Insomnia is seen as one of the most common sleep disorders, characterized by difficulty in initiating and / or maintaining sleep and by daytime symptoms that impair the occupational functioning, interfering in the daily activities of the individuals, and may even cause physical incapacity. Therefore, the need to evaluate such repercussions becomes important in the search for further clarification on the subject, and the 6-Minute Walk Test (TC6M) is a good evaluation tool. The study will aim to evaluate the functional capacity in adult patients with insomnia assisted in Basic Health Units (BHU) of Divinópolis. The study will be cross-sectional observational, carried out with a consecutive and convenience sample, recruited from BHU in the city of Divinópolis, being approved by the Ethics Committee in Research with Human Beings of the university, protocol number 1,475,521/2016. All patients will be submitted to the 6MWT after being clinically evaluated and responding to the Insomnia Severity Index, requiring the presence of insomnia to perform the same. The 6MWT is a good alternative in the evaluation of functional capacity because it is easy to apply and low cost.

Recently, Exelmans and Van den Bulck (2017) provided empirical evidence of reduced sleep quality. Some 32% of net flex binge viewers have poor sleep quality of reduced total sleep time, fragmented sleep and daytime sleepiness. Binge viewing is prevalent among young adults, as well as streaming, gaming and social networking [1-3]. The issue with media use and sleep is multifaceted. The media itself is cognitively, emotionally and visually activating. The time spent with the media use instead of presleep relaxing behaviors or sleep is a significant factor. It is estimated that bedtimes are interrupted or delayed because of media use. The interruption of sleep- the waking up to a “ping” alarm from a phone/tablet that indicates a myriad of activities from text message, posting on facebook/Instagram or a voice mail compels the sleeper out of sleep to respond it seems [4].

Purpose: This study investigated the rates of periodic limb movements disorder (PLMD) in children with attention-deficit/hyperactivity disorder (ADHD) compared to typically developing (TD) children, the impact of stimulant medication on PLMD, and sleep disparities in children with ADHD with and without PLMD.

Method: 25 medication-naïve children with diagnosed ADHD and 25 TD age- and sex-matched children, 6 -12 years (mean: 8.81 years) were enrolled. Participants completed a 1-week baseline assessment of typical sleep. Participants with ADHD subsequently completed a 4-week blinded randomized controlled trial of stimulant medication (2 weeks each of placebo and medication). Overnight polysomnography was recorded in a sleep laboratory following each condition.

Results: Children with ADHD had significantly higher rates of PLMD (ADHD=26%, TD=4%, p<0.05), longer sleep onset latency (SOL, ADHD=40.92±30.84, TD=24.07±14.01, p<0.05), and increased arousal index (AI, ADHD=11.01±2.47, TD=7.74±2.18, p<0.05). Children with ADHD meeting clinical threshold for PLMD (i.e., periodic limb movement of sleep index of ≥5.0/hour) had increased sleep stages shifts with increased AI compared to children with ADHD without PLMD. Stimulant treatment was not associated with changes in periodic limb movements, however, longer SOL and reduced sleep efficiency (SE) was observed in children with PLMD during treatment compared to placebo.

Conclusion: There are consistent findings across studies (including this one) of increased PLMD in children with ADHD. Children with ADHD and PLMD may have increased sleep difficulties in response to medication. Further study is warranted on the impact of stimulant treatment on sleep in children with ADHD and PLMD.