Search

Reut Gruber,1,2 Liron Salamon,3 Riva Tauman,4 Michal Al-Yagon3 1Department of Psychiatry, McGill University, Montreal, QC, Canada; 2Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada; 3Department of School Counseling and Special Education, Tel-Aviv University, Tel-Aviv, Israel; 4Sleep Disorders Center, Tel Aviv Souraski Medical Center, Tel Aviv, IsraelCorrespondence: Reut Gruber, Department of Psychiatry, McGill University, Montreal, QC, Canada, Email Reut.Gruber@Douglas.Mcgill.CaIntroduction: Delayed sleep phase syndrome (DSPS) and insomnia disorders are prevalent in adolescents and are comorbid with attention-deficit/hyperactivity disorder (ADHD), but only limited information is available regarding the prevalence of DSPS and insomnia in adolescents with ADHD. Moreover, previous studies comparing objective sleep parameters averaged the findings across all participants of each group (ADHD, control) regardless of each individual’s level of reported sleep disturbance. This might have resulted in inconsistency between information obtained by objective and subjective sleep measures in adolescents with ADHD. The objectives of the present study were 1) to compare the prevalence of risk for DSPS and insomnia in adolescents with ADHD and control adolescents in our samples; 2) to compare objectively measured sleep characteristics of adolescents with ADHD and controls while taking into consideration their levels of risk for DSPS or their level of insomnia; and 3) to compare the ADHD symptom levels of adolescents with moderate/high and low risk for DSPS or insomnia.Methods: Seventy-three adolescents (37 ADHD, 36 controls) aged 12– 15 years participated in a cross-sectional study. Actigraphy was used to characterize objective sleep parameters and parents’ or adolescents’ reports were used to characterize subjective sleep parameters.Results: Of the participants in the ADHD and control groups, 33.33% and 27%, respectively, had moderate/high levels of risk for DSPS. Adolescents in the high-risk group for DSPS had an objectively measured delayed sleep schedule and more variable sleep duration, time in bed, and sleep efficiency compared to adolescents in the low-risk group for DSPS, regardless of their ADHD diagnosis. Adolescents with higher levels of insomnia spent more time in bed and had more variable sleep efficiency compared to adolescents with no insomnia, regardless of their diagnosis.Conclusion: The prevalence of moderate/high risk for DSPS was similarly high in adolescents with ADHD and controls. Participants’ subjective reports of sleep disturbances were consistent with their objective sleep parameters when the type and level of subjectively defined sleep disturbance were considered. ADHD symptom levels were not different in adolescents with moderate/high or low risk for DSPS or insomnia.Keywords: delayed sleep phase, insomnia, subjective sleep measures, actigraphy

Lanyi Lin,1 Gail Somerville,2 Johanne Boursier,3 Jose Arturo Santisteban,1 Reut Gruber1,4 1Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montréal, QC H4H 1R3, Canada; 2Riverside School Board, Saint-Hubert, QC J3Y 0N7, Canada; 3Heritage High School, Riverside School Board, St. Hubert, QC J3Y 3S3, Canada; 4Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, QC H4H 1R3, CanadaCorrespondence: Reut GruberDouglas Mental Health University Institute, 6875 LaSalle Boulevard, Verdun, Montréal, QC H4H 1R3, CanadaTel +1 514 761 6131 ext 3476Fax +1 514 762 3858Email reut.gruber@douglas.mcgill.caPurpose: To examine the associations between objective measures of sleep during the school week and academic achievement in mathematics and languages in typically developing adolescent girls.Methods: Eighty adolescent girls aged 12– 17 years (M=14.74, SD=1.3) participated. For five consecutive weeknights, sleep was assessed in the home environment using an actigraph. Academic achievement was assessed using report card grades.Results: Girls who obtained on average less sleep than the recommended amount of 8 to 10 hrs per night had significantly lower grades in mathematics compared to girls who obtained the recommended amount (77.61 vs 86.16, respectively; ηp2=0.11). Hierarchical regression analyses adjusted for age, pubertal status, and socioeconomic status revealed that longer average sleep time was significantly associated with higher grades in mathematics (B=4.78, 95% CI [2.03,7.53]). No significant associations were found between sleep variables and grades in languages.Conclusion: Longer average weekday sleep duration is associated with academic achievement of adolescent girls in mathematics.Keywords: actigraphy, adolescence, grades, report card, gender

Dafna Wajszilber,1 José Arturo Santiseban,1,2 Reut Gruber1,2 1Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, Quebec, Canada; 2Attention Behavior and Sleep Lab, Douglas Research Center, Montréal, Quebec, Canada Abstract: Attention deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders in childhood, enduring through adolescence and adulthood and presenting with symptoms of inattention, hyperactivity, and/or impulsivity and significantly impairing functioning. Primary sleep disorders such as sleep-disordered breathing, restless leg syndrome, circadian rhythm sleep disorder, insomnia, and narcolepsy are commonly comorbid in these individuals but not often assessed and are therefore often left untreated. Sleep disturbances in individuals with ADHD can result in significant functional impairments that affect mood, attention, behavior, and ultimately school/work performance and quality of life. Previous reviews have described findings related to sleep but have neglected to examine potential impacts of these sleep disorders and ADHD on daytime functioning. This review investigates empirical findings pertaining to sleep abnormalities and related cognitive, behavioral, emotional, and physical impairments in individuals with ADHD and comorbid primary sleep disorders across the life span. It discusses implications to management and highlights existing limitations and recommended future directions. Keywords: ADHD, impairments, sleep-disordered breathing, restless leg syndrome, circadian rhythm sleep disorders, insomnia, narcolepsy

Jamie Cassoff,1,2 Sabrina T Wiebe,1,2 Reut Gruber1,21Attention, Behavior and Sleep Lab, Douglas Mental Health University Institute, Montréal, Quebec, Canada; 2McGill University, Montréal, Quebec, CanadaAbstract: Attention-deficit/hyperactivity disorder (ADHD) is often associated with comorbid sleep disturbances. Sleep disturbances may be a risk factor for development of the disorder, a symptom of the disorder, or a comorbid condition affected by a similar psychopathology. Various studies have examined the impact of sleep deprivation on the presence/exacerbation of ADHD symptomology, as well as longitudinal and concurrent associations between different sleep disturbances and ADHD, yet the notion of sleep disturbances as a predecessor to ADHD remains unclear. As such, this review examines the evidence for sleep disturbances as a risk factor for the development of ADHD, as well as the mechanisms underlying the association between sleep patterns and ADHD. Additionally, clinical implications regarding the comorbid nature of sleep disturbances and ADHD will be considered.Keywords: sleep disturbances, ADHD, development

Sabrina T Wiebe, Jamie Cassoff, Reut GruberAttention, Behavior and Sleep Laboratory, Douglas Mental Health University Institute, Montréal; McGill University, Montréal, Quebec, CanadaAbstract: Psychological disorders, particularly mood disorders, such as unipolar depression, are often accompanied by comorbid sleep disturbances, such as insomnia, restless sleep, and restricted sleep duration. The nature of the relationship between unipolar depression and these sleep disturbances remains unclear, as sleep disturbance may be a risk factor for development, an initial manifestation of the disorder, or a comorbid condition affected by similar mechanisms. Various studies have examined the impact of sleep deprivation on the presence of (or exacerbation of) depressive symptoms, and have examined longitudinal and concurrent associations between different sleep disturbances and unipolar depression. This review examines the evidence for sleep disturbances as a risk factor for the development and presence of depression, as well as examining common underlying mechanisms. Clinical implications pertaining to the comorbid nature of various sleep patterns and depression are considered.Keywords: sleep, depression, insomnia, sleep deprivation, development

Reut Gruber1,2, Sonia Michaelsen1,2, Lana Bergmame2, Sonia Frenette3,4, Oliviero Bruni5, Laura Fontil2, Julie Carrier3,41Department of Psychiatry, McGill University, 2Attention, Behavior and Sleep Lab, Douglas Mental Health University Institute, 3Centre du Sommeil et des Rythmes Biologiques, Hôpital du Sacré-Coeur de Montréal, 4Departement de Psychologie, Université de Montréal, Montreal, QC, Canada; 5Child Neuropsychiatry Unit, University of Rome, Rome, ItalyPurpose: Pediatric, clinical, and research data suggest that insufficient sleep causes tiredness and daytime difficulties in terms of attention-focusing, learning, and impulse modulation in children with attention deficit hyperactivity disorder (ADHD) or in those with ADHD and primary sleep disorders. The aim of the present study was to examine whether sleep duration was associated with ADHD-like symptoms in healthy, well-developing school-aged children.Patients and methods: Thirty-five healthy children (20 boys, 15 girls), aged 7–11 years participated in the present study. Each child wore an actigraphic device on their nondominant wrist for two nights prior to use of polysomnography to assess their typical sleep periods. On the third night, sleep was recorded via ambulatory assessment of sleep architecture in the child's natural sleep environment employing portable polysomnography equipment. Teachers were asked to report symptoms of inattention and hyperactivity/impulsivity on the revised Conners Teacher Rating Scale.Results: Shorter sleep duration was associated with higher levels of teacher-reported ADHD-like symptoms in the domains of cognitive problems and inattention. No significant association between sleep duration and hyperactivity symptoms was evident.Conclusion: Short sleep duration was found to be related to teacher-derived reports of ADHD-like symptoms of inattention and cognitive functioning in healthy children.Keywords: ADHD-like symptoms, sleep duration, inattention, hyperactivity, impulsivity, healthy school-aged children