Avaliação da qualidade do sono em pacientes com Transtorno do Déficit de Atenção e Hiperatividade (TDAH) primário e TDAH como comorbidade da epilepsia

Abstract

Objective/Background: Either epilepsy or attention deficit hyperactivity disorder (ADHD) can influence in different ways sleep organization. The aim of this study is to evaluate quality of sleep in children and adolescents with ADHD and epilepsy and to analyze the influence of methylphenidate on sleep organization. Methods: This is an observational, cross sectional study, with children and adolescents with epilepsy, seizure free for at least 3 months, and with ADHD, selected from the epilepsy and child neurology outpatient clinic of a tertiary hospital in Brazil. Patients were divided into four different groups with 21 patients each: ADHD as comorbidity of epilepsy using methylphenidate; ADHD as comorbidity of epilepsy not using methylphenidate; only ADHD and a health control group. All participants were evaluated with the Sleep Disturbance Scale for Children and monitored with actigraphy for five nights. Results: Actigraphic analysis showed a higher number of night awakenings at the epilepsy/ADHD groups, most prominent at the group without methylphenidate (p=0,001). Parental reports demonstrated a higher risk for sleep disturbances at the epilepsy/ADHD without methylphenidate and ADHD groups (p<0,001). Conclusion: Primary ADHD or ADHD as a comorbidity of epilepsy impairs sleep organization in children. The use of methylphenidate seems to improve sleep quality.