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Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD

Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD

Published on: March 12, 2020

Changes in sleep duration and disturbances during Covid-19 lockdown and internalizing-externalizing behaviors in

Maria Grazia Melegari¹, Raffaele Ferri², Martina Giallonardo³

¹Department of Developmental and Social Psychology, Sapienza University, Rome, Italy; Consortium Humanitas, Lumsa University, Rome, Italy.

|November 19, 2022

Insights

Sleep problems during COVID-19 lockdowns negatively impacted children with Attention Deficit Hyperactivity Disorder (ADHD). Children experiencing new or persistent sleep issues showed more internalizing and externalizing behaviors than those with no sleep problems.

Area of Science:

Pediatric Psychology
Neurodevelopmental Disorders
Sleep Medicine

Background:

The COVID-19 pandemic introduced significant disruptions to daily routines, including sleep patterns.
Children with Attention Deficit Hyperactivity Disorder (ADHD) are often more susceptible to sleep disturbances.
Understanding the impact of pandemic-related sleep changes on ADHD symptomology is crucial.

Purpose of the Study:

To investigate how alterations in sleep patterns and the emergence or resolution of sleep problems during the COVID-19 lockdown influenced the mood and behavior of children with ADHD.
To identify specific sleep problems that most significantly affect the daytime functioning of children with ADHD.

Main Methods:

A study involving 992 children diagnosed with ADHD (mean age 11.52 years) was conducted.
Parents reported on sleep changes (duration, onset/remission of problems) and emotional/behavioral functioning using validated questionnaires.
Statistical analyses examined the association between sleep pattern changes and internalizing/externalizing behavior scores.

Main Results:

Sleep duration changes had minimal impact on behaviors after controlling for covariates.
Children with ADHD and no sleep problems exhibited significantly lower internalizing and externalizing scores compared to those with new or persistent sleep issues.
Specific sleep problems like sleep terrors were associated with higher internalizing and externalizing scores.

Conclusions:

Sleep problems significantly impair the daytime functioning of children with ADHD.
Different types of sleep disturbances have varying impacts on mood and behavioral outcomes in this population.
Targeting specific sleep issues may be essential for improving the overall well-being of children with ADHD.

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Abstract

Objective:

To examine how changes in sleep patterns and sleep problems occurring between the pre-pandemic and the Covid-19 lockdown period influenced mood-behavioral functioning of children with Attention Deficit Hyperactivity Disorder (ADHD).

Methods:

Parents of 992 children with ADHD (85.4% boys, mean age: 11.52 years, SD = 3.17), recruited from the Italian ADHD family association, completed a modified version of the Sleep Disturbance Scale for Children and filled out 11 emotional behavioral items selected from the Child Behavior Checklist (CBCL) 6-18 questionnaire. Subgroups identified based on sleep duration changes ("maintained", "increased", "reduced") and of sleep problems during lockdown ("onset", "remission", "maintained", "no sleep problem") were analyzed to evaluate the association with internalizing and externalizing scores.

Results:

Sleep duration showed no or low influence on internalizing and externalizing behaviors after control for age, sex, and socioeconomic status. Patients with ADHD with "no sleep problem" showed significant lower scores in internalizing and externalizing behaviors than those who "maintained" or had "onset" of different sleep problems. The effect sizes were higher for internalizing than externalizing behaviors. Lower internalizing scores were found in those who remitted difficulty in falling asleep, daytime sleepiness, nightmares, vs. the "maintained" or "onset" groups and those who remitted hypnic jerks vs. the "onset" group. Children with ADHD who "maintained" sleep terrors reported higher internalizing and mainly externalizing scores than the other groups.

Conclusion:

Sleep problems negatively influence daytime functioning of patients with ADHD. but mood and behavioral domains show different susceptibility to the changes of sleep problems, and different vulnerability to specific sleep problems.

Keywords:

ADHD Covid 19 Internalizing and externalizing behaviors Lockdown Sleep disorder Sleep duration

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