The relationship between sleep and problem behaviors in children with attention-deficit/hyperactivity disorder
Fanar Ghanim1, Kelsey Harkness1, Bevin Wiley1
1Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Insights
Parent-reported sleep issues in children with ADHD correlate with behavioral problems, unlike data from wearable sleep trackers. These findings highlight the importance of subjective sleep reports in understanding ADHD and child well-being.
Area of Science:
- Neurodevelopmental disorders
- Pediatric sleep science
- Child psychology
Background:
- Children with attention deficit/hyperactivity disorder (ADHD) experience more parent-reported sleep difficulties than neurotypical children.
- Commercially available actigraphy did not show differences in sleep patterns between children with and without ADHD.
- Actigraphy-measured sleep showed no correlation with parent-reported behavioral difficulties in children.
Purpose of the Study:
- To investigate the relationship between sleep disturbances and behavioral problems in children diagnosed with ADHD.
- To compare sleep data from parent reports (SDSC) and wearable actigraphy (Fitbit) in relation to ADHD-related behaviors.
- To identify key determinants of behavioral and emotional responses in children with ADHD, focusing on sleep quality.
Main Methods:
- Utilized data from the Adolescent Brain Cognitive Development (ABCD) database.
- Included 212 children aged 10-13 with ADHD and 212 age/sex-matched controls.
- Collected sleep data via Sleep Disturbance Scale for Children (SDSC) and wearable actigraphy (Fitbit); behavioral data from Child Behavior Checklist (CBCL).
Main Results:
- Significant differences in sleep parameters were found between ADHD and control groups using the SDSC, but not with wearable actigraphy.
- ADHD diagnosis, family income, and specific SDSC subscores were significantly associated with problem behavior scores on the CBCL.
- Wearable actigraphy measures, including sleep latency, did not significantly correlate with problem behavior scores.
Conclusions:
- Parent-reported sleep difficulties are associated with behavior and emotional responses in children with ADHD, whereas wearable actigraphy measures are not.
- Comprehensive evaluation of sleep in children with ADHD should include parent reports, direct sleep measures, and behavioral assessments.
- Understanding subjective sleep experiences is crucial for addressing the health and functioning of children with ADHD.
Abstract:
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is commonly associated with sleep disturbances. Sleep disruption can contribute to difficulties in a child's life and, therefore, can be an important determinant of their quality of life. This study uses data from the large multisite Adolescent Brain Cognitive Development (ABCD) database to examine the relationship between sleep and behavior in children with ADHD. We hypothesized that shorter and more interrupted sleep would relate to increased problem behaviors such as inattention and social difficulties. Sleep data was obtained using commercially available actigraphy (Fitbit) measures, and the Sleep Disturbance Scale for Children (SDSC) for 212 children ages 10 to 13 years, with ADHD and an age and sex matched control group (n = 212). Behavioral and emotional subscores were obtained from the Child Behavior Checklist (CBCL). SDSC sleep data was significantly different between ADHD and control groups, while wearable actigraphy data was not. ADHD diagnosis, family income, sleep latency (measured by wearable device), and 3 out of 6 of the SDSC subscores were significantly related to problem behavior scores measured by the CBCL.
Conclusion:
The results of this study indicate that parent report of sleep difficulties, but not wearable actigraphy measures of sleep, were associated with behavior and emotional responses in children with ADHD. Parent report of sleep difficulties, direct measures of sleep parameters, as well as behavior and quality of life, should be considered when evaluating or investigating sleep in children to better understand the influence on health and functioning.
What Is Known:
• Children with attention deficit/hyperactivity disorder (ADHD) have increased parent-reported sleep difficulties compared to neurotypical children.
What Is New:
• Sleep measures from commercially available actigraphy were not different in children with ADHD compared to those that do not have ADHD. • Sleep measured from commercially available actigraphy had no correlation with parent-reported behavior difficulties.
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