Abstract
Background: Excessive daytime sleepiness (EDS) is central in Attention deficit hyperactivity disorder (ADHD) but its causes remain unclear. The aim of this study was to explore objective EDS and homeostatic sleep pressure buildup, evaluated by power theta–alpha frequency (PTAF), in drug-free sleepy adults with ADHD and controls.Methods: Participants were placed during a 36-h period of extended wakefulness under constant routine protocol to strictly control sleep time, sleep duration, and circadian zeitgebers.Results: Eight drug-free sleepy patients with ADHD and 7 matched controls were included. The ADHD group had significantly shorter sleep latency on the Maintenance of Wakefulness Test (MWT) throughout extended wakefulness than the control group. There was no significant difference between the groups in PTAF evolution during extended wakefulness and in kinetic sleep pressure buildup, evaluated by the time constant of saturating exponential function.Limitations: The sample was small, so the findings cannot be generalized. Moreover, psychiatric comorbidities and circadian regulation should be taken into account in future studies.Conclusion: In very controlled conditions, mean sleep latency on the MWT during the whole extended wakefulness was significantly shorter in sleepy patients with ADHD than in control subjects. However, the difficulty to remain awake during soporific circumstances observed in these patients with ADHD cannot be explained by changes in the kinetic of sleep pressure buildup.Clinical Trials Registration: www.clinicaltrials.gov/, Identifier: NCT02217371.
Highlights
Attention deficit hyperactivity disorder (ADHD) is the most common developmental disorder and is characterized by inappropriate levels of inattention, impulsivity, and hyperactivity [1]
There was no significant difference between the groups in power theta–alpha frequency (PTAF) evolution during extended wakefulness and in kinetic sleep pressure buildup, evaluated by the time constant of saturating exponential function
In very controlled conditions, mean sleep latency on the Maintenance of Wakefulness Test (MWT) during the whole extended wakefulness was significantly shorter in sleepy patients with ADHD than in control subjects
Summary
Attention deficit hyperactivity disorder (ADHD) is the most common developmental disorder and is characterized by inappropriate levels of inattention, impulsivity, and hyperactivity [1]. Excessive daytime sleepiness (EDS) is an interesting focus within the context of ADHD in adults as shown in studies using an automatic resting EEG classification of sleepiness (VIGALL, 7 EEG-vigilance stages) who demonstrated unstable arousal regulation in children and adults with ADHD This arousal instability was characterized by a faster decline to the low EEG-vigilance stages and more fluctuations in their stages of vigilance [4, 5]. In a study [6] conducted on a population of regularly registered highways drivers: those with ADHD symptoms expressed greater EDS than those who did not have these. Excessive daytime sleepiness (EDS) is central in Attention deficit hyperactivity disorder (ADHD) but its causes remain unclear. The aim of this study was to explore objective EDS and homeostatic sleep pressure buildup, evaluated by power theta–alpha frequency (PTAF), in drug-free sleepy adults with ADHD and controls
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