Abstract
A recent study has applied a novel statistical framework (functional linear modeling: FLM) to the study of circadian activity rhythm (CAR) in adult attention-deficit hyperactivity disorder (ADHD), pointing out the absence of the physiological post-lunch dip. The aim of the present study was to apply FLM to explore the features of CAR in pediatric ADHD. To this end, a secondary analysis of previously collected data was carried out. Twenty-four ADHD children (four females, mean age 8.67 ± 1.74) and 107 controls (C, 60 females, mean age 10.25 ± 0.48) were examined. The actigraph model Actiwatch AW64 was used to objectively monitor sleep/wake behavior and CAR. In the original study each participant wore the actigraph on the non-dominant wrist for one week. FLM was applied to examine the differences between groups in CAR. Compared with C, the CAR of ADHD children was distinguished by a higher motor activity during the whole of the daytime and within a reduced time window during the nighttime.
Highlights
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of hyperactivity, impulsivity, and inattention
With reference to actigraphic sleep parameters, we found two significant differences between the groups (Table 1), with longer wake after sleep onset (WASO) and lower sleep efficiency (SE) in attention-deficit hyperactivity disorder (ADHD) children compared to C
We examined 24 ADHD children who were being treated at the Child Neuropsychiatry Unit of the Fondazione Mondino (Istituto Neurologico Nazionale a Carattere Scientifico | IRCCS (Pavia, Italy)), and who participated in a study on actigraphic sleep quality and raw hourly circadian activity rhythm (CAR) between 2004 and 2006, the results of which have previously been reported as abstracts [14,15]
Summary
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of hyperactivity, impulsivity, and inattention. The prevalence of ADHD in childhood and adolescence is high, around 10% [1], with an important persistence into adulthood [2]. While excessive motor behavior is an important feature of ADHD, the assessment of this component during the diagnostic process is carried out through standardized scales. One technique that has the potential to provide an objective assessment of motor activity is actigraphy. Actiwatches are wrist-worn devices equipped with an accelerometer that measures the limb activity related to movements occurring during both wake and sleep, i.e., the whole 24 h [3]. Actigraphy has the unique advantage of providing an objective and naturalistic measure of circadian activity rhythm (CAR). Each epoch of raw motor activity data can be scored as sleep or wake, according to validated algorithms, providing an indirect assessment of sleep
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