Association between symptoms and subtypes of attention-deficit hyperactivity disorder and sleep problems/disorders

Abstract

SUMMAR Y This study aimed to investigate the association between attention-deficit hyperactivity disorder (ADHD) symptoms and subtypes, and sleep schedules, daytime inadvertent napping, and sleep problems ⁄ disorders in children and adolescents with and without ADHD. The sample included 325 patients with ADHD, aged 10-17 years [male: 81.5%; combined type (ADHD-C): 174; predominantly inattentive type (ADHD-I): 130; predominantly hyperactive-impulsive type (ADHD-HI): 21], and 257 children and adolescents without lifetime ADHD (non-ADHD). We conducted psychiatric interviews with the participants and their mothers before making the diagnoses of ADHD, other psychiatric disorders, and sleep problems or disorders. We also collected the medication treatment data and parent and teacher reports of ADHD symptoms. Multilevel models were used for data analyses controlling for sex, age, psychiatric comorbidities, and treatment with methylphenidate. The ADHD-C and ADHD-I groups had more daytime inadvertent napping. In general, the three subtypes were associated with increased rates of sleep problems ⁄ disorders. Specifically, ADHD-C rather than ADHD-I was associated with circadian rhythm problems, sleep-talking, nightmares (also ADHD-HI), and ADHD-I was associated with hypersomnia. The most-related sleep schedules and problems for inattention and hyperactivity-impulsivity were earlier bedtime, later rise time, longer nocturnal sleep, more frequent daytime napping, insomnia, sleep terrors, sleep-talking, snoring, and bruxism across informants. The findings imply that in addition to the dichotomous approach of ADHD and considering the psychiatric comorbid conditions, ADHD subtypes and symptom dimensions need to be considered in clinical practice and in the research regarding the association between ADHD and sleep problems ⁄ disorders.k e y w o r d s adolescent, attention-deficit hyperactivity disorder subtype, attentiondeficit hyperactivity disorder symptoms, sleep problems ⁄ disorders, sleep schedules

Altered circadian profiles in attention-deficit/hyperactivity disorder: An integrative review and theoretical framework for future studies

“…Although some authors described more difficulties with morning awakenings (Chiang et al, 2010;Corkum et al, 2001;Owens et al, 2009), others found no support for this (Corkum et al, 1999;Mick et al, 2000;O'Brien et al, 2003a). With regard to daytime parameters, excessive daytime sleepiness has consistently been found to be more common in CIRCADIAN PROFILES IN ADHD 14 children with ADHD compared to normal controls (Chiang et al, 2010;Cortese et al, 2009;O'Brien et al, 2003a;O'Brien et al, 2003b;Owens et al, 2009;Owens et al, 2000). To date, there are few studies of adolescents and adults.…”

“…Cases with ADHD and sleepwake problems and cases with executive function (state regulation) deficit problems would be especially interesting to study. ADHD subgroups may be differentially affected by time of day effects; however, some may show eveningness chronotypology to inattention problems (Caci et al, 2009), whereas others reported the combined group to be more vulnerable for circadian problems (Chiang et al, 2010).…”

The influence of test experience and NK1 receptor antagonists on the performance of NK1R-/- and wild type mice in the 5-Choice Serial Reaction-Time Task

“…Cognitive and motor activity both show circadian variation (Beau, 1992;Weinert and Waterhouse, 1998;Winocur and Hasher, 2004). Moreover, this rhythm is abnormal in the Spontaneously Hypertensive Rat (SHR), the established rodent model of ADHD (Adriani et al, 2003), and in ADHD patients (Chiang et al, 2010). In view of the findings discussed below, it is interesting that L-type Ca 2+ v channels are under circadian control (e.g.…”

Psychiatric Comorbidities in Adolescents with Attention- Deficit Hyperactivity Disorder and Their Siblings

“…40 Findings [40][41][42][43][44] provide strong evidence to support the relation between ADHD and sleep problems. Studies 40 showed that adolescents with a childhood diagnosis of ADHD, regardless of persistence of ADHD at adolescence or not, were more likely to have various sleep problems such as dyssomnia, sleep-wake pattern disturbance, and breathing-related sleep problems.…”