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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

Variation in sleep profiles in children with ADHD and associated clinical characteristics

Emma Sciberras^1,2,3, Harriet Hiscock^2,3,4, Samuele Cortese^5,6,7,8,9

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

Journal of Child Psychology and Psychiatry, and Allied Disciplines

|June 5, 2023

Insights

Children with attention-deficit/hyperactivity disorder (ADHD) experience varied sleep issues. Identifying specific sleep profiles and associated factors is crucial for developing tailored interventions for ADHD sleep difficulties.

Area of Science:

Child and Adolescent Psychiatry
Sleep Medicine
Neurodevelopmental Disorders

Background:

Sleep difficulties are frequently observed in children with attention-deficit/hyperactivity disorder (ADHD).
The heterogeneity of sleep problems within this population necessitates detailed investigation.
Understanding variations in sleep difficulties and their clinical correlates is essential.

Purpose of the Study:

To identify distinct profiles of sleep difficulties in children with ADHD.
To examine the association between these sleep profiles and clinical factors, including co-occurring mental health conditions, stimulant use, and parental mental health.

Main Methods:

Utilized data from two harmonized studies involving 392 children with ADHD (ages 5-13).
Employed latent profile analysis to categorize sleep difficulty patterns.
Used multinomial logistic regression to assess clinical correlates of identified sleep profiles.

Main Results:

Identified five sleep profiles: insomnia/delayed sleep phase (36%), generalized sleep difficulties (25%), high anxiety/bedtime resistance (11%), overnight difficulties (5%), and no difficulties (22%).
Generalized, anxious/bedtime resistance, and insomnia/delayed sleep phase profiles were associated with greater parent-reported emotional/conduct symptoms, anxiety, and parental mental health issues.
The generalized and anxious/bedtime resistance groups showed higher parent-reported ADHD symptoms; the anxious/bedtime resistance group also had more depression and teacher-reported emotional symptoms.

Conclusions:

Sleep difficulties in children with ADHD are diverse and present in distinct profiles.
Interventions must consider these specific sleep profiles and associated clinical characteristics.
Tailored approaches, including addressing parental mental health, are likely necessary for effective support.

Read full analysis

Abstract

Background:

Sleep difficulties are common in children with attention-deficit/hyperactivity disorder (ADHD). However, sleep problems are multifaceted and little is known about the variation in sleep difficulties across children with ADHD. We examined the profiles of sleep difficulties in children with ADHD and associated clinical factors (e.g. co-occurring mental health conditions, stimulant use and parent mental health).

Methods:

Data from two harmonised studies of children with ADHD (total: N = 392, ages 5-13 years) were used. Parents completed measures of children's sleep, co-occurring mental health conditions and their own mental health. Both parents and teachers completed measures of child ADHD symptoms and emotional and conduct symptoms. Latent profile analysis was used to identify sleep profiles, and multinomial logistic regression assessed clinical correlates of the groups.

Results:

Five sleep profiles were identified: (a) insomnia/delayed sleep phase (36%), (b) generalised sleep difficulties at sleep onset and overnight (25%), (c) high anxious/bedtime resistance difficulties (11%), (d) overnight sleep difficulties including obstructive sleep apnoea and parasomnias (5%) and (e) no sleep difficulties (22%). Compared with the group without sleep difficulties, the generalised, anxious/bedtime resistance and insomnia/delayed sleep phase sleep had greater parent-reported emotional and conduct symptoms, co-occurring anxiety and increased parent mental health difficulties. The generalised and anxious/bedtime resistance groups also had greater parent-reported ADHD symptoms, with the anxious/bedtime resistance sleep group also having more frequent co-occurring depression and teacher-reported emotional symptoms.

Conclusions:

The sleep difficulties experienced by children with ADHD are varied. Supports to help children with ADHD need to consider the particular profiles of sleep difficulties experienced and broader clinical characteristics. Tailored intervention approaches are likely needed (including a need to address parent mental health).

Keywords:

Attention-deficit/hyperactivity disorder bedtime comorbidity sleep

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