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Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD

LINDITA IMERAJ UGent, Inge Antrop UGent, Herbert Roeyers UGent, Ellen Deschepper UGent, Sarah Bal UGent and Dirk Deboutte (2011) EUROPEAN CHILD & ADOLESCENT PSYCHIATRY. 20(8). p.381-392
abstract
Previous studies suggest an altered circadian regulation of arousal in children with attention-deficit hyperactivity disorder (ADHD) as measured by activity, circadian preference, and sleep-wake patterns. Although heart rate is an important measure to evaluate arousal profiles, to date it is unknown whether 24-h heart rate patterns differentiate between children with and without ADHD. In this study, 24-h heart rate data were collected in 30 non-medicated children with ADHD (aged 6-11) and 30 sex-, class-, and age-matched normal controls in their naturalistic home and school setting, during 5 days. Simultaneously, 24-h activity patterns were registered. Confounding effects of demographic variables (e.g., age, sex, BMI, pubertal stage) and comorbid internalizing and externalizing problems on heart rate levels were additionally assessed. Longitudinal analysis showed that heart rate levels were overall higher in the ADHD group (p < 0.01)-with the largest effects during afternoon and night-in a model controlling for age. Other factors did not significantly contribute to variations in heart rate levels. Compared to controls, children with ADHD showed higher activity levels during daytime (especially early afternoon), but not during nighttime (p < 0.05). Post hoc analyses showed that environmental effects might influence daytime variations. Findings suggest an autonomic imbalance in children with ADHD as compared to controls, with higher heart rate levels in the ADHD group. Nighttime tachycardia in this group could not be explained by nighttime activity levels or comorbid externalizing/internalizing problems. Further research on autonomic functioning in ADHD is recommended because of the major impact of higher resting heart rate on health outcomes.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
DEFICIT-HYPERACTIVITY DISORDER, ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, CORTICAL COGNITIVE FUNCTION, ANTISOCIAL-BEHAVIOR, CLASSROOM-BEHAVIOR, PHYSICAL-ACTIVITY, SLEEP, METAANALYSIS, MORTALITY, PSYCHOPHYSIOLOGY, ADHD, Arousal, Circadian, Heart rate, Activity
journal title
EUROPEAN CHILD & ADOLESCENT PSYCHIATRY
Eur. Child Adolesc. Psych.
volume
20
issue
8
pages
381 - 392
Web of Science type
Article
Web of Science id
000293022100002
JCR category
PEDIATRICS
JCR impact factor
2.821 (2011)
JCR rank
18/113 (2011)
JCR quartile
1 (2011)
ISSN
1018-8827
DOI
10.1007/s00787-011-0188-y
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1893590
handle
http://hdl.handle.net/1854/LU-1893590
date created
2011-08-26 16:10:04
date last changed
2015-06-17 09:49:58
@article{1893590,
  abstract     = {Previous studies suggest an altered circadian regulation of arousal in children with attention-deficit hyperactivity disorder (ADHD) as measured by activity, circadian preference, and sleep-wake patterns. Although heart rate is an important measure to evaluate arousal profiles, to date it is unknown whether 24-h heart rate patterns differentiate between children with and without ADHD. In this study, 24-h heart rate data were collected in 30 non-medicated children with ADHD (aged 6-11) and 30 sex-, class-, and age-matched normal controls in their naturalistic home and school setting, during 5 days. Simultaneously, 24-h activity patterns were registered. Confounding effects of demographic variables (e.g., age, sex, BMI, pubertal stage) and comorbid internalizing and externalizing problems on heart rate levels were additionally assessed. Longitudinal analysis showed that heart rate levels were overall higher in the ADHD group (p {\textlangle} 0.01)-with the largest effects during afternoon and night-in a model controlling for age. Other factors did not significantly contribute to variations in heart rate levels. Compared to controls, children with ADHD showed higher activity levels during daytime (especially early afternoon), but not during nighttime (p {\textlangle} 0.05). Post hoc analyses showed that environmental effects might influence daytime variations. Findings suggest an autonomic imbalance in children with ADHD as compared to controls, with higher heart rate levels in the ADHD group. Nighttime tachycardia in this group could not be explained by nighttime activity levels or comorbid externalizing/internalizing problems. Further research on autonomic functioning in ADHD is recommended because of the major impact of higher resting heart rate on health outcomes.},
  author       = {IMERAJ, LINDITA and Antrop, Inge and Roeyers, Herbert and Deschepper, Ellen and Bal, Sarah and Deboutte, Dirk},
  issn         = {1018-8827},
  journal      = {EUROPEAN CHILD \& ADOLESCENT PSYCHIATRY},
  keyword      = {DEFICIT-HYPERACTIVITY DISORDER,ATTENTION-DEFICIT/HYPERACTIVITY DISORDER,CORTICAL COGNITIVE FUNCTION,ANTISOCIAL-BEHAVIOR,CLASSROOM-BEHAVIOR,PHYSICAL-ACTIVITY,SLEEP,METAANALYSIS,MORTALITY,PSYCHOPHYSIOLOGY,ADHD,Arousal,Circadian,Heart rate,Activity},
  language     = {eng},
  number       = {8},
  pages        = {381--392},
  title        = {Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD},
  url          = {http://dx.doi.org/10.1007/s00787-011-0188-y},
  volume       = {20},
  year         = {2011},
}

Chicago
IMERAJ, LINDITA, Inge Antrop, Herbert Roeyers, Ellen Deschepper, Sarah Bal, and Dirk Deboutte. 2011. “Diurnal Variations in Arousal: a Naturalistic Heart Rate Study in Children with ADHD.” European Child & Adolescent Psychiatry 20 (8): 381–392.
APA
IMERAJ, L., Antrop, I., Roeyers, H., Deschepper, E., Bal, S., & Deboutte, D. (2011). Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD. EUROPEAN CHILD & ADOLESCENT PSYCHIATRY, 20(8), 381–392.
Vancouver
1.
IMERAJ L, Antrop I, Roeyers H, Deschepper E, Bal S, Deboutte D. Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD. EUROPEAN CHILD & ADOLESCENT PSYCHIATRY. 2011;20(8):381–92.
MLA
IMERAJ, LINDITA, Inge Antrop, Herbert Roeyers, et al. “Diurnal Variations in Arousal: a Naturalistic Heart Rate Study in Children with ADHD.” EUROPEAN CHILD & ADOLESCENT PSYCHIATRY 20.8 (2011): 381–392. Print.