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Sleep and alertness in children with attention-deficit/hyperactivity disorder: a systematic review of the literature

Sleep and alertness in children with attention-deficit/hyperactivity disorder: a systematic review of the literature
Sleep and alertness in children with attention-deficit/hyperactivity disorder: a systematic review of the literature
STUDY OBJECTIVE: To review evidence on sleep and alertness in children with attention-deficit/hyperactivity disorder (ADHD) controlling for potential confounding factors.

METHODS: A PubMed search. Studies using ADHD diagnostic criteria other than DSM-III-R or IV and studies not excluding or controlling for psychiatric comorbidity or medication status were not included in the review. Results from objective studies were combined using meta-analysis.

RESULTS: From the 46 studies located, 13 were retained. With regard to objective studies, the proportion of subjects who fell asleep during the Multiple Sleep Latency Test, the number of movements in sleep, and the apnea-hypopnea index were significantly higher in children with ADHD than in controls. We found no significant differences in other objective parameters (sleep-onset latency; number of stage changes; percentages of stage 1 sleep, stage 2 sleep, slow-wave sleep, or rapid eye movement sleep; rapid eye movement sleep latency; and sleep efficiency). Limited evidence from subjective studies suggests no significant differences in sleep-onset difficulties and bedtime resistance between children with ADHD and controls, after controlling for comorbidity and medication status. Data on sleep duration, night and morning awakenings, and parasomnias are still very limited.

CONCLUSION: Results from our systematic review suggest that children with ADHD have higher daytime sleepiness, more movements in sleep, and higher apnea-hypopnea indexes compared with controls. Given the limited number of studies controlling for confounding factors, further subjective and objective studies are needed to better understand alterations in sleep and alertness in children with ADHD.
0161-8105
504-511
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Konofal, Eric
6328bf1a-74f1-4438-8c14-333ccc8931eb
Yateman, Nigel
75fc046c-67bf-49c8-a0a9-620a74242d12
Mouren, Marie-Christine
9c60d8ab-fe73-4121-91a8-4522492cd6d5
Lecendreux, Michel
51135545-1b33-4540-8ba9-1e8a1cc57173
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Konofal, Eric
6328bf1a-74f1-4438-8c14-333ccc8931eb
Yateman, Nigel
75fc046c-67bf-49c8-a0a9-620a74242d12
Mouren, Marie-Christine
9c60d8ab-fe73-4121-91a8-4522492cd6d5
Lecendreux, Michel
51135545-1b33-4540-8ba9-1e8a1cc57173

Cortese, Samuele, Konofal, Eric, Yateman, Nigel, Mouren, Marie-Christine and Lecendreux, Michel (2006) Sleep and alertness in children with attention-deficit/hyperactivity disorder: a systematic review of the literature. Sleep, 29 (4), 504-511. (PMID:16676784)

Record type: Article

Abstract

STUDY OBJECTIVE: To review evidence on sleep and alertness in children with attention-deficit/hyperactivity disorder (ADHD) controlling for potential confounding factors.

METHODS: A PubMed search. Studies using ADHD diagnostic criteria other than DSM-III-R or IV and studies not excluding or controlling for psychiatric comorbidity or medication status were not included in the review. Results from objective studies were combined using meta-analysis.

RESULTS: From the 46 studies located, 13 were retained. With regard to objective studies, the proportion of subjects who fell asleep during the Multiple Sleep Latency Test, the number of movements in sleep, and the apnea-hypopnea index were significantly higher in children with ADHD than in controls. We found no significant differences in other objective parameters (sleep-onset latency; number of stage changes; percentages of stage 1 sleep, stage 2 sleep, slow-wave sleep, or rapid eye movement sleep; rapid eye movement sleep latency; and sleep efficiency). Limited evidence from subjective studies suggests no significant differences in sleep-onset difficulties and bedtime resistance between children with ADHD and controls, after controlling for comorbidity and medication status. Data on sleep duration, night and morning awakenings, and parasomnias are still very limited.

CONCLUSION: Results from our systematic review suggest that children with ADHD have higher daytime sleepiness, more movements in sleep, and higher apnea-hypopnea indexes compared with controls. Given the limited number of studies controlling for confounding factors, further subjective and objective studies are needed to better understand alterations in sleep and alertness in children with ADHD.

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More information

Published date: April 2006
Organisations: Clinical Neuroscience

Identifiers

Local EPrints ID: 380469
URI: http://eprints.soton.ac.uk/id/eprint/380469
ISSN: 0161-8105
PURE UUID: 807a03bf-9e19-4bd5-a9c0-022e67113ab2
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

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Date deposited: 15 Sep 2015 12:29
Last modified: 03 Dec 2019 01:33

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