Sleep, executive functions, and functional impairment in children with specific learning disorder: An investigation of the mediating pathways.

Abstract

Sleep problems and executive dysfunction are associated with functional impairment in children with neurodevelopmental disorders. In this study, we aimed to investigate these aspects in children with Specific Learning Disorders (SLD) and SLD with comorbid Attention-Deficit Hyperactivity Disorder (ADHD), while also evaluating differences with typically developing (TD) children. Our study hypothesizes that children with SLD, especially those with comorbid ADHD, face greater sleep disturbances and executive function challenges compared to TD peers. We also propose that sleep disturbances aggravate functional impairment and that executive functions mediate this relationship. The data obtained from psychiatric evaluations, semi-structured interviews and questionnaires filled out by parents were analyzed. SLD + ADHD group had worse scores in all scales, followed by SLD and TD groups. Mediator analysis demonstrated that executive functions had a mediator role in the relationship between sleep problems and functional impairment. Our findings suggest that children with SLD experience more significant difficulties in daily living than their typically developing peers and having ADHD comorbidity, poor executive functions, and additional sleep problems can further exacerbate impairment. Notably, our mediation analysis suggests that executive functions mediate the relationship between sleep disturbances and the severity of functional impairments.