1127 LEG MOVEMENT ACTIVITY DURING SLEEP IN ADULTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

Abstract

Sleep disturbances are prevalent in Attention Deficit Hyperactivity Disorder (ADHD). The hypothesis that the typical daytime hyperactivity observed in these patients may correspond to an increased motor activity during the night, thus causing sleep disruption, has been studied in children, but rarely in adults. Here we present a first detailed analysis of the nocturnal motor activity in ADHD adults compared to healthy controls, including the time structure of leg movements (LM) during sleep. Fifteen ADHD patients and eighteen control subjects underwent four in-lab polysomnographic sleep recordings. The periodic character of LM was evaluated using validated markers of “periodicity”, i.e. the periodicity index, inter-movement intervals and time distribution of LM during sleep, in addition to standard parameters, such as the periodic leg movement during sleep index (PLMSI) and periodic leg movement during sleep arousal index (PLMSAI). Sleep quality and the prevalence of insomnia symptoms were assessed with the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI). None of the participants had restless legs syndrome. Objective sleep parameters from the baseline night did not differ between ADHD and control subjects, with the exception of a longer sleep latency (p=0.007) in the patient group, as well as a slightly higher PLMSI (p=0.044) and PLMS duration (p=0.023), only in REM sleep. The PSQI questionnaire indicated a poor sleep quality and the ISI the prevalence of subclinical insomnia symptoms in ADHD patients. Leg movement activity during sleep in ADHD adult subjects was neither more frequent than in healthy controls nor did the nocturnal motor events show an increased periodicity. The reduced subjective sleep quality reported by ADHD adults was in contrast to the normal objective polysomnographic parameters, suggesting a sleep-state misperception in these individuals or more subtle sleep abnormalities not picked up by the traditional sleep staging. none