Polysomnographic Findings in Children with Attention-Deficit/Hyperactivity Disorder Investigated for Sleep
Abstract
Study objectives: A retrospective assessment of sleep disorders in patients with attention-deficit/hyperactivity disorder (ADHD) referred to nocturnal polysomnography. Patients and methods: Our cohort included 80 children, 60 males, age range 4-18 years, mean age 10 +/- 4.2).
We evaluated presenting complaints, subjective sleep problems, polysomnographic findings and final diagnosis. Results: Presenting complaints were parasomnia - sleep terrors, somnambulism (28% patients), insomnia with difficulty in falling asleep (25%), obstructive sleep apnea - OSA (13%) and excessive daytime sleepiness (11%).
The most frequent polysomnographic findings were periodic limb movements in sleep PLMS (25%), parasomnia disorders of arousal from NREM sleep (24%), OSA (18%) and delayed sleep phase disorder (11%). 10% of patients had normal polysomnography. Comparison of sleep parameters of the entire ADHD group and subgroups with various sleep disorders did not reveal any statistically significant changes in polysomnographic results. 70% of patients presenting with insomnia had a diagnosis of various sleep disorders (delayed sleep phase disorder 8 patients, periodic limb movement disorder 4 patients, restless legs syndrome 2 patients).
Conclusion: Sleep disorders (PLMS, parasomnia, OSA) are to be considered among comorbidities found in children with ADHD, whereas nocturnal polysomnography plays an important role in their diagnostics. Sleep phase delay, periodic limb movement disorder or restless legs syndrome all may manifest as ADHD-associated insomnia.