NREM sleep instability is reduced in children with attention-deficit/ hyperactivity disorder

  • Silvia Miano
  • , Renato Donfrancesco
  • , Oliviero Bruni
  • , Raffaele Ferri
  • , Serafina Galiffa
  • , Jacopo Pagani
  • , Enza Montemitro
  • , Leila Kheirandish
  • , David Gozal
  • , Maria Pia Villa

Research output: Contribution to journalArticlepeer-review

118 Scopus citations

Abstract

Study Objectives: To evaluate non-rapid eye movement sleep instability (NREM), as measured by the cyclic alternating pattern (CAP), in a cohort of children with attention-deficit/hyperactivity disorder (ADHD) and normal controls. Design: Prospective study. Settings: Sleep laboratory. Participants: Twenty consecutive outpatients with ADHD (18 boys and 2 girls; age range 6-13 years, mean age 9.3 years) and 20 normal children matched for age and socioeconomic status underwent polysomnographic recordings for 2 consecutive nights in a standard laboratory setting. Sleep was visually scored for sleep macrostructure and CAP, according to standard criteria. Measurements and Results: Children with ADHD showed significantly reduced sleep duration and increased rate of stage shifts. All children with ADHD had an apnea-hypopnea index less than 1. Those with ADHD presented lower total CAP rates and lower CAP rates during sleep stage 2 than did normal controls. Moreover, in children with ADHD, we found a lower number of CAP sequences and a reduced total A1 index, mainly in light sleep (sleep stages 1 and 2). We did not find differences in A subtype percentages, but there was a longer duration of A1 subtypes in children with ADHD. Conclusions: Children with ADHD showed a lower CAP rate and a lower number of CAP sequences; this supports the hypothesis of the existence of a hypoarousal state in these patients.

Original languageEnglish
Pages (from-to)797-803
Number of pages7
JournalSleep
Volume29
Issue number6
StatePublished - Jun 1 2006

Keywords

  • Attention-deficit/hyperactivity disorder
  • Cyclic alternating pattern
  • NREM sleep instability
  • Sleep macrostructure
  • Sleep microstructure

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