Silvia Miano1, Ninfa Amato2, Giuseppe Foderaro3, Valdo Pezzoli3, Gian Paolo Ramelli4, Lorenzo Toffolet2, Mauro Manconi2. 1. Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), via Tesserete 46, Lugano, 6903, Switzerland. Electronic address: silvia.miano@eoc.ch. 2. Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), via Tesserete 46, Lugano, 6903, Switzerland. 3. Department of Pediatrics, Civic Hospital of Lugano, Lugano, Switzerland. 4. Department of Pediatrics, San Giovanni Hospital, Bellinzona, Switzerland.
Abstract
OBJECTIVE: A case-control study was performed to test the hypothesis that children with attention deficit hyperactivity disorder (ADHD) have chronic sleep deprivation and may be classified into specific sleep-related phenotypes. METHODS: Thirty outpatients with ADHD (nine females, mean age 10.1 ± 2.1 years) were recruited consecutively, and given a comprehensive sleep assessment, including blood exams, sleep questionnaires, laboratory video-polysomnographic recordings (v-PSG), multiple sleep latency tests, and one-week actigraphy. The PSG parameters were compared to those of 25 age-matched controls (12 females, mean age 10.34 ± 1.54 years) who underwent only the v-PSG. RESULTS: ADHD children were classified as follows: a narcolepsy-like phenotype was found in four; delayed sleep onset insomnia in five; obstructive sleep apnea (OSA) in 15; periodic limb movements in eight, and sleep epileptiform discharges in 10 children. All subjects had a total sleep time shorter than 9 h at actigraphy, ferritin levels lower than 60 mcg/L, and a history of sleep problems (mainly OSA and insomnia). Compared to controls, the ADHD group had a higher apnea-hypopnea index at PSG. CONCLUSIONS: A full sleep assessment in children with ADHD confirmed the validity of the sleep phenotypes hypothesis, and revealed a much higher percentage of sleep problems than that found in the literature. Beyond the sleep phenotypes, all children reported a history of sleep problems and slept less than 9 h per night, indicating chronic sleep deprivation that should be evaluated as a possible unifying marker of ADHD.
OBJECTIVE: A case-control study was performed to test the hypothesis that children with attention deficit hyperactivity disorder (ADHD) have chronic sleep deprivation and may be classified into specific sleep-related phenotypes. METHODS: Thirty outpatients with ADHD (nine females, mean age 10.1 ± 2.1 years) were recruited consecutively, and given a comprehensive sleep assessment, including blood exams, sleep questionnaires, laboratory video-polysomnographic recordings (v-PSG), multiple sleep latency tests, and one-week actigraphy. The PSG parameters were compared to those of 25 age-matched controls (12 females, mean age 10.34 ± 1.54 years) who underwent only the v-PSG. RESULTS:ADHDchildren were classified as follows: a narcolepsy-like phenotype was found in four; delayed sleep onset insomnia in five; obstructive sleep apnea (OSA) in 15; periodic limb movements in eight, and sleep epileptiform discharges in 10 children. All subjects had a total sleep time shorter than 9 h at actigraphy, ferritin levels lower than 60 mcg/L, and a history of sleep problems (mainly OSA and insomnia). Compared to controls, the ADHD group had a higher apnea-hypopnea index at PSG. CONCLUSIONS: A full sleep assessment in children with ADHD confirmed the validity of the sleep phenotypes hypothesis, and revealed a much higher percentage of sleep problems than that found in the literature. Beyond the sleep phenotypes, all children reported a history of sleep problems and slept less than 9 h per night, indicating chronic sleep deprivation that should be evaluated as a possible unifying marker of ADHD.
Authors: Maria Silvia Saccani; Luciana Ursumando; Silvia Di Vara; Giulia Lazzaro; Cristiana Varuzza; Stefano Vicari; Deny Menghini Journal: Int J Environ Res Public Health Date: 2022-05-25 Impact factor: 4.614
Authors: Anna Castelnovo; Althea Lividini; Giulio Bernardi; Valdo Pezzoli; Giuseppe Foderaro; Gian Paolo Ramelli; Mauro Manconi; Silvia Miano Journal: Children (Basel) Date: 2022-02-03