorithm for children with ADHD.
  • Accurate identification of sleep phenotypes can guide more targeted and effective therapeutic interventions.
Abstract

Keywords:
AttentionChildrenEpilepsyHyperactivitySleep

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