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Sleep phenotypes in attention deficit hyperactivity disorder

Silvia Miano1, Ninfa Amato1, Giuseppe Foderaro2

  • 1Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), via Tesserete 46, Lugano, 6903, Switzerland.

Sleep Medicine
|November 1, 2018
PubMed

Insights

Children with attention deficit hyperactivity disorder (ADHD) experience chronic sleep deprivation and can be categorized into distinct sleep phenotypes. These findings highlight sleep issues as a potential unifying marker for ADHD.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Neurodevelopmental Disorders

Background:

  • Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder.
  • Chronic sleep deprivation is suspected in children with ADHD, but specific sleep phenotypes remain underexplored.

Purpose of the Study:

  • To investigate the hypothesis that children with ADHD suffer from chronic sleep deprivation.
  • To identify and classify distinct sleep-related phenotypes within the ADHD pediatric population.

Main Methods:

  • A case-control study involving 30 children with ADHD and 25 age-matched controls.
  • Comprehensive sleep assessments included blood tests, questionnaires, video-polysomnography (v-PSG), multiple sleep latency tests, and actigraphy.
  • v-PSG parameters were compared between ADHD patients and controls.

Main Results:

  • Children with ADHD exhibited specific sleep phenotypes: narcolepsy-like (4), delayed sleep onset insomnia (5), obstructive sleep apnea (OSA) (15), periodic limb movements (8), and sleep epileptiform discharges (10).
  • All ADHD subjects reported <9 hours of total sleep time, low ferritin levels (<60 mcg/L), and a history of sleep problems (OSA, insomnia).
  • The ADHD group showed a significantly higher apnea-hypopnea index compared to controls.

Conclusions:

  • The study validates the hypothesis of distinct sleep phenotypes in children with ADHD.
  • A higher prevalence of sleep problems was observed in ADHD children than previously reported.
  • Chronic sleep deprivation (<9 hours/night) in all ADHD participants suggests it may be a unifying marker for the disorder.
Abstract

Keywords:
ADHDEpilepsyNarcolepsyPediatrics – InsomniaPediatrics – Sleep apnea

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