Abstract
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.
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.
- Content Type Journal Article
- Category Original Contribution
- Pages 1-10
- DOI 10.1007/s00787-012-0308-3
- Authors
- Roumen Kirov, Department of Cognitive Psychophysiology, Institute of Neurobiology, Bulgarian Academy of Sciences, Acad. G. Bonchev Str. 23, 1113 Sofia, Bulgaria
- Henrik Uebel, Clinic for Child and Adolescent Psychiatry, University of Göttingen, Göttingen, Germany
- Bjoern Albrecht, Clinic for Child and Adolescent Psychiatry, University of Göttingen, Göttingen, Germany
- Tobias Banaschewski, Clinic for Child and Adolescent Psychiatry, Central Institute of Mental Health, Mannheim, Germany
- Juliana Yordanova, Department of Cognitive Psychophysiology, Institute of Neurobiology, Bulgarian Academy of Sciences, Acad. G. Bonchev Str. 23, 1113 Sofia, Bulgaria
- Aribert Rothenberger, Clinic for Child and Adolescent Psychiatry, University of Göttingen, Göttingen, Germany
- Journal European Child & Adolescent Psychiatry
- Online ISSN 1435-165X
- Print ISSN 1018-8827