Sleep disorders and daytime sleepiness in children with attention-deficit/hyperactivity disorder: A two-night polysomnographic study with a multiple sleep latency test

Příhodová, Iva; Paclt, Ivo; Kemlink, David; Skibová, J; Ptáček, Radek; Nevšímalová, Soňa

doi:10.1016/j.sleep.2010.03.017

Cited by 69 publications

(64 citation statements)

References 55 publications

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“…[19][20][21][22][23] Normative data for the MSLT in children have been reported to be 17.5 ± 3.5 minutes (n = 46, age 9.2 ± 1.5 years) 24 and 17.1 ± 2.4 minutes (n = 25, age 8.7 ± 1.1 years). 25 The determinants of sleep latency include prior sleep time before the MSLT, sleep fragmentation, circadian phase, pubertal status, and caffeine usage. 22,26 Contemporaneous caffeine intake increases sleep latency during MSLT in individuals with normal and restricted sleep by approximately 4 minutes.…”

Section: Discussionmentioning

confidence: 99%

Drug Testing in Children with Excessive Daytime Sleepiness During Multiple Sleep Latency Testing

Katz

Maski

Jenkins

2014

Journal of Clinical Sleep Medicine

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Study Objective: To determine the incidence of positive drug screens in children undergoing a multiple sleep latency test (MSLT) for evaluation of excessive daytime sleepiness (EDS). Methods: A retrospective analysis was performed in children evaluated at the Boston Children's Hospital Sleep Center between 1998 and 2013 who underwent MSLT for EDS with a concurrent urine and/or serum drug screen. Results: A total of 210 MSLTs were accompanied by drug testing. Children were 12.7 ± 3.7 years old (mean ± SD), 43% were female, and 24% had narcolepsy. Positive tests were obtained in 32% for caffeine, 5% for prescription medications, and 4% for over-the-counter drugs. No drugs of abuse were identifi ed. Children testing positive for caffeine were older (13.8 ± 3.5 vs. 12.4 ± 3.7) and more likely female (59% vs. 36%), but did not differ in MSLT or overnight polysomnographic parameters compared to children without caffeine detected.Overall, only 14% had specifi c documentation regarding caffeine intake, though 90% were referred from a sleep clinic. Of the children testing positive for caffeine, 5% acknowledged use, 3% denied use, and 92% did not have a documented caffeine intake history during their sleep clinic visit. Conclusions: Routine drug testing for drugs of abuse during an MSLT for EDS yielded no positive results over a 15-year period, indicating that this routine practice is unnecessary in our pediatric population without specifi c concerns. However, objective evidence for caffeine exposure was found in 32% of tested children undergoing an MSLT. Sleep physicians rarely documented the caffeine intake history during clinic visits for EDS. Keywords: narcolepsy, hypersomnia, caffeine Citation: Katz ES, Maski K, Jenkins AJ. Drug testing in children with excessive daytime sleepiness during multiple sleep latency testing.

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Section: Discussionmentioning

confidence: 99%

Drug Testing in Children with Excessive Daytime Sleepiness During Multiple Sleep Latency Testing

Katz

Maski

Jenkins

2014

Journal of Clinical Sleep Medicine

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“…Prihodova et al examined 31 children between the ages of 6 and 12 years with a diagnosis of ADHD and compared them to 26 age-matched typically developing controls. 12 This consecutive, 2-night sleep laboratory-based study is unique in that it reports that there was no first night effect on any variable in the control group of children. The ADHD group is reported to have an increase in sleep efficiency, a decrease in wakefulness, and shortened sleep latency on the second night.…”

mentioning

confidence: 94%

“…The ADHD group is reported to have an increase in sleep efficiency, a decrease in wakefulness, and shortened sleep latency on the second night. 12 Sleep problems are widely reported in children with autism spectrum disorders (ASD), and understanding the nature of the problems may provide insight into pathophysiology and potential treatments. Conducting laboratory-based sleep studies on children with ASD is not only expensive but often difficult, due to the neurodevelopmental deficits and behavioral challenges common in autism.…”

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confidence: 99%

First Night Effect Analysis in a Cohort of Young Children with Autism Spectrum Disorder

Buckley

Wingert

Swedo

et al. 2013

Journal of Clinical Sleep Medicine

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Study Objectives: To evaluate for the fi rst night effect (FNE) in a group of young children with autism. Design: Analysis of polysomnographic data from a 2-night sleep laboratory study. Setting: Clinical Center of the National Institutes of Health. Patients or Participants: 15 children (aged 2-10 years) with a diagnosis of an ASD. Interventions: None. Measurements and Results: Polysomnographic analysis showed the presence of a FNE for wake after sleep onset minutes, stage 2, and sleep effi ciency, but not for REM sleep parameters or TST. Conclusions S C I E N T I F I C I N V E S T I G A T I O N ST he fi rst night effect (FNE) refers to the well-accepted phenomenon of a poorer quality of sleep on the fi rst night when subjects undergo two or more consecutive nights in the sleep lab. Typically, FNE effects include lower sleep effi ciency, less total sleep time, less REM sleep, longer latency to REM sleep, and more intermittent awake time on night one.1,2 While this phenomenon is well recognized among adult populations, there are few exclusively pediatric studies that have examined FNE, and fewer still that have included young children with disorders affecting development.The largest pediatric study examining the FNE was performed in 1984. It was a laboratory-based evaluation of 87 healthy children between the ages of 6 and 15 years. This experiment reported an increase in TST and a decrease in sleep latency for night two. It also revealed similar second night fi ndings as had been seen in adult cohorts, namely, better sleep effi ciency, fewer wake after sleep onset (WASO) minutes, decreased REM latency, and increased REM percentage.3 Palm et al. conducted a 2-night at home study in 1989 on 18 healthy children between 8 and 12 years and did not fi nd such an effect. 4 Instead, there was an increase in sleep latency, an increase in percentage of stage 1 sleep, and an increase in REM latency, all on the second night.The majority of FNE data in children have come from studies using patient populations that frequently undergo overnight polysomnography (PSG) as part of a routine diagnostic assessment. Several studies have examined the FNE among children with suspected sleep disordered breathing (SDB) and obese children who are at risk for developing SDB. Scholle et al. evaluated 131 children between the ages of 2 and 17 years with suspected SDB for 2 nights in the laboratory. 5 The work concluded that while there was a FNE effect for WASO and REM percentage, a second night was not needed for pertinent respiratory parameters. Similarly, Verhulst et al. examined 70 children between the ages of 2 and 17 years, also referred for SDB, and found a FNE for REM sleep parameters but not for respiratory measures.6 Li et al. compared 46 obese children to 44 normal weight children between the ages of 7 and 15 years. 7 The groups were later further broken down for the presence or absence of SDB, and sleep architecture was examined using a 2-night, laboratory-based study. Children with and without SDB had increased TST and greater ...

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“…4,5 However, it is now generally accepted that the effect of stimulants is just one of the causes of these patients' sleep problems, 6 and behavioral symptoms related to ADHD can cause sleep problems, including a higher level of nocturnal activity, [7][8][9] longer sleep latency, 10 lower sleep efficiency, 11 more frequent night awakenings, 12 and shorter total sleep time. [11][12][13] Conversely, other studies reported that primary sleep disorders, such as obstructive sleep apnea (OSA), 14,15 restless leg syndrome (RLS), 8,16 and periodic limb movement disorder (PLMD), 15,17 can induce daytime attention deficiency, hyperactivity, and cognitive dysfunction in children. Moreover, it has been reported that these ADHD-like symptoms are improved with sleep disorder treatment.…”

Section: Introductionmentioning

confidence: 99%

“…23,26 In contrast, results based on the multiple sleep latency test (MSLT) consistently show that ADHD patients have a shorter sleep latency during the daytime. 15,25 Polysomnography and MSLT are the most objective and comprehensive tests. However, these tests also have some disadvantages, in that daily activity is limited during the test, the cost is considerable, and the results are limited by test time.…”

Section: Introductionmentioning

confidence: 99%

Sleep and cognitive problems in patients with attention-deficit hyperactivity disorder

Jeong

Kim

et al. 2015

Sleep Medicine

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Sleep disorders and daytime sleepiness in children with attention-deficit/hyperactivity disorder: A two-night polysomnographic study with a multiple sleep latency test

Cited by 69 publications

References 55 publications

Drug Testing in Children with Excessive Daytime Sleepiness During Multiple Sleep Latency Testing

Drug Testing in Children with Excessive Daytime Sleepiness During Multiple Sleep Latency Testing

First Night Effect Analysis in a Cohort of Young Children with Autism Spectrum Disorder

Sleep and cognitive problems in patients with attention-deficit hyperactivity disorder

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