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Parent and carer perspectives on behavioural sleep management strategies for children with ADHD
Samantha J Hornsey1, Alison Rowsell2, Catherine M Hill3
1Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK; Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
Insights
Parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and chronic insomnia find behavioral sleep strategies challenging to implement. They desire flexible digital support that validates their experiences and includes peer testimonials.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychology
- Behavioral Health
Background:
- Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent in children, often co-occurring with chronic insomnia.
- Chronic insomnia in children with ADHD negatively impacts child development, family well-being, and exacerbates ADHD symptoms.
- Behavioral sleep interventions are first-line treatments but face implementation challenges for parents/carers.
Purpose of the Study:
- To explore parents/carers' views on behavioral sleep management strategies for children with ADHD and insomnia.
- To understand parents/carers' help-seeking behaviors for childhood sleep problems.
- To gauge parent/carer perceptions of a potential digital sleep guide for managing childhood sleep issues.
Main Methods:
- Qualitative study employing semi-structured interviews with 18 parents/carers of children with ADHD and chronic insomnia symptoms.
- Participants recruited via social media and purposively sampled for diversity.
- Inductive thematic analysis of transcribed interview data.
Main Results:
- Parents/carers value behavioral sleep strategies but face challenges in implementation due to perceived ineffectiveness, real-world difficulties, child's behavior, and parental exhaustion.
- Parents/carers expressed openness to digital sleep support, citing a perceived lack of professional help.
- Key needs for digital interventions include flexibility, realistic expectations, pragmatic approaches, and peer support/testimonials.
Conclusions:
- Parents/carers require tailored, flexible support and reassurance when managing sleep problems in children with ADHD and chronic insomnia.
- Digital sleep guides should validate parent/carer experiences and incorporate testimonials from other parents/carers to enhance engagement and effectiveness.
Objective/Background:
Attention-Deficit/Hyperactivity Disorder (ADHD) is common in children. Many children with ADHD have chronic insomnia, which is associated with negative outcomes for the child and family and can worsen ADHD symptoms. Behavioural sleep interventions can be effective for children with ADHD and are the recommended first-line approach to management. However, many parents/carers may not have access to, or struggle to implement, interventions in practice. This study explored parents/carers views and experiences of: 1) behavioural sleep management strategies, 2) help-seeking for managing sleep problems and 3) perceptions about a potential digital sleep guide for managing sleep problems.
Patients/Methods:
A qualitative study using semi-structured interviews of parents/carers of children with ADHD/ADHD traits and chronic insomnia symptoms (CIS). Participants were recruited via social media and purposively sampled for diverse characteristics. Interviews were conducted by telephone/videocall, recorded and transcribed verbatim. Data were analysed using inductive thematic analysis.
Results:
Eighteen parents/carers took part; two themes and six subthemes were developed. Despite valuing behavioural sleep strategies, parents/carers noted many challenges to engaging with them, including perceiving these strategies to be both ineffective for children with ADHD and not easy to implement in the real world. They described that tiredness, exhaustion, ADHD symptoms and challenging behaviour make parent engagement with strategies difficult. Parents/carers welcomed digital support in principle, particularly because they perceived health professional support to be lacking. However, they noted that digital interventions must address their key support needs regarding flexibility, realistic expectations and a pragmatic approach, as well as comradeship, support and testimonials from other parents/carers.
Conclusion:
Tailored but flexible support and reassurance are necessary for parents/carers of children with ADHD and CIS. Digital support must validate parent/carer experiences and include experiences from other parents/carers.
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