0227 Impact of 5-night sleep restriction on actigraphy-estimated sleep in young adolescents: preliminary associations with ADHD traits

Abstract

Abstract Introduction Prior research suggests that children with attention-deficit/hyperactivity-disorder (ADHD) may experience disrupted sleep. In typically developing children, short-term sleep restriction increases sleep pressure and efficiency; however, whether a similar homeostatic response occurs in children with ADHD is unknown. Here we explore the effects of 5 nights of experimental sleep restriction on actigraphy-estimated sleep of children with and without high ADHD characteristics. Methods Nineteen young adolescents (Mage=12.24yr, range 10.17-13.88yr; 10F/9M) participated in an at-home crossover protocol. After ≥5 nights of stabilization (10hr time-in-bed[TIB] set to habitual risetimes), participants had five nights of sleep optimization (SO; same stabilization schedule) or restriction (SR; 7.5hr TIB, sleep opportunity reduced by delaying bedtime and advancing risetime equally), a 2-3 night restabilization, and then the reverse schedule. Sleep was assessed via wrist-worn actigraphy (AMI Micro Motionlogger), sleep diaries, and twice-daily phone calls ensuring schedule adherence. Primary sleep variables included: total sleep time (TST; min), sleep period time (SPT; min), and sleep efficiency (TST/SPT*100). Children were grouped by parent-rated Conners 3 ADHD-Probability-Index: < 50% (low-ADHD; n=10, 8F) or >=50% (high-ADHD; n=9, 2F). Results Mixed-effects ANOVAs evaluating condition (SO vs. SR) and group (low- vs. high-ADHD) on schedule adherence indicated significant effects of condition; that is, SR reduced both SPT (M±SD SO=9.08[0.54]hr, SR=7.10[0.57]hr; F(1,17)=479.75, p<.001, ηp2=.97) and TST (M±SD SO=7.92[0.97]hr, SR=6.38[0.86]hr; F(1,17)=302.13, p<.001, ηp2=.95). No group or group-by-condition effects were significant (all ps>.21). For sleep efficiency, a group-x-condition interaction (F(1,17)=8.29, p=.01, ηp2=.33) revealed that SR significantly increased sleep efficiency in low-ADHD children (M±SD SO=85.08[9.95]%, SR=89.74[7.66]%, Bonferroni-p<.001) but not in high-ADHD children (M±SD SO=90.67[3.74]%, SR=91.21[3.19]%, Bonferroni-p=.61). Other between-group effects were not significant (all ps>.12). Conclusion These preliminary data indicate that our sleep restriction protocol successfully reduces sleep opportunity and sleep duration in peripubertal children, including those with high ADHD traits. Notably, sleep restriction improved sleep efficiency in low-ADHD children, whereas sleep efficiency was high and unchanging in our high-ADHD group. It is possible that high-ADHD children maintained higher sleep pressure even after stabilization. While data collection (matching groups on sex and age) continues, we are examining waking EEG markers to explore this possibility. Support (if any) R01HD103655, P20GM139743