Children's experiences of sleep disturbances in ADHD: A qualitative investigation

Sleep disturbances are nearly three times as common in children with Attention-Deficit/Hyperactivity Disorder (ADHD) than in the non-clinical child population. Nevertheless, little is known about how children with ADHD perceive their sleep disturbances, as existing literature relies on caregiver accounts. The current study aimed to investigate children's experiences of comorbid sleep disturbances.

Adopting a qualitative, child-centered approach the study draws on 15 semi-structured interviews with children aged 9-13 diagnosed with ADHD and parent-reported sleep disturbances. Reflexive thematic analysis was conducted.

Three themes were generated, including one comprising two subthemes. Theme 1 captures how the children often experience sleep disturbances as persistent, severe, and generally life aggravating. Theme 2 captures how the children commonly experience restlessness at bedtime and throughout the night, which is perceived as a central cause of sleep disturbances. Restlessness emerged as a mental and a physical phenomenon, thus the theme is divided into two subthemes, each exploring one of these manifestations. Theme 3 captures how conflicts at bedtime, concerning sleep and the process of going to bed, are common both with parents and within the child. These conflicts further shape bedtime and sleep as unpleasant experiences.

The findings reinforce the need for sustained clinical attention in this population, as sleep disturbances are commonly perceived as severe and persistent, with evenings and nights often dominated by restlessness and conflicts. The study represents a novel contribution to the field as one of few qualitative studies exploring pediatric ADHD-related sleep disturbances directly with a child participant group.