ADHD subtypes are associated differently with circadian rhythms of motor activity, sleep disturbances, and body mass index in children and adolescents: a case–control study

Oct 16, 2020European child & adolescent psychiatry

Different ADHD types relate to daily activity patterns, sleep problems, and body weight in children and teens

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Abstract

One-hundred twenty children and adolescents were assessed for circadian patterns of motor activity related to ADHD.

ADHD patients exhibited a trend towards eveningness and reported greater sleep disturbances compared to controls.
Children with ADHD-combined subtype had significantly higher mean motor activity and a notable delay in bedtime.
In ADHD-combined patients, hyperactivity symptoms were significantly linked to at least 5 hours of activity.
Increased fragmentation of the circadian pattern was associated with inattention symptoms in ADHD-inattentive patients.
ADHD-inattentive patients showed a significant increase in body mass index by 2.52 kg/m² compared to controls.

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To date, few studies have examined the circadian pattern of motor activity in children and adolescents newly diagnosed with attention-deficit/hyperactivity disorder (ADHD). The objective was to study the circadian pattern of motor activity in subjects with ADHD (medication naïve) and to investigate the relationships between alterations in circadian patterns, the ADHD subtype (combined or inattentive), sleep disturbances and body mass index (BMI). One-hundred twenty children and adolescents (60 medication naïve ADHD and 60 controls) were included in a gender- and age-matched case-control study. ADHD was diagnosed according to the DSM-IV-TR, the Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, and the Conner's Parents Rating Scale-Revised. Circadian rhythms of motor activity and sleep parameters were measured using actigraphy and the Sleep Disturbance Scale for Children. BMI and dietary intake were also evaluated. ADHD patients showed a trend towards eveningness and greater sleep disturbances than controls. Additionally, patients with ADHD-combined had significantly higher mean values of motor activity and showed a significant delay in bedtime. Furthermore, among ADHD-C patients hyperactivity symptoms were significantly associated with the least 5 h of activity. Regarding patients with ADHD-inattentive, increased fragmentation of the circadian pattern was associated with inattention symptoms, and they also showed a significant increase in BMI of 2.52 kg/m[95% CI 0.31, 4.73] in comparison with controls. Our findings highlight the potential use of actigraphy as a clinical tool to aid in the diagnosis of ADHD. It should be noted that evaluating motor activity variables could also allow the differentiation between ADHD subtypes. 2

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ADHD subtypes are associated differently with circadian rhythms of motor activity, sleep disturbances, and body mass index in children and adolescents: a case–control study

Abstract

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