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Abstract(s)
Introdução: A Perturbação de Hiperatividade e Défice de Atenção (PHDA) é uma das
Perturbações Neurocomportamentais mais comuns em crianças e adolescentes, podendo
persistir na idade adulta. Esta perturbação caracteriza-se pela hiperatividade,
impulsividade e/ou desatenção e estima-se que a sua prevalência ronde os 7,2% na idade
pediátrica. A identificação precoce de fatores que possam influenciar esta condição é
relevante para uma intervenção eficaz, proporcionando uma melhoria na qualidade de
vida e funcionamento diário destes pacientes. No que diz respeito ao sono, é consensual
que o mesmo tem uma função restauradora e essencial nos processos de aprendizagem,
consolidação da memória e na melhoria do humor. No que concerne às Perturbações do
Sono, estas, são condições que podem ter repercussões negativas na função cognitiva,
comportamental e emocional dos indivíduos, originando um possível prejuízo funcional
destes.
Objetivo: Esta dissertação tem por objetivo realizar uma revisão de literatura sobre as
Perturbações do Sono na Perturbação de Hiperatividade e Défice de Atenção. Entender
se existe alguma relação entre estas perturbações poderá dar origem a uma nova
abordagem para gerir cada uma destas patologias. Deste modo, pretende-se, com esta
revisão bibliográfica, adquirir um melhor conhecimento sobre ambas as patologias e a
sua relação.
Métodos: Para garantir uma pesquisa abrangente e atualizada, analisou-se artigos e
estudos, entre 2014 e 2024, de duas bases de dados: Pubmed e b-on. Para a seleção de
artigos optou-se por utilizar o método PRISMA para assegurar uma seleção mais fiável e
rigorosa. A população em estudo abrange crianças e adolescentes até aos 18 anos, de
várias nacionalidades, etnias e ambos os géneros, com diagnóstico de PHDA. Além do
mais, procurou-se incluir artigos que abordassem a existência de uma possível relação
entre a PHDA e as Perturbações do Sono, tendo sido incluídos alguns estudos que
abordam a prevalência de Perturbações do Sono, tanto em crianças e adolescentes
saudáveis, como com PHDA.
Resultados: De entre 323 resultados, foram selecionados 36 artigos para análise na
íntegra, após aplicação dos critérios de inclusão e exclusão. Deste modo, os resultados
foram agrupados em quatro categorias: Perturbação de Hiperatividade e Défice de
Atenção, Características do Sono, Perturbações do Sono e Outros parâmetros.
Relativamente à primeira categoria mencionada, observou-se que existe um risco
aumentado de ter Perturbações do Sono em indivíduos com PHDA, assim como existem diferenças entras as diferentes apresentações desta perturbação. Assim sendo, a PHDA
de apresentação combinada apresenta mais problemas severos do sono, a PHDA de
apresentação predominantemente de desatenção e a combinada estão associadas a
dificuldade em adormecer e a apresentação predominantemente de hiperatividade
associa-se a mais comportamentos de Parassónia. Quanto às Características do Sono,
estes indivíduos parecem apresentar maior frequência de despertares noturnos,
fragmentação do sono, aumento da latência do sono, alterações do ciclo sono-vigília,
menor eficiência, qualidade e duração do sono e dificuldade em adormecer. Além do
mais, foi relatada a presença de algumas Perturbações do Sono em crianças com PHDA,
não tendo sido possível compreender quais as mais frequentes. Por sua vez, foi
encontrada uma prevalência elevada de uso de medicação para tratamento de
Perturbações ou alterações do Sono, existindo um risco superior de indivíduos com
PHDA apresentarem tratamento farmacológico para estas alterações. Associações
longitudinais também foram encontradas, referindo que Perturbações do Sono na
infância e adolescência predizem aumento de sintomas da PHDA no futuro e vice-versa,
sendo uma associação bidirecional.
Conclusão: A partir desta revisão de literatura, demonstrou-se que as Perturbações do
Sono são frequentes em crianças e adolescentes com PHDA e estas perturbações
encontram-se associadas nesta população. No entanto, são notórias algumas lacunas
nesta área de investigação e sugere-se uma pesquisa mais dirigida de forma a colmatar
as dúvidas ainda existentes. Desta forma, é necessário entender quais as diferenças desta
questão entre o género masculino e feminino, assim como entre crianças e adolescentes.
Para além disso, é crucial entender e perceber quais as Perturbações do Sono mais
frequentes nesta população, de modo a orientar uma melhor abordagem e
acompanhamento destes indivíduos, tal como uma avaliação inicial mais dirigida. Posto
isto, considera-se que ainda existe um longo caminho de pesquisa que irá esclarecer e
desbravar a associação entre a PHDA e as Perturbações do Sono.
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurobehavioral disorders in children and adolescents and can persist into adulthood. This disorder is characterised by hyperactivity, impulsivity and/or inattention and its prevalence is estimated at around 7.2% in children. The early identification of factors that may influence this condition is relevant for effective intervention, providing an improvement in the quality of life and daily functioning of these patients. Regarding sleep, there is a consensus that it has a restorative and essential function in learning processes, memory consolidation and mood improvement. Sleep disorders are conditions that can have negative repercussions on the cognitive, behavioural and emotional function of individuals, leading to possible functional impairment. Objective: The aim of this dissertation is to carry out a literature review on Sleep Disorders in Attention Deficit Hyperactivity Disorder. Understanding whether there is any relationship between these disorders could lead to a new approach to managing each of these pathologies. The aim of this literature review is to gain a better understanding of both disorders and their relationship. Methods: To ensure a comprehensive and up-to-date search, we analysed articles and studies from 2014 to 2024, from two databases: Pubmed and b-on. The PRISMA method was used to select the articles to ensure a more reliable and rigorous selection. The study population includes children and adolescents up to the age of 18, of various nationalities, ethnicities and both genders, with a diagnosis of ADHD. In addition, we sought to include articles that addressed the existence of a possible relationship between ADHD and Sleep Disorders and included some studies that address the prevalence of Sleep Disorders both in healthy children and adolescents as with ADHD. Results: Out of 323 results, 36 articles were selected for full analysis after applying the inclusion and exclusion criteria. The results were grouped into four categories: Attention Deficit Hyperactivity Disorder, Sleep Characteristics, Sleep Disorders and Other Parameters. About the first category mentioned, it was observed that there is an increased risk of having Sleep Disorders in individuals with ADHD, as well as differences between the different presentations of this disorder. Thus, ADHD with a combined presentation has more severe sleep problems, ADHD with a predominantly inattentive and combined presentation is associated with difficulty falling asleep and the predominantly hyperactive presentation is associated with more parasomnia behaviours As for Sleep Characteristics, these individuals seem to have a higher frequency of nocturnal awakenings, sleep fragmentation, increased sleep latency, alterations in the sleep-wake cycle, lower sleep efficiency, quality and duration and difficulty falling asleep. Furthermore, the presence of some Sleep Disorders in children with ADHD has been reported, but it has not been possible to understand which are the most frequent. In turn, a high prevalence of medication uses to treat sleep disorders or alterations was found, with a higher risk of individuals with ADHD having pharmacological treatment for these alterations. Longitudinal associations have also been found, stating that sleep disorders in childhood and adolescence predict an increase in ADHD symptoms in the future and vice versa, making it a bidirectional association. Conclusion: This literature review has shown that sleep disorders are frequent in children and adolescents with ADHD and that these disorders are associated in this population. However, there are some notable gaps in this area of research and more targeted research is suggested to resolve the doubts that still exist. It is therefore necessary to understand the differences in this issue between males and females, as well as between children and adolescents. In addition, it is crucial to understand and realise which Sleep Disorders are most common in this population, to guide a better approach and monitoring of these individuals, as well as a more targeted initial assessment. Having said this, we believe that there is still a long road of research that will clarify and unravel the association between ADHD and Sleep Disorders.
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurobehavioral disorders in children and adolescents and can persist into adulthood. This disorder is characterised by hyperactivity, impulsivity and/or inattention and its prevalence is estimated at around 7.2% in children. The early identification of factors that may influence this condition is relevant for effective intervention, providing an improvement in the quality of life and daily functioning of these patients. Regarding sleep, there is a consensus that it has a restorative and essential function in learning processes, memory consolidation and mood improvement. Sleep disorders are conditions that can have negative repercussions on the cognitive, behavioural and emotional function of individuals, leading to possible functional impairment. Objective: The aim of this dissertation is to carry out a literature review on Sleep Disorders in Attention Deficit Hyperactivity Disorder. Understanding whether there is any relationship between these disorders could lead to a new approach to managing each of these pathologies. The aim of this literature review is to gain a better understanding of both disorders and their relationship. Methods: To ensure a comprehensive and up-to-date search, we analysed articles and studies from 2014 to 2024, from two databases: Pubmed and b-on. The PRISMA method was used to select the articles to ensure a more reliable and rigorous selection. The study population includes children and adolescents up to the age of 18, of various nationalities, ethnicities and both genders, with a diagnosis of ADHD. In addition, we sought to include articles that addressed the existence of a possible relationship between ADHD and Sleep Disorders and included some studies that address the prevalence of Sleep Disorders both in healthy children and adolescents as with ADHD. Results: Out of 323 results, 36 articles were selected for full analysis after applying the inclusion and exclusion criteria. The results were grouped into four categories: Attention Deficit Hyperactivity Disorder, Sleep Characteristics, Sleep Disorders and Other Parameters. About the first category mentioned, it was observed that there is an increased risk of having Sleep Disorders in individuals with ADHD, as well as differences between the different presentations of this disorder. Thus, ADHD with a combined presentation has more severe sleep problems, ADHD with a predominantly inattentive and combined presentation is associated with difficulty falling asleep and the predominantly hyperactive presentation is associated with more parasomnia behaviours As for Sleep Characteristics, these individuals seem to have a higher frequency of nocturnal awakenings, sleep fragmentation, increased sleep latency, alterations in the sleep-wake cycle, lower sleep efficiency, quality and duration and difficulty falling asleep. Furthermore, the presence of some Sleep Disorders in children with ADHD has been reported, but it has not been possible to understand which are the most frequent. In turn, a high prevalence of medication uses to treat sleep disorders or alterations was found, with a higher risk of individuals with ADHD having pharmacological treatment for these alterations. Longitudinal associations have also been found, stating that sleep disorders in childhood and adolescence predict an increase in ADHD symptoms in the future and vice versa, making it a bidirectional association. Conclusion: This literature review has shown that sleep disorders are frequent in children and adolescents with ADHD and that these disorders are associated in this population. However, there are some notable gaps in this area of research and more targeted research is suggested to resolve the doubts that still exist. It is therefore necessary to understand the differences in this issue between males and females, as well as between children and adolescents. In addition, it is crucial to understand and realise which Sleep Disorders are most common in this population, to guide a better approach and monitoring of these individuals, as well as a more targeted initial assessment. Having said this, we believe that there is still a long road of research that will clarify and unravel the association between ADHD and Sleep Disorders.
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Keywords
Adolescentes Crianças Perturbações do Sono Phda