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The associations of insomnia symptoms with daytime behavior and cognitive functioning in children with

Xiao Li1, Ka Sin Caroline Shea2, Waiyan Vivian Chiu1

  • 1Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region (SAR).

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|May 31, 2022
PubMed

Insights

Children with attention-deficit/hyperactivity disorder (ADHD) and insomnia symptoms exhibit more severe ADHD symptoms and cognitive deficits, particularly in sustained attention and processing speed. Further research is needed to understand long-term impacts.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Neurodevelopmental Disorders

Background:

  • Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
  • Insomnia symptoms frequently co-occur with ADHD, potentially exacerbating core symptoms and impacting daily functioning.
  • Understanding the relationship between sleep disturbances and cognitive deficits in ADHD is crucial for effective management.

Purpose of the Study:

  • To investigate the association between insomnia symptoms and daytime behavior in children with ADHD.
  • To examine the impact of insomnia symptoms on cognitive functioning in children diagnosed with ADHD.
  • To compare cognitive performance and ADHD symptom severity between children with ADHD with and without insomnia symptoms.

Main Methods:

  • A cross-sectional study involving three groups: children with ADHD and insomnia, children with ADHD without insomnia, and healthy controls (ages 6-12).
  • Parent-report questionnaires assessed insomnia (Children's Sleep Habits Questionnaire) and ADHD symptoms (SWAN).
  • A cognitive test battery evaluated sustained attention (CPT), processing speed (Letter-digit), working memory (Digit Span, N-back), planning (TOL), and set-shifting (BCST).

Main Results:

  • Children with ADHD and insomnia reported significantly higher ADHD symptom scores (total, inattention, hyperactivity) compared to those with ADHD alone and controls.
  • After controlling for confounders, children with ADHD and insomnia demonstrated poorer performance on the Continuous Performance Test (sustained attention) and Letter-digit test (processing speed).
  • These findings indicate a link between insomnia symptoms and specific cognitive impairments in the ADHD population.

Conclusions:

  • Insomnia symptoms are associated with increased ADHD symptom severity and cognitive impairments, particularly in sustained attention and processing speed, in children with ADHD.
  • Longitudinal studies are warranted to elucidate the long-term effects of insomnia on cognitive function in this population.
  • Sleep-focused interventions may offer a potential avenue for improving cognitive outcomes in children with ADHD and comorbid insomnia.
Abstract

Keywords:
ADHDchildrencognitive functioningdaytime behaviorinsomniasleep

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