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Coherency of attention deficit/hyperactivity and sleep-related problems

Results from a cross-sectional study in elementary school children

Zusammenhang von Symptomen einer Aufmerksamkeitsdefizit- Hyperaktivitätsstörung mit Schlafproblemen

Ergebnisse einer Querschnittsstudie bei Grundschulkindern

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Abstract

In the process of the Cologne Children’s Sleep Study, we assessed whether the occurrence of symptoms indicative of sleep onset and maintenance problems, daytime sleepiness, sleep disordered breathing (SDB), and restless legs syndrome (RLS) is related to an increased risk for the presence of symptoms of hyperactivity (ADHD).

A total of 8,599 parents and 4th grade public school children were surveyed in a cross-sectional study concerning sleep habits, sleep problems, and environmental factors with a parental sleep questionnaire. Relative risks were calculated to examine the relationship between various sleep problems and ADHD symptoms. Frequent snoring was reported in 3.7% of the children, apneas in 0.6% and restless legs in 1.0%. Of the children, 8.9% were reported to be frequently hyperactive. Symptoms of sleep onset and maintenance problems were related to an increased risk of hyperactivity in contrast to daytime sleepiness that was not related to hyperactivity. Moreover, a significantly elevated risk for the symptom hyperactivity could be calculated for children presenting restless legs, snoring, and apneas. For apneas, however, this relationship only existed in children with moderate symptoms of hyperactivity but not in children with frequent hyperactivity.

Our results clearly demonstrate that symptoms of hyperactivity are related to sleep onset and maintenance problems. In contrast, no indication was found for hyperactivity in children presenting increased daytime sleepiness. Our study results further support the hypothesis of significant correlations between ADHD, RLS, and SDB.

Zusammenfassung

Im Rahmen der Kölner Kinderschlafstudie „Gesunder Schlaf für Kölner Kinder“ untersuchten wir, ob Symptome, die verdächtig sind auf Vorliegen ein Ein- oder Durchlafstörung, von erhöhter Tagesmüdigkeit, einer schlafbezogenen Atmungsstörung (SBAS) oder eines Restless-legs-Syndroms mit einem erhöhten Risiko einhergehen für das Vorhandensein von Symptomen einer Aufmerksamkeitsdefizit-Hyperaktivitäts-Störung (ADHS).

In einer Querschnittstudie wurden 8599 Eltern von Schülern der 4. Grundschulklasse in einem Fragebogen zu den Schlafgewohnheiten, zu Schlafproblemen und zu Umgebungsfaktoren befragt. Zur Prüfung des Zusammenhangs von Schlafproblemen mit Symptomen einer ADHS wurden relative Risiken berechnet. Häufiges Schnarchen trat bei 3,7% der Kinder auf, Apnoen bei 0,6% und bei 1% der Kinder Symptome eines Restless-legs-Syndroms. 8,7% der Kinder wurden von ihren Eltern als eindeutig hyperaktiv eingeschätzt. Bei Vorliegen von Ein- oder Durchschlafproblemen, Schnarchen, Apnoen und Symptomen eines Restless-legs-Syndroms bestand ein signifikant erhöhtes Risiko für das Auftreten von Symptomen einer ADHS, nicht dagegen für das Symptom Tagesmüdigkeit. Der Zusammenhang zwischen Apnoen und ADHS-Symptomen bestand aber nur, wenn diese normgrenzwertig ausgeprägt war.

Die vorliegende Studie weist bei einem großen Untersuchungskollektiv nochmals eindeutig signifikante Zusammenhänge von Ein- und Durchschlafstörungen sowie Symptomen eines ADHS und eines Restless-legs-Syndroms nach, zugleich aber im Unterschied zu neueren anderen Studien kein erhöhtes Risiko bei Vorliegen einer erhöhten Tagesmüdigkeit. Des Weiteren bestehen Zusammenhänge zwischen Symptomen einer SBAS und einer ADHS, anscheinend aber nur bei Vorhandensein moderater Hyperaktivität.

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The corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln, Robert-Koch-Straße 10, 50931, Köln, Deutschland

    J. Frölich, G. Lehmkuhl & L. Fricke

  2. Kinderklinik, Klinik Porz am Rhein, Köln, Deutschland

    A. Wiater

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  1. J. Frölich
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  2. G. Lehmkuhl
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  3. L. Fricke
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  4. A. Wiater
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Correspondence to J. Frölich.

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Frölich, J., Lehmkuhl, G., Fricke, L. et al. Coherency of attention deficit/hyperactivity and sleep-related problems. Somnologie 13, 176–181 (2009). https://doi.org/10.1007/s11818-009-0428-2

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