An Open-Label Pilot Trial of a Brief, Parent-Based Sleep Intervention in Children With ADHD.

OBJECTIVE: To assess the effects of a brief parent-based behavioral sleep intervention in children with ADHD. METHODS: Families with a child with ADHD and parent-reported sleep problems received a brief parent-based sleep intervention, which involved two one-to-one consultation sessions and one telephone follow-up with the parent/caregiver. Child's sleep and clinical symptoms, and parental sleep and daytime functioning were assessed at baseline, 2-week post-intervention, and 3-month follow-up. RESULTS: Sixty eligible families (mean age of the child: 9.4 ± 1.5 years; boys: 75%) were recruited, and 43 (72%) completed the whole intervention. The intervention resulted in significant improvements in the child's sleep, clinical symptoms, and parental sleep and parenting stress, and these improvements were generally maintained at 3-month follow-up. CONCLUSION: The findings supported the promising effects of a brief parent-based sleep intervention on improving sleep and clinical symptoms in children with ADHD and parental sleep and parenting stress. Further randomized clinical trials with long-term follow-up are needed to test the robustness of the effectiveness of the intervention.

The associations of insomnia symptoms with daytime behavior and cognitive functioning in children with attention-deficit/hyperactivity disorder.

STUDY OBJECTIVES: The current study aimed to examine the association of insomnia symptoms with daytime behavior and cognitive functioning in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Thirty-six children with ADHD and insomnia symptoms, 27 children with ADHD without insomnia symptoms, and 21 age-matched healthy controls were recruited in this study (age range: 6-12 years, 70% male). They were assessed by parent-report questionnaires on insomnia symptoms (Children's Sleep Habits Questionnaire) and ADHD symptoms (Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale [SWAN]), and completed a battery of cognitive tests including the Continuous Performance Test (CPT) for sustained attention, Letter-digit test for processing speed, Digit Span forward test and N-back task for working memory, Tower of London (TOL) test for planning skills and Bergs Card Sorting Test (BCST) for set-shifting ability. RESULTS: Children with ADHD and insomnia symptoms had the highest scores on SWAN total and inattention and hyperactivity subscales, followed by children with ADHD without insomnia and healthy controls (all P < .05). After controlling for potential confounders, children with ADHD and insomnia symptoms showed poorer performance on the CPT and Letter-digit test as compared with children with ADHD without insomnia and healthy controls (all P < .05). CONCLUSIONS: Insomnia symptoms are associated with more severe ADHD symptoms and cognitive impairments in children with ADHD, especially deficits in sustained attention and processing speed. Future longitudinal studies are needed to explore the long-term impacts of insomnia symptoms and the effects of sleep-focused intervention on cognitive functioning in children with ADHD. CITATION: Li X, Shea KSC, Chiu WV, et al. The associations of insomnia symptoms with daytime behavior and cognitive functioning in children with attention-deficit/hyperactivity disorder. J Clin Sleep Med. 2022;18(8):2029-2039.

Nucleotide-derived theranostic nanodots with intrinsic fluorescence and singlet oxygen generation for bioimaging and photodynamic therapy.

Nucleic acids are important molecules of life and have recently emerged as important functional materials to synthesize, organize and assemble inorganic nanoparticles for various technological applications. In this study, we have systematically investigated the four basic nucleotides of DNA as precursors to form fluorescent nucleotide derived biodots (N-dots) with unique singlet oxygen generation properties by one-pot hydrothermal synthesis. It has been discovered for the first time that the nitrogenous base adenine accounts for the bright fluorescence, while the sugar and phosphate groups of the nucleotide endow the N-dots with good photo-stability. Among the N-dots synthesized in this study, adenosine triphosphate (ATP)-dots were found to exhibit the highest fluorescence quantum yield (QY) of 13.9%, whereas adenosine diphosphate (ADP)-dots exhibited the best photo-stability maintaining 97.6% photoluminescence intensity after continuous UV excitation for 30 min. Overall, deoxyadenosine monophosphate (dAMP)-dots display both high fluorescence QY (12.4%) and good photo-stability (91.9%). Most critically, dAMP-dots show the highest singlet oxygen generation with a remarkable singlet oxygen (1O2) quantum yield of 1.20 surpassing the 1O2 quantum yield of the conventional photosensitizer Rose Bengal (0.75). Further cellular experiments reveal that dAMP-dots possess excellent cellular uptake ability for successful fluorescent labeling with the ability to kill >60% HeLa cancer cells under white light treatment within 10 minutes. Additionally, N-dots possess excellent stability against both UV irradiation and DNase enzymatic action. These results demonstrate the unique physiochemical properties of N-dots, including an ultra-small size for cellular uptake, tunable photoluminescence for bioimaging, excellent aqueous solubility, high chemical stability and photo-stability as well as excellent singlet oxygen quantum yield with inherent biocompatibility for photodynamic therapy, which are important factors contributing to the promising theranostic applications in future personalized nanomedicine.