Article2005

Actigraphic and Parent Reports of Sleep Patterns and Sleep Disorders in Children With Subtypes of Attention-Deficit Hyperactivity Disorder

Luci D. Wiggs · Paul Montgomery · Gregory Stores

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Abstract

STUDY OBJECTIVE: To describe parent-reported and actigraphically assessed sleep patterns and sleep disorders in stimulant-medication-free children with attention-deficit/hyperactivity disorder (ADHD), divided according to ADHD subtype. PARTICIPANTS: Seventy-one stimulant-medication-free children with a clinical diagnosis of ADHD (8 girls; mean 8.8 years (SD 2.6), range 3-15 years) recruited from child psychiatry clinics. MEASUREMENTS: ADHD: ADHD Rating Scale DSM IV- Home Version to subdivide children into those with predominantly attention deficit, mainly hyperactivity, and those with both aspects equally. Sleep: Parent-completed sleep diary, clinical history, and 5 nights of actigraphy. RESULTS: Parents reported a wide range of frequently occurring sleep disturbances in their children. However, the objective sleep patterns were not abnormal and did not differ between the ADHD subtypes, and objective sleep patterns did not predict ADHD severity. There was poor correspondence between parent report and actigraphy. Careful clinical consideration of each case suggested that sleep disorders may be widespread in this group of children; only 8 of the 71 children had no discernable likely sleep disorder. Symptoms of sleep-disordered breathing, sleeplessness and reports of restless legs featured prominently. CONCLUSIONS: Parents of children with ADHD may not be accurate reporters of their children's sleep pattern and/or the sleep disturbances that come to parents' attention are not best detected by actigraphy. Results highlight the prominence of parent-reported sleep disturbance in children with ADHD and the need for clinicians to routinely screen for the presence of sleep disorders and assess detailed sleep physiology where indicated.

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References

1997The Strengths and Difficulties Questionnaire: A Research Note 1994Activity-Based Sleep-Wake Identification: An Empirical Test of Methodological Issues 1999Estimating Sleep Patterns with Activity Monitoring in Children and Adolescents: How Many Nights Are Necessary for Reliable Measures?2002Sleepiness in children and adolescents: clinical implications 2000Parental and Self-report of Sleep in Children With Attention-Deficit/Hyperactivity Disorder 2000Instability of Sleep Patterns in Children With Attention-Deficit/Hyperactivity Disorder 2004Sleep Disorders and Daytime Sleepiness in Children with Attention-Deficit/ Hyperactive Disorder 1999Sleep Problems in Children With Attention‐Deficit/Hyperactivity Disorder: Impact of Subtype, Comorbidity, and Stimulant Medication

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2011Sleep estimates in children: parental versus actigraphic assessments 2012Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression 2015Sleep in Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder 2008Actigraphic and Parental Reports of Sleep Difficulties in Children With Attention-Deficit/Hyperactivity Disorder

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