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Sleep and Alertness in Children with ADHD
Abstract
Objective: To evaluate sleep and alertness and to investigate the presence of possible underlying sleep/wake disorders in children with attention‐deficit/hyperactivity disorder (ADHD). Method: After 3 nights of adaptation in a room reserved for sleep studies in the department of child psychiatry, children underwent polysomnography (PSG) followed by the Multiple Sleep Latency Test (MSLT) and reaction time tests (RT) during the daytime. Thirty boys diagnosed as having ADHD (DSM‐IV), aged between 5 and 10 years, and 22 ageand sex‐matched controls participated in the study. All children were medication‐free and showed no clinical signs of sleep and alertness problems. Results: No significant differences in sleep variables were found between boys with ADHD and controls. The mean latency period was shorter in children with ADHD. Significant differences were found for MSLT 1, 2 and 3 ( p < .05). Mean reaction time was longer in children with ADHD, with significant differences in all tests ( p < .05). Number and duration of sleep onsets measured by the MSLT correlated significantly with the hyperactivity‐impulsivity and inattentive‐passivity ndices of the CTRS and CPRS. Conclusion: Children with ADHD were more sleepy during the day, as shown by the MSLT, and they had longer reaction times. These differences are not due to alteration in the quality of nocturnal sleep. The number of daytime sleep onsets and the rapidity of sleep‐onsets measured as MSLT were found to be pertinent physiological indices to discriminate between ADHD subtypes. These results suggest that children with ADHD have a deficit in alertness. Whether this deficit is primary or not requires further studies.
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“an additional dose of a short-acting stimulant, or the use of a formulation with an increased duration of action, may prevent sleep disturbances resulting from worsening of hyperactivity or behavioral difficulties at bedtime (Cortese et al. 2013a, b; Lecendreux et al. 2000).”
From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Lecendreux et al. 2000
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Associations between sleep, daytime sleepiness and functional outcomes in adolescents with ADHD
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“Others have suggested that daytime sleepiness may be part of the ADHD phenotype, rather than being a causal result of sleep problems (Lecendreux et al., 2000).”
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“napping [21] (inadvertent napping is also associated with the combined subtype); whereas in some studies, those with predominantly hyperactive-impulsive (HI) symptoms showed higher bedtime resistance [16, 18], a higher risk of snoring [17], and higher rates of specific sleep disorders [16], including daytime sleepines…”
ResultBioulac, S., Sagaspe, P., Micoulaud‐Franchi, J., Altena, E., Taillard, J., Schroder, C. M., Bouvard, M. P., Fabrigoule, C., & Philip, P. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716633751 · Cited by 20
Self-citationPilot Phase II study of mazindol in children with attention deficit/hyperactivity disorder
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Self-citationAttention deficit disorders: Are we barking up the wrong tree?
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“Although not measures of ADHD, the items included in the Externalizing and Internalizing scores represent parents’ perception of behaviors that are frequently associated with ADHD (e.g., Connor, Ford, Albert, & Doerfler 2007; Manassis, 2007; Piek et al., 2007).”
BackgroundIst manisches Verhalten ein autoregulatorischer Versuch zur Vigilanzstabilisierung?
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Self-citationPediatric Narcolepsy Type 1: A State-of-the-Art Review
Baldini, V., Biscarini, F., Varallo, G., Pizza, F., & Plazzi, G. (2024) · Clinical and Translational Neuroscience · doi:10.3390/ctn8030025 · Cited by 4
“Due to the deficits of alertness and sleep disturbances that have been hypothesized to contribute to ADHD, comorbid ADHD symptoms are likely to be found in young people with narcolepsy [105].”
BackgroundSleep and ADHD: A review article
Mehta, T., Gurung, P., Nene, Y., Fayyaz, M., & Bollu, P. C. (2019) · Current Developmental Disorders Reports · doi:10.1007/s40474-019-00178-6 · Cited by 5
Mayes, S. D., Puzino, K., DiGiovanni, C. D., & Calhoun, S. L. (2021) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-021-09799-9 · Cited by 4
“, 1999), and have more daytime sleepiness assessed by multiple sleep latency tests (Lecendreux et al., 2000).”
MethodSleep and Attention Deficit Hyperactivity Disorder
O'Brien, L. M., & Gozal, D. (2005) · Contemporary clinical neuroscience · doi:10.1385/1-59259-891-9:435 · Cited by 4
Konofal, É., Lecendreux, M., & Mouren‐Siméoni, M. (2002) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/s0003-4487(01)00090-7 · Cited by 4
Self-citationFrölich, J., Wiater, A. H., Lehmkuhl, G., et al. (2001) · Somnologie - Schlafforschung und Schlafmedizin · doi:10.1046/j.1439-054x.2001.01165.x · Cited by 4
AlAhmari, F. S., & Uddin, M. (2022) · Saudi Medical Journal · doi:10.15537/smj.2022.43.8.20220247 · Cited by 3
Konofal, É., Lecendreux, M., Jacqz-Aigrain, É., et al. (2012) · Médecine du Sommeil · doi:10.1016/j.msom.2012.01.005 · Cited by 3
Self-citationThe Treatment of Adult ADHD: Complexity at Hand
Pallanti, S., & Salerno, L. (2020) · Springer eBooks · doi:10.1007/978-3-030-39051-8_19 · Cited by 3
Kooij, J. J. S. (2012) · Springer eBooks · doi:10.1007/978-1-4471-4138-9_2 · Cited by 3
Assessment and treatment of disturbed sleep in attention deficit hyperactivity disorder
Hoban, T. F. (2004) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.4.2.307 · Cited by 3
Inattentive and impulsive profiles of the CPT -II and their relationship with DSM -IV ADHD subtypes
Kirlin, K. A. (2002) · The Mathematics Enthusiast · Cited by 3
Wiggs, L. D. (2019) · Sleep and ADHD · doi:10.1016/b978-0-12-814180-9.00003-x · Cited by 2
Metadata
- Authors
- Lecendreux, M., Konofal, E., Bouvard, M., Falissard, B., & Mouren‐Siméoni, M.
- Affiliations
- Hôpital Robert-Debré (FR)
- Centre Hospitalier Charles Perrens (FR)
- Hôpital Paul-Brousse (FR)
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2000-09
- Volume
- 41
- Issue
- 6
- Pages
- 803-812
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2115025001
- Cited by
- 269
- References
- 0
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 8 · 2023: 4 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 14 · 2018: 9 · 2017: 6 · 2016: 14 · 2015: 9 · 2014: 16 · 2013: 6 · 2012: 20
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- attention deficit hyperactivity disorder, sleep, daytime alertness, multiple sleep latency test, reaction time, sleep latency, daytime sleepiness, ADHD subtypes, hyperactivity/impulsivity, children
- MeSH terms
- Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Humans, Methylphenidate, Psychiatric Status Rating Scales, Reaction Time, Severity of Illness Index, Sleep, REM, Wakefulness
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