Attention deficit hyperactivity disorder (ADHD) is commonly associated with sleep problems, possibly due to shared pathophysiology. Microstructural sleep electroencephalographic (EEG) alterations may likely represent markers of disordered cortical maturation in ADHD, although literature data are still conflicting, deserving further assessment. After having systematically reviewed the literature, we included 11 studies from 598 abstracts, and assessed 23 parameters of cyclic alternating pattern (CAP), four parameters of sleep EEG power and one parameter of sleep graphoelements through 29 meta-analyses and, when possible, univariate meta-regressions. Slow wave activity (SWA) in ADHD was significantly higher in early childhood and lower in late childhood/adolescence compared to controls, with an inversion point at 10 years. Total CAP rate and CAP A1 index in non-rapid eye movement (NREM) stage 2 sleep, and CAP A1 rate in NREM sleep were significantly lower in ADHD patients than controls. SWA and CAP A1 changes are therefore possible markers of altered cortical maturation in ADHD, consistently with the neuropsychological deficits characterizing the disorder, likely fostering earlier detection of at-risk/milder conditions, and more tailored therapeutic interventions.

中文翻译：

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注意缺陷多动障碍儿童和青少年的睡眠脑电图微观结构：系统评价和荟萃分析

注意缺陷多动障碍 (ADHD) 通常与睡眠问题有关，可能是由于共同的病理生理学所致。微结构睡眠脑电图 (EEG) 改变可能代表 ADHD 皮质成熟障碍的标志物，尽管文献数据仍然相互矛盾，值得进一步评估。在系统回顾文献后，我们纳入了来自 598 篇摘要的 11 项研究，并通过 29 项荟萃分析评估了 23 项循环交替模式 (CAP) 参数、4 项睡眠 EEG 功率参数和 1 项睡眠图元参数，并在可能的情况下进行单变量分析元回归。与对照组相比，ADHD 的慢波活动 (SWA) 在儿童早期显着较高，而在儿童晚期/青春期则较低，反转点为 10 年。ADHD 患者在非快速眼动 (NREM) 阶段 2 睡眠中的总 CAP 率和 CAP A1 指数以及 NREM 睡眠中的 CAP A1 率在 ADHD 患者中显着低于对照组。因此，SWA 和 CAP A1 变化可能是 ADHD 皮质成熟改变的标志，与表征该疾病的神经心理缺陷一致，可能促进早期发现高危/轻度疾病，以及更量身定制的治疗干预。