Sleep And Circadian Rhythms In Children With Attention Deficit Hyperactivity Disorder

Download or read book Sleep and Circadian Rhythms in Children with Attention Deficit-hyperactivity Disorder written by Mairav Cohen-Zion and published by . This book was released on 2005 with total page 308 pages. Available in PDF, EPUB and Kindle. Book excerpt: Attention Deficit-Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood. Age-inappropriate daytime and nighttime locomotor overactivity and disturbed sleep have been well documented in ADHD. This study's objective was to examine the relationships between daytime hyperactivity symptoms, sleep and rest/activity circadian rhythms in children with ADHD before and after treatment with stimulant medication. Fourteen unmedicated boys (mean age 8.7 years) with ADHD-Combined Type participated. The children's psychiatric symptoms and sleep and circadian rhythms were assessed using parental and teacher reports, one overnight polysomnographic recording, and ambulatory activity monitoring for 96 consecutive hours. The psychiatric and sleep assessments were repeated following a stimulant titration period of approximately 4-8 weeks. It was hypothesized that at the pre-treatment phase, increased hyperactivity severity would be associated with poorer sleep, weaker and more delayed rest/activity rhythms. Those children with weaker baseline circadian patterns were also hypothesized to have more sleep difficulties at post-treatment. Spearman correlations and canonical correlations were computed between ADHD severity and the sleep and circadian variables, controlling for any primary sleep disorders. Pre-treatment results indicated that increased hyperactivity levels were associated with (1) parental reports of poorer sleep hygiene and more difficulties initiating but not maintaining sleep, (2) objectively greater nocturnal activity and more disturbed sleep, and (3) weaker but not shifted rest/activity circadian rhythms. Although parents did not perceive any sleep changes as a function of treatment, an stimulant-induced objective improvement in sleep consolidation was observed. Post-treatment results also indicated a weaker baseline circadian rhythm did not increase the risk of poor sleep, however an overall reduction in the robustness of the rest/activity rhythm was seen. The weakening of the rest/activity circadian rhythm is likely reflective of the stimulant-induced decrease in objective daytime activity, resulting in a reduced fit of the circadian model to the rest/activity data. The number and severity of inattention symptoms were not related to any of the sleep or circadian variables at pre- or post-treatment. These findings suggested daytime hyperactivity may be linked to nighttime overactivity and poor sleep in ADHD, and that stimulant treatment may have positive effects on sleep and rest/activity rhythms.