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Artigos Científicos

sexta-feira, 15 junho 2018 16:52

Inflammation, Sleep and ADHD

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Denise Bijlenga, PhD1Denise Bijlenga, PhD2, J.J. Sandra Kooij, MD, PhD3

1
PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
2
PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
3
Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands

Journal of Clinical Sleep Medicine

June 15, 2018


INTRODUCTION

Our group previously investigated adult ADHD symptoms, Metabolic Syndrome (MetSyn) and obesity-related variables in a large population study with different stages of comorbid affective disorders (Netherlands Study of Depression and Anxiety, NESDA). Interestingly, we showed few clear associations: ADHD was not associated with MetSyn. It is possible that these associations are difficult to detect and therefore we failed to find them. Also, both the concept and definition of MetSyn have been questioned as it is possible that not all MetSyn risk factors contribute significantly to cardiovascular diseases/diabetes in the general population. Concerning obesity, a meta-analysis showed that it was significantly associated with ADHD. Both obesity and Met-Syn are considered proinflammatory conditions. Another possible link includes sleep disturbance, which was associated with systemic inflammation markers in the NESDA cohort. ADHD is comorbid with insomnia, RLS and circadian dysregulation. Preliminary evidence links ADHD to inflammatory processes. The circadian system and clock genes control both the sleep-wake cycle and metabolism. Fasting glucose, lipid levels, blood pressure and the sleep-wake cycle are rhythmically coordinated by the biological clock. Disruption of either the circadian or metabolic system can lead to derangement of the other, predisposing to MetSyn, obesity or diabetes. Once again, inflammatory processes may be the link between ADHD, circadian rhythm and metabolic disturbance. We therefore support further investigation of these overlapping processes, as causality is unknown.


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