Sleep Quality in Children with Attention Deficit Hyperactivity Disorder: Is one night polysomnography as good as two nights?
A Gupta, M Mehta, Garima Shukla, AA Joseph, NT Hazari, G Kumar, R Pandey, R Sagar
attention-deficit/hyperactivity disorder, sleep quality, polysomnography, sleep lab adaptation, first night effect.
Citation Information :
Gupta A, Mehta M, Shukla G, Joseph A, Hazari N, Kumar G, Pandey R, Sagar R. Sleep Quality in Children with Attention Deficit Hyperactivity Disorder: Is one night polysomnography as good as two nights?. Indian Sleep Med 2013; 8 (3):116-122.
Objective: One of the factors that possibly account for conflicting results from research studies examining sleep problems in children with attention-deficit/hyperactivity disorder (ADHD) is sleep lab adaptation. The aim of the present study was to study sleep quality in children with ADHD and investigate the presence of a first night effect in children with ADHD using polysomnography (PSG) in a sleep lab.
Methods: Sleep architecture and sleep quality were assessed in children with ADHD using two consecutive nights of PSG and parent reported sleep questionnaires.
Results: A total of 13 children diagnosed with ADHD were studied over a period of 1 year. Sleep disturbances most frequently reported by parents included bedtime resistance, excessive daytime sleepiness, parasomnias and restless legs syndrome. Comparison of sleep latency, sleep efficiency, wakefulness, REM latency, total sleep time, N1, N2, N3, AHI, arousal index, REM and PLMI revealed no difference between 1st and the 2nd night of polysomnography.
Conclusion: Children with ADHD have disturbed sleep but do not show a first night effect during PSG, and hence, a single night PSG has been shown to suffice in assessment of sleep among patients with ADHD.
Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007;164:942–8.
Gruber R; Xi T; Frenette S; Robert M; Vannasinh P; Car-rier J. Sleep disturbances in prepubertal children with attention defi-cit hyperactivity disorder: A home polysomnography study. SLEEP 2009;32(3):343-350.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: American Psychiatric Association, 1994
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (3rded). Washington, DC: American Psychiatric Association, 1980
Sadeh A, Pergamin L, Bar-Haim Y. Sleep in children with atten-tion-deficit hyperactivity disorder: a meta-analysis of polysomno-graphic studies. Sleep Med Rev 2006;10:381- 98
Webb WB, Campbell SS. The first night effect revisited with age as a variable. Waking Sleeping 1979;3:319-24.
Agnew HW Jr., Webb WB, Williams RL. The first night effect: an EEG study of sleep. Psychophysiology 1966;2:263-6.
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14 :540– 545
Owens J, Spirito A, McGuinn M. The children's sleep habits questionnaire (CSHQ):Psychometric properties of a survey in-strument for school-aged children. Sleep 2000;23:1043-51
Horne JA, Ostberg O. A self-assessment questionnaire to determinemorningness-eveningness in human circadian rhythms. Int JChronobiol.1976;4(2):97–110.
Conners CK. Conners’ Global Index-Parents. North Noranda (NY): Multihealth Systems, 2003.
Conners CK. Conners’ Global Index-Teachers. North Noranda (NY): Multihealth Systems, 2003.
Conners CK. Conners’ Rating Scales – revised. North Tonowanda, NY: Multi-Health Systems Publishing; 1997
Sheehan, D., Lecrubier, Y., Sheehan, K., Amorim, P., Janavs, J., Weiller, E., et al. (1998).The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal Of Clinical Psychiatry, 59(Suppl. 20), 22–33.
Malin AJ.Intelligence Scale for Indian children (MISIC)- adaptation of Weschler's intelligence Scale for Children. Indian Psychological Corporation, Lucknow,1969.
Tim J Cole, Mary C Bellizzi, Katherine M Flegal, William H Dietz Establishing a standard definition for child overweightand obesity worldwide: international survey BMJ 2000;320:1243–4
Iber C et al. American Academy of Sleep Medicine (AASM), 2007
American Academy of Sleep Medicine. The International Classification of Sleep Disorders, Second Edition (ICSD-2): Diagnostic and Coding Manual. Second Edition 2005.
Huang YS, Chen NH, Li HY et al. Sleep disorders in Taiwanese children with attention deficit/hyperactivity disorder. J Sleep Res 2004;13:269-77
Golan, N; Shahar E; Ravid S; Pillar G. Sleep disorders and daytime sleepiness in children with attention-deficit/ hyperactive disorder. SLEEP 2004;27(2):261-6.
Picchietti DL, England SJ, Walters AS, Willis K, Verrico T. Periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. J Child Neurol1998;13:588-94.
Picchietti DL, Underwood DJ, Farris WA. Further studies on periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. Mov Disord1999;14:1000-7.
Konofal E, Lecendreux, M, Bouvard, MP, Mouren-Simeoni MC. High levels of nocturnal activity in children with Attention- Deficit Hyperactivity Disorder: A video analysis. Psychiatry Clin Neurosci 2001;55:97-103.
Philipsen A; Feige B; Hesslinger B et al. Sleep in adults withattention-deficit/hyperactivity disorder: a controlled polysomnographicstudy including spectral analysis of the sleep EEG. SLEEP 2005;28(7):877-884.
Prihodova I, Paclt I, Kemlink D, Skibova J, Ptacek R, Nevsimalova S. Sleepdisorders and daytime sleepiness in children with attention-deficit/hyperactivitydisorder: a twonight polysomnographic study with a multiple sleep latency test. Sleep Med 2010;11:922-8.
Bessey M, Richards, J, Corkum, P. Sleep Lab Adaptation in Children with Attention-Deficit/Hyperactivity Disorder and Typically Developing Children. Sleep Disorders, vol. 2013, Article ID 698957, 4 pages, 2013. doi:10.1155/2013/ 698957
Coble PA, Kupfer DJ, Taska LS, Kane J. EEG sleep of normal healthy children. Part I: Findings using standard measurement methods. Sleep 1984;7:289-303.
Palm L, Persson E, Elmqvist D, Blennow G. Sleep and wakefulness in normalpreadolescent children. Sleep 1989;12:299-308.
Scholle S, Scholle HC, Kemper A, et al. First night effect in children and adolescents undergoing polysomnography for sleep-disordered breathing. Clin Neurophysiol 2003;114:2138-45
Buckley A; Wingert K; Swedo S; Thurm A; Sato S;Appel S; Rodriguez AJ. First night effect analysis in a cohort of young children with autism spectrum disorder. J Clin SleepMed 2013;9(1):67-70