|M.Sc Student||Golan Natali|
|Subject||The Association between Nocturnal Sleep, Daytime Sleepiness|
and Behavior in Children with and without
Attention Deficit Hyperactivity
|Department||Department of Medicine||Supervisor||Professor Giora Pillar|
Attention Deficit Hyperactivity Disorder (ADHD) is a neuro-behavioral disorder, affecting 3-7% of children. Several studies reported sleep disturbances in ADHD, although objective measurements only partially support subjective complaints. Some studies found high prevalence of breathing or movement disorders. Experimental sleep restriction has been shown to be associated with ADHD-like behavior. Furthermore, the most effective treatments for ADHD are stimulant medications. Thus, the aim of this study was to examine whether some of the behavioral problems seen in ADHD result from daytime somnolence, possibly due to nocturnal sleep disorders.
34 children with a previous diagnosis of ADHD (age 12.4±4.6 mean ± STD), and 32 matched controls (age 12.0 ± 3.6y) underwent a full night polysomnographic study followed by a multiple sleep latency test (MSLT).
Sleep latency, total sleep time and sleep efficiency were comparable between the groups. However, higher prevalence of OSA (55% vs. 22%) and PLMD (15% vs. 0) was found in the ADHD group compared to the control group. MSLT results indicated that ADHD children were significantly sleepier during the day (mean MSLT score of 21.9±5.5min vs. 27.9±2.0min, p<0.005). In the ADHD group, children without a notable primary sleep disorder had the lowest nocturnal sleep efficiency and total sleep time.
We conclude that children with ADHD demonstrate nocturnal primary sleep disturbances and objective daytime somnolence, which can explain the beneficial effects of stimulant medications. Preliminary data suggest that ADHD may improve when sleep disorders are treated. Primary sleep disorders should be looked for in ADHD children.