Abstract
BackgroundChildren with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, but the comorbidity mechanism has not been sufficiently studied. This study aimed to determine the comorbidity of ADHD symptoms and sleep problems as well as the moderating effects of bedtime activities and depression/anxiety symptoms on the relationship between ADHD symptoms and sleep problems.MethodsWe recruited 934 primary students from third to fifth grade and their parents by stratified random sampling from three primary schools in Shanghai, China. This study used parent-reported versions of the ADHD Rating Scale-IV, Children’s Sleep Habits Questionnaire, and Achenbach Child Behavior Checklist. We used hierarchical linear regression analysis to clarify the moderating effects of bedtime activities and depression/anxiety symptoms.ResultsWe found that children with more ADHD symptoms had shorter sleep durations and more sleep problems on weekdays. Screen time before bedtime strengthened the relationship between ADHD symptoms and sleep-disordered breathing. Children with more screen time were more likely to have sleep onset delay, while those with less screen time had more sleep onset problems with increasing ADHD symptoms. The high bedtime eating group experienced more night waking with increasing ADHD symptoms compared with the low bedtime eating group. Anxiety/depression exacerbated total sleep problems and further interacted with ADHD symptoms to predict sleep length and sleep duration problems.ConclusionsBedtime activities and emotional problems had important moderating effects on the relationship between ADHD symptoms and sleep problems. These findings indicate that appropriate bedtime management and emotional management may reduce sleep problems and improve sleep duration for children with ADHD symptoms.
Highlights
Children with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, but the comorbidity mechanism has not been sufficiently studied
The first purpose of this study is to explore the relationship between screen time and eating behaviors before bedtime with sleep problems, the interaction between ADHD and bedtime activities
The proportion of ADHD children did not differ by grades (χ2 = 2.187, P > 0.1)
Summary
Children with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, but the comorbidity mechanism has not been sufficiently studied. Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children, characterized by hyperactivity, inattention, and impulsivity. It affects 5–10% of school-age children worldwide [1,2,3]. ADHD is commonly associated with a number of other behavioral and emotional disorders, such as conduct disorder, anxiety disorder, depression disorder [4, 5], and sleep problems, one of the most common comorbidities [6]. Children with ADHD symptoms are more likely to report sleep problems such as prolonged sleep onset latency, difficulty falling asleep, bedtime resistance problems, sleep-disordered breathing, restless leg movements during sleep, night awakenings, and difficulties with morning awakening [7, 8]. A population-based study with a sample of 9486 adolescents found that ADHD symptoms were linked to shorter sleep duration, longer sleep latency, longer nocturnal wake time, and sleep deficiency [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
