Saturday, February 25, 2017

Attention Deficit Disorders and Sleep/Arousal Disturbance

aClinic for Attention and Related Disorders, Yale University School of Medicine,
New Haven, Connecticut 06519, USA
bCalifornia Pacific Epilepsy Center, San Francisco, California 94115, USA
ABSTRACT: Many children, adolescents, and adults with Attention Deficit Disorders
report chronic difficulties with falling asleep, awakening and/or maintaining
adequate daytime alertness. These problems may be due to a variety of
factors, including environment, lifestyle, and psychiatric comorbidities.
Impairments in sleep/arousal may also be related more directly to the underlying
pathophysiology of ADD. This chapter describes clinical manifestations
of sleep/arousal problems often associated with ADD and reviews behavioral
and medication options for treatment.
KEYWORDS: ADD; ADHD; Sleep disturbances; Sleep disorders.

"Given the above, it is not surprising that a fair degree of overlap exists between
these two disorders, though the rates of sleep disturbance in children with attention
deficit/hyperactivity disorder (ADHD) is much higher than one would expect even
given the high prevalence of sleep problems in the general school-age cohort. Ball
et al.
9 have reported that more than 50% of children with ADHD have difficulty falling
asleep. Stein10 reported that moderate to severe sleep problems occurred at least
once a week in nearly 20% of children with ADHD compared to 13.3% of psychiatric
controls, and 6.2% of pediatric controls."


Adolescent and adult patients too may suffer from inadequate wind-down routines
to prepare for sleep or from ruminative worry, or from evening family conflicts.
Some report that they remain awake primarily due to becoming distracted by activity
that is inconsistent with sleep (reading, surfing the internet, socializing). For some it
is actually easier to concentrate in the evening when background environmental
stimulation may be reduced relative to the targeted activity. Attempts at daytime
attention to target material may be thwarted by frequent interruption by distracting
background activity, while evening activity is both more stimulating than sleep (e.g.,
it is the distractor), and less often interrupted by competing stimuli. These patients
sometimes are able to fall asleep when they so engage, but establish behavior patterns
over time that preclude adequate sleep. Others may attempt to self medicate
sleep disturbance by using over the counter sleep aids or alcohol. These attempts are
often less than effective because they may not work, they may contribute to exacerbation
of attention problems, and they may alter the quality of sleep attained.25,26
Attention to proper sleep hygiene (discussed later in this chapter) and avoidance of
potentially maladaptive behavior patterns may offer some relief from problems falling
asleep in these patients.
Other patients with ADD report a lifelong pattern of consistently becoming more
alert in the evening, feeling more energized and more ready to engage in work or
social activities after dark than in the daytime. These individuals often describe a
pattern of difficulty falling asleep until very late at night; as preschoolers they may
not have been able to settle and fall into sleep until 10 or 11 P.M. most nights. As
adolescents or adults they may chronically feel restless and unable to sleep until 2 or
3 A.M. or later. Attention to proper sleep hygiene may help these patients, but they
may continue to experience delayed onset of sleep due to internal restlessness, even
in the absence of maladaptive behavioral patterns.
At present, it is not clear how these problems in getting to sleep are related to the
pathophysiology of ADD. Dahl has emphasized that there is a strong relationship
between the control of sleep and the regulation of mood and behavior in waking
states, yet he notes that “Our current knowledge of these complex relationships
between sleep, development and psychiatric well-being is at an embryonic state.”17
These issues are discussed later in this chapter

Sunday, February 19, 2017

The interaction between nutrition and the brain and its consequences for body weight gain and metabolism; studies in rodents and men. - PubMed - NCBI

The interaction between nutrition and the brain and its consequences for body weight gain and metabolism; studies in rodents and men. - PubMed - NCBI

The interaction between nutrition and the brain and its consequences for body weight gain and metabolism; studies in rodents and men.
la Fleur SE1, Serlie MJ2.
Author information
Aberrant feeding behavior can lead to obesity and obesity-related medical consequences, such as insulin resistance and diabetes. Although alterations in glucose metabolism (i.e. insulin resistance), in the presence of excessive fat tissue are often explained by the consequences of dysfunctional adipose tissue, evidence is emerging that also altered brain functions might be an important determinant of insulin resistance. In this review, we provide an overview of how feeding behavior and obesity interact with brain circuitry and how these interactions affect glucose metabolism. Because brain circuitries involved in food intake have been shown to partly control glucose metabolism as well, targeting these circuitries in obese subjects might not only affect food intake and body weight but also glucose metabolism.

Wednesday, February 08, 2017

Do Dopaminergic Impairments Underlie Physical Inactivity in People with Obesity? - PubMed - NCBI

Do Dopaminergic Impairments Underlie Physical Inactivity in People with Obesity? - PubMed - NCBI: Do Dopaminergic Impairments Underlie Physical Inactivity in People with Obesity?
Kravitz AV1, O'Neal TJ2, Friend DM2.
Author information
Obesity is associated with physical inactivity, which exacerbates the negative health consequences of obesity. Despite a wide consensus that people with obesity should exercise more, there are few effective methods for increasing physical activity in people with obesity. This lack is reflected in our limited understanding of the cellular and molecular causes of physical inactivity in obesity. We hypothesize that impairments in dopamine signaling contribute to physical inactivity in people with obesity, as in classic movement disorders such as Parkinson's disease. Here, we review two lines of evidence supporting this hypothesis: (1) chronic exposure to obesogenic diets has been linked to impairments in dopamine synthesis, release, and receptor function, particularly in the striatum, and (2) striatal dopamine is necessary for the proper control of movement. Identifying the biological determinants of physical inactivity may lead to more effective strategies for increasing physical activity in people with obesity, as well as improve our understanding of why it is difficult for people with obesity to alter their levels of physical activity.

Saturday, February 04, 2017

Exercise can help adults better cope with ADHD symptoms

Exercise can help adults better cope with ADHD symptoms: Exercise, even a small amount, can help alleviate symptoms of ADHD in adults, according to a new study. About 6 percent of American adults report symptoms consistent with attention deficit hyperactivity disorder, or ADHD, which lead to anxiety, depression, low energy and motivation, poor performance at work or school and also increased traffic accidents.

The study tested 32 young men with elevated ADHD symptoms who cycled at a moderate intensity for 20 minutes on one day, and on another day sat and rested for 20 minutes as a control condition. The participants were asked to perform a task requiring focus both before and after the different conditions, and researchers noted leg movement, mood, attention and self-reported motivation to perform the task.
As a result, researchers found that it was only after the exercise when the participants felt motivated to do the task; they also felt less confused and fatigued and instead felt more energetic. Interestingly, leg movements and performance on the task did not change after the exercise--rather, the exercise helped the young men feel better about doing the task.
These findings are consistent with prior research that shows a single bout of exercise helps people feel more energetic, said O'Connor, who is also co-director of the UGA Exercise Psychology Laboratory. The results suggest that young men who have symptoms of ADHD can benefit psychologically from the short workouts, similar to the benefits enjoyed by typical adults who work out.
"The reduced feelings of confusion and increased motivation to perform a cognitive task suggest that other types of acute exercise also may benefit cognitive performance," added study co-author Kathryn Fritz, a UGA doctoral student who completed the study as part of her master's thesis. "We speculate that a different mode or duration or intensity of exercise, other than a boring cycle ride in a sterile lab, may show larger cognitive effects for those suffering from ADHD symptoms."