# Behavioral and Electrophysiological Markers of Attention Fluctuations in Children with Hypersomnolence

## TL;DR

This study compares attention and brain activity in children with hypersomnolence, ADHD, and controls to understand attention fluctuations in hypersomnolence.

## Contribution

The study introduces a BLAST–EEG protocol for objectively assessing attentional fluctuations in children with hypersomnolence.

## Key findings

- Children with HYP had lower reaction times and BLAST-Stability than controls.
- The AESS score correlated with error percentage and BLAST-Intensity in children with HYP.
- HYP children showed no significant EEG differences compared to ADHD children.

## Abstract

Background. No device is yet available to effectively capture the attentional repercussions of hypersomnolence (HYP). The present study aimed to compare attentional performance of children with HYP, attention deficit hyperactivity disorder (ADHD), and controls using behavioral and electrophysiological (EEG) markers, and to assess their relationship with conventional sleepiness measurements. Methods. Children with HYP underwent a multiple sleep latency test (MSLT) and completed the adapted Epworth sleepiness scale (AESS). Along with age-matched children with ADHD, they were submitted to a resting EEG followed by the Bron–Lyon Attention Stability Test (BLAST). The control group only performed the BLAST. Multivariate models compared reaction time (RT), error percentage, BLAST-Intensity, BLAST-Stability, theta activity, and theta/beta ratio between groups. Correlations between these measures and conventional sleepiness measurements were conducted in children with HYP. Results. Children with HYP had lower RT and BLAST-Stability than controls but showed no significant difference in BLAST/EEG markers compared to children with ADHD. The AESS was positively correlated with the percentage of errors and negatively with BLAST-Intensity. Conclusions. Children with HYP showed impulsivity and attention fluctuations, without difference from children with ADHD for BLAST/EEG markers. The BLAST–EEG protocol could be relevant for the objective assessment of attentional fluctuations related to hypersomnolence.