Longitudinal assessment of NREM sleep EEG in typically developing and medication-free ADHD adolescents: first year results

Abstract

Objective: Clinical observation and structural MRI studies suggest that delayed brain maturation is a major cause of attention deficit hyperactivity disorder (ADHD). Sleep electroencephalogram (EEG) which exhibits major changes across adolescence provides an opportunity to investigate brain electrophysiology evidence for maturational delay. We present data from an ongoing longitudinal study of sleep EEG in medication-free ADHD and typically developing adolescents to investigate brain electrophysiological evidence for this maturational delay.

Methods: Nine adolescents diagnosed with ADHD (combined presentation, DSM-V criteria, mean age 12.39 ± 0.61 years, 2 females), and nine typically developing controls (12.08 ± 0.35 years, 4 females) were recruited. Subjects underwent an adaptation night and all night polysomnography twice yearly at the Laboratory.

Results: Basic sleep structure did not differ between the ADHD and control groups. In addition, we found no group differences on delta power (p = 0.77), but found a possible trend toward higher theta power (p = 0.057) for the ADHD group. The decline of standardized delta power across the 4 non-rapid eye movement (NREM) periods differed by group (p < 0.05) with the percent delta power in the first NREM period being lower in the ADHD group.

Conclusions: Our data support the preponderant evidence that basic sleep structure is unaltered with ADHD. Our data do suggest altered sleep homeostatic recuperative processes in ADHD. The theta findings from the first two recordings are suggestive of a maturational delay associated with ADHD, but follow-up data-points are needed.

Keywords: ADHD; Adolescents; Brain development; EEG spectra; Sleep.