Characterizing the Effects of Sleep Extension on Overnight EEG Dynamics in Children with Attention-Deficit/Hyperactivity Disorder

Ahren B. Fitzroy1,2, Amanda Cremone3, & Rebecca M. C. Spencer1
1University of Massachusetts, Amherst, MA; 2Mount Holyoke College, South Hadley, MA; 3Boston Children's Hospital, Boston, MA

Poster presented at the annual meeting of the Associated Professional Sleep Societies, Baltimore, MD (2018)
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Introduction: Attention-deficit/hyperactivity disorder (ADHD) is associated with impaired sleep in children, and short sleep duration is associated with increased inattention and hyperactivity/impulsivity. These findings suggest that unmet sleep need underlies some portion of the sleep disturbances often observed in ADHD. Thus, we hypothesized that extending sleep duration in children with ADHD would reduce sleep atypicality.
Methods: Overnight EEG data were collected from 11 children (6 - 9 y.o.) previously diagnosed with ADHD and 10 typically developing (TD) children (6 - 9 y.o.) on a typical sleeping night, and on the last day of a 5-night sleep extension protocol. Dynamic changes in spectral power over the course of the night were assessed using power envelopes generated by Hilbert-transforming the overnight EEG after filtering into subdelta (0.1 - 0.5 Hz), delta (0.5 - 4 Hz), theta (4 - 8 Hz), and sigma (12 - 16 Hz) frequency bands, and by performing wavelet based time-frequency decomposition of the EEG data.
Results: On the typical sleeping night, children with ADHD had increased delta activity during the first two hours of the night (p = 0.047) and increased subdelta activity during the second two hours of the night (p = 0.047) relative to TD children. These differences were not evident after following the sleep extension protocol (p’s > 0.4). 
Conclusion: Our results suggest that children with ADHD have unmet sleep need that is dissipated by a sleep extension protocol, as indicated by the increased subdelta and delta power early in the night for ADHD children on the typical night but not the extended sleep night.
Support (If Any): This work was supported by NIH R01 HL111695 to RMCS, and by a UMass Dissertation Research Grant to AC.

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