Sleep Disturbance in Preschool-Aged Hyperactive and Nonhyperactive Children

Abstract

In spite of inadequate laboratory demonstrations of sleep problems in children with attention deficit disorder with hyperactivity, the belief persists that such problems exist. Sleep restlessness is, in fact, one of the criteria in the Diagnostic and Statistical Manual of Mental Disorders, ed 3, definition of attention deficit disorder with hyperactivity, and sleep problems are listed on two major checklists often used for describing the symptoms of this disorder. In a series of three studies, sleep problems were investigated in preschool-aged children with attention deficit disorder relative to control children without the disorder. Results of the first two studies demonstrated clearly that parents of hyperactive children considered their children to have many more sleep problems than did parents of the control children. Parental daily documentation, which is less likely to be affected by reporting bias, was used in the third study. Although the results of the third study supported the finding of increased frequency of night wakings in these children, there was no difference in total sleep time or sleep onset latency between the two groups. Two other significant group differences (enuresis and night sweats) were primarily due to subgroups of children with attention deficit disorder and hyperactivity. The greater number of sleep wakings, which disrupt parents' sleep, may be responsible for the clinical reports that these children are poor sleepers.

Sleep disorders in children.

“…Furthermore, some studies have reported disturbed sleep to be associated with attention-deficit hyperactivity disorder (ADHD; APA, 1987). Kaplan, McNicol, Conte, and Moghadam (1987) documented that a sample of children, ages 3 and 6 years, identified as hyperactive had significantly more sleep problems than matched controls. These clinically reported sleep problems in ADHD children, however, have not been supported by polysomnographic evidence (e.g., Busby, Firestone, & Pivik, 1981).…”

(Mis)perception of sleep in insomnia: A puzzle and a resolution.

“…Indeed, a discrepancy between subjective and objective measures of sleep has been documented in patients with posttraumatic stress disorder (Dagan, Zinger, & Lavie, 1997; Klein, Koren, Arnon, & Lavie, 2002, Klein, Koren, Arnon, & Lavie, 2003), bipolar disorder (Harvey, Schmidt, Scarna, Semler, & Goodwin, 2005), unipolar depression (Rotenberg, Indursky, Kayumov, Sirota, & Melamed, 2000), alcohol problems (Currie, Malhotra, & Clark, 2004), chronic pain (Wilson, Watson, & Currie, 1998), chronic fatigue syndrome (Neu et al, 2007), irritable bowel syndrome (Elsenbruch, Harnish, & Orr, 1999), and rheumatoid arthritis (Hirsch et al, 1994), although we also note occasional nonreplications (e.g., Armitage, Trivedi, Hoffmann, & Rush, 1997; Rotenberg et al, 2000). The tendency to misperceive sleep has also been reported among youth with attention-deficit/hyperactivity disorder (Kaplan, McNicol, Conte, & Moghadam, 1987) and depressed youth, although not youth with anxiety disorders (Bertocci et al, 2005; Forbes et al, 2008). The tendency toward misperception is also evident regardless of whether sleep is monitored in the patient's own home (Mercer, Bootzin, & Lack, 2002; Tang & Harvey, 2004a, Tang & Harvey, 2006; Wicklow & Espie, 2000) or in the sleep lab (Bixler et al, 1973; Schneider-Helmert & Kumar, 1995).…”

Diseases of the respiratory system.

“…One widely disseminated hypothesis suggested that the prevalence of autoimmune and allergic disorders was higher among children with dyslexia (Pennington, Smith, Kimberling, Green, & Haith, 1987), thus supporting the contention that changes in the immune system may be associated with alterations in normal brain development that affect specific learning or behavioral problems (Geschwind & Galaburda, 1987). Other investigators suggested that children with allergies experience difficulties with auditory and visual perception (Havard, 1975) and an increased prevalence of hyperkinetic (Kaplan, McNichol, Conte, & Moghadam, 1987) or attention deficit disorders (Roth, Beyreiss, Schlenzka, & Beyer, 1991). Havard (1975) concluded that many children with hyperactivity, language disabilities, DISEASES OF THE RESPIRATORY SYSTEM learning disabilities, minimal brain damage, or emotional disturbances may in fact have allergy problems that play a role in their disability.…”