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Furthermore, the potential moderating effects of age and gender on these differential patterns remained insufficiently characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291725102158_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The current study systematically analyzed multimodal sleep monitoring data (polysomnography, actigraphy, electroencephalography, and questionnaires) from 34 articles spanning three decades (44 independent studies: 2,239 ADHD children vs. 57,181 TD children), focusing on core sleep metrics (total sleep time, sleep efficiency, sleep latency, wake after sleep onset, awakening index, and stage shifts) and their complex moderating mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291725102158_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results demonstrated that ADHD children exhibited impaired sleep continuity (reduced total sleep time, increased stage shifts), severe sleep interruption (prolonged wake after sleep onset, elevated awakening index), and abnormal sleep process effectiveness (decreased sleep efficiency, extended sleep latency). Demographic analyses revealed that maturation exacerbated ADHD-related sleep deficits, and male ADHD children had more severe sleep problems than female ADHD children. Furthermore, the moderating effect of gender composition on the awakening index showed interaction effects with other sleep metrics. In addition, slow-wave sleep acted as both a moderator and mediator in group differences of the awakening index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291725102158_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings provided novel neurodevelopmental explanations for sleep dysregulation in ADHD and proposed clinically translatable strategies involving gender-specific interventions and neuromodulation targeting slow-wave sleep.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291725102158","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T09:24:50Z","timestamp":1761643490000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":12,"title":["Sleep dysregulation in ADHD children: a systematic review and 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