The relationship between sleep and DHA, EPA, phosphatidylserine levels in children and adolescents with attention deficit hyperactivity disorder

Objectıve: Attention Deficit Hyperactivity Disorder (ADHD) is a commonly seen neurodevelopmental disorder in childhood, and sleep problems are detected at very high rates, and it is still unclear what differences in etiology cause sleep disorders in patients diagnosed with ADHD today. In this study, it is aimed to examine the relationship between sleep problems in children with ADHD and serum levels of DHA, EPA, and Phosphatidylserine. In case of a significant difference between the levels of parameters examined in our study, it will be beneficial in terms of applying complementary interventions when arranging the treatments of patients diagnosed with ADHD with sleep disorders in clinical practice. Method: The research was conducted at the Department of Child and Adolescent Psychiatry of Manisa Celal Bayar University Faculty of Medicine Polyclinic between February 2023 and February 2024. The sample of the study consisted of 50 patients aged between 7 and 13 years who were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) during a clinical psychiatric interview conducted using the "Emotional Disorders and Schizophrenia Interview Schedule for School-Age Children - Present and Lifetime Version (ED-SIS-PL)" at the Manisa Celal Bayar University Department of Child and Adolescent Psychiatry Polyclinic and who met the inclusion criteria for the study. Subsequently, the "Children's Sleep Disturbance Scale (CSDS)" was administered to the families of the patient group, and 25 patients with a cutoff score of 39 or higher were classified as "Children with ADHD diagnosed with sleep disorder," while 25 patients with a cutoff score below 39 were classified as "Children with ADHD diagnosed without sleep disorder." The control group consisted of 30 children aged 7 to 13 years who met the inclusion criteria for the study and volunteered, along with their parents. Three survey forms were given to the children to fill out, two to the families, and one to the teachers. The forms given to the children were "Sociodemographic Data Form," "Children's Anxiety Screening Scale (CASS)," and "Child Depression Inventory (CDI)." The forms given to the families were "Turgay DSM-IV Disruptive Behavior Disorders Rating Scale" and "Children's Sleep Disturbance Scale (CSDS)." The form given to the teachers was "Turgay DSM-IV Disruptive Behavior Disorders Rating Scale." On the day of psychometric assessment, approximately 10 ml of venous blood was drawn from the cases constituting the ADHD and control groups, centrifuged, and serum/plasma samples were separated. The samples were stored at -80°C until the analysis day. After all samples were collected, the levels of DHA, EPA, and Phosphatidylserine were examined using the ELISA method. Results: In our study, no relationship was found between serum levels of DHA, EPA, and Phosphatidylserine in individuals with ADHD and the control group. No relationship was found between serum levels of DHA, EPA, and Phosphatidylserine in individuals with ADHD with sleep problems compared to those without sleep problems. A statistically significant positive correlation was found between Phosphatidylserine and DHA. A statistically significant negative correlation was found between Phosphatidylserine and total scores on the Children's Depression Inventory (CDI) for children. Conclusions: To understand the role of parameters such as DHA, EPA, and Phosphatidylserine, which are thought to be associated with sleep, in the etiopathogenesis of sleep disturbances in ADHD, and to use them as complementary interventions in the treatment of patients diagnosed with ADHD with sleep disorders, there is a need for further studies with larger samples addressing the limitations in our study. Keywords: ADHD, sleep, EPA, DHA, phosphatidylserine, omega-3, PUFA