Sleep disturbances in prepubertal children with attention deficit hyperactivity disorder: A home polysomnography study

Department of Psychiatry, McGill University, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Verdun (Quebec), Canada H4H 1R3.
Sleep (Impact Factor: 4.59). 03/2009; 32(3):343-50.
Source: PubMed


To examine sleep architecture and reported sleep problems in children with ADHD and normal controls, while considering the roles of pertinent moderating factors.
Overnight sleep recordings were conducted in 15 children diagnosed with ADHD (DSM-IV) without comorbid psychiatric problems and in 23 healthy controls aged 7 to 11 years. Children were on no medication, in good health and did not consume products containing caffeine > or = 7 days prior to the polysomnography (PSG) study. PSG evaluation was performed at each child's home; children slept in their regular beds and went to bed at their habitual bedtimes.
Standard overnight multichannel PSG evaluation was performed using a portable polysomnography device. In addition, parents were asked to complete a sleep questionnaire.
Compared to controls, children in the ADHD group had significantly shorter duration of REM sleep, smaller percentage of total sleep time spent in REM sleep, and shorter sleep duration. In addition, the ADHD group had higher scores on the insufficient sleep and sleep anxiety factors than children in the control group.
The present findings support the hypothesis that children with ADHD present sleep disturbances.

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Available from: Manon Robert, Sep 12, 2014
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    • "It has been used for the assessment of sleep architecture in children with attention deficit hyperactivity disorder [9]. HPSG has been also fully validated for the assessment of suspected obstructive sleep apnea (OSA) in adults [6]. "
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    ABSTRACT: But de l’étude La polysomnographie à domicile se développe actuellement avec des niveaux de qualité variables selon le type de troubles du sommeil étudiés. Cette étude a pour objectif de montrer la faisabilité des enregistrements polysomnographiques à domicile, alliant faible coût et haute qualité, et qui sont nécessaires au diagnostic de troubles neurologiques du sommeil. Patients et méthodes Entre mai 2011 et août 2011, les patients se présentant à la consultation spécialisée du sommeil du Centre hospitalier et universitaire de Nancy ont été évalués. Étaient éligibles les patients nécessitant une polysomnographie pour le diagnostic de troubles neurologiques du sommeil. L’enregistrement polysomnographique nocturne était réalisé à domicile par un technicien spécialisé. Le coût total de l’acte était déterminé avant les inclusions. Un enregistrement était considéré comme satisfaisant si tous les critères suivants étaient réunis : au moins une voie EEG permettant de définir le stade de sommeil sur minimum 66 % du temps total de sommeil, au moins une voie respiratoire (débit ventilatoire ou sangles) sur minimum 66 % du temps total de sommeil, et l’oxymétrie analysable sur minimum 66 % du temps total de sommeil. Résultats Quarante-huit des 139 patients évalués ont été inclus. Sur les 48 enregistrements, 35 (72,9 %) étaient satisfaisants. Treize (27,1 %) enregistrements ont présenté une perte non satisfaisante des signaux EEG, incluant les sept (14,6 %) enregistrements avec une perte non satisfaisante des signaux respiratoires. Conclusion La polysomnographie à domicile prescrite chez les patients suspects de troubles neurologiques du sommeil est donc réalisable. Les coûts sont faibles mais la qualité reste suffisamment haute. Des études complémentaires sont nécessaires pour mesurer l’impact médico-économique réel des explorations du sommeil neurologique à domicile.
    Neurophysiologie Clinique/Clinical Neurophysiology 09/2014; 44(3). DOI:10.1016/j.neucli.2014.08.005 · 1.24 Impact Factor
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    • "point to a possible improvement of sleep quality in ADHD treated with stimulants ( Kooij et al . 2001 ; Sobanski et al . 2008 ) . To illustrate the central role and high prevalence of sleep problems in ADHD , symptoms of disturbed sleep were initially even included in the DSM as diagnostic criteria , but later dropped due to being non - specific ( Gruber et al . 2009 ) . Nonetheless , it has been discussed that sleep and circadian disorders might play a pathogenetic role in ADHD symptomatology ( Arns and Kenemans 2012 ; Be - ebe 2011 ; Yoon et al . 2012 ) . Experimental studies on sleep restriction demonstrated induction or aggravation of some ADHD symptoms by sleep reduction ( Fallone et al . 2005 "
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    ABSTRACT: Hypoarousal as indicated by skin conductance and electroencephalography (EEG) has been discussed as a pathogenetic factor in attention-deficit/hyperactivity disorder (ADHD). The aim of this paper was to review these arousal-related pathogenetic concepts and to present the more recently proposed vigilance regulation model of affective disorders and ADHD. The latter builds on methodological advances in classifying short EEG segments into vigilance stages (Vigilance Algorithm Leipzig, VIGALL), indicating different states of global brain function ("brain arousal"). VIGALL allows the objective assessment of vigilance regulation under defined conditions, e.g. how fast vigilance declines to lower vigilance stages associated with drowsiness during 15-20-min EEG recordings under resting conditions with eyes closed. According to the vigilance regulation model, the hyperactivity and sensation seeking observed in overtired children, ADHD and mania may be interpreted as an autoregulatory attempt to create a stimulating environment in order to stabilize vigilance. The unstable regulation of vigilance observed in both mania and ADHD may thus explain the attention deficits, which become especially prominent in monotonous sustained attention tasks. Among the arguments supporting the vigilance regulation model are the facts that destabilizing vigilance (e.g. via sleep deprivation) can trigger or exacerbate symptoms of ADHD or mania, whereas stabilizing vigilance (e.g. via psychostimulants, reducing sleep deficits) alleviates these symptoms. The potential antimanic effects of methylphenidate are presently being studied in an international randomized controlled trial. We propose vigilance regulation as a converging biomarker, which could be useful for identifying treatment responders to psychostimulants and forming pathophysiologically more homogeneous ADHD subgroups for research purposes.
    ADHD Attention Deficit and Hyperactivity Disorders 09/2014; 6(3). DOI:10.1007/s12402-014-0144-z
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    • "Sleep and circadian disorders are highly prevalent in ADHD, and it has been discussed that they might play a pathogenetic role in ADHD symptomatology (Arns and Kenemans, 2012; Yoon et al., 2012). In a consistent manner, all factors, which destabilise vigilance or induce sleep deficits, are found to aggravate ADHD, whereas interventions improving sleep quality and stabilising vigilance are helpful in ameliorating ADHD (Fallone et al., 2005; Gruber et al., 2009; Yoon et al., 2012; Gruber et al., 2011). Psychostimulants reduce the slow wave activity as has to be expected from a drug with vigilance stabilising properties (Bresnahan et al., 2006). "
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    ABSTRACT: According to the recently proposed vigilance model of affective disorders (vigilance in the sense of "brain arousal"), manic behaviour is partly interpreted as an autoregulatory attempt to stabilise vigilance by creating a stimulating environment, and the sensation avoidance and withdrawal in Major Depressive Disorder (MDD) is seen as an autoregulatory reaction to tonically increased vigilance. Indeed, using a newly developed EEG-based algorithm, hyperstable vigilance was found in MDD, and the contrary, with rapid drops to sleep stages, in mania. Furthermore, destabilising vigilance (e.g. by sleep deprivation) triggers (hypo)mania and improves depression, whereas stabilising vigilance, e.g. by prolonged sleep, improves mania. ADHD and mania have common symptoms, and the unstable vigilance might be a common pathophysiology. There is even evidence that psychostimulants might ameliorate both ADHD and mania. Hyperactivity of the noradrenergic system could explain both the high vigilance level in MDD and, as recently argued, anhedonia and behavioural inhibition. Interestingly, antidepressants and electroconvulsions decrease the firing rate of neurons in the noradrenergic locus coeruleus, whereas many antimanic drugs have opposite effects.
    Neuroscience & Biobehavioral Reviews 07/2014; 44:45-57. DOI:10.1016/j.neubiorev.2012.10.008 · 8.80 Impact Factor
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