[Features of the organization of sleep in children with attention deficit hyperactivity disorder]
T P Kalashnikova1, G V Anisimov2
1Wagner Perm State Medical University, Perm, Russia.
Insights
Children with attention deficit hyperactivity disorder (ADHD) often experience sleep disturbances, including difficulty falling asleep and restless sleep. These sleep issues are linked to ADHD
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Neurodevelopmental Disorders
Background:
- Attention deficit hyperactivity disorder (ADHD) is frequently associated with sleep problems in children.
- Understanding the intricate relationship between sleep architecture and ADHD pathophysiology is crucial for effective management.
Purpose of the Study:
- To explore current insights into sleep characteristics in children with ADHD.
- To examine the links between sleep disturbances, executive functions, and social maladjustment in ADHD.
- To discuss potential therapeutic strategies for sleep disorders in ADHD.
Main Methods:
- Review of modern clinical and research findings on sleep in ADHD.
- Analysis of sleep macrostructure, cyclic organization, and polysomnography data.
- Investigation of potential pathogenetic mechanisms involving neurotransmitters, circadian rhythms, and iron metabolism.
Main Results:
- Children with ADHD exhibit sleep onset difficulties, increased motor activity during sleep, daytime sleepiness, and associations with Restless Legs Syndrome (RLS) and Periodic Leg Movement Syndrome (PLMS).
- Circadian desynchrony and altered REM sleep proportion are implicated in ADHD pathogenesis.
- Metabolic disturbances (melatonin, dopamine, serotonin, iron, ferritin) and social jet lag may contribute to comorbid sleep issues and ADHD.
Conclusions:
- Sleep disturbances are a significant feature of ADHD, impacting executive functions and social adjustment.
- Common pathogenetic pathways link sleep disorders and ADHD, involving circadian rhythm disruption and neurochemical imbalances.
- Addressing sleep problems may offer a viable strategy for managing ADHD symptoms.
Abstract:
The article presents modern ideas about the clinical features of sleep in children with attention deficit hyperactivity disorder (ADHD), the macrostructure of sleep, its cyclic organization and possible common links in the pathogenesis of sleep disorders and behavioral problems in patients. The relationship between the structure of sleep and impaired executive functions, the level of social maladjustment in patients with ADHD has been proven. Typical of children with ADHD are difficulty in going to sleep and falling asleep for a long time (resistance to sleep time), increased motor activity associated with sleep, including the association of ADHD with Restless legs syndrome (RLS) and periodic leg movement syndrome (PLMS), daytime sleepiness. The presence of circadian desynchrony in children with ADHD explains the relationship between chronotype, circadian typology, and clinical manifestations of the syndrome. Multidirectional data on the representation of REM sleep by nocturnal polysomnography in children with ADHD depend on age. However, the change in the proportion of REM sleep during the night is considered as a leading factor in the pathogenesis of ADHD manifestations. Various variants of metabolic disorders of melatonin, dopamine, serotonin, aggravated by social jet lag, are considered by the conjugatedcommon pathogenetic mechanisms of sleep disturbance and ADHD. As well as changes in the concentration of iron and ferritin in the blood, which may explain the frequency of RLS and PLMS in children with ADHD. The change in the number of sleep cycles during the night in patients has been demonstrated. Possible strategies for correcting sleep disorders in children with ADHD and their impact on the manifestation of ADHD are discussed.
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