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Sleep disorders and daytime sleepiness in children with attention-deficit/hyperactive disorder.

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TLDR
It is concluded that children with ADHD demonstrate objective daytime somnolence, which may explain the beneficial effects of treatment with stimulant medications.
Abstract
Study Objectives: Children with attention-deficit/hyperactive disorder (ADHD), in spite of being hyperactive, still benefit from treatment with stimulant medications. We hypothesized that children with ADHD are in fact sleepy during the day, and we sought to test it objectively. Design: Single blind comparative study Setting: University medical center Participants: Thirty-four children with a previous diagnosis of ADHD (mean age ± SD, 12.4 ± 4.6 years) and 32 matched controls (mean age, 12.0 ± 3.6 years ). Interventions: N/A. Measurements: All participants underwent a full-night polysomnographic study followed by a multiple sleep latency test (MSLT). Results: Sleep latency, total sleep time, and sleep efficiency were comparable between the groups, yet children with ADHD were significantly sleepier during the day than those in the control group (mean MSLT score of 21.9 ± 5.5 minutes versus 27.9 ± 2.0 minutes, P <.005). Of the children with ADHD, 17 (50%) had signs of sleep-disordered breathing, compared with 7 of the control group (22%, P <.05). Five of the ADHD group had periodic limb movements during sleep (15%) versus none in the control group. Children without sleep-disordered breathing or periodic limb movements during sleep had the lowest nocturnal sleep efficiency and total sleep time. Conclusions: We conclude that children with ADHD demonstrate objective daytime somnolence, which may explain the beneficial effects of treatment with stimulant medications. Primary sleep disorders, especially sleep-disordered breathing and periodic limb movement disorder, should be looked for in children with ADHD. Citation: Golan, N; Shahar E; Ravid S; Pillar G. Sleep disorders and daytime sleepiness in children with attention-deficit/hyperactive disorder.

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Sleep in Children With Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Subjective and Objective Studies

TL;DR: In this paper, a meta-analysis of subjective and objective sleep studies in children with Attention Deficit/Hyperactivity disorder (ADHD) versus controls was performed, which indicated that children with ADHD had significantly higher bedtime resistance (Z = 6.94, p z = 9.15, p =.031), difficulties with early morning awakenings, and daytime sleepiness compared with the controls.
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Neurobehavioral morbidity associated with disordered breathing during sleep in children : A comprehensive review

TL;DR: There is strong evidence that childhood sleep-disordered breathing is associated with deficits in behavior and emotion regulation, scholastic performance, sustained attention, selective attention, and alertness and that SDB is a biologically plausible cause of neurobehavioral deficits.
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The ADHD and Sleep Conundrum: A Review

TL;DR: A discussion of the multilevel relationships among sleep quality and quantity, neurobehavioral functioning, and the clinical syndrome of ADHD expands on previous reviews of the literature and synthesizes what is currently known about the interaction of sleep and attention/arousal in children to propose possible underlying mechanisms.
References
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Journal ArticleDOI

Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD.

TL;DR: A theoretical model that links inhibition to 4 executive neuropsychological functions that appear to depend on it for their effective execution is constructed and finds it to be strongest for deficits in behavioral inhibition, working memory, regulation of motivation, and motor control in those with ADHD.
Book

Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment

TL;DR: Barkley et al. as discussed by the authors discussed the nature of ADHD, primary symptoms, diagnosis criteria, prevalence, and gender differences, and the treatment of ADHD in adults.
Journal ArticleDOI

Sleep-disordered breathing and school performance in children

TL;DR: SAGEA is frequently present in poorly performing first-grade students in whom it adversely affects learning performance and the data suggest that a subset of children with behavioral and learning disabilities could have SAGEA and may benefit from prospective medical evaluation and treatment.
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