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Parent-reported attention-deficit/hyperactivity disorder symptomatology and sleep problems in a preschool-age
Michael T Willoughby1, Adrian Angold, Helen L Egger
1Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Carrboro, NC 27510, USA. willoughby@unc.edu
Insights
Attention-deficit/hyperactivity disorder (ADHD) in preschoolers is linked to sleep issues, but only inattentive symptoms specifically predict daytime sleepiness, even with other conditions present.
Area of Science:
- Child Psychology
- Developmental Neuroscience
- Sleep Medicine
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
- Sleep problems are frequently reported in children with ADHD.
- The specific relationship between ADHD symptomatology and various sleep issues in preschoolers requires further clarification.
Purpose of the Study:
- To investigate the association between ADHD symptoms and parent-reported sleep problems in preschoolers aged 2-5 years.
- To differentiate the impact of hyperactive-impulsive versus inattentive symptoms on sleep.
- To control for psychiatric comorbidities and demographic factors in the analysis.
Main Methods:
- A cohort of 1,073 parents of preschoolers completed the Child Behavior Checklist.
- A subsample underwent the Preschool Age Psychiatric Assessment.
- Poisson regression analyzed the link between ADHD symptoms and sleep problems, adjusting for covariates.
Main Results:
- Elevated hyperactive-impulsive symptoms correlated with sleep assistance, parasomnias, and dyssomnias, but this link disappeared when controlling for comorbidities.
- Elevated inattentive symptoms were significantly associated with daytime sleepiness, independent of other psychiatric conditions.
Conclusions:
- Neither hyperactive-impulsive nor inattentive ADHD symptoms were uniquely linked to sleep assistance, parasomnias, or dyssomnias.
- Inattentive ADHD symptomatology showed a unique association with daytime sleepiness in preschoolers, beyond other factors.
Objective:
To examine the association between attention-deficit/hyperactivity disorder symptomatology and parent-reported sleep problems among preschoolers ages 2 to 5 years.
Method:
A total of 1,073 parents of preschoolers ages 2 to 5 years attending a large pediatric clinic completed the Child Behavior Checklist 1(1/2)-5 years. A stratified probability sample of 193 parents of high scorers and 114 parents of low scorers were interviewed with the Preschool Age Psychiatric Assessment. Poisson regression was used to test the association between parent-reported sleep problems and attention-deficit/hyperactivity disorder symptomatology, as well as psychiatric and demographic covariates.
Results:
When considered without reference to other psychiatric disorders, elevated hyperactive-impulsive symptomatology was positively associated with parent reported problems including sleep assistance, parasomnias, and dyssomnias; however, all of these effects were attenuated to nonsignificance once psychiatric comorbidity was controlled. In contrast, elevated inattentive symptomatology (especially at lower levels of hyperactive-impulsive symptoms) was positively associated with daytime sleepiness even after psychiatric comorbidity was controlled.
Conclusions:
Neither hyperactive-impulsive nor inattentive attention-deficit/hyperactivity disorder symptomatology was uniquely related to parent-reported problems involving sleep assistance, parasomnias, or dyssomnias. However, inattentive symptomatology was uniquely related to daytime sleepiness above and beyond commonly occurring patterns of psychiatric comorbidity, sleep duration, and demographic factors.
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