This article discusses current concepts of the clinical features of sleep in children with attention deficit hyperactivity disorder (ADHD), along with sleep macrostructure, its cyclical organization, and the possible common pathways in the pathogenesis of sleep disorders and regulatory functions, and levels of social maladaptation of patients with ADHD. Typical features of children with ADHD are difficulty going to sleep and long times to onset of sleep (resistance to sleep time), increased sleep-related movement activity, including the association of ADHD with restless legs syndrome (RLS) and periodic leg movement during sleep syndrome (PLMS), and daytime sleepiness. The occurrence of circadian desynchronization in children with ADHD explains the link between the chronotype, the circadian typology, and the clinical signs of the syndrome. There are opposing data on the level of rapid eye movement (REM) sleep based on nocturnal polysomnography data in children with ADHD depending on age. However, changes in the proportion of REM sleep during the night are regarded as the leading factor in the pathogenesis of signs of ADHD. Common pathogenetic mechanisms are identified for sleep disorders and ADHD: a diversity of impairments to the metabolism of melatonin, dopamine, and serotonin, aggravation of “social jetlag,” and changes in blood iron and ferritin concentrations, which may explain the frequency of RLS and PLMS in children with ADHD. This group of patients displays changes in the number of sleep cycles during the night. Possible strategies for correcting sleep disorders in children with ADHD and their influences on the signs of ADHD are discussed.
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Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 121, No. 4, Iss. 2, Insomnia, pp. 55–60, April, 2021.
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Kalashnikova, T.P., Anisimov, G.V. Features of the Organization of Sleep in Children with Attention Deficit Hyperactivity Disorder. Neurosci Behav Physi 52, 236–241 (2022). https://doi.org/10.1007/s11055-022-01230-6
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DOI: https://doi.org/10.1007/s11055-022-01230-6