KOMORBIDITAS GANGGUAN TIDUR PADA ANAK DENGAN GANGGUAN PEMUSATAN PERHATIAN DAN HIPERAKTIVTAS

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Evi Evi
Tjhin Wiguna
Khamelia Malik

Abstract

Gangguan Pemusatan Perhatian dan Hiperaktivitas (GPPH) adalah gangguan perkembangan yang ditandai dengan kesulitan dalam mempertahankan atensi, disorganisasi dan atau perilaku psikomotor yang hiperaktif. Patofisiologi dan etiologi GPPH sangat kompleks, bersifat multiaksial dan multifaktorial, melibatkan faktor genetik, lingkungan, berbagai perubahan pada struktur, fungsi dan biokimia dari otak. Sebagai konsekuensinya, GPPH umumnya tidak berdiri sendiri melainkan sering disertai oleh satu atau lebih kondisi komorbid di mana salah satu di antaranya adalah gangguan tidur. Gangguan tidur memang dapat terjadi pada setiap orang, akan tetapi prevalensi gangguan tidur pada GPPH kira-kira 5 kali lebih banyak dari pada tanpa GPPH. Hubungan antara gangguan tidur dan GPPH bersifat kompleks dan multidireksional. Gangguan tidur dapat merupakan gejala dari GPPH, dapat diperburuk oleh GPPH, atau sebaliknya membuat gejala seperti GPPH, dan menambah gejala GPPH bertambah berat.

 

Gangguan Pemusatan Perhatian dan Hiperaktivitas (GPPH) adalah gangguan perkembangan yang ditandai dengan kesulitan dalam mempertahankan atensi, disorganisasi dan atau perilaku psikomotor yang hiperaktif. Patofisiologi dan etiologi GPPH sangat kompleks, bersifat multiaksial dan multifaktorial, melibatkan faktor genetik, lingkungan, berbagai perubahan pada struktur, fungsi dan biokimia dari otak. Sebagai konsekuensinya, GPPH umumnya tidak berdiri sendiri melainkan sering disertai oleh satu atau lebih kondisi komorbid di mana salah satu di antaranya adalah gangguan tidur. Gangguan tidur memang dapat terjadi pada setiap orang, akan tetapi prevalensi gangguan tidur pada GPPH kira-kira 5 kali lebih banyak dari pada tanpa GPPH. Hubungan antara gangguan tidur dan GPPH bersifat kompleks dan multidireksional. Gangguan tidur dapat merupakan gejala dari GPPH, dapat diperburuk oleh GPPH, atau sebaliknya membuat gejala seperti GPPH, dan menambah gejala GPPH bertambah berat.

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References

American Psychiatric association. Diagnostic and statistical manual of mental disorders. 5th (DSM-V). 5th ed. Arlington, VA, American Psychiatric Association; 2013.

Rowland AS, Lesesne CA, Abramowitz AJ. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view. Ment Retard Dev Disabil Res Rev. 2002;8 (3):162–170.

Bartholomew, K., & Owens, J, M.D., MPH. Sleep and AD/HD: A review. Med Health R I. 2006;89:91–3.

Spruyt K, Gozal D. Sleep disturbances in children with attention-deficit/hyperactivity disorder. Expert Rev Neurother. 2011 Apr;11(4):565–77.

Weiss DMD, Salpekar J. Sleep Problems in the Child with Attention-Deficit Hyperactivity Disorder. CNS Drugs. 2012 Sep 14;24(10):811–28.

Chervin, R. D., Archbold, K. H., Panahi, P, Pituch, K. J. Sleep Problems Seldom Addressed at Two General Pediatric Clinics. Pediatrics. 2001;107 (6):1375-1380.

Sadock BJ, Sadock VA, Ruiz P, Kaplan HI. Kaplan & Sadock’s comprehensive textbook of psychiatry. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2009.

Dahl RE. The regulation of sleep and arousal: Development and psychopathology. Dev Psychopathol. 1996 Dec;8(01):3–27.

Durston, S., Tottenham, N.T., Thomas, K.M., Davidson, M.C., Eigsti, I.M., Yang, Y., Ulug, A.M., & Casey, B.J. Differential patterns of striatal activation in young children with and without ADHD. Soc Biol Psychiatry. 2003;53:871–8.

Curatolo P, Paloscia C, D’Agati E, Moavero R, Pasini A. The neurobiology of attention deficit/hyperactivity disorder. Eur J Paediatr Neurol. 13(4):299–304.

Konrad K, Eickhoff SB. Is the ADHD brain wired differently? A review on structural and functional connectivity in attention deficit hyperactivity disorder. Hum Brain Mapp. 2010 Jun 1;31(6):904–16.

Sharp SI, McQuillin A, Gurling HM. Genetics of attention-deficit hyperactivity disorder (ADHD). Neuropharmacology. 2009;57:590–600.

Gizer IR, Ficks C, Waldman ID. Candidate gene studies of ADHD: a metaanalytic review. Hum Genet. 2009;126:51–90.

Smoller JW, Biederman J, Arbeitman L, Doyle AE, Fagerness J, Perlis RH, Sklar P,, Faraone SV. Association between the 5HT1B receptor gene (HTR1B) and the inattentive subtype of ADHD. Biol Psychiatry. 2006;59:460–7.

Mick E, Faraone SV. Genetics of attention deficit hyperactivity disorder. Child Adolesc Psychiatr Clin N Am. 2008;17:261–84.

Coffin JM, Baroody S, Schneider K, O’Neill J. Impaired cerebellar learning in children with prenatal alcohol exposure: a comparative study of eyeblink conditioning in children with ADHD and dyslexia. Cortex. 2005;41:389–98.

D’Onofrio BM, Van Hulle CA, Waldman ID, Rodgers JL, Rathouz PJ, Lahey BB: Causal inferences regarding prenatal alcohol exposure and childhood externalizing problems. Arch Gen Psychiatry. 2007;64:1296–304.

Milberger S, Biederman J, Faraone SV, Chen L, Jones J: Is maternal smoking during pregnancy a risk factor for attention deficit hyperactivity disorder in children? Am J Psychiatry. 1996;153:1138–42.

Kotimaa AJ, Moilanen I, Taanila A, Ebeling H, Smalley SL, McGough JJ,, Hartikainen AL, Jarvelin MR: Maternal smoking and hyperactivity in 8- year-old children. J Am Acad Child Adolesc Psychiatry. 2003;42:826-833.

Weiss S, Tzavara ET, Davis RJ, Nomikos GG, Michael McIntosh J, Giros B,, Martres MP: Functional alterations of nicotinic neurotransmission in dopamine transporter knock-out mice. Neuropharmacology. 2007;52:1496–508.

Taylor E, Rogers JW: Practitioner review: early adversity and developmental disorders. J Child Psychol Psychiatry. 2005;46:451–67.

Raz R, Gabis L: Essential fatty acids and attention-deficit-hyperactivity disorder: a systematic review. Dev Med Child Neurol. 2009;51:580–92.

Juneja M, Jain R, Singh V, Mallika V: Iron Deficiency in Indian Children with Attention Deficit Hyperactivity Disorder. Indian Pediatr. 2010;955–8.

Tripp, G., Wickens, J.R. Neurobiology of ADHD. Neuropharmacology. 2009;57:579–89.

Swanson, J.M., Flodman, P., Kennedy, J., Spence, M.A., Moyzis, R., Schucka, S., Murias, M.,, Moriarity, J., Barr, C., Smith, M., Posner, M. Dopamine genes and ADHD. Neurosci Biobehav Rev. 2000;25:21–5.

Rosa-Neto P, Lou HC, Cumming P, Pryds O, Karrebaek H, Lunding J, Gjedde A. Methylphenidate-evoked changes in striatal dopamine correlate with inattention and impulsivity in adolescents with attention deficit hyperactivity disorder. NeuroImage. 2005;25 (3):868–76.

Del Campo N, Chamberlain SR, Sahakian BJ, Robbins TW. The Roles of Dopamine and Noradrenaline in the Pathophysiology and Treatment of Attention- Deficit/Hyperactivity Disorder. Biol Psychiatry. 2011;69 (12):e145–57.

Owens, J.A. The ADHD and Sleep Conundrum: A Review. Dev Behav Pediatr. 2005;6 (4):312–22.

Mindell JA, Owens JA. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Phila Lippincott Williams Wilkins. 2010;

Fuller PM, Gooley JJ, Saper CB. Neurobiology of the sleep-wake cycle: sleep architecture, circadian regulation, and regulatory feedback. J Biol Rhythms. 2006;21 (6):482 (12).

Espana, RA; Scammell TE. Sleep neurobiology for the clinician. Sleep. 2004;

Lu B, Zee P. Neurobiology of Sleep. Clin Chest Med. 2010;31:309–18.

Chervin, R. D., Ruzicka, D. L., Archbold, K. H., Dillon, J. E. Snoring Predicts Hyperactivity Four Years Later. Sleep. 28(7):885–90.

Hodges, E.K., Bloomfied, E., Coulas, T., Giordani, B. Cognitive and behavioral change after adenotonsillectomy in children with sleep-disordered breathing: A review. Minerva Psichiatr. 49 (4):307–20.

O’Brien, L. M., Holbrook, C. R., Mervis, C. B., Klaus, C. J., Bruner, J. L., Raffield, T. J.,, Rutherford, J., Mehl, R. C., Wang, M., Tuell, A., Hume, B. C., Gozal, D. Sleep and Neurobehavioral Characteristics of 5- to 7-Year-Old Children With Parentally Reported Symptoms of Attention-Deficit/Hyperactivity Disorder. Pediatrics. 111 (3):554–63.

Cortese S, Konofal E, Lecendreux M, et al. Restless legs syndrome and attention-deficit/ hyperactivity disorder: a review of the literature. Sleep. 2005;28 (8):1007–1013.

Krause J. SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder. Expert Rev Neurother. 2008;8:611–25.

Picchietti, M. A., Picchietti, D. L. Restless Legs Syndrome and Periodic Limb Movement Disorder in Children and Adolescents. Semin Pediatr Neurol. 2008;15:91–9.

Coghill D, Banaschewski T. The genetics of attention-deficit/hyperactivity disorder. Exper Rev Neurother. 2009;9:1547–65.

Schormair B, Kemlink D, Roeske D, Eckstein G, Xiong L, Lichtner P, et al. PTPRD (protein tyrosine phosphatase receptor type delta) is associated with restless legs syndrome. Nat Genet. 2008;40:946–8.

Elia J, Gai X, Xie HM, Perin JC, Geiger E, Glessner JT, et al. Rare structural variants found in attention-deficit hyperactivity disorder are preferentially associated with neurodevelopmental genes. Mol Psychiatry. 2010;15:637–46.

Oner, P., Dirik, E.B., Taner, Y., et al. Association between low serum ferritin and restless legs syndrome in patients with attention deficit hyperactivity disorder. Tohoku J Exp Med. 2007;213:269–76.

Galland BC, Dawes PJ, Tripp EG, Taylor BJ. Changes in behavior and attentional capacity after adenotonsillectomy. Pediatr Res. 2006;59:711–6.

Li HY, Huang YS, Chen NH, et al. Impact of adenotonsillectomy on behavior in children with sleep-disordered breathing. 2006;116:1142–7.

Dillon, J.E. Blunden, S. Ruzicka, D.L. Guire, K.E. Champine, D. Weatherly, R.A. Hodges,, E.K. Giordani, B.J. Chervin, R.D. DSM-IV Diagnoses and Obstructive Sleep Apnea in Children Before and 1 Year After Adenotonsillectomy. Am Acad Child Adolesc Psychiatry. 2007;46 (11):1425–36.

England SJ, Picchietti DL, Couvadelli BV, Fisher BC, Siddiqui F, Wagner ML, et al. L-Dopa improves Restless Legs Syndrome and periodic limb movements in sleep but not Attention-Deficit-Hyperactivity Disorder in a double-blind trial in children. Sleep Med. 2011 May;12(5):471–7.