ADHD subtypes are associated differently with circadian rhythms of motor activity, sleep disturbances, and body mass ind
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ORIGINAL CONTRIBUTION
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 María Fernanda Zerón‑Rugerio1,2 · Tannia Valeria Carpio‑Arias3 · Estrella Ferreira‑García4 · Antoni Díez‑Noguera5 · Trinitat Cambras5 · Jose Ángel Alda6,7 · Maria Izquierdo‑Pulido1,2 Received: 31 May 2020 / Accepted: 5 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract 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/m2 [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. Keywords ADHD · Circadian rhythms · Circadian misalignment · Hyperactivity · Inattention · Obesity
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00787-020-01659-5) contains supplementary material, which is available to authorized users. Maria Fernanda Zeron-Rugerio and Tannia Valeria Carpio-Arias had similar contributions. Jose Ángel Alda and Maria Izquierdo-Pulido have shared senior authorship. * Maria Izquierdo‑Pulido [email protected] Extended author information available on the last page of the article
Attention Deficit Hyperactivity Disorder (ADHD) is a childhood neurodevelopmental disorder and is one of the most common disorders in this stage in life [1], which can often persist into adulthoo
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