Sleep problems in children with attention-deficit hyperactivity disorder: associations with parenting style and sleep hygiene.

Abstract

We aimed to examine the association between sleep problems and parenting and sleep hygiene in children with attention-deficit/hyperactivity disorder (ADHD). Participants included 5-13-year-old children with DSM 5 defined ADHD and a parent-reported moderate-to-severe sleep problem (N=361). Sleep was assessed using the parent-reported Children's Sleep Habits Questionnaire. Parents also completed checklists assessing sleep hygiene, parenting consistency, and parenting warmth. Linear regression established prediction models controlling for confounding variables including child age and sex, ADHD symptom severity, comorbidities, medication use, and socio-demographic factors. More consistent parenting was associated with decreased bedtime resistance (β=-0.16) and decreased sleep anxiety (β=-0.14), while greater parental warmth was associated with increased parasomnias (β=+0.18) and sleep anxiety (β=+0.13). Poorer sleep hygiene was associated with increased bedtime resistance (β=+0.20), increased daytime sleepiness (β=+0.12), and increased sleep duration problems (β=+0.13). In conclusion, sleep hygiene and parenting are important modifiable factors independently associated with sleep problems in children with ADHD. These factors should be considered in the management of sleep problems in children with ADHD.