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Brain Sciences
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Advances in Sleep and ADHD
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Advances in Sleep and ADHD

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuropsychology".

Deadline for manuscript submissions: closed (15 August 2022) | Viewed by 30634

Special Issue Editor

Dr. Alexander Prehn-Kristensen

E-Mail Website
Guest Editor
Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Niemannsweg 147, 24105 Kiel, Schleswig-Holstein, Germany
Interests: ADHD; ASD; sleep; memory; emotion; odor; tDCS; imaging

Special Issue Information

Dear Colleagues,

Attention-deficit/hyperactivity disorder (ADHD) as a neurodevelopmental disorder is one of the most frequent psychiatric diagnoses in children and adolescents, often persisting into adulthood. The core symptoms are disturbances in maintaining attention, elevated motor activity, and enhanced impulsiveness. Several neurocognitive impairments are related to ADHD; however, most of them are also common symptoms of disturbed sleep. For example, sleep deprivation has a direct impact on attentional processes, motor control, and response inhibition. At the same time, sleep problems are often reported in ADHD. Therefore, the question of whether ADHD causes sleep problems or whether sleep problems cause ADHD is still under debate. This Special Issue will focus on the connection between ADHD and sleep by revealing unique sleep patterns (e.g., sleep spindles, brain oscillations) in ADHD and their consequences to ADHD symptom severity.

The Special Issue follows the assumption that sleep is affected in ADHD specifically, which in turn amplifies ADHD symptoms. Any reports in favor of or against this hypothesis are welcome. Research regarding sleep and neurodevelopment, sleep and cognitive functioning, and sleep in ADHD using electrophysiological/imaging or brain stimulation techniques are especially invited.

Original research papers, review papers, meta-analyses, and high-impact case series are of interest.

Dr. Alexander Prehn-Kristensen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ADHD
  • sleep
  • symptom severity
  • cognitive performance
  • neurodevelopment
  • imaging
  • brain stimulation

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Published Papers (9 papers)

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Research

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12 pages, 846 KiB  
Article
Negative Impacts of Sleep–Wake Rhythm Disturbances on Attention in Young Adults
by Zijun Li, Shimin Fu, Fan Jiang and Weizhi Nan
Brain Sci. 2022, 12(12), 1643; https://doi.org/10.3390/brainsci12121643 - 30 Nov 2022
Viewed by 2034
Abstract
Sleep–wake rhythm disturbances have a negative impact on attention. However, how it affects attention and whether the restoration of regular rhythms can restore attention are unclear. This study aims to explore the effects of sleep–wake rhythm disturbances on three subfunctions of attention (alertness, [...] Read more.
Sleep–wake rhythm disturbances have a negative impact on attention. However, how it affects attention and whether the restoration of regular rhythms can restore attention are unclear. This study aims to explore the effects of sleep–wake rhythm disturbances on three subfunctions of attention (alertness, orientation, and executive control) and the restoration of regular rhythms on these functions. Twenty-one participants in the experimental group (who experienced sleep–wake rhythm disturbances for at least one month; aged 18–26) were required to sleep regularly following a sleep schedule, whereas 20 participants in the control group (who maintained regular sleep for at least three months; aged 19–22) received no manipulation of their sleep. All participants were assessed using the attention network test three times in six days. All of them wore spectrum activity monitors and kept sleep diaries every day. The results showed that the effects of alertness and executive control in the experimental group were significantly lower than those in the control group. After five days of regular sleep, the difference in the alertness effect between the two groups significantly decreased. These results suggested that under natural conditions, sleep–wake rhythm disturbances could negatively influence alertness and executive control, and a short period of restoring a regular rhythm has a recovery effect on alertness. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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14 pages, 2042 KiB  
Article
Clock Genes Profiles as Diagnostic Tool in (Childhood) ADHD—A Pilot Study
by Alexander Dück, Olaf Reis, Henrike Wagner, Katja Wunsch, Frank Häßler, Michael Kölch, Mariana Astiz, Johannes Thome, Christoph Berger and Henrik Oster
Brain Sci. 2022, 12(9), 1198; https://doi.org/10.3390/brainsci12091198 - 5 Sep 2022
Cited by 5 | Viewed by 2181
Abstract
Attention deficit hyperactivity disorder (ADHD) is a very common disorder in children and adults. A connection with sleep disorders, and above all, disorders of the circadian rhythm are the subject of research and debate. The circadian system can be represented on different levels. [...] Read more.
Attention deficit hyperactivity disorder (ADHD) is a very common disorder in children and adults. A connection with sleep disorders, and above all, disorders of the circadian rhythm are the subject of research and debate. The circadian system can be represented on different levels. There have been a variety of studies examining 24-h rhythms at the behavioral and endocrine level. At the molecular level, these rhythms are based on a series of feedback loops of core clock genes and proteins. In this paper, we compared the circadian rhythms at the behavioral, endocrine, and molecular levels between children with ADHD and age- and BMI-matched controls, complementing the previous data in adults. In a minimally invasive setting, sleep was assessed via a questionnaire, actigraphy was used to determine the motor activity and light exposure, saliva samples were taken to assess the 24-h profiles of cortisol and melatonin, and buccal mucosa swaps were taken to assess the expression of the clock genes BMAL1 and PER2. We found significant group differences in sleep onset and sleep duration, cortisol secretion profiles, and in the expression of both clock genes. Our data suggest that the analysis of circadian molecular rhythms may provide a new approach for diagnosing ADHD in children and adults. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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14 pages, 1038 KiB  
Article
Sleep Fosters Odor Recognition in Children with Attention Deficit Hyperactivity Disorder but Not in Typically Developing Children
by Manuel Munz, Christian Dirk Wiesner, Meike Vollersen-Krekiehn, Lioba Baving and Alexander Prehn-Kristensen
Brain Sci. 2022, 12(9), 1182; https://doi.org/10.3390/brainsci12091182 - 2 Sep 2022
Cited by 1 | Viewed by 2411
Abstract
Prior experience represents a prerequisite for memory consolidation across various memory systems. In the context of olfaction, sleep was found to enhance the consolidation of odors in adults but not in typically developing children (TDC), likely due to differences in pre-experience. Interestingly, unmedicated [...] Read more.
Prior experience represents a prerequisite for memory consolidation across various memory systems. In the context of olfaction, sleep was found to enhance the consolidation of odors in adults but not in typically developing children (TDC), likely due to differences in pre-experience. Interestingly, unmedicated children with attention deficit hyperactivity disorder (ADHD), a neurodevelopmental condition related to dopamine dysfunction, showed lower perceptive thresholds for odors, potentially allowing for more odor experience compared to TDC. We investigated sleep-associated odor memory consolidation in ADHD. Twenty-eight children with ADHD and thirty age-matched TDC participated in an incidental odor recognition task. For the sleep groups (ADHD: n = 14, TDC: n = 15), the encoding of 10 target odorants took place in the evening, and the retention of odorants was tested with 10 target odorants and 10 distractor odorants the next morning. In the wake groups (ADHD: n = 14, TDC: n = 15), the time schedule was reversed. Odor memory consolidation was superior in the ADHD sleep group compared to the TDC sleep and the ADHD wake groups. Intensity and familiarity ratings during encoding were substantially higher in ADHD compared to TDC. Sleep-associated odor memory consolidation in ADHD is superior to TDC. Abundant pre-experience due to lower perceptive thresholds is suggested as a possible explanation. Olfaction might serve as a biomarker in ADHD. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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21 pages, 683 KiB  
Article
A Cross-Sectional Comparative Study of Sleep Disturbances in Children with ADHD and Matched Controls
by Angela Ann Joseph, Anupama Gupta, Nandita Hazari, Mani Kalaivani, Ravindra Mohan Pandey, Rajesh Sagar, Manju Mehta and Garima Shukla
Brain Sci. 2022, 12(9), 1158; https://doi.org/10.3390/brainsci12091158 - 30 Aug 2022
Cited by 3 | Viewed by 2334
Abstract
Background: Systematic reviews conducted on sleep disturbances in attention deficit hyperactivity disorder (ADHD) have found inconsistent results due to the presence of several moderating variables which were not controlled for in previous studies. The aim of this study was to examine sleep disturbances [...] Read more.
Background: Systematic reviews conducted on sleep disturbances in attention deficit hyperactivity disorder (ADHD) have found inconsistent results due to the presence of several moderating variables which were not controlled for in previous studies. The aim of this study was to examine sleep disturbances in children with ADHD compared to their typically developing peers after controlling for moderating variables (age, sex, medication status, body mass index, and psychiatric and medical comorbidities). Methods: ADHD was diagnosed using DSM-IV-TR criteria (Diagnostic and Statistical Manual of Mental Disorders) and Conners’ Parent Rating Scales. Children recruited (aged 6–12 years) for the ADHD group (n = 40) met the following criteria: IQ > 80, unmedicated, and no psychiatric or medical comorbidities. The control group consisted of age- and sex-matched typically developing peers (n = 40). Sleep was assessed subjectively (through parent reported questionnaires and sleep logs) and objectively (using video polysomnography). Results: 65% of children with ADHD had a sleep disorder, as compared to 17% of controls. The ADHD group reported more sleep disturbances and disorders, both on subjective measures and objective measures. Conclusions: Sleep disturbances and primary sleep disorders in children with ADHD exist independent of moderating variables and differences in sleep assessment methods, thereby bolstering support for previously documented literature on the ADHD and sleep connection. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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23 pages, 512 KiB  
Article
The Association of Self-Reported ADHD Symptoms and Sleep in Daily Life of a General Population Sample of School Children: An Inter- and Intraindividual Perspective
by Lilly Buhr, Tomasz Moschko, Anne Eppinger Ruiz de Zarate, Ulrike Schwarz, Jan Kühnhausen and Caterina Gawrilow
Brain Sci. 2022, 12(4), 440; https://doi.org/10.3390/brainsci12040440 - 25 Mar 2022
Viewed by 2409
Abstract
Sleep and Attention-Deficit/Hyperactivity Disorder (ADHD) have repeatedly been found to be associated with each other. However, the ecological validity of daily life studies to examine the effect of sleep on ADHD symptoms is rarely made use of. In an ambulatory assessment study with [...] Read more.
Sleep and Attention-Deficit/Hyperactivity Disorder (ADHD) have repeatedly been found to be associated with each other. However, the ecological validity of daily life studies to examine the effect of sleep on ADHD symptoms is rarely made use of. In an ambulatory assessment study with measurement burst design, consisting of three bursts (each 6 months apart) of 18 days each, 70 German schoolchildren aged 10–12 years reported on their sleep quality each morning and on their subjective ADHD symptom levels as well as their sleepiness three times a day. It was hypothesized that nightly sleep quality is negatively associated with ADHD symptoms on the inter- as well as the intraindividual level. Thus, we expected children who sleep better to report higher attention and self-regulation. Additionally, sleepiness during the day was hypothesized to be positively associated with ADHD symptoms on both levels, meaning that when children are sleepier, they experience more ADHD symptoms. No association of sleep quality and ADHD symptoms between or within participants was found in multilevel analyses; also, no connection was found between ADHD symptoms and daytime sleepiness on the interindividual level. Unexpectedly, a negative association was found on the intraindividual level for ADHD symptoms and daytime sleepiness, indicating that in moments when children are sleepier during the day, they experience less ADHD symptoms. Explorative analyses showed differential links of nightly sleep quality and daytime sleepiness, with the core symptoms of inattention and hyperactivity/impulsivity, respectively. Therefore, future analyses should take the factor structure of ADHD symptoms into account. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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11 pages, 725 KiB  
Article
Transient Destabilization of Declarative Memory—Opposing Impact of Physical Exercise or Rest after Encoding in Typically Developing Children and Children with Attention Deficit Hyperactivity Disorder but No Difference after Subsequent Sleep
by Manuel Munz, Lioba Baving and Alexander Prehn-Kristensen
Brain Sci. 2022, 12(3), 322; https://doi.org/10.3390/brainsci12030322 - 27 Feb 2022
Cited by 2 | Viewed by 2601
Abstract
Background: Children are especially sensitive to a broad range of influences and show a remarkable capacity for learning. One prominent example is declarative memory, which may be influenced by a variety of factors and is impaired in attention deficit hyperactivity disorder (ADHD). Exercise [...] Read more.
Background: Children are especially sensitive to a broad range of influences and show a remarkable capacity for learning. One prominent example is declarative memory, which may be influenced by a variety of factors and is impaired in attention deficit hyperactivity disorder (ADHD). Exercise and sleep, or both combined, might foster declarative memory. Methods: Here, 12 typically developing children (TDC) and 12 age-matched children with ADHD participated in an exercise and rest condition before a night in the sleep laboratory. Declarative memory was encoded before exercise or rest and retrieved before and after a night of sleep. Results: Exercise in TDC but rest in ADHD lead to a transient destabilization of declarative memory, while there were no more differences after a night of sleep. Rapid eye movement (REM) sleep latency was prolonged after exercise in both groups. Conclusions: Exercise leads to opposing effects on immediate declarative memory formation. The factors or contexts that promote or hinder declarative memory formation in children ADHD and TDC differ, and further work is needed to determine the recommendations for declarative learning in children with ADHD. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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19 pages, 1232 KiB  
Article
Actigraphy-Derived Sleep Profiles of Children with and without Attention-Deficit/Hyperactivity Disorder (ADHD) over Two Weeks—Comparison, Precursor Symptoms, and the Chronotype
by Mirjam Ziegler, Anna Kaiser, Christine Igel, Julia Geissler, Konstantin Mechler, Nathalie E. Holz, Katja Becker, Manfred Döpfner, Marcel Romanos, Daniel Brandeis, Sarah Hohmann, Sabina Millenet and Tobias Banaschewski
Brain Sci. 2021, 11(12), 1564; https://doi.org/10.3390/brainsci11121564 - 27 Nov 2021
Cited by 4 | Viewed by 3094
Abstract
Although sleep problems are common in children with ADHD, their extent, preceding risk factors, and the association between neurocognitive performance and neurobiological processes in sleep and ADHD, are still largely unknown. We examined sleep variables in school-aged children with ADHD, addressing their intra-individual [...] Read more.
Although sleep problems are common in children with ADHD, their extent, preceding risk factors, and the association between neurocognitive performance and neurobiological processes in sleep and ADHD, are still largely unknown. We examined sleep variables in school-aged children with ADHD, addressing their intra-individual variability (IIV) and considering potential precursor symptoms as well as the chronotype. Additionally, in a subgroup of our sample, we investigated associations with neurobehavioral functioning (n = 44). A total of 57 children (6–12 years) with (n = 24) and without ADHD (n = 33) were recruited in one center of the large ESCAlife study to wear actigraphs for two weeks. Actigraphy-derived dependent variables, including IIV, were analyzed using linear mixed models in order to find differences between the groups. A stepwise regression model was used to investigate neuropsychological function. Overall, children with ADHD showed longer sleep onset latency (SOL), higher IIV in SOL, more movements during sleep, lower sleep efficiency, and a slightly larger sleep deficit on school days compared with free days. No group differences were observed for chronotype or sleep onset time. Sleep problems in infancy predicted later SOL and the total number of movements during sleep in children with and without ADHD. No additional effect of sleep problems, beyond ADHD symptom severity, on neuropsychological functioning was found. This study highlights the importance of screening children with ADHD for current and early childhood sleep disturbances in order to prevent long-term sleep problems and offer individualized treatments. Future studies with larger sample sizes should examine possible biological markers to improve our understanding of the underlying mechanisms. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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13 pages, 1997 KiB  
Article
Sleep Instability Correlates with Attentional Impairment in Boys with Attention Deficit Hyperactivity Disorder
by Katia Gagnon, Mélanie Labrosse, Marc-André Gingras and Roger Godbout
Brain Sci. 2021, 11(11), 1425; https://doi.org/10.3390/brainsci11111425 - 27 Oct 2021
Cited by 5 | Viewed by 2183
Abstract
Theoretical models of sleep and attention deficit hyperactivity disorder (ADHD) suggest that symptoms of ADHD are associated with daytime sleepiness, but it has received little support. The present study aimed at testing an alternative model involving the association of attentional instability with sleep [...] Read more.
Theoretical models of sleep and attention deficit hyperactivity disorder (ADHD) suggest that symptoms of ADHD are associated with daytime sleepiness, but it has received little support. The present study aimed at testing an alternative model involving the association of attentional instability with sleep instability, i.e., sleep stage transitions and arousals. Twelve ADHD and 15 healthy control (HC) boys aged between 8 and 12 years old underwent polysomnography recording and attentional testing. The microarousal index, the number of awakenings, and the number of stage shifts between stages 1, 2, 3, 4 and REM sleep throughout the night were computed as sleep stability parameters. Attentional functioning was assessed using the Continuous Performance Test-II. We found significantly higher sleep instability in ADHD compared to HC. Sleep arousals and stage transitions (micro arousal index, stage 4/3 and 2/4 transitions) in ADHD significantly correlated with lower attentional scores. No association whatsoever was found between sleep instability and attentional functioning in HC. The results show that sleep instability is associated with lower attentional performance in boys with ADHD, but not in HC. This could be compatible with a model according to which attention and sleep stability share a common neural substrate in ADHD. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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Review

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11 pages, 464 KiB  
Review
Managing Sleep in Adults with ADHD: From Science to Pragmatic Approaches
by Craig B. H. Surman and Daniel M. Walsh
Brain Sci. 2021, 11(10), 1361; https://doi.org/10.3390/brainsci11101361 - 16 Oct 2021
Cited by 10 | Viewed by 9255
Abstract
Background: Sleep disorders and sleep problems commonly occur in adults with ADHD and add to functional impairment. Evidence-based treatments for sleep could improve function in the adult ADHD population. Methods: A literature review was conducted to present the clinical science informing treatment of [...] Read more.
Background: Sleep disorders and sleep problems commonly occur in adults with ADHD and add to functional impairment. Evidence-based treatments for sleep could improve function in the adult ADHD population. Methods: A literature review was conducted to present the clinical science informing treatment of sleep in adults with ADHD. Results: Six systematic prospective studies of sleep intervention in adults with ADHD were identified. Three of these, all including well-characterized ADHD patients, offered evidence for a significant effect of morning light therapy. Across the studies, preliminary evidence for melatonin, behavioral therapy, and weighted blankets were also found. Implication: Low-risk interventions such as light therapy may improve sleep in adults with ADHD, but many sleep interventions currently in use remain unstudied in the ADHD population. Considerations for evidence-informed practice and future research directions are discussed. Full article
(This article belongs to the Special Issue Advances in Sleep and ADHD)
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