Abstract
BackgroundChildren with attention-deficit/hyperactivity disorder (ADHD) are two to three times more likely to experience sleep problems. The purpose of this study is to determine the relative contributions of circadian preferences and behavioral problems to sleep onset problems experienced by children with ADHD and to test for a moderation effect of ADHD diagnosis on the impact of circadian preferences and externalizing problems on sleep onset problems.MethodsAfter initial screening, parents of children meeting inclusion criteria documented child bedtime over 4 nights, using a sleep log, and completed questionnaires regarding sleep, ADHD and demographics to assess bedtime routine prior to PSG. On the fifth night of the study, sleep was recorded via ambulatory assessment of sleep architecture in the child’s natural sleep environment employing portable polysomnography equipment. Seventy-five children (26 with ADHD and 49 controls) aged 7–11 years (mean age 8.61 years, SD 1.27 years) participated in the present study.ResultsIn both groups of children, externalizing problems yielded significant independent contributions to the explained variance in parental reports of bedtime resistance, whereas an evening circadian tendency contributed both to parental reports of sleep onset delay and to PSG-measured sleep-onset latency. No significant interaction effect of behavioral/circadian tendency with ADHD status was evident.ConclusionsSleep onset problems in ADHD are related to different etiologies that might require different interventional strategies and can be distinguished using the parental reports on the CSHQ.
Highlights
Children with attention-deficit/hyperactivity disorder (ADHD) are two to three times more likely to experience sleep problems
Despite the clinical and scientific relevance of sleep problems to the understanding and management of ADHD, the etiologies of such sleep issues remain unclear. This is important for an accurate evaluation of possible causes related to parental descriptions of sleep onset problems in children with ADHD and in choosing the most effective intervention
The aim of the present study was to explore how behavioral and biological factors previously found to be associated with ADHD symptoms contribute to sleep-onset insomnia and bedtime resistance commonly encountered in children with ADHD
Summary
Children with attention-deficit/hyperactivity disorder (ADHD) are two to three times more likely to experience sleep problems. Accurate diagnosis and effective management of sleep problems are key to significantly improving the quality-of-life of both children with ADHD and their family members. Despite the clinical and scientific relevance of sleep problems to the understanding and management of ADHD, the etiologies of such sleep issues remain unclear. This is important for an accurate evaluation of possible causes related to parental descriptions of sleep onset problems in children with ADHD and in choosing the most effective intervention
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