Objective: Attention deficit hyperactivity syndrome (ADHD) is one of the most frequent psychiatric disorders of childhood. The main symptoms of ADHD such as inattention, impulsivity and irritability are also known to be symptoms of sleep deficiency. Although problems regarding sleep structure and efficiency have been reported in children with ADHD in recent studies, underlying factors as well as etiopathogenesis of this potential relationship is unclear. The aim of this study was to identify sleep habits and to investigate sleep problems which can be of a higher incidence than in the general population in children diagnosed as ADHD but not receiving pharmacological intervention.
Methods: This study was conducted at the Child Psychiatry Department of Erciyes University, Medicine School between 2012 and 2014. The study sample consisted of 50 children aged 7-12 years who presented to outpatient clinic with inattention, hyperactivity and impulsivity for the first time and were diagnosed as combined type ADHD based on DSM-IV criteria by using KSADS-PL interview but had not received pharmacological therapy, and 50 age- and sex-matched, healthy children who had no neurological or psychiatric disorder and were not on medication. WISC-R score=42 points in the total score of the scale, which is considered to be clinically significant, and there was significant difference between groups (p<0.001). Moreover, it was found that there was a difference in bedtime resistance, which was eliminated in factor analysis. No significant differences were found in sleep disruption, sleep anxiety (being afraid of sleeping in the dark, afraid of sleeping alone, awakening patterns, need for sleeping with another person, daytime sleepiness, and enuresis. No significant differences were found in total sleep duration, bedtime and time to fall asleep in case of night awakenings in open-ended questions.
Conclusion: This study revealed that children have significantly higher degrees of sleep disorders regardless of any drug therapy. In addition, it should be kept in mind that attention and learning issues that can be seen in sleep disorders can exacerbate existing ADHD symptoms and higher rates of parasomnia can cause increased behavioral problems in children with ADHD. In these children, assessment and management of sleep disorders at diagnosis can significantly reduce behavioral symptoms and may improve quality of life for children and families.