Child and Adolescent Psychiatric Clinics of North America
Sleep Characteristics of Children and Adolescents with Attention Deficit-Hyperactivity Disorder
Section snippets
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
References (107)
- et al.
Attention-deficit hyperactivity disorder
Lancet
(2005) - et al.
Sleep in children with attention-deficit hyperactivity disorder (ADHD): a review of naturalistic and stimulant intervention studies
Sleep Med Rev
(2004) The impact of inadequate sleep on children's daytime cognitive function
Semin Pediatr Neurol
(1996)- et al.
Sleep in children with attention-deficit hyperactivity disorder: a meta-analysis of polysomnographic studies
Sleep Med Rev
(2006) - et al.
Instability of sleep patterns in children with ADHD
J Am Acad Child Adolesc Psychiatry
(2000) - et al.
Effect of melatonin on sleep, behavior, and cognition in ADHD and chronic sleep-onset insomnia
J Am Acad Child Adolesc Psychiatry
(2007) - et al.
Sleep problems in children with attention-deficit hyperactivity disorder: impact of subtype, comorbidity, and stimulant medication
J Am Acad Child Adolesc Psychiatry
(1999) - et al.
Sleep and sleep disorders in adults with attention deficit/hyperactivity disorder
Sleep Med Rev
(2006) - et al.
Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia
J Am Acad Child Adolesc Psychiatry
(2006) Attention deficit disorder with hyperactivity (ADDH): the contribution of catecholaminergic activity
Prog Neurobiol
(1987)
Neurobiology of attention deficit disorder with hyperactivity: where have we come in 50 years?
J Am Acad Child Adolesc Psychiatry
Neurobiology of executive functions: catecholamine influences on prefrontal cortical functions
Biol Psychiatry
Attention-deficit disorder: a paradigm for psychotropic medication intervention in pediatrics
Pediatr Clin North Am
Stimulant medication
J Am Acad Child Adolesc Psychiatry
Chromosomal mapping of the human catechol-O-methyltransferase gene to 22q11.1–q11.2
Genomics
Cloning, expression and structure of catechol-O-methyltransferase
Biochim Biophys Acta
Restless legs syndrome and periodic limb movement disorder in children and adolescents
Child Adolesc Psychiatr Clin N Am
Restless legs syndrome and periodic limb movement disorder in children and adolescents
Semin Pediatr Neurol
Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: Results from a clinically-referred sample
J Am Acad Child Adolesc Psychiatry
Psychiatric comorbidity and functioning in clinically referred preschool children and school-age youths with ADHD
J Am Acad Child Adolesc Psychiatry
Preliminary evidence for sleep complaints among children referred for anxiety
Sleep Med
Ultradian rhythms and temporal coherence in sleep EEG in depressed children and adolescents
Biol Psychiatry
Sleep in children with psychiatric disorders
Pediatr Clin North Am
Stimulant treatment over five years: adherence, effectiveness, and adverse effects
J Am Acad Child Adolesc Psychiatry
Actigraphic monitoring during sleep of children with ADHD on methylphenidate and placebo
J Am Acad Child Adolesc Psychiatry
Diagnostic and statistical manual of mental disorders
The ADHD and sleep conundrum: a review
J Dev Behav Pediatr
Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family
Arch Pediatr Adolesc Med
Assessment and treatment of attention deficit hyperactivity disorder in children with comorbid psychiatric illness
Curr Opin Pediatr
Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD
Psychol Bull
The regulation of sleep and arousal
Dev Psychopathol
Dysfunctions in dopamine systems and ADHD: evidence from animals and modeling
Neural Plast
Involvement of norepinephrine in the control of activity and attentive processes in animal models of attention deficit hyperactivity disorder
Neural Plast
Sleep and alertness in children with attention-deficit/hyperactivity disorder: a systematic review of the literature
Sleep
Sleep patterns in hyperkinetic and normal children
Sleep
Sleep architecture and REM sleep measures in prepubertal children with attention deficit disorder with hyperactivity
Sleep
High levels of nocturnal activity in children with attention-deficit hyperactivity disorder: a video analysis
Psychiatry Clin Neurosci
Sleep and wakefulness in preadolescent children with deficits in attention, motor control and perception
Acta Paediatr
Is there a specific polysomnographic sleep pattern in children with attention deficit/hyperactivity disorder?
J Sleep Res
Sleep REM latency in hyperkinetic boys
Am J Psychiatry
Sleep disturbances in children with attention deficit hyperactivity disorder
Pediatrician
Sleep disturbances in prepubertal children with attention deficit hyperactivity disorder: a home polysomnography study
Sleep
Subjective and objective measures of sleep in children with attention-deficit/hyperactivity disorder
Sleep Med
Sleep and neurobehavioral functioning in children with ADHD
Sleep
Unravelling sleep problems in treated and untreated children with ADHD
J Child Adolesc Psychopharmacol
Snoring, sleep quality, and sleepiness across Attention-Deficit/Hyperactivity Disorder subtypes
Sleep
Actigraphic and parent reports of sleep patterns and sleep disorders in children with subtypes of attention-deficit hyperactivity disorder
Sleep
Hypnopolygraphic alterations in attention deficit disorder (ADD) children
Int J Neurosci
ADHD subtypes and comorbid anxiety, depression, and oppositional-defiant disorder: differences in sleep problems
J Pediatr Psychol
Cited by (65)
Shorter rapid eye movement sleep duration in children with attention-deficit /hyperactivity disorder: the impact on quality of life
2021, Sleep MedicineCitation Excerpt :In addition, the current study found a significant difference in sleep macrostructures, detected by polysomnogram between the ADHD sample and the control group. However, previous literature failed to replicate this finding [37–40], or in other words, they reported little difference in a single objective sleep parameter [41–44]. Our results demonstrated that; ADHD patients had significantly lower total sleep time and lower sleep efficiency, in contrast to that of healthy children.
Nonobstructive Pediatric Sleep Disorders
2021, Cummings Pediatric OtolaryngologyThe Associations Between Sleep and Externalizing and Internalizing Problems in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: Empirical Findings, Clinical Implications, and Future Research Directions
2021, Child and Adolescent Psychiatric Clinics of North America