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PurposePediatric, clinical, and research data suggest that insufficient sleep causes tiredness and daytime difficulties in terms of attention-focusing, learning, and impulse modulation in children with attention deficit hyperactivity disorder (ADHD) or in those with ADHD and primary sleep disorders. The aim of the present study was to examine whether sleep duration was associated with ADHD-like symptoms in healthy, well-developing school-aged children.Patients and methodsThirty-five healthy children (20 boys, 15 girls), aged 7–11 years participated in the present study. Each child wore an actigraphic device on their nondominant wrist for two nights prior to use of polysomnography to assess their typical sleep periods. On the third night, sleep was recorded via ambulatory assessment of sleep architecture in the child’s natural sleep environment employing portable polysomnography equipment. Teachers were asked to report symptoms of inattention and hyperactivity/impulsivity on the revised Conners Teacher Rating Scale.ResultsShorter sleep duration was associated with higher levels of teacher-reported ADHD-like symptoms in the domains of cognitive problems and inattention. No significant association between sleep duration and hyperactivity symptoms was evident.ConclusionShort sleep duration was found to be related to teacher-derived reports of ADHD-like symptoms of inattention and cognitive functioning in healthy children.

BackgroundChildren with attention-deficit/hyperactivity disorder (ADHD) are two to three times more likely to experience sleep problems. The purpose of this study is to determine the relative contributions of circadian preferences and behavioral problems to sleep onset problems experienced by children with ADHD and to test for a moderation effect of ADHD diagnosis on the impact of circadian preferences and externalizing problems on sleep onset problems.MethodsAfter initial screening, parents of children meeting inclusion criteria documented child bedtime over 4 nights, using a sleep log, and completed questionnaires regarding sleep, ADHD and demographics to assess bedtime routine prior to PSG. On the fifth night of the study, sleep was recorded via ambulatory assessment of sleep architecture in the child’s natural sleep environment employing portable polysomnography equipment. Seventy-five children (26 with ADHD and 49 controls) aged 7–11 years (mean age 8.61 years, SD 1.27 years) participated in the present study.ResultsIn both groups of children, externalizing problems yielded significant independent contributions to the explained variance in parental reports of bedtime resistance, whereas an evening circadian tendency contributed both to parental reports of sleep onset delay and to PSG-measured sleep-onset latency. No significant interaction effect of behavioral/circadian tendency with ADHD status was evident.ConclusionsSleep onset problems in ADHD are related to different etiologies that might require different interventional strategies and can be distinguished using the parental reports on the CSHQ.

Objective We sought to determine the dose-response effects of extended-release (ER) dexmethylphenidate (d-MPH) and ER mixed amphetamine salts (MAS) on objective measures of sleep. Methods This was an 8-week, double-blind, placebo-controlled, randomized, two period, crossover study of youth with attention-deficit hyperactivity disorder (ADHD) as confirmed by the Kiddie Schedule for Affective Disorders for School-Age Children–Present and Lifetime version (K-SADS-PL). Children aged 10–17 years were recruited from clinical practice, colleague referrals, and flyers. Participants were randomized to initially receive either d-MPH or MAS. During each 4-week drug period, children received three dose levels (10, 20, and 25/30 mg) in ascending order, with placebo substituted for active medication in a randomized fashion during 1 week of the study. After 4 weeks, participants were switched to the alternative medication for another 4 weeks of treatment. The main outcome measure was sleep duration as measured by actigraphy. Children, parents, and researchers were blinded to drug, dose, and placebo status. Results Sixty-five participants met the inclusion criteria and were enrolled in the study. Of these, 37 participants with sufficient sleep data for analysis were included. Sleep schedule measures showed a significant effect for dose on sleep start time (F(1,36) = 6.284; p < 0.05), with a significantly later sleep start time when children were receiving 20- or 30-mg doses, compared with placebo (p < 0.05). A significant dose effect was found on actual sleep duration (F(1,36) = 8.112; p < 0.05), with significantly shorter actual sleep duration for subjects receiving 30 mg compared with those receiving placebo (p < 0.05). There were no significant differences on sleep duration or sleep schedule between the two stimulant medications. The trial is complete and closed to follow-up. Conclusions Higher stimulant doses were associated with reduced sleep duration and later sleep start times, regardless of medication class. Trial registration ClinicalTrials.gov: NCT00393042.

). The increase in technologically assisted psychoeducational interventions using text, apps, and interactive Internet-based programming results in a qualitative update of psychoeducational interventions and program evaluations. Also noted is an increase in the number of family-focused interventions that have been evaluated and published. The results of the current comprehensive literature review yield 42 evaluative studies of psychoeducational interventions for adolescents with type 1 diabetes with mixed outcomes. Despite the variety of interventions and research designs, only two of the 42 studies reported moderate effect sizes. All the others indicated no effects or small effects. Although not conclusive, the most promising approaches involve the use of motivational interviewing involving individual, family, and technological support. The ramifications for future research, potential value of psychoeducational interventions for adolescents, and implementation of technology for delivering psychoeducational interventions for adolescents with diabetes are described. Background Type 1 diabetes is one of the most common chronic illnesses affecting young people in North America (Babler & Strickland, 2015). The incidence of diabetes is growing in the general population, but this growth is especially apparent in low socioeconomic status and ethnic minority groups (Kassai et al., 2015). Being diagnosed with diabetes has a negative influence on academic, social, medical, and overall well-being. However, these negative outcomes are mitigated by effective medical and psychoeducational management (Murphy, Wadham, Hassler-Hurst, Rayman, & Skinner, 2012). Medical management of diabetes requires a multidisciplinary approach that includes medical treatment and adherence to supportive lifestyle management (Sajatovic et al., 2011;Shalev, & Geffken, 2015). Changing behaviour involves psychoeducational interventions that are implemented by physicians, nurses, educators, and parents for the benefit of adolescents. However, the effectiveness of these interventions for changing long-term behaviours is not clear.Adolescents with diabetes present a specific set of developmental challenges in care and management. There is an increased desire for independence, yet the daily living skills required for independence are developing (Markowitz, Garvey, & Laffel, 2015). For all adolescents, this is a challenging developmental period. Many experience a wide range of adjustment and mental health problems (Chilton & Pires-Yfantouda, 2015). Behavior patterns established during this process, including those related to the management of chronic medical issues such as diabetes, can have long-lasting positive or negative effects on future health and well-being. As a result, professionals have unique opportunities to influence adolescents. Parents, members of the community, medical professionals, and educators have the responsibility to promote adolescent development and adjustment as well as to intervene effectively when problems arise. For adolescent...