Snoring, sleep quality, and sleepiness across attention-deficit/hyperactivity disorder subtypes
Monique K LeBourgeois1, Kristin Avis, Michele Mixon
1E.P Bradley Hospital Sleep and Chronobiology Research Laboratory, Brown Medical School, Department of Psychiatry and Human Behavior, Providence, RI 02906, USA. monique_lebourgeois@brown.edu
Insights
Children with ADHD often have poorer sleep quality and increased daytime sleepiness. Chronic snoring is linked specifically to the ADHD-Hyperactive/Impulsive subtype, not other ADHD types.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
- Child Psychology
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
- Sleep disturbances, including snoring and daytime sleepiness, are frequently reported in children with ADHD.
- Understanding the specific relationships between ADHD subtypes and sleep issues is crucial for effective management.
Purpose of the Study:
- To investigate the association between pediatric ADHD subtypes, chronic snoring, and sleep quality.
- To examine the prevalence of daytime sleepiness in children with different ADHD subtypes.
- To compare sleep characteristics between children with ADHD and healthy controls.
Main Methods:
- A cross-sectional study involving 74 children (45 with ADHD, 29 controls), aged 6-16 years.
- Participants were categorized into ADHD subtypes: Predominantly Inattentive (ADHD-I), Hyperactive/Impulsive (ADHD-HI), and Combined (ADHD-C).
- Caretakers completed the Pediatric Sleep Questionnaire (PSQ) and the Children's Sleep-Wake Scale (CSWS) to assess sleep patterns.
Main Results:
- Chronic snoring was significantly associated with the ADHD-Hyperactive/Impulsive (ADHD-HI) subtype only.
- Children with ADHD exhibited poorer overall sleep quality compared to controls, with no significant differences across ADHD subtypes.
- Increased daytime sleepiness was observed in children with ADHD, particularly those with the ADHD-Predominantly Inattentive (ADHD-I) subtype.
Conclusions:
- Chronic snoring may be a specific correlate for a subset of children with ADHD, potentially those with ADHD-HI.
- While children with ADHD generally experience poorer sleep quality and greater daytime sleepiness, these two factors are not strongly interrelated.
- These findings highlight the heterogeneity of sleep disturbances within the ADHD population and suggest subtype-specific considerations.
Study Objectives:
To characterize the relationship between pediatric attention-deficit/hyperactivity disorder (ADHD) subtypes, chronic snoring, and indexes of sleep quality and daytime sleepiness.
Design:
A cross-sectional design with planned comparisons of ADHD (all subtypes) versus general community controls; ADHD Predominantly Inattentive Type (ADHD-I) versus a group with both ADHD Predominantly Hyperactive/Impulsive Type (ADHD-HI) and ADHD Combined Type (ADHD-C); and ADHD-HI versus ADHD-C.
Setting:
Subjects recruited from a pediatric clinic, a university psycholgy clinic, and the general community.
Participants:
Caretakers of 74 children (45 with ADHD, 29 community controls; 53 boys, 21 girls; mean age, 9.6 years; age range, 6 to 16 years). Thirty-two (71.1%) of the children with ADHD were taking stimulant medication and 7 (15.5%) were taking hypnotic medication.
Interventions:
N/A.
Measurements And Results:
Caretakers completed the Pediatric Sleep Questionnaire (PSQ) and the Children's Sleep-Wake Scale (CSWS). Only the ADHD-HI diagnosis was associated with an increased likelihood of chronic snoring. Sleep quality was poorer among children with ADHD than controls; however, there were no differences in sleep quality across ADHD subtypes. Sleepiness was greater in children with ADHD, especially the ADHD-I Type.
Conclusions:
Chronic snoring may be a correlated feature in only a subgroup of the ADHD population, possibly those more likely to be diagnosed with ADHD-HI. Although children with ADHD have poorer sleep quality and greater daytime sleepiness, these 2 features of ADHD are not closely related.
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