title: Disturbed sleep in attention-deficit hyperactivity disorder (ADHD) is not a question of psychiatric comorbidity or ADHD presentation.
abstract: Attention-deficit hyperactivity disorder (ADHD) is a heterogeneous psychiatric disorder with three different presentations and high levels of psychiatric comorbidity. Serious sleep complaints are also common, but the role of the presentations and comorbidity in sleep is under-investigated in ADHD. Consequently, the goal of the study was to investigate sleep problems in medicine-naive school-aged children (mean age = 9.6 years) with ADHD compared to controls using objective methods and to examine the role of comorbidity and presentations. Ambulatory polysomnography results suggested that children with ADHD (n = 76) had significantly more sleep disturbances than controls (n = 25), including a larger percentage of rapid eye movement (REM) sleep and more sleep cycles, as well as lower mean sleep efficiency, mean non-REM (NREM) sleep stage 1 and mean NREM sleep stage 3. No significant between-group differences were found on the multiple sleep latency test. Stratifying for comorbidity in the ADHD group did not reveal major differences between groups, but mean sleep latency was significantly longer in children with ADHD and no comorbidity compared to controls (36.1 min; SD = 30.1 versus 22.6 min; SD = 15.2). No differences were found between ADHD presentations. Our results support the presence of night-time sleep disturbances in children with ADHD. Poor sleep does not appear to be attributable to comorbidity alone, nor do sleep disturbances differ within ADHD presentations.
authors.affiliation: Centre for Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Aarhus, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Virring
authors.affiliation: Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Lambek
authors.affiliation: Centre for Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Aarhus, Denmark.
authors.forename: Per H
authors.initials: PH
authors.lastname: Thomsen
authors.affiliation: Centre for Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Aarhus, Denmark.
authors.forename: Lene R
authors.initials: LR
authors.lastname: Møller
authors.affiliation: Rigshospitalet, Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Poul J
authors.initials: PJ
authors.lastname: Jennum
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D012895:Sleep, REM; D013997:Time Factors
keywords: multiple sleep latency test; polysomnography