Exploring the effects of repetitive transcranial magnetic stimulation on co-morbid sleep disorders in preschool children with ADHD

Abstract

Abstract Background Attention Deficit Hyperactivity Disorder(ADHD) is one of the most common neurological developmental disorders in children and sleep disorders (SD) are a common co-morbidity in children with ADHD. There are currently no pharmacological treatment options for SD in children with ADHD of preschool age (4–6 years). Repetitive transcranial magnetic stimulation (rTMS) is a novel non-invasive neuromodulation technique. This study explored the effectiveness of rTMS for co-morbid SD in preschool-aged children with ADHD. Methods Thirty-five children of preschool age with ADHD and co-morbid SD were recruited for this study. They met the diagnostic criteria for ADHD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The children were divided into a parent behaviour management training (PBMT) group (n = 19) and a repetitive transcranial magnetic stimulation combined with parent behaviour management training group (n = 16). Both groups underwent eight weeks of PBMT. Children in the rTMS combined with PBMT group were given a right DLPFC low frequency stimulation intervention three times a week for the first four weeks. The children's SD levels were assessed using the Chinese version of the Children's Sleep Habits Questionnaire (CSHQ), which was measured before the start of the intervention, at the end of the eight-week intervention and four weeks after the end of the intervention, and was used to measure the effects of both intervention methods. Within-group differences were compared using a one-way ANOVA, and between-group differences were compared using an independent samples T-test. Results Both the PBMT group and the rTMS combined with PBMT group significantly improved the SD of preschool-aged children with ADHD (p < 0.05), but the effect of the intervention was more pronounced in the rTMS combined with PBMT group (p < 0.05) and lasted longer than the PBMT group (p < 0.05). Conclusion Repetitive transcranial magnetic stimulation(rTMS) is a promising non-pharmacological therapy to improve SD in preschool-aged children with ADHD.