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Objective/background: Few adolescents report obtaining adequate amounts of sleep. Correlational studies have linked adolescent short sleep with driving crashes and sluggish cognitive tempo (SCT), a cluster of symptoms that include sluggishness and low persistence which are related to but distinct from inattention and sleepiness. The relationship between SCT and driving is understudied and no study has experimentally examined the relation between SCT and sleep. We examined the relationship between SCT and driving problems in a sample of chronically short-sleeping adolescents. We also examined whether experimentally extending sleep improved SCT and driving behaviors. Participants/Methods: Licensed 16–18-year-olds who regularly obtain 5–7 hours of sleep completed a 5-week at-home experimental protocol: a baseline week to determine typical sleep (TYP), followed in counterbalanced order by 2-week spans in which school-night bedtimes and rise times were (a) matched to TYP, or (b) modified to extend (EXT) time in bed by 1.5 hours/night. Sleep was monitored via actigraphy. Self- and parent-reported SCT and inattention, as well as self-report of driving problems, were obtained at baseline and following each condition. Of the 38 eligible participants who completed the baseline session, 24 completed all 5 weeks. Results: After controlling for inattention, only parent-reported SCT was significantly positively associated with self-report of purposeful driving violations at baseline. Adolescents reported less SCT during EXT than TYP. Also after controlling for inattention, participants who reported improvement in SCT demonstrated fewer driving problems during EXT than during TYP. Conclusions: Preliminary findings suggest that extending sleep in short-sleeping adolescents may help alleviate SCT symptoms and improve driving.

The use of stimulants as a treatment for attention-deficit/hyperactivity disorder (ADHD) among elite athletes is a controversial area with some arguing that stimulant use should not be permitted because it offers an advantage to athletes (fair play perspective). Guided by an integrated model of athletic performance, we address common concerns raised about stimulant use in sports from our perspective, which we coined the "performance and health perspective," highlighting relevant research and pointing to gaps in empirical research that should be addressed before bans on use of stimulants for athletes with ADHD are considered. The current article posits that a stimulant ban for athletes with ADHD does not necessarily facilitate fair play, ensure safety, or align with existing policies of large governing bodies. Instead, we recommend that stimulant medication be allowed in high-level sport, following proper diagnosis by a trained professional and a cardiac assessment to confirm no underlying heart conditions. Athletes with ADHD approved to use stimulant medication should be monitored by a health care professional, physically reevaluated and reassessed for ADHD as clinically appropriate and as indicated by relevant sports governing bodies. This performance and health perspective is consistent with that of multiple sport governing bodies who offer therapeutic use.