Features of the organization of sleep in children with attention deficit hyperactivity disorder

Abstract

The article presents modern ideas about the clinical features of sleep in children with attention deficit hyperactivity disorder (ADHD), the macrostructure of sleep, its cyclic organization and possible common links in the pathogenesis of sleep disorders and behavioral problems in patients. The relationship between the structure of sleep and impaired executive functions, the level of social maladjustment in patients with ADHD has been proven. Typical of children with ADHD are difficulty in going to sleep and falling asleep for a long time (resistance to sleep time), increased motor activity associated with sleep, including the association of ADHD with Restless legs syndrome (RLS) and periodic leg movement syndrome (PLMS), daytime sleepiness. The presence of circadian desynchrony in children with ADHD explains the relationship between chronotype, circadian typology, and clinical manifestations of the syndrome. Multidirectional data on the representation of REM sleep by nocturnal polysomnography in children with ADHD depend on age. However, the change in the proportion of REM sleep during the night is considered as a leading factor in the pathogenesis of ADHD manifestations. Various variants of metabolic disorders of melatonin, dopamine, serotonin, aggravated by social jet lag, are considered by the conjugatedcommon pathogenetic mechanisms of sleep disturbance and ADHD. As well as changes in the concentration of iron and ferritin in the blood, which may explain the frequency of RLS and PLMS in children with ADHD. The change in the number of sleep cycles during the night in patients has been demonstrated. Possible strategies for correcting sleep disorders in children with ADHD and their impact on the manifestation of ADHD are discussed.