Attention-deficit/hyperactivity disorder (ADHD) and adaptation night as determinants of sleep patterns in children.
Sleep problems are a prominent feature in children with attention-deficit/hyperactivity disorder (ADHD) but their relationships to sleep structure are not consistent across studies. We aimed at further examining the sleep architecture in children with ADHD, while considering the role of the first-night effect (FNE) as a possible confounder. Twenty unmedicated children with ADHD combined type (8-15 years old; mean 11.24, SD 2.31) and 19 healthy controls, matched for age and gender, underwent polysomnography during an adaptation and a consecutive second night. ADHD and controls displayed a typical FNE without group differences. Independently of testing night, children with ADHD spent more time in sleep and had shortened rapid eye movement (REM) sleep latency and a greater amount of REM sleep relative to controls. However, the increased REM sleep amount in ADHD children was more expressed in the second night when it was also significantly related to scores of inattention and hyperactivity. Our results (1) document similar sleep adaptation processes in children with ADHD and typically developing children, (2) reveal that REM sleep changes in association with ADHD-specific psychopathology may characterize sleep in ADHD children, which is evident only when the FNE is accounted for, (3) indicate that ADHD psychopathology and adaptation night may exert opposite effects on REM sleep in children. These results may prompt the awareness of clinicians about the importance of actual sleep alterations and their precise evaluation in children with ADHD, which could significantly contribute to better diagnostic, treatment and early prevention strategies.
Department of Cognitive Psychophysiology, Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria. roumen_kirov@yahoo.com
Roumen
R
Kirov
Henrik
H
Uebel
Bjoern
B
Albrecht
Tobias
T
Banaschewski
Juliana
J
Yordanova
Aribert
A
Rothenberger
D000222:Adaptation, Physiological; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D015999:Multivariate Analysis; D017286:Polysomnography; D012894:Sleep Stages; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology