Abstract
Sleep disturbances are common in attention deficit hyperactivity disorder (ADHD) and associated with poor outcomes. We tested whether, in children with ADHD, (1) polygenic liability for sleep phenotypes is over- or under-transmitted from parents, (2) this liability is linked to comorbid sleep disturbances, and (3) ADHD genetic risk is associated with comorbid sleep disturbances. We derived polygenic scores (PGS) for insomnia, chronotype, sleep duration, and ADHD, in 758 children (5–18 years old) diagnosed with ADHD and their parents. We conducted polygenic transmission disequilibrium tests for each sleep PGS in complete parent–offspring ADHD trios (N = 328) and an independent replication sample of ADHD trios (N = 844). Next, we tested whether insomnia, sleep duration, and ADHD PGS were associated with co-occurring sleep phenotypes (hypersomnia, insomnia, restless sleep, poor sleep quality, and nightmares) in children with ADHD. Children’s insomnia and chronotype PGS did not differ from mid-parent average PGS but long sleep duration PGS were significantly over-transmitted to children with ADHD. This was supported by a combined analysis using the replication sample. Insomnia, sleep duration, and ADHD PGS were not associated with comorbid sleep disturbances. There is weak evidence that children with ADHD over-inherit polygenic liability for longer sleep duration and do not differentially inherit polygenic liability for insomnia or chronotype. There was insufficient evidence that childhood sleep disturbances were driven by polygenic liability for ADHD or sleep traits, suggesting that sleep disturbances in ADHD may be aetiologically different to general population sleep phenotypes and do not index greater ADHD genetic risk burden.
Highlights
Attention deficit hyperactivity disorder (ADHD) is a common and impairing neurodevelopmental condition, which frequently co-occurs with sleep disturbances
The polygenic transmission disequilibrium test (pTDT) analysis of 328 complete parent–offspring trios indicated that polygenic liability for sleep duration was over-inherited by children with ADHD, compared to the average of their parents’ polygenic profiles [mean = 0.13(0.05), pFDR = 0.032]
Sleep problems are common in children with ADHD and impact on illness course, quality of life and family relationships [2–4]
Summary
Attention deficit hyperactivity disorder (ADHD) is a common and impairing neurodevelopmental condition, which frequently co-occurs with sleep disturbances. Children with ADHD are more likely to experience sleep disorder symptoms such as insomnia, hypersomnia, and delayed sleep phase syndrome compared to children without ADHD [1]. These sleep disturbances are important to identify and treat, Katie Lewis and Joanna Martin are joint first authors. There is evidence that improving sleep could improve ADHD symptoms [6, 7]. It is, important to determine why ADHD and sleep disturbances co-occur and identify which individuals with ADHD are at heightened risk for developing such problems
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