Study On The Sleep Structure Of Children With Attention Deficit Hyperactivity Disorder

OBJECTIVE: To Discuss the sleep structure , epileptiform discharge in sleep and periodiclimb movement during sleep(PLMS) in children with attention deficit hyperactivity disorder(ADHD); To compare the difference of sleep structure between ADHD subtypes ;and to discuss the effect of stimulant drugs on the sleep structure of children with ADHD. METHODS The sample were 162 children who diagnosed as ADHD in capital institute of pediatrics clinic from 2004.6-2006.4 metting with DSM-IV criteria ( 139 boys, 23 girls; mean age, 9.5±2.4 years; age range, 6 to 16 years) .We also had 30 normal control children(25 boys, 5 girls; mean age, 9.2±2.9 years; age range, 6 to 16 years). In the ADHD group, there were 78 children with combined type ADHD (ADHD-C), 67 children with predominant inattention type ADHD (ADHD-I); and 17 children with predominant hyperactivity impulsivity type ADHD (ADHD-H). 41 of ADHD group and control group underwent full ovemight PSG assessment.6 children had taking stimulant drugs (ADHDmed group) and 35 children had not taking any drugs (ADHDnon) among these 41 children with ADHD. RESULTS 1. In the ADHD group there were 139 boys(85.8%), of which 72(51.8%) with combined type ADHD (ADHD-C) , 52(37.4%) with predominant inattention type ADHD (ADHD-I) and 15(10.8%) with predominant hyperactivity impulsivity type ADHD (ADHD-H) ; there were 23 girls(14.2%), of which 15(65.2%) with ADHD-I, 6(26.1%) with ADHD-C and 2(8.7%) with ADHD-H..2. Compared with normal controls, children with ADHD had decreased latency of REM, increased sleep latency and decreased sleep efficiency, these differences were all statistically significant(P＜0.05). 3. Compared with ADHD-I type, ADHD-C type demonstrated increased percentage of stageⅡ(P＜0.05).4. The prevalence of PLMS was 41.46% in ADHD group compared with the normal control group was 13.33% the difference of prevalence between the two groups was statistically significant(P＜0.05). 5.The differences of sleep structure between ADHDmed group and ADHDnon group were not significant.6. Epileptiform discharge had not been found in both ADHD group and normal control group. CONCLUSIONS 1. More male children than female in ADHD group, and the most type is ADHD-I in female children. It should be paid more attention to a girl with leaming difficulties whether she suffered from ADHD. 2. Children with ADHD display significantly problems during sleep , which include decreased latency of REM, difficulty with fall asleep and decreased sleep efficiency.3. PLMS are common in children with ADHD and it is one of the reason which lead to the decrease of sleep quality in children with ADHD.4 Stimulant medication had not affect on the sleep structure of children with ADHD.5. There is not epileptiform discharge in ADHD group and it is safe for children with ADHD to take stimulant medication.