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Backgroundto investigate the sleep problems in children with different ADHD presentations and effects of methylphenidate (MPH) on the sleep problems of children with ADHD by both subjective and objective measurements.Methods71 children with ADHD and 30 controls were included. 35 had ADHD with predominantly inattentive presentation (ADHD-I) and 36 with predominantly hyperactive/impulsive or combined presentation (ADHD-C). We used the pediatric sleep questionnaire (PSQ) and a nocturnal polysomnography (PSG) to assess the sleep problems in children with ADHD before and 6 months after being treated with methylphenidate (0.3–0.7 mg/kg/dose).ResultsPSG showed significantly higher apnea-hypopnea index and hypopnea counts, and lower slow-wave sleep percentage in children with ADHD. The results of PSQ reported by parents showed significantly higher rates of delay initiation of sleep, sleep onset latency, sleep fragment, daytime sleepiness, enuresis, bruxism, nightmares, periodic limb movement disorder (PLMD), and snoring in children with ADHD compared to normal controls. Comparisons of ADHD presentations revealed no significant difference between ADHD-I and ADHD-C by either PSG or PSQ measurements. After 6-month MPH treatment, the PSG showed significantly increased total sleep time and reduced periodic limb movement index (PLMI). The PSQ indicated significant reduction in bruxism and snoring in ADHD-I, as well as nightmares in ADHD-C, and both subgroups showed significant reduction in PLMD.Conclusionsubjective and objective approaches produced inconsistent findings regarding the sleep problems in children with ADHD. Besides, MPH didn't worsen the sleep problems in children with ADHD.

Background Children with attention-deficit/hyperactivity disorder (ADHD), a neurobehavioral disorder, display behaviors of inattention, hyperactivity, or impulsivity, which can affect their ability to learn and establish proper family and social relationships. Various tools are currently used by child and adolescent psychiatric clinics to diagnose, evaluate, and collect information and data. The tools allow professional physicians to assess if patients need further treatment, following a thorough and careful clinical diagnosis process. Objective We aim to determine potential indicators extracted from a mobile electroencephalography (EEG) device (Mindset; NeuroSky) and an actigraph (MotionWatch 8; CamNtech) and to validate them for diagnosis of ADHD. The 3 indicators are (1) attention, measured by the EEG; (2) meditation, measured by the EEG; and (3) activity, measured by the actigraph. Methods A total of 63 participants were recruited. The case group comprised 40 boys and 9 girls, while the control group comprised 5 boys and 9 girls. The groups were age matched. The test was divided into 3 stages—pretest, in-test, and posttest—with a testing duration of 20 minutes each. We used correlation analysis, repeated measures analysis of variance, and regression analysis to investigate which indicators can be used for ADHD diagnosis. Results With the EEG indicators, the analysis results show a significant correlation of attention with both hit reaction time (RT) interstimulus interval (ISI) change (r=–0.368; P=.003) and hit standard error (SE) ISI change (r=–0.336; P=.007). This indicates that the higher the attention of the participants, the smaller both the hit RT change and the hit SE ISI change. With the actigraph indicator, confidence index (r=0.352; P=.005), omissions (r=0.322; P=.01), hit RT SE (r=0.393; P=.001), and variability (r=0.351; P=.005) were significant. This indicates that the higher the activity amounts, the higher the impulsive behavior of the participants and the more target omissions in the continuous performance test (CPT). The results show that the participants with ADHD present a significant difference in activity amounts (P<0.001). The actigraph outperforms the EEG in screening ADHD. Conclusions When the participants with ADHD are stimulated under restricted conditions, they will present different amounts of activity than in unrestricted conditions due to participants’ inability to exercise control over their concentration. This finding could be a new electronic physiological biomarker of ADHD. An actigraph can be used to detect the amount of activity exhibited and to help physicians diagnose the disorder in order to develop more objective, rapid auxiliary diagnostic tools.

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