0751 Early Childhood Sleep Associated with Adolescent Sleep Physiology among Youth with ADHD

Abstract

Abstract Introduction Sleep complaints are prevalent and impairing symptoms among adolescents with ADHD. Our recent work has shown that key aspects of sleep physiology differentiate adolescents with ADHD from healthy controls (HC), including reduced slow-wave sleep percentage (SWS%) and relative delta power (rDelta) and increased stage 2 percentage (N2%) and relative sigma power (rSigma) after accounting for sleep duration. ADHD-related sleep problems may emerge as early as toddlerhood, yet little is known about the trajectory of sleep disturbances over time in ADHD. The current study examines relationships between early childhood sleep problems and adolescent sleep physiology in ADHD and HC. Methods Sixty-two medication-free adolescents (31 with ADHD, mean age=15.3, 50% female) completed a diagnostic interview (Mini International Neuropsychiatric Interview) and 3 nights of at-home polysomnography. Spectral analysis was conducted on a single O1-C3 channel. Caregivers reported on participants’ sleep problems during toddlerhood and preschool (Child Behavior Questionnaire; CBQ). Linear regressions controlling for age, sex, and pubertal status examined relationships between early childhood sleep problems and aspects of sleep physiology implicated in adolescent ADHD (SWS%, rDelta, N2%, rSigma) and whether associations differed between groups. Results Adolescents with ADHD had greater caregiver-reported early childhood sleep problems compared to HC (t(60)=3.71, p<.001). In the full sample, greater caregiver-reported sleep problems in early childhood were associated with reduced SWS% (β=-.28, p=.04) and rDelta (β=-.27, p=.04), and increased rSigma (β=.33, p=.02), in adolescence. An early childhood sleep by group interaction was observed for rDelta (β=1.09, p=.04), such that the association was significantly stronger for adolescents with ADHD than HC. Conclusion The current study found that sleep problems in early development were associated with disruptions in sleep physiology in adolescents, including relatively less time spent in SWS, reduced delta power, and increased sigma power. Results suggest that ADHD-related sleep problems may begin early in life and persist into adolescence. Screening for and treating sleep problems during early development may be important for supporting sleep health among adolescents with ADHD, and future studies should assess this possibility. Future studies employing longitudinal designs may clarify the contribution of sleep disturbances to the onset and persistence of ADHD symptoms across development. Support (if any) K23MH108704; R34MH128440