Hyperactive behavior (HB) is a vexing problem for a large number of children with and without a formal diagnosis of attention- deficit/hyperactivity disorder (ADHD). Although the causes of HB are poorly understood, one such cause may be primary sleep disorders; the small subset of children seen at sleep centers often have HB that resolves when a sleep disorder is identified and treated. Arising from this observation, the long-term objective of this application is to examine the impact of undiagnosed sleep disorders on HB in children. The research plan starts with a cross-sectional survey of 1000 patients at a general pediatrics clinic to test for associations between HB and symptoms of sleep disorders in children aged 2-14 years. Subjects thus found to be hyperactive will be tested to establish the frequency of sleep disorders. A randomized controlled clinical trial will then be performed to determine whether HB improves when children's sleep disorders are treated. Finally, the cohort of children originally identified as being free of HB will be reassessed 4 years later to determine which symptoms of sleep disorder might predict later development of HB. The candidate for this research career award is a tenure-tract assistant professor in neurology with special expertise in sleep medicine who seeks to establish a clinical research career at the interface of the two disciplines. He plans to acquire additional expertise in children's sleep and behavior and to initiate prospective research in a promising new area. His long-term goals are to focus on neurological and behavioral effects of sleep-related breathing disorder to develop optimal standards and techniques for diagnosis of these conditions and to improve effectiveness of their treatment. To foster these goals, the University of Michigan offers internationally recognized colleagues and state-of-the-art facilities for pediatric polysomnography. The Department of Neurology provides an unwavering commitment to the development of the P.I. has an independent investigator, including funds for the candidate's graduate studies at the School of Public Health in clinical research design and biostatistics (M.S. expected in May 1997). This training, combined with prior education in neurology and sleep disorders under distinguished clinicians and researchers, leaves the candidate will-prepared for a successful independent research center.
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