Hypersomnia Foundation

Posts Tagged 'ADHD'

Meet the Doctor, Doctor Lecendreux

Meet Michel Lecendreux, MD, child psychiatrist, University Hospital, Robert-Debré, Paris, France, and newest member of the Hypersomnia Foundation’s Medical Advisory Board.

For those of you who watched the Livestream or attended the Denver Regional Conference in person, you may remember Dr. Lecendreux. He gave a fascinating presentation on what hypersomnia looks like in children and adolescents and told us that hypersomnia is often unrecognized and undiagnosed. He also shared some of his research findings, which indicate that many of these children and adolescents have emotional difficulties, have behavioral or cognitive problems (attention deficit hyperactivity disorder–ADHD–symptoms), have decreased academic performance, become loners, and avoid athletic activities.

Dr. Lecendreux is involved in pediatric sleep research, and he also cares for children and adolescents in the clinic. He is the head of the Pediatric Sleep Centre at Hospital Robert-Debré in Paris. His main fields of interests are sleep, alertness, narcolepsy, and ADHD.

Dr. Lecendreux is one of the directors of the French Reference Center for Pediatric Narcolepsy, Idiopathic Hypersomnias and Kleine-Levin Syndrome in the Department of Neurophysiology and is a member of numerous international sleep societies.

Dr. Lecendreux has written many journal articles, editorials, chapters and books in the area of pediatric narcolepsy, ADHD and sleep and is an editorial board member for the Journal of Attention Disorders. Together with his colleagues, he reported on the role of vigilance impairment in children ADHD and insisted on the role of iron deficiency in the pathophysiology of ADHD. Dr. Lecendreux is also involved in numerous activities, including teaching medicine and education and research on attention disorders at the Faculty of Medicine of Paris.

So now that you know all about Dr. Lecendreux, don’t forget to write into our Ask the Doctor column and ask him questions pertaining to children or adolescents and hypersomnia.

Posted in: SomnusNooze

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ADHD Symptoms in Children with Narcolepsy

Background
Compared with adults with narcolepsy, children with narcolepsy often have higher levels of excessive daytime sleepiness (EDS), are more likely to have cataplexy without a trigger, and are more likely to have a secondary form of narcolepsy. The EDS and disturbed night-time sleep of narcolepsy may lead to reduced quality of life and lower academic performance because of the associated obesity, depression, and attention-deficit/hyperactivity disorder (ADHD) that often accompany narcolepsy. ADHD has two main types of symptoms–inattention (such as trouble paying attention or organizing tasks or Sleepy childbeing easily distracted) and hyperactivity-impulsivity (such as fidgeting or trouble staying seated or waiting for a turn). Other research has shown that adults with narcolepsy have ADHD at a higher rate than the typical adult population, but no one has studied this in children.

Who were the participants and what did they do?
All children with narcolepsy who were seen at one of the national narcolepsy centers in France over a four-year period were invited to participate in this study. Children with narcolepsy (86 with cataplexy [NwC] and 22 without [Nw/oC]) and children without narcolepsy  (67 control subjects) were recruited. With the help of their parents if necessary, these children completed several questionnaires, including the Pediatric Daytime Sleepiness Scale, Chalder Fatigue Scale, the ADHD Rating Scale, and the Children’s Depression Inventory.

Who were the researchers and what did they do?
The researchers were physicians from the four national narcolepsy centers in France. They examined each of the participants, calculated the subjects’ body mass index (weight divided by height, in meters squared), and prescribed treatment for narcolepsy for those subjects who had narcolepsy. They did not specifically treat the symptoms of ADHD, although many of the wake-promoting treatments for narcolepsy are also used for ADHD. They reviewed the patients’ responses to the questionnaires.

What were the results of the study?
sleepy teenThe children ranged in age from 6.5 to 17.9 years. The children with Nw/oC were, on average, younger that those in the other two groups. Slightly more than half of the children with narcolepsy were overweight, as compared with 10% of the control subjects. About 20% of patients with narcolepsy were obese, compared with 4% of the control subjects. Of the control subjects, 5% to 6% had clinically significant ADHD symptoms, as did 30% of patients with NwoC and 15% of patient with NwC. Those with higher levels of ADHD symptoms had higher rates of depression and decreased quality of life.

With regard to medications, 73% of children with Nw/oC were receiving treatment (> 90% with stimulants, none with sodium oxybate) and 67% of children with NwC were receiving treatment (>90% with stimulants, 14% with sodium oxybate). “Moreover, in contrast to narcolepsy symptoms, for which some benefit of therapy was observed, ADHD symptoms appeared to be largely unresponsive to psychostimulant therapy. It remains unclear, therefore, whether psychostimulant therapy is effective for ADHD symptoms in pediatric narcolepsy and whether hypersomnias and ADHD may or may not share a common underlying pathophysiology.”

Lecendreux M, Lavault S, Lopez R, Inocente CO, Konofal E, Cortese S, Franco P, Arnulf I, Dauvilliers Y. Attention-deficit/hyperactivity disorder (ADHD) symptoms in pediatric narcolepsy: a cross-sectional study. Sleep 2015;38(8):1285-95.

Reviewed by Dr. Isabelle Arnulf.

Posted in: narcolepsy, Research

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