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Associations Between Child Sleep Problems and Maternal Mental Health in Children with ADHD

Christina A Martin¹, Nicole Papadopoulos², Nicole Rinehart²

¹School of Psychology, Deakin University , Geelong, VIC, Australia.

Behavioral Sleep Medicine

|November 26, 2019

Insights

Maternal anxiety and stress are linked to most childhood sleep issues in children with attention-deficit/hyperactivity disorder (ADHD). These findings suggest family-centered interventions for ADHD and parental mental health.

Area of Science:

Child Psychology
Neurodevelopmental Disorders
Maternal Mental Health

Background:

Children with attention-deficit/hyperactivity disorder (ADHD) exhibit higher sleep disturbances compared to neurotypical peers.
Mothers of children with ADHD report increased rates of depression and anxiety.
Existing research highlights the bidirectional relationship between parental mental health and child behavior.

Purpose of the Study:

To investigate the association between specific sleep problems in children with ADHD and maternal mental health difficulties.
To identify which maternal mental health issues correlate with particular sleep disturbances in children diagnosed with ADHD.
To inform family-centered intervention strategies for ADHD and co-occurring sleep and mental health issues.

Main Methods:

A cohort of 379 female caregivers of children aged 5-13 years with ADHD participated.
Caregivers completed the Depression Anxiety Stress Scale (DASS) for mental health assessment.
Children's sleep patterns were evaluated using the Children's Sleep Habits Questionnaire (CSHQ).

Main Results:

Adjusted analyses revealed significant associations between most child sleep problems (e.g., bedtime resistance, sleep duration, daytime sleepiness) and maternal anxiety and stress.
Maternal depression was also significantly associated with bedtime resistance, sleep duration, daytime sleepiness, and overall sleep problems in children.
Sleep anxiety in children showed a significant association with maternal anxiety, but not with maternal depression or stress.

Conclusions:

This study confirms significant links between various childhood sleep problems and maternal mental health indicators.
Findings support the integration of family-focused approaches in behavioral sleep interventions for children with ADHD and mental health support for parents.
Longitudinal research is recommended to further elucidate the interplay between child sleep and parental mental health for improved intervention development.

Read full analysis

Abstract:

Objective/Background: Children with attention-deficit/hyperactivity disorder (ADHD) experience more sleep problems than typically developing children. In addition, higher rates of depression are experienced by mothers of children with ADHD compared to mothers of children without ADHD. This study aimed to determine whether particular sleep problems in children with ADHD are associated with specific maternal mental health difficulties. Participants: Female caregivers of 379 children with ADHD (5-13 years) participated. The child's ADHD diagnosis was reconfirmed during recruitment by caregivers completing the ADHD Rating Scale-IV. Method: Caregivers reported on their mental health using the Depression Anxiety Stress Scale and their child's sleep using the Children's Sleep Habits Questionnaire. Unadjusted and adjusted regression analyzes were undertaken. Results: In the adjusted analyzes, there were small significant associations between most aspects of child sleep (i.e. Bedtime Resistance, Night Waking, Parasomnias, Sleep Duration, Daytime Sleepiness and Total Sleep Problems) and maternal Anxiety and Stress, with the exception of Sleep-Onset Delay. Bedtime Resistance, Sleep Duration, Daytime Sleepiness and Total Sleep Problems also had small significant associations with maternal Depression. Sleep Anxiety had a small significant association with maternal Anxiety only. Conclusions: This study demonstrates important connections between many child sleep problems and particular aspects of maternal mental health, suggesting adaptations to behavioral sleep interventions for children and mental health interventions for parents to take a family approach may be beneficial. Future research should consider the longitudinal associations between child sleep and parent mental health in an effort to inform future intervention approaches.

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