Sleep Characteristics of Children and Adolescents with Attention Deficit-Hyperactivity Disorder

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Sleep Architecture in Children Who Have Attention-Deficit/Hyperactivity Disorder

Polysomnography (PSG) studies conducted on children who have ADHD have failed to reveal consistent findings in objective sleep parameters.15, 16, 17, 18 Some studies have shown rapid eye movement (REM) sleep abnormalities in children who have ADHD,19, 20, 21, 22 a significantly higher number of sleep cycles relative to healthy controls,19 and shorter sleep durations.22, 23 Other studies have found no significant differences between unmedicated children who have ADHD and controls, however.

Sleep Patterns and Nocturnal Activity

Sleep in children with attention-deficit/hyperactivity disorder and comorbid primary sleep disorders

Pediatric, clinical, and research data have suggested that inadequate sleep results in tiredness and daytime difficulties with focused attention, learning, and impulse modulation.9, 60, 61, 62 Several researchers4, 63, 64, 65, 66, 67, 68, 69 have studied the association between sleep and neurobehavioral functioning in children who have ADHD and sleep-disordered breathing (ADHD/SDB) and in children who have ADHD and restless legs syndrome (RLS). These studies have consistently shown that sleep

Sleep in children who have attention-deficit/hyperactivity disorder and psychiatric comorbidities

Comorbidities are common in subjects who have ADHD and may affect sleep. Approximately 50% of ADHD children have ODD, 33% have an anxiety disorder, and 33% have dysthymic disorder or major depression.87, 88, 89, 90, 91 Sleep problems often occur in children who have anxiety and depression,92, 93, 94, 95 and behavioral problems are more common in poor sleepers than in good sleepers.96 Follow-up studies of children who have ADHD indicate that subgroups who have both ADHD and comorbid disorders

Sleep alterations associated with medications used to treat attention-deficit/hyperactivity disorder and comorbid conditions

Stimulants, such as MPH and amphetamine, and the nonstimulant atomoxetine (ATX), are the first-line FDA-approved treatments for ADHD. In short- and long-term clinical trials, parents have listed sleep problems as one of the most common and persistent side effects of stimulant medication98 yet studies assessing the effect of MPH in children who have ADHD have yielded inconsistent and conflicting findings. Some researchers have found no or minimal clinically significant differences in sleep

Summary

ADHD has been universally accepted as the most common neurobehavioral disorder of childhood. Despite the widely appreciated magnitude of the problem, there is still a critical absence in our understanding of how sleep and ADHD interact. Conclusive evidence that sleep in children who have ADHD is associated with waking alertness and neurobehavioral functioning would provide compelling motivation for the development of interventions that use sleep as a means to improve the daytime functioning of

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