RESUMO
BACKGROUND: A compelling hypothesis about ADHD etiopathogenesis is that the ADHD phenotype reflects a delay in cortical maturation. Slow-wave activity (SWA) of non-rapid eye movement (NREM) sleep electroencephalogram (EEG) is an electrophysiological index of sleep intensity reflecting cortical maturation. Available data on ADHD and SWA are conflicting and developmental differences, or the effect of pharmacological treatment are relatively unknown. METHODS: We examined, in samples (Mage=16.4, SD=1.2), of ever-medicated adolescents at-risk for ADHD (n=18, 72%boys), medication naïve adolescents at-risk for ADHD (n=15, 67%boys), and adolescents not at-risk for ADHD (n=31, 61%boys) matched for chronological age, whether controlling for non-ADHD pharmacotherapy, ADHD pharmacotherapy modulates the association between NREM SWA and ADHD risk in home sleep. RESULTS: Findings indicated medication naïve adolescents at-risk for ADHD exhibited greater first sleep cycle and entire night NREM SWA than both ever-medicated adolescents at-risk for ADHD and adolescents not at-risk for ADHD and no difference between ever-medicated, at-risk adolescents and not at-risk adolescents. CONCLUSIONS: Results support atypical cortical maturation in medication naïve adolescents at-risk for ADHD that appears to be normalized by ADHD pharmacotherapy in ever-medicated adolescents at-risk for ADHD. Greater NREM SWA may reflect a compensatory mechanism in middle-later adolescents at-risk for ADHD that normalizes an earlier occurring developmental delay.
RESUMO
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Although data show ADHD is associated with sleep problems, approaches to analyze the association between ADHD and sleep electrophysiology are limited to a few methods with circumscribed foci. AIMS: Sleep EEG was analyzed by a mixed-radix FFT routine and power spectrum parametrization in adolescents with ADHD and adolescents not at-risk for ADHD. Spectral components of sleep EEG were analyzed employing a novel, model-based approach of EEG power spectra. METHODS AND PROCEDURES: The DREEM mobile polysomnography headband was used to record home sleep EEG from 19 medication-free adolescents with ADHD and 29 adolescents not at-risk for ADHD (overall: N = 56, age range 14-19 years) and groups were compared on characteristics of NREM sleep. OUTCOMES AND RESULTS: Adolescents with ADHD exhibited lower frequency of spectral peaks indicating sleep spindle oscillations whereas adolescents not at-risk for ADHD showed lower spectral power in the slow sleep spindle and beta frequency ranges. CONCLUSIONS AND IMPLICATIONS: The observed between-groups difference might indicate delayed brain maturity unraveled during sleep in ADHD.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Humanos , Adolescente , Adulto Jovem , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Eletroencefalografia/métodos , Encéfalo , Sono/fisiologia , PolissonografiaRESUMO
OBJECTIVE: Psychostimulants are widely used pharmacotherapeutic tools in the treatment process of severe or non-responsive childhood attention-deficit/hyperactivity disorder. Despite their efficacy, stimulants can influence the quality and quantity of sleep as a side effect, but this issue remains insufficiently clarified in the existing literature, with partly contradictory findings. The aim of this review is to provide a comprehensive analysis of research results based on polysomnography, shedding light on the current state of knowledge in this area. This insight can be valuable for guiding the design of future research and optimizing therapeutic plans. METHODS: Following the PRISMA guidelines, we systematically reviewed and analyzed studies that assessed the quality of sleep using polysomnography during stimulant treatment. As a result of our search, we identified 331 potential publications, which were independently screened, and a total of 13 relevant articles were analyzed in detail. RESULTS: Based on the results of the examined studies, there were a total of 5 instances of sleep-facilitating effects reported in the context of stimulant treatments, while 5 studies indicated sleep-inhibiting effects, and in three cases, no effects were observed. CONCLUSIONS: Although it is important to consider the impact of medication on sleep in the treatment of childhood attention-deficit/hyperactivity disorder, further research is required to clarify this issue. This will enable the customization of therapeutic recommendations and plans, aligning with the principles of precision medicine, taking into account the varying research designs and sample sizes.
