SCIENTIFIC EVIDENCE IN SLEEP MEDICINE
Introduction:
Attention Deficit Hyperactivity Disorder (ADHD) is a major public health problem in our society today, being the most common behavioral disorder in children and adolescents, with an estimated prevalence of 3-7%.
The relationship between sleep and ADHD has been known for decades and this interrelationship is complex, multifactorial and multidirectional: we know that children with insufficient sleep, restless sleep or poor quality sleep develop symptoms similar to ADHD and, on the other hand, sleep disorders are very frequent in children with ADHD and appear in up to half of them (5 times more frequent than in healthy children).
Asking the parents how the child sleeps is not enough to identify the specific sleep disorder because there are more than 80 and it is necessary to conduct a targeted and oriented interview according to the age of the child and the symptoms described.
Sleep, cognition, and behavioral problems in school-age children: a century of research meta-analyzed. Astill RG, Van der Heijden KB, Van Ijzendoorn MH, Van Someren EJ.
Psychol Bull. 2012 Nov;138(6):1109-38.
There is an association between sleep, school performance and the child’s behavior during the day.
A recent meta-analysis [1] systematically summarized 86 studies that examined sleep, cognition and behavioral problems in 35,936 healthy school-aged children (5-12 years). Sleep duration shows a significant positive relationship with cognitive performance, executive functioning (e.g., task elaboration), school performance, and behavioral problems (e.g., hyperactivity) but not with intelligence.
Clinical significance:
In practical terms, the results suggest that sleep deprivation in children is associated with impairments in complex cognitive functions, school performance and increased behavioral problems. Normalization of sleep may improve daytime symptoms, avoiding unnecessary treatment with psychostimulants in these cases.
Dr. Milagros Merino Andreu
[1] Meta-analysis: Analysis that synthesizes the data obtained in several studies, estimating the effect of a factor or treatment in context. For example, to evaluate the risk or correlation between salt intake and arterial hypertension.
