Sleep in Children with Attention Deficit Hyperactivity Disorder (ADHD): Difference between revisions

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== Clinically Relevant Anatomy<br> ==
==Background==
 
Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder in childhood. The prevalence of ADHD among preschool children is around 8%<ref>Addanki SS, Chandradekaran V, Kandasamy P. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159562/ Attention Deficit Hyperactivity Disorder in Preschool Children: A Cross-Sectional Study of Clinical Profile and Co-morbidity]. Indian Journal of Psychological Medicine. 2023; 45(3): 257-262</ref>, with the disorder being three to nine times more common in males than females<ref>Thomas R, Sanders S, Doust J, Beller E, Glasziou P. [https://www.researchgate.net/publication/273124705_Thomas_R_Sanders_S_Doust_J_BellerE_Glasziou_P_Prevalence_of_Attention_Deficit_Hyperactivity_Disorder_A_systematic_review_and_meta-analysis Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis]. Pediatrics. 2015; 135: e994-1001</ref>.
 
Quality sleep plays a crucial role in body repair, memory integration, brain information processing, and emotional regulation. All these aspects collectively have substantial effects on children's physical development, cognitive growth, emotional regulation, attention, behavior, metabolism, and immune function<ref>Ophoff D, Slaats MA, Boudewyns A, Glazemakers I, Van Hoorenbeeck K, Verhulst SL. [https://link.springer.com/article/10.1007/s00431-018-3116-z Sleep disorders during childhood: a practical review]. European Journal of Pediatrics. 2018; 177: 641-648</ref>. Poorer sleep is associated with worse academic performance<ref>Matsuoka M, Nagamitsu S, Iwasaki M, Iemura A, Yamashita Y, Maeda M. High incidence of sleep problems in children with developmental disorders: results of a questionnaire survey in a Japanese elementary school. Brain & Development. 2014; 36(1): 35-44</ref>.
 
Sleep problems are more common in children with ADHD (prevalence range from 30 to 74.6%, based on gender, age, ADHD subtype, co-morbidities, and use of medication<ref>Tsai MH, Hsu JF, Huang YS. Sleep problems in children with attention deficit/hyperactivity disorder: current status of knowledge and appropriate management. Current Psychiatry Reports. 2016; 18(8): 76 </ref>) than in children without ADHD<ref>Owens J, Sangal RB, Sutton VK, Bakken R, Allen AJ, Kelsey D. Subjective and objective measures of sleep in children with attention-deficit/hyperactivity disorder. Sleep Medicine. 2008; 10(4): 446-456</ref><ref name=":0">Yin H, Yang D, Yang L, Wu G. [https://www.frontiersin.org/articles/10.3389/fped.2022.919572/full Relationship between sleep disorders and attention-deficit-hyperactivity disorder in children.] Frontiers in Pediatrics. 2022; 10: 919572</ref><ref>Hosiri T, Punyapas S, Sawangsri W. The Prevalence and Patterns of Sleep Problem in Children with ADHD. Journal of the Medical Association of Thailand. 2018; 101(1): s34-40</ref><ref>Cortese S, Brown TE, Corkum P, Gruber R, O'Brien LM, Stein M. [https://www.researchgate.net/publication/251568565_Assessment_and_Management_of_Sleep_Problems_in_Youths_With_Attention-DeficitHyperactivity_Disorder Assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder]. Journal of the American Academy of Child & Adolescent Psychiatry. 2013; 52(8): 784-96</ref><ref>Chiraphadhanakul K, Jaimchariyatam N, Pruksananonda C, Chonchaiya W. Increased Sleep Disturbances in Thai Children With Attention-Deficit Hyperactivity Disorder Compared With Typically Developing Children. Behavioral Sleep Medicine. 2016; 14(6): 677-86</ref><ref>Yoon SY, Jain U, Shapiro C. [https://www.ndsu.edu/pubweb/~hilmert/SPRG/SPRGPapers/Yoon_2012.pdf Sleep in attention-deficit/hyperactivity disorder in children and adults: past, present, and future]. Sleep Medicine Reviews. 2012; 16(4): 371-88</ref><ref>Lycett K, Mensah FK, Hiscock H, Sciberras E. A prospective study of sleep problems in children with ADHD. Sleep Medicine. 2014; 15: 1354-61</ref><ref>Lee SH, Kim HB, Lee KW. Association between sleep duration and attention-deficit hyperactivity disorder: a systematic review and meta-analysis of observational studies. Journal of Affective Disorders. 2019; 256: 62-9</ref>. Poor sleep quality and delayed bedtime can result in daytime fatigue, impacting mood, concentration, behavior, and physical health. Numerous studies have indicated a connection between sleep issues and heightened severity of ADHD symptoms or behavioral challenges in school-aged children with ADHD<ref name=":0" /><ref>Paavonen EJ, Raikkonen K, Lahti J, Komsi N, Heinonen K, Pesonen AK. [https://www.researchgate.net/publication/24378329_Short_Sleep_Duration_and_Behavioral_Symptoms_of_Attention-DeficitHyperactivity_Disorder_in_Healthy_7-to_8-Year-Old_Children Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in health 7- to 8-year-old children]. Pediatrics. 2009; 123(5): e857-64</ref><ref>Lucas I, Mulraney M, Sciberras E. Sleep problems and daytime sleepiness in children with ADHD: associations with social, emotional, and behavioral functioning at school, a cross-sectional study. Behavioral Sleep Medicine. 2019; 17: 411-22</ref>. It is also associated with depressive symptoms<ref>Becker SP, Langberg JM, Evans SW. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526027/ Sleep problems predict comorbid externalizing behaviors and depression in young adolescents with attention deficit/hyperactivity disorder.] European Child & Adolescent Psychiatry. 2015; 24(8): 897-907</ref>, and poorer mental health of primary caregivers<ref>Sung V, Hiscock H, Sciberras E, Efron D. [https://www.researchgate.net/publication/5461696_Sleep_Problems_in_Children_With_Attention-DeficitHyperactivity_Disorder Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family]. Archives of Pediatrics and Adolescents Medicine. 2008; 162(4): 336-42</ref>.


add text here relating to '''''clinically relevant''''' anatomy of the condition<br>
== Physiological factors ==
There are several factor that can play a role in the sleep problems in children with ADHD:


== Mechanism of Injury / Pathological Process<br> ==
* It is possible that factors such as rapid eye movement (REM) sleep abnormalities, which are frequently observerd in children with ADHD<ref>Scarpelli S, Gorgoni M, D'atri A, Reda F, De Gennaro L. [https://www.mdpi.com/2077-0383/8/10/1737 Advances in understanding the relationship between sleep and attention deficit-hyperactivity disorder (ADHD)]. Journal of Clinical Medicine. 2019; 8(10): 1737</ref>,may play a significant role. This is because REM is linked to parasomnias like nightmare disorder, which often lead to awakenings<ref>Bruni O, DelRosso LM, Melegari MG, Ferri R. The parasomnias. Child and Adolescent Psychiatric Clinics of North America. 2021; 30(1): 131-142</ref>, and it also affects neurobehavioral functioning in children with ADHD<ref>Kirov R, Brand S, Banaschewski T, Rothenberger A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220062/ Opposite impact of REM sleep on neurobehavioral functioning in children with common psychiatric disorders compared to typically developing children.] Frontiers in Psychology. 2017; 7: 2059</ref>.<br>


add text here relating to the mechanism of injury and/or pathology of the condition<br>
==Sleep problems==


== Clinical Presentation  ==
The higher the ADHD symptoms. the more sleep problems a child has. Behavioral disruptions may affect sleep at night and functioning in the daytime in the following ways:


add text here relating to the clinical presentation of the condition<br>  
* Insomnia<ref name=":0" /><ref name=":1">Um YH, Jeong JH, Hong SC, Kim TW, Lim HK, Seo HJ. [https://www.researchgate.net/publication/321345871_PT555_Association_between_Sleep_Parameters_and_Cognitive_Function_in_Drug-naive_Children_with_Attention-deficit_Hyperactivity_Disorder_A_Polysomnographic_Study Association between sleep parameters and cognitive function in drug-naïve children with attention-deficit hyperactivity disorder: a polysomnographic study]. Sleep Medicine. 2016; 21: 165-70</ref>
* Struggling before falling asleep<ref name=":0" /><ref name=":1" /><ref name=":2">Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. Journal of the American Academy of Child & Adolescent Psychiatry, 2009; 48(9): 894-908</ref>
* Poor sleep quality<ref name=":0" /><ref name=":1" />
* Insufficient sleep duration<ref name=":0" /><ref name=":1" />
* Awakening at night<ref name=":2" /><ref name=":3">Stickley A, Shirama A, Kitamura S, Kamio Y, Takahashi H, Saito A. [https://pdf.sciencedirectassets.com/272127/1-s2.0-S1389945721X00068/1-s2.0-S1389945721002653/am.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjELX%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJIMEYCIQD%2BmrvpA34iQDeri3pc1jrhE8iw7YHWRdoymQjeKrp1jAIhAKfvrMw8HJFugAXUycmHkvZAOXvSUMyyqkDqGClj9k%2BYKrwFCK7%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQBRoMMDU5MDAzNTQ2ODY1IgwdpKdpbLbhZlSahGYqkAVFRH8XW7%2BC6j7Oy1nwfcaXIT93EumX1YZPULeRlDPkBzsLTfBdLx87HWZB3W0MRR3NMa2j6KUXpvhCgJjQ8OF3bdHND6ciuzJGP2%2FUcakBasblDmFGvRsEiYoe%2F92kpepcNBBGdtbpZzWvC%2FuK%2FVGsHJ6RfnbNxGlJht1ZqndZH%2BxrU8f4T31no9%2Fq9A1hZXvzZwKa5RVdKtTSYGML%2BsLUxBOQIDPCXL0opR%2BF7qW8MjNkfChOfVkoy%2Bd289KbslXDUerIfeZ%2BhRIgmg%2BBhuIt9TucyBr3QQXWbhqv3GbJVpOBPzQXI%2F3Jq8TEaTjYhpdwfK1CmJG0wBFV0%2BE8Lbeut3%2B7iiB5ESLVJvT9Hq4yp5KS0D2nhWSrsJANvCWR%2BPujdWhuu9TTtIQr5X7kxz%2FBJiWyNlO48RApQCTMEBhSI6aj03Tk%2F89YVT7HM%2FezM8uqLfjz2y4WVHGFU7WjIOFFaMMY3bBuTu8LkvqYerV0%2FGX1HmmxOQLqIclNXB20uX3qZ7%2FjBswgSxCLHg7s%2FgJ0OJ35frL92yBafwmXBhCcRyClVav3NOdYSrx6%2FtRz1g7LxZyVD6%2FgAj25NlhtB%2FgxiXVF%2FemP9eB0mUqkxImSI8ceWxHXBhJsdaiomPvib4TucEIlI1W93R%2Bg8tcKTifGbG4QfsDre%2B6xel8wqf0l6WEpY4ESv1Z8gYA%2B3oQuhJj8NH8FI9u5OwulWi6hXqMeII9HMonpne4R1bX88Gdw72RBESqeUHLwQE%2F2cECh6skPRhc7%2FzjjXWKzU1%2FQcvhLBXtFypAONI8Jd4q2S2%2FcbEWvBWW4nI%2Fuf1YyUq38y5y2WlAzITRcAjnzo1QRATQVk7vxItPYEQZZhlntHYjkmjC9q6OvBjqwAQOebxnvf1SLhD96hj8LI09BB0oMntqAI%2F9V7m3%2FVvkyC2x4Yykv%2Bof2brTOLUDwcHpN83bISAr2XIFwQJKK4JowTCLXgfity1w%2B%2BM2iYcftF%2F8wKtqE0feuS1FN1lfGCZ7PmX4xLMKlnDDDNoMGJZngMzLeOYO7oXJYe5orONU9bzEiQ%2BU0ZY%2Bb0upBrdWvfDY2Nm9EMIYeEhSAmVbM6ehTZhZbJjYa%2FdP9xvYgOtWh&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20240306T220547Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTY7WWG2ZE2%2F20240306%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=c22eda64fa9df047fde9f6164f3de4b87d15ad19cc79c418eabafc3901d208eb&hash=2c078c53095bad2484be1ab7fb14f5a4285498f5ccd869f412913bac50a9326f&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1389945721002653&tid=pdf-05dcaacb-b6f9-49e5-bbca-057a4c02cdd6&sid=c79a9c884e2be543e2292dd-2bdad6c21295gxrqb&type=client Attention deficit/hyperactivity disorder symptoms and sleep problems in preschool children: the role of autistic traits]. Sleep Medicine. 2021; 83: 214-21</ref>
* Nightmares<ref name=":3" />
* Snoring and Sleep Disordered Breathing<ref name=":2" /><ref name=":3" />
* Morning awakenings problems<ref name=":2" />
* Daytime sleepiness<ref name=":2" /><br>


== Diagnostic Procedures  ==
== Sleep and medication==


add text here relating to diagnostic tests for the condition<br>  
add text here relating to the clinical presentation of the condition<br>


== Outcome Measures ==
== Gender ==
The occurrence of symptoms related to sleep problems differs based on gender. In the age group of 6-14 years, parents report a higher prevalence of sleep disorder symptoms in boys (5.19%) compared to girls of the same age (3.67%)<ref>Huang MM, Qian Z, Wang J, Vaughn MG, Lee YL, Dong GH. Validation of the sleep disturbance scale for children and prevalence of parent-reported sleep disorder symptoms in Chinese children. Sleep Medicine. 2014; 15: 923-8</ref>, but there is also evidence that there is no significant difference between male and female children with sleep disorders<ref name=":0" />.
 
==Sleep hygiene==
 
There are several sleep hygiene factors associated with the sleep quality of children with ADHD:
 
* Co-sleeping (bed and room sharing): it has been linked to various sleep problems in children<ref>Li S, Jin X, Yan C, Wu S, Jiang F, Shen X. Bed- and room-sharing in Chinese school-aged children: prevalence and association with sleep behaviors. Sleep Medicine. 2008; 9: 555-63</ref>.
* <br>
 
== Other sleep associated factors ==
There are more factors that might contribute to sleep problems in children with ADHD:
 
* Parents' own sleep behavior (sleep timing) might be associated with poorer quality sleep<ref>Iwata S, Iwata O, Matsuishi T. [https://www.researchgate.net/publication/235657709_Sleep_patterns_of_Japanese_preschool_children_and_their_parents_Implications_for_co-sleeping Sleep patterns of Japanese preschool children and their parents: implications for co-sleeping]. Acta Peadiatrica. 2013; 102: e257-62</ref>
 
== Outcome Measures==


add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]])  
add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]])  


== Management / Interventions<br> ==
==Interventions==
 
The severity of ADHD can be reduced by improving the sleep of children with behavioral sleep interventions<ref name=":0" />. Other interventions might be:


add text here relating to management approaches to the condition<br>  
* Drug treatments
* Non-pharmacological sleep-related interventions might be important for treating sleep problems including those that focus on sleep hygiene, sensory based factors, parental stress and eduction<ref>Ramtekkar UP. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575584/ DSM-5 changes in attention deficit hyperactivity disorder and autism spectrum disorder: implications for comorbid sleep issues.] Children. 2017; 4: 62</ref><br>


== Differential Diagnosis<br>  ==
==Differential Diagnosis ==


add text here relating to the differential diagnosis of this condition<br>  
add text here relating to the differential diagnosis of this condition<br>  


== Resources <br> ==
==Resources  ==


add appropriate resources here  
add appropriate resources here  


== References ==
==References==


<references />
<references />

Revision as of 01:13, 7 March 2024

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (7/03/2024)
Original Editor - User Name
Top Contributors - Romy Hageman

Background[edit | edit source]

Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder in childhood. The prevalence of ADHD among preschool children is around 8%[1], with the disorder being three to nine times more common in males than females[2].

Quality sleep plays a crucial role in body repair, memory integration, brain information processing, and emotional regulation. All these aspects collectively have substantial effects on children's physical development, cognitive growth, emotional regulation, attention, behavior, metabolism, and immune function[3]. Poorer sleep is associated with worse academic performance[4].

Sleep problems are more common in children with ADHD (prevalence range from 30 to 74.6%, based on gender, age, ADHD subtype, co-morbidities, and use of medication[5]) than in children without ADHD[6][7][8][9][10][11][12][13]. Poor sleep quality and delayed bedtime can result in daytime fatigue, impacting mood, concentration, behavior, and physical health. Numerous studies have indicated a connection between sleep issues and heightened severity of ADHD symptoms or behavioral challenges in school-aged children with ADHD[7][14][15]. It is also associated with depressive symptoms[16], and poorer mental health of primary caregivers[17].

Physiological factors[edit | edit source]

There are several factor that can play a role in the sleep problems in children with ADHD:

  • It is possible that factors such as rapid eye movement (REM) sleep abnormalities, which are frequently observerd in children with ADHD[18],may play a significant role. This is because REM is linked to parasomnias like nightmare disorder, which often lead to awakenings[19], and it also affects neurobehavioral functioning in children with ADHD[20].

Sleep problems[edit | edit source]

The higher the ADHD symptoms. the more sleep problems a child has. Behavioral disruptions may affect sleep at night and functioning in the daytime in the following ways:

Sleep and medication[edit | edit source]

add text here relating to the clinical presentation of the condition

Gender[edit | edit source]

The occurrence of symptoms related to sleep problems differs based on gender. In the age group of 6-14 years, parents report a higher prevalence of sleep disorder symptoms in boys (5.19%) compared to girls of the same age (3.67%)[24], but there is also evidence that there is no significant difference between male and female children with sleep disorders[7].

Sleep hygiene[edit | edit source]

There are several sleep hygiene factors associated with the sleep quality of children with ADHD:

  • Co-sleeping (bed and room sharing): it has been linked to various sleep problems in children[25].

Other sleep associated factors[edit | edit source]

There are more factors that might contribute to sleep problems in children with ADHD:

  • Parents' own sleep behavior (sleep timing) might be associated with poorer quality sleep[26]

Outcome Measures[edit | edit source]

add links to outcome measures here (see Outcome Measures Database)

Interventions[edit | edit source]

The severity of ADHD can be reduced by improving the sleep of children with behavioral sleep interventions[7]. Other interventions might be:

  • Drug treatments
  • Non-pharmacological sleep-related interventions might be important for treating sleep problems including those that focus on sleep hygiene, sensory based factors, parental stress and eduction[27]

Differential Diagnosis[edit | edit source]

add text here relating to the differential diagnosis of this condition

Resources[edit | edit source]

add appropriate resources here

References[edit | edit source]

  1. ↑ Addanki SS, Chandradekaran V, Kandasamy P. Attention Deficit Hyperactivity Disorder in Preschool Children: A Cross-Sectional Study of Clinical Profile and Co-morbidity. Indian Journal of Psychological Medicine. 2023; 45(3): 257-262
  2. ↑ Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 2015; 135: e994-1001
  3. ↑ Ophoff D, Slaats MA, Boudewyns A, Glazemakers I, Van Hoorenbeeck K, Verhulst SL. Sleep disorders during childhood: a practical review. European Journal of Pediatrics. 2018; 177: 641-648
  4. ↑ Matsuoka M, Nagamitsu S, Iwasaki M, Iemura A, Yamashita Y, Maeda M. High incidence of sleep problems in children with developmental disorders: results of a questionnaire survey in a Japanese elementary school. Brain & Development. 2014; 36(1): 35-44
  5. ↑ Tsai MH, Hsu JF, Huang YS. Sleep problems in children with attention deficit/hyperactivity disorder: current status of knowledge and appropriate management. Current Psychiatry Reports. 2016; 18(8): 76
  6. ↑ Owens J, Sangal RB, Sutton VK, Bakken R, Allen AJ, Kelsey D. Subjective and objective measures of sleep in children with attention-deficit/hyperactivity disorder. Sleep Medicine. 2008; 10(4): 446-456
  7. ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 Yin H, Yang D, Yang L, Wu G. Relationship between sleep disorders and attention-deficit-hyperactivity disorder in children. Frontiers in Pediatrics. 2022; 10: 919572
  8. ↑ Hosiri T, Punyapas S, Sawangsri W. The Prevalence and Patterns of Sleep Problem in Children with ADHD. Journal of the Medical Association of Thailand. 2018; 101(1): s34-40
  9. ↑ Cortese S, Brown TE, Corkum P, Gruber R, O'Brien LM, Stein M. Assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 2013; 52(8): 784-96
  10. ↑ Chiraphadhanakul K, Jaimchariyatam N, Pruksananonda C, Chonchaiya W. Increased Sleep Disturbances in Thai Children With Attention-Deficit Hyperactivity Disorder Compared With Typically Developing Children. Behavioral Sleep Medicine. 2016; 14(6): 677-86
  11. ↑ Yoon SY, Jain U, Shapiro C. Sleep in attention-deficit/hyperactivity disorder in children and adults: past, present, and future. Sleep Medicine Reviews. 2012; 16(4): 371-88
  12. ↑ Lycett K, Mensah FK, Hiscock H, Sciberras E. A prospective study of sleep problems in children with ADHD. Sleep Medicine. 2014; 15: 1354-61
  13. ↑ Lee SH, Kim HB, Lee KW. Association between sleep duration and attention-deficit hyperactivity disorder: a systematic review and meta-analysis of observational studies. Journal of Affective Disorders. 2019; 256: 62-9
  14. ↑ Paavonen EJ, Raikkonen K, Lahti J, Komsi N, Heinonen K, Pesonen AK. Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in health 7- to 8-year-old children. Pediatrics. 2009; 123(5): e857-64
  15. ↑ Lucas I, Mulraney M, Sciberras E. Sleep problems and daytime sleepiness in children with ADHD: associations with social, emotional, and behavioral functioning at school, a cross-sectional study. Behavioral Sleep Medicine. 2019; 17: 411-22
  16. ↑ Becker SP, Langberg JM, Evans SW. Sleep problems predict comorbid externalizing behaviors and depression in young adolescents with attention deficit/hyperactivity disorder. European Child & Adolescent Psychiatry. 2015; 24(8): 897-907
  17. ↑ Sung V, Hiscock H, Sciberras E, Efron D. Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family. Archives of Pediatrics and Adolescents Medicine. 2008; 162(4): 336-42
  18. ↑ Scarpelli S, Gorgoni M, D'atri A, Reda F, De Gennaro L. Advances in understanding the relationship between sleep and attention deficit-hyperactivity disorder (ADHD). Journal of Clinical Medicine. 2019; 8(10): 1737
  19. ↑ Bruni O, DelRosso LM, Melegari MG, Ferri R. The parasomnias. Child and Adolescent Psychiatric Clinics of North America. 2021; 30(1): 131-142
  20. ↑ Kirov R, Brand S, Banaschewski T, Rothenberger A. Opposite impact of REM sleep on neurobehavioral functioning in children with common psychiatric disorders compared to typically developing children. Frontiers in Psychology. 2017; 7: 2059
  21. ↑ 21.0 21.1 21.2 21.3 Um YH, Jeong JH, Hong SC, Kim TW, Lim HK, Seo HJ. Association between sleep parameters and cognitive function in drug-naïve children with attention-deficit hyperactivity disorder: a polysomnographic study. Sleep Medicine. 2016; 21: 165-70
  22. ↑ 22.0 22.1 22.2 22.3 22.4 Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. Journal of the American Academy of Child & Adolescent Psychiatry, 2009; 48(9): 894-908
  23. ↑ 23.0 23.1 23.2 Stickley A, Shirama A, Kitamura S, Kamio Y, Takahashi H, Saito A. Attention deficit/hyperactivity disorder symptoms and sleep problems in preschool children: the role of autistic traits. Sleep Medicine. 2021; 83: 214-21
  24. ↑ Huang MM, Qian Z, Wang J, Vaughn MG, Lee YL, Dong GH. Validation of the sleep disturbance scale for children and prevalence of parent-reported sleep disorder symptoms in Chinese children. Sleep Medicine. 2014; 15: 923-8
  25. ↑ Li S, Jin X, Yan C, Wu S, Jiang F, Shen X. Bed- and room-sharing in Chinese school-aged children: prevalence and association with sleep behaviors. Sleep Medicine. 2008; 9: 555-63
  26. ↑ Iwata S, Iwata O, Matsuishi T. Sleep patterns of Japanese preschool children and their parents: implications for co-sleeping. Acta Peadiatrica. 2013; 102: e257-62
  27. ↑ Ramtekkar UP. DSM-5 changes in attention deficit hyperactivity disorder and autism spectrum disorder: implications for comorbid sleep issues. Children. 2017; 4: 62
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