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Published on: October 2, 2019
Actigraphy and parental ratings of sleep in children with attention-deficit/hyperactivity disorder (ADHD)
P Corkum1, R Tannock, H Moldofsky
1Department of Education, School Psychology Program, Mount Saint Vincent University, Halifax, Nova Scotia. penny.corkum@msvu.ca
Insights
Children with Attention Deficit Hyperactivity Disorder (ADHD) experience more sleep issues, often linked to challenging bedtime behaviors rather than intrinsic sleep disorders. Objective measures did not fully confirm parental reports of sleep problems.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
- Child Psychology
Background:
- Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder affecting children.
- Sleep disturbances are frequently reported in children with ADHD, but objective data is often inconsistent.
- Understanding the nature and origin of sleep problems in ADHD is crucial for effective intervention.
Purpose of the Study:
- To compare sleep parameters between children with ADHD and typically developing peers.
- To investigate discrepancies between subjective parental reports and objective sleep measures.
- To identify behavioral factors contributing to sleep difficulties in children with ADHD.
Main Methods:
- A comparative study involving 50 children (ages 7-11), with 25 diagnosed with ADHD (medication-naive) and 25 controls.
- Utilized a retrospective parental questionnaire, a 7-night actigraphy monitoring period, and daily sleep diaries.
- Rigorous diagnostic procedures were employed for ADHD diagnosis, focusing on pervasive symptomatology.
Main Results:
- Parents of children with ADHD reported significantly more sleep problems than controls.
- Actigraphy and diary data largely did not corroborate subjective reports, except for longer sleep duration in the ADHD group.
- Increased bedtime resistance and more challenging child-parent interactions during bedtime routines were noted in the ADHD group.
Conclusions:
- While intrinsic sleep issues like longer sleep duration may exist, behavioral challenges at bedtime appear to significantly contribute to sleep problems in children with ADHD.
- Discrepancies between subjective and objective measures highlight the complexity of assessing sleep in this population.
- Further research is needed to understand the interplay of behavioral factors and sleep in pediatric ADHD.
Study Objectives:
To assess various sleep parameters in latency-aged children with ADHD and their normally developing peers through the use of multiple sleep measures.
Design:
Six sleep parameters were evaluated for two groups of children, ADHD and normal comparison. Each group consisted of 25 children (20 males, 5 females) who ranged in age from 7 to 11 years. All children underwent rigorous diagnostic procedures and the ADHD subjects were selected only if they displayed pervasiveness in their symptomatology and were medication naive. Parents completed a retrospective questionnaire which evaluated sleep problems over the past six months. Additionally, each child wore an actigraph for seven consecutive nights, and the child's parents completed a sleep diary during this time period.
Setting:
N/A.
Patients Or Participants:
N/A.
Interventions:
N/A.
Results:
Based on the findings from the questionnaire, parents of children with ADHD reported significantly more sleep problems than parents of normally developing children. However, the majority of these sleep differences were not verified through actigraphy or sleep diary data, with the exception of longer sleep duration for children with ADHD and parent reports that describe increased bedtime resistence. It was also found that child-parent interactions during bedtime routines were more challenging in the ADHD group.
Conclusions:
Despite the possibility of intrinsic sleep problems such as longer sleep duration, results indicate that many of the sleep problems of children with ADHD may be due to challenging behaviours during bedtime routines. The reason for discrepancies among sleep studies employing objective measures as well as between retrospective and prospective measures are discussed.
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