Sleep in Children With Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Subjective and Objective Studies

A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea

“…Cognitive and behavioral abnormalities have been shown to be reduced after adenotonsillectomy in some, [24][25][26][27]29 but not all, 30 nonrandomized studies, with inconsistency in the reported effect after treatment. 25,29,32 Previous studies have been limited by small samples, lack of randomization or appropriate controls, heterogeneous study groups, and sole reliance on parent questionnaires rather than including neuropsychological testing.…”

Advancing a Biopsychosocial and Contextual Model of Sleep in Adolescence: A Review and Introduction to the Special Issue

“…What is clear is that sleep problems are considerably more common in individuals diagnosed with ADHD in comparison to the general population, with approximately 30 % of children and 60 % of adults with ADHD exhibiting significant sleep problems (Yoon et al 2012). A diagnosis of ADHD is associated with a wide-range of sleep problems but is most consistently linked with inadequate sleep duration, poor sleep quality, and daytime sleepiness (Cortese et al 2009;Gruber 2009). The association between ADHD and sleep problems has been documented for several decades, with restless sleep even included as a symptom of Attention Deficit Disorder in the Third Edition of the DSM (American Psychiatric Association 1980).…”

“…In fact, the most recent meta-analysis examining the sleep functioning of youth with ADHD in comparison to typically developing youth identified only three studies with participants above age 14 years, with all three of these studies using a cross-sectional design (Cortese et al 2009). In identifying the need to spur research in this area, a multidisciplinary group of experts in sleep and ADHD was recently formed to develop a consensus working group report to guide future research on sleep and ADHD (Owens et al 2013).…”

“…Studies comparing objective sleep indices between youth with and without ADHD have yielded mixed findings, but there is converging evidence that the sleep problems and patterns of youth diagnosed with ADHD do appear to be different than their peers (Cortese et al 2009;Kirov and Brand 2014). For example, although no differences were found in overall sleep architecture, a meta-analysis of studies using objective measures of sleep found that, in comparison to typically developing youth, children with ADHD had longer sleep onset latency [as measured with actigraphy but not with polysomnography (PSG)], lower sleep efficiency (based on PSG but not actigraphy), shorter true sleep time (based on actigraphy), a greater number of sleep stages/shifts per hour (based on PSG), shorter time to fall asleep during the Multiple Sleep Latency Test (MLST; indicating greater daytime sleepiness), and a higher apnea-hypoapnea index (Cortese et al 2009).…”

“…For example, although no differences were found in overall sleep architecture, a meta-analysis of studies using objective measures of sleep found that, in comparison to typically developing youth, children with ADHD had longer sleep onset latency [as measured with actigraphy but not with polysomnography (PSG)], lower sleep efficiency (based on PSG but not actigraphy), shorter true sleep time (based on actigraphy), a greater number of sleep stages/shifts per hour (based on PSG), shorter time to fall asleep during the Multiple Sleep Latency Test (MLST; indicating greater daytime sleepiness), and a higher apnea-hypoapnea index (Cortese et al 2009). In addition, the lack of consistent findings pertaining to sleep architecture may be due to youth with ADHD differing from typically developing children in the developmental trajectory of rapid eye movement (REM) sleep (so-called ''active sleep'').…”