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Sleep disturbance in preschool-aged hyperactive and nonhyperactive children
B J Kaplan1, J McNicol, R A Conte
1Department of Pediatrics, University of Calgary, Alberta, Canada.
Insights
Children with attention deficit disorder with hyperactivity experience more night wakings, challenging the notion of overall poor sleep. Parental reports indicate increased sleep disturbances, but objective measures show similar sleep duration and onset.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychology
- Neurodevelopmental Disorders
Background:
- Attention deficit disorder with hyperactivity (ADHD) is often associated with sleep problems, despite limited empirical evidence.
- Sleep disturbances are included in diagnostic criteria and symptom checklists for ADHD.
- Previous research has relied heavily on parental reports, which may be subject to bias.
Purpose of the Study:
- To investigate sleep problems in preschool-aged children with ADHD compared to controls.
- To differentiate between subjective parental reports and objective sleep measures.
- To identify specific sleep-related issues associated with ADHD.
Main Methods:
- Three studies were conducted involving preschool-aged children diagnosed with ADHD and a control group.
- Parental questionnaires and daily sleep diaries were utilized.
- Objective sleep parameters such as total sleep time and sleep onset latency were assessed.
Main Results:
- Parents of children with ADHD reported significantly more sleep problems than parents of control children.
- Objective data revealed no significant differences in total sleep time or sleep onset latency between groups.
- Increased frequency of night wakings was observed in children with ADHD.
- Enuresis and night sweats were more prevalent in subgroups of children with ADHD.
Conclusions:
- While parental reports suggest widespread sleep issues in children with ADHD, objective measures indicate specific disturbances like increased night wakings.
- The frequent night wakings may contribute to the perception of poor sleep in children with ADHD.
- Further research is needed to understand the underlying mechanisms and implications of these specific sleep disturbances.
Abstract:
In spite of inadequate laboratory demonstrations of sleep problems in children with attention deficit disorder with hyperactivity, the belief persists that such problems exist. Sleep restlessness is, in fact, one of the criteria in the Diagnostic and Statistical Manual of Mental Disorders, ed 3, definition of attention deficit disorder with hyperactivity, and sleep problems are listed on two major checklists often used for describing the symptoms of this disorder. In a series of three studies, sleep problems were investigated in preschool-aged children with attention deficit disorder relative to control children without the disorder. Results of the first two studies demonstrated clearly that parents of hyperactive children considered their children to have many more sleep problems than did parents of the control children. Parental daily documentation, which is less likely to be affected by reporting bias, was used in the third study. Although the results of the third study supported the finding of increased frequency of night wakings in these children, there was no difference in total sleep time or sleep onset latency between the two groups. Two other significant group differences (enuresis and night sweats) were primarily due to subgroups of children with attention deficit disorder and hyperactivity. The greater number of sleep wakings, which disrupt parents' sleep, may be responsible for the clinical reports that these children are poor sleepers.