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Sleep Problems in Children with Attention Deficit Hyperactivity Disorder

Year 2018, , 81 - 86, 11.12.2018
https://doi.org/10.18678/dtfd.489684

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders of childhood. ADHD; is a heterogeneous developmental disorder characterized by distraction, impulsivity, irritability and hyperactivity. Studies have shown that approximately 25-50% of children and adolescents with ADHD have sleep problems and have significantly more sleep problems than healthy controls. Studies in healthy children show that inadequate sleep causes attention and behavioral problems, impulsivity, and serious impairments in social and academic functioning. It was found that sleep problems were associated with increased risk for psychiatric problems. In ADHD patients, lifelong and personalized treatment strategies are needed for the treatment of sleep problems. Many patients with ADHD may present with primary sleep complaints, or many patients with sleep difficulties may present with ADHD complaints. Clinicians need interventions to manage both disorders. In this study, we focused on the most common sleep disorders in children with ADHD and their relation with media use and sleep as a popular subject were also investigated. It is aimed to present the most recent studies on the prevalence of sleep problems in children with ADHD, the relationship with the clinic and treatment strategies and to shed light on some possible research areas.

References

  • Polanczyk G, De Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-8.
  • Zorlu A, Unlu G, Cakaloz B, Zencir M, Buber A, Isildar Y. The prevalence and comorbidity rates of ADHD among school-age children in Turkey. J Atten Disord. 2015:1087054715577991.
  • Cortese S, Imperati D, Zhou J, Proal E, Klein RG, Mannuzza S, et al. White matter alterations at 33-year follow-up in adults with childhood attention-deficit/hyperactivity disorder. Biol Psychiatry. 2013;74(8):591-8.
  • Pliszka SR. The neuropsychopharmacology of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57(11):1385-90.
  • Mindell JA, Owens JA, Carskadon MA. Developmental features of sleep. Child Adolesc Psychiatr Clin N Am. 1999;8(4):695-725.
  • Paavonen EJ, Solantaus T, Almqvist F, Aronen ET. Four-year follow-up study of sleep and psychiatric symptoms in preadolescents: relationship of persistent and temporary sleep problems to psychiatric symptoms. J Dev Behav Pediatr. 2003;24(5):307-14.
  • Golan N, Shahar E, Ravid S, Pillar G. Sleep disorders and daytime sleepiness in children with attention-deficit/hyperactive disorder. Sleep. 2004;27(2):261-6.
  • Weiss MD, Salpekar J. Sleep problems in the child with attention-deficit hyperactivity disorder. CNS drugs. 2010;24(10):811-28.
  • Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J Am Acad Child Adolesc Psychiatry. 2009;48(9):894-908.
  • Becker SP, Cusick CN, Sidol CA, Epstein JN, Tamm L. The impact of comorbid mental health symptoms and sex on sleep functioning in children with ADHD. Eur Child Adolesc Psychiatry. 2018;27(3):353-65.
  • Bériault M, Turgeon L, Labrosse M, Berthiaume C, Verreault M, Berthiaume C, et al. Comorbidity of ADHD and anxiety disorders in school-age children: impact on sleep and response to a cognitive-behavioral treatment. J Atten Disord. 2018;22(5):414-24.
  • Abdelgadir IS, Gordon MA, Akobeng AK. Melatonin for the management of sleep problems in children with neurodevelopmental disorders: a systematic review and meta-analysis. Arch Dis Child. 2018:archdischild-2017-314181.
  • Cao H, Yan S, Gu C, Wang S, Ni L, Tao H, et al. Prevalence of attention-deficit/hyperactivity disorder symptoms and their associations with sleep schedules and sleep-related problems among preschoolers in mainland China. BMC Pediatr. 2018;18(1):70.
  • Melegari MG, Sette S, Vittori E, Mallia L, Devoto A, Lucidi F, et al. Relations Between Sleep and Temperament in Preschool Children With ADHD. J Atten Disord. 2018:1087054718757645.
  • Martin CA, Hiscock H, Rinehart N, Heussler HS, Hyde C, Fuller-Tyszkiewicz M, et al. Associations Between Sleep Hygiene and Sleep Problems in Adolescents With ADHD: A Cross-Sectional Study. J Atten Disord. 2018:1087054718762513.
  • Sung V, Hiscock H, Sciberras E, Efron D. Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family. Arch Pediatr Adolesc Med. 2008;162(4):336-42.
  • Kaynak DK. Bacak Sendromu ve Uykuda Periyodik Hareket Bozukluğu. Noro Psikiyatr Ars. 2007;44:95-100.
  • Cortese S, Konofal E, Lecendreux M, Arnulf I, Mouren M-C, Darra F, et al. Restless legs syndrome and attention-deficit/hyperactivity disorder: a review of the literature. Sleep. 2005;28(8):1007-13.
  • Cortese S, Lecendreux M, Dalla Bernardina B, Mouren MC, Sbarbati A, Konofal E. Attention-deficit/hyperactivity disorder, Tourette’s syndrome, and restless legs syndrome: the iron hypothesis. Med Hypotheses. 2008;70(6):1128-32.
  • Walters AS, Mandelbaum DE, Lewin DS, Kugler S, England SJ, Miller M, et al. Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD. Pediatr Neurol. 2000;22(3):182-6.
  • Sangal RB, Owens JA, Sangal J. Patients with attention-deficit/hyperactivity disorder without observed apneic episodes in sleep or daytime sleepiness have normal sleep on polysomnography. Sleep. 2005;28(9):1143-8.
  • Lecendreux M, Konofal E, Bouvard M, Falissard B, Mouren-Simeoni M-C. Sleep and alertness in children with ADHD. The Journal of Child Psychology and Psychiatry and Allied Disciplines. 2000;41(6):803-12.
  • Tarakçıoğlu MC, Kadak MT, Gürbüz GA, Poyraz BÇ, Erdoğan F, Aksoy UM. Evaluation of the Relationship Between Attention Deficit Hyperactivity Disorder Symptoms and Chronotype. Archives of Neuropsychiatry/Noropsikiatri Arsivi. 2018;55(1).
  • Vélez-Galarraga R, Guillen-Grima F, Crespo-Eguílaz N, Sánchez-Carpintero R. Prevalence of sleep disorders and their relationship with core symptoms of inattention and hyperactivity in children with attention-deficit/hyperactivity disorder. Eur J Paediatr Neurol. 2016;20(6):925-37.
  • Dillon JE, Blunden S, Ruzicka DL, Guire KE, Champine D, Weatherly RA, et al. DSM-IV diagnoses and obstructive sleep apnea in children before and 1 year after adenotonsillectomy. J Am Acad Child Adolesc Psychiatry. 2007;46(11):1425-36.
  • Sedky K, Bennett DS, Carvalho KS. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis. Sleep Med Rev. 2014;18(4):349-56.
  • Stein MA, Weiss M, Hlavaty L. ADHD treatments, sleep, and sleep problems: complex associations. Neurotherapeutics. 2012;9(3):509-17.
  • Sangal RB, Owens J, Allen AJ, Sutton V, Schuh K, Kelsey D. Effects of atomoxetine and methylphenidate on sleep in children with ADHD. Sleep. 2006;29(12):1573-85.
  • Prince JB, Wilens TE, Biederman J, Spencer TJ, Wozniak JR. Clonidine for sleep disturbances associated with attention-deficit hyperactivity disorder: a systematic chart review of 62 cases. J Am Acad Child Adolesc Psychiatry. 1996;35(5):599-605.
  • Rugino TA. Effect on primary sleep disorders when children with ADHD are administered guanfacine extended release. J Atten Disord. 2018;22(1):14-24.
  • Hoebert M, Van Der Heijden KB, Van Geijlswijk IM, Smits MG. Long‐term follow‐up of melatonin treatment in children with ADHD and chronic sleep onset insomnia. Journal of pineal research. 2009;47(1):1-7.
  • Weiss MD, Wasdell MB, Bomben MM, Rea KJ, Freeman RD. Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia. J Am Acad Child Adolesc Psychiatry. 2006;45(5):512-9.
  • Nathanson AI, Beyens I. The role of sleep in the relation between young children's mobile media use and effortful control. Br J Dev Psychol. 2018;36(1):1-21.
  • Ra CK, Cho J, Stone MD, De La Cerda J, Goldenson NI, Moroney E, et al. Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents. JAMA. 2018;320(3):255-63.
  • Genuneit J, Brockmann PE, Schlarb AA, Rothenbacher D. Media consumption and sleep quality in early childhood: Results from the Ulm SPATZ Health Study. Sleep Med. 2018;45:7-10.
  • Thoma VK, Schulz-Zhecheva Y, Oser C, Fleischhaker C, Biscaldi M, Klein C. Media Use, Sleep Quality, and ADHD Symptoms in a Community Sample and a Sample of ADHD Patients Aged 8 to 18 Years. J Atten Disord. 2018.
  • Becker SP, Lienesch JA. Nighttime media use in adolescents with ADHD: links to sleep problems and internalizing symptoms. Sleep Med. 2018;51:171-8.
  • Owens JA, Dalzell V. Use of the ‘BEARS’sleep screening tool in a pediatric residents' continuity clinic: a pilot study. Sleep Med. 2005;6(1):63-9.
  • Fiş NP, Arman A, Ay P, Topuzoğlu A, Güler AS, Gökçe İmren S, et al. Çocuk uyku alışkanlıkları anketinin Türkçe geçerliliği ve güvenilirliği. Anadolu Psikiyatri Derg. 2010;11(2):151-60.
  • Foundation NS. How much sleep do we really need? : National Sleep Foundation Arlington, VA; 2011.
  • Cortese S, Brown TE, Corkum P, Gruber R, O’Brien LM, Stein M, et al. Assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2013;52(8):784-96.
  • Cortese S, Holtmann M, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, et al. Practitioner review: current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents. J Child Psychol Psychiatry. 2013;54(3):227-46.

Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları

Year 2018, , 81 - 86, 11.12.2018
https://doi.org/10.18678/dtfd.489684

Abstract

Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB), çocukluk çağının en sık görülen nöropsikiyatrik bozukluklarındandır. DEHB; dikkat dağınıklığı, dürtüsellik, irritabilite ve hiperaktivite ile karakterize, heterojen, gelişimsel bir bozukluktur. Çalışmalar DEHB tanılı çocuk ve ergenlerin yaklaşık %25-50'sinin uyku problemlerine sahip olduğunu, sağlıklı kontrollere göre anlamlı olarak daha fazla uyku problemleri yaşadıklarını göstermektedir. Sağlıklı çocuklarda yapılan çalışmalar yetersiz uykunun dikkat ve davranışsal sorunlara, dürtüselliğe, sosyal ve akademik işlevsellikte ciddi bozulmalara yol açtığını göstermektedir. Uyku problemlerinin psikiyatrik problemler için artmış risk ile ilişkili olduğu bulunmuştur. DEHB hastalarında uyku sorunlarının tedavisinde hayat boyu uygulanabilir ve kişiselleştirilmiş tedavi stratejilerine ihtiyaç vardır. DEHB'si olan çoğu hasta birincil uyku şikâyetiyle başvurabilir veya uyku güçlüğü olan çoğu hasta da DEHB şikâyetleriyle karşımıza gelebilir. Klinisyenler her iki bozukluğun yönetimine yönelik müdahalelere ihtiyaç duymaktadır. Bu çalışmada DEHB tanılı çocuklarda en sık görülen uyku bozukluklarına odaklanıldı ve popüler bir konu olarak medya kullanımı ve uyku ile ilişkisi de incelendi. DEHB'li çocuklardaki uyku problemlerinin yaygınlığı, klinikle ilişkisi ve tedavi stratejileri ile ilgili en güncel çalışmaların sunulması ve olası bazı araştırma alanlarına ışık tutulması amaçlanmıştır.

References

  • Polanczyk G, De Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-8.
  • Zorlu A, Unlu G, Cakaloz B, Zencir M, Buber A, Isildar Y. The prevalence and comorbidity rates of ADHD among school-age children in Turkey. J Atten Disord. 2015:1087054715577991.
  • Cortese S, Imperati D, Zhou J, Proal E, Klein RG, Mannuzza S, et al. White matter alterations at 33-year follow-up in adults with childhood attention-deficit/hyperactivity disorder. Biol Psychiatry. 2013;74(8):591-8.
  • Pliszka SR. The neuropsychopharmacology of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57(11):1385-90.
  • Mindell JA, Owens JA, Carskadon MA. Developmental features of sleep. Child Adolesc Psychiatr Clin N Am. 1999;8(4):695-725.
  • Paavonen EJ, Solantaus T, Almqvist F, Aronen ET. Four-year follow-up study of sleep and psychiatric symptoms in preadolescents: relationship of persistent and temporary sleep problems to psychiatric symptoms. J Dev Behav Pediatr. 2003;24(5):307-14.
  • Golan N, Shahar E, Ravid S, Pillar G. Sleep disorders and daytime sleepiness in children with attention-deficit/hyperactive disorder. Sleep. 2004;27(2):261-6.
  • Weiss MD, Salpekar J. Sleep problems in the child with attention-deficit hyperactivity disorder. CNS drugs. 2010;24(10):811-28.
  • Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J Am Acad Child Adolesc Psychiatry. 2009;48(9):894-908.
  • Becker SP, Cusick CN, Sidol CA, Epstein JN, Tamm L. The impact of comorbid mental health symptoms and sex on sleep functioning in children with ADHD. Eur Child Adolesc Psychiatry. 2018;27(3):353-65.
  • Bériault M, Turgeon L, Labrosse M, Berthiaume C, Verreault M, Berthiaume C, et al. Comorbidity of ADHD and anxiety disorders in school-age children: impact on sleep and response to a cognitive-behavioral treatment. J Atten Disord. 2018;22(5):414-24.
  • Abdelgadir IS, Gordon MA, Akobeng AK. Melatonin for the management of sleep problems in children with neurodevelopmental disorders: a systematic review and meta-analysis. Arch Dis Child. 2018:archdischild-2017-314181.
  • Cao H, Yan S, Gu C, Wang S, Ni L, Tao H, et al. Prevalence of attention-deficit/hyperactivity disorder symptoms and their associations with sleep schedules and sleep-related problems among preschoolers in mainland China. BMC Pediatr. 2018;18(1):70.
  • Melegari MG, Sette S, Vittori E, Mallia L, Devoto A, Lucidi F, et al. Relations Between Sleep and Temperament in Preschool Children With ADHD. J Atten Disord. 2018:1087054718757645.
  • Martin CA, Hiscock H, Rinehart N, Heussler HS, Hyde C, Fuller-Tyszkiewicz M, et al. Associations Between Sleep Hygiene and Sleep Problems in Adolescents With ADHD: A Cross-Sectional Study. J Atten Disord. 2018:1087054718762513.
  • Sung V, Hiscock H, Sciberras E, Efron D. Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family. Arch Pediatr Adolesc Med. 2008;162(4):336-42.
  • Kaynak DK. Bacak Sendromu ve Uykuda Periyodik Hareket Bozukluğu. Noro Psikiyatr Ars. 2007;44:95-100.
  • Cortese S, Konofal E, Lecendreux M, Arnulf I, Mouren M-C, Darra F, et al. Restless legs syndrome and attention-deficit/hyperactivity disorder: a review of the literature. Sleep. 2005;28(8):1007-13.
  • Cortese S, Lecendreux M, Dalla Bernardina B, Mouren MC, Sbarbati A, Konofal E. Attention-deficit/hyperactivity disorder, Tourette’s syndrome, and restless legs syndrome: the iron hypothesis. Med Hypotheses. 2008;70(6):1128-32.
  • Walters AS, Mandelbaum DE, Lewin DS, Kugler S, England SJ, Miller M, et al. Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD. Pediatr Neurol. 2000;22(3):182-6.
  • Sangal RB, Owens JA, Sangal J. Patients with attention-deficit/hyperactivity disorder without observed apneic episodes in sleep or daytime sleepiness have normal sleep on polysomnography. Sleep. 2005;28(9):1143-8.
  • Lecendreux M, Konofal E, Bouvard M, Falissard B, Mouren-Simeoni M-C. Sleep and alertness in children with ADHD. The Journal of Child Psychology and Psychiatry and Allied Disciplines. 2000;41(6):803-12.
  • Tarakçıoğlu MC, Kadak MT, Gürbüz GA, Poyraz BÇ, Erdoğan F, Aksoy UM. Evaluation of the Relationship Between Attention Deficit Hyperactivity Disorder Symptoms and Chronotype. Archives of Neuropsychiatry/Noropsikiatri Arsivi. 2018;55(1).
  • Vélez-Galarraga R, Guillen-Grima F, Crespo-Eguílaz N, Sánchez-Carpintero R. Prevalence of sleep disorders and their relationship with core symptoms of inattention and hyperactivity in children with attention-deficit/hyperactivity disorder. Eur J Paediatr Neurol. 2016;20(6):925-37.
  • Dillon JE, Blunden S, Ruzicka DL, Guire KE, Champine D, Weatherly RA, et al. DSM-IV diagnoses and obstructive sleep apnea in children before and 1 year after adenotonsillectomy. J Am Acad Child Adolesc Psychiatry. 2007;46(11):1425-36.
  • Sedky K, Bennett DS, Carvalho KS. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis. Sleep Med Rev. 2014;18(4):349-56.
  • Stein MA, Weiss M, Hlavaty L. ADHD treatments, sleep, and sleep problems: complex associations. Neurotherapeutics. 2012;9(3):509-17.
  • Sangal RB, Owens J, Allen AJ, Sutton V, Schuh K, Kelsey D. Effects of atomoxetine and methylphenidate on sleep in children with ADHD. Sleep. 2006;29(12):1573-85.
  • Prince JB, Wilens TE, Biederman J, Spencer TJ, Wozniak JR. Clonidine for sleep disturbances associated with attention-deficit hyperactivity disorder: a systematic chart review of 62 cases. J Am Acad Child Adolesc Psychiatry. 1996;35(5):599-605.
  • Rugino TA. Effect on primary sleep disorders when children with ADHD are administered guanfacine extended release. J Atten Disord. 2018;22(1):14-24.
  • Hoebert M, Van Der Heijden KB, Van Geijlswijk IM, Smits MG. Long‐term follow‐up of melatonin treatment in children with ADHD and chronic sleep onset insomnia. Journal of pineal research. 2009;47(1):1-7.
  • Weiss MD, Wasdell MB, Bomben MM, Rea KJ, Freeman RD. Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia. J Am Acad Child Adolesc Psychiatry. 2006;45(5):512-9.
  • Nathanson AI, Beyens I. The role of sleep in the relation between young children's mobile media use and effortful control. Br J Dev Psychol. 2018;36(1):1-21.
  • Ra CK, Cho J, Stone MD, De La Cerda J, Goldenson NI, Moroney E, et al. Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents. JAMA. 2018;320(3):255-63.
  • Genuneit J, Brockmann PE, Schlarb AA, Rothenbacher D. Media consumption and sleep quality in early childhood: Results from the Ulm SPATZ Health Study. Sleep Med. 2018;45:7-10.
  • Thoma VK, Schulz-Zhecheva Y, Oser C, Fleischhaker C, Biscaldi M, Klein C. Media Use, Sleep Quality, and ADHD Symptoms in a Community Sample and a Sample of ADHD Patients Aged 8 to 18 Years. J Atten Disord. 2018.
  • Becker SP, Lienesch JA. Nighttime media use in adolescents with ADHD: links to sleep problems and internalizing symptoms. Sleep Med. 2018;51:171-8.
  • Owens JA, Dalzell V. Use of the ‘BEARS’sleep screening tool in a pediatric residents' continuity clinic: a pilot study. Sleep Med. 2005;6(1):63-9.
  • Fiş NP, Arman A, Ay P, Topuzoğlu A, Güler AS, Gökçe İmren S, et al. Çocuk uyku alışkanlıkları anketinin Türkçe geçerliliği ve güvenilirliği. Anadolu Psikiyatri Derg. 2010;11(2):151-60.
  • Foundation NS. How much sleep do we really need? : National Sleep Foundation Arlington, VA; 2011.
  • Cortese S, Brown TE, Corkum P, Gruber R, O’Brien LM, Stein M, et al. Assessment and management of sleep problems in youths with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2013;52(8):784-96.
  • Cortese S, Holtmann M, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, et al. Practitioner review: current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents. J Child Psychol Psychiatry. 2013;54(3):227-46.
There are 42 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Review
Authors

Berkan Şahin 0000-0003-4699-3418

Abdullah Bozkurt 0000-0002-8359-6131

Koray Karabekiroğlu 0000-0001-5439-9940

Publication Date December 11, 2018
Submission Date November 29, 2018
Published in Issue Year 2018

Cite

APA Şahin, B., Bozkurt, A., & Karabekiroğlu, K. (2018). Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları. Duzce Medical Journal, 20(3), 81-86. https://doi.org/10.18678/dtfd.489684
AMA Şahin B, Bozkurt A, Karabekiroğlu K. Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları. Duzce Med J. December 2018;20(3):81-86. doi:10.18678/dtfd.489684
Chicago Şahin, Berkan, Abdullah Bozkurt, and Koray Karabekiroğlu. “Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları”. Duzce Medical Journal 20, no. 3 (December 2018): 81-86. https://doi.org/10.18678/dtfd.489684.
EndNote Şahin B, Bozkurt A, Karabekiroğlu K (December 1, 2018) Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları. Duzce Medical Journal 20 3 81–86.
IEEE B. Şahin, A. Bozkurt, and K. Karabekiroğlu, “Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları”, Duzce Med J, vol. 20, no. 3, pp. 81–86, 2018, doi: 10.18678/dtfd.489684.
ISNAD Şahin, Berkan et al. “Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları”. Duzce Medical Journal 20/3 (December 2018), 81-86. https://doi.org/10.18678/dtfd.489684.
JAMA Şahin B, Bozkurt A, Karabekiroğlu K. Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları. Duzce Med J. 2018;20:81–86.
MLA Şahin, Berkan et al. “Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları”. Duzce Medical Journal, vol. 20, no. 3, 2018, pp. 81-86, doi:10.18678/dtfd.489684.
Vancouver Şahin B, Bozkurt A, Karabekiroğlu K. Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuklarda Uyku Sorunları. Duzce Med J. 2018;20(3):81-6.