Consequences of Confinement Due to COVID-19 in Spain on Anxiety, Sleep and Executive Functioning of Children and Adolescents with ADHD

Abstract

The outbreak and the quick expansion of SARS-CoV-2, from December 2019 to today, has forced countries around the world to resolve virus containment measures in order to slow down the contagion curve. Between these measures, the situation of lockdown, and the isolation or limitation of social contact between the citizens, there has been an unknown psychological impact. Certain groups (the elderly, children and teenagers, and the clinical population, for instance) arouse serious fears among professionals due to their greater vulnerability and ignorance regarding the short- and long-term consequences. The main purposes of this work are first of all to evaluate the consequences of the lockdown in children and teenagers diagnosed with attention deficit hyperactivity disorder (ADHD), sleep-related problems, and problems with executive functions. Secondly, we aim to compare the effects produced with respect to the previously mentioned variables with normotypic subjects; that is to say, between a group that was subject to lockdown and another group that was not confined. The findings show that the clinic confined group had high levels of state anxiety and problems with sleep and executive functions; differences could also be seen between the two groups, with the confined ADHD group being more negatively affected in all measured variables.

Changes in Sleep Patterns and Disorders in Children and Adolescents with Attention Deficit Hyperactivity Disorders and Autism Spectrum Disorders during the COVID-19 Lockdown

“…ASD patients showed less changes in weekday-weekend risetime than both ADHD and controls, while children with ADHD reported higher delays in bedtime than the other groups. Our findings are supported by specific studies on these two clinical groups and controls [ 2 , 16 ], reporting delayed bedtime in children with ADHD [ 10 , 17 ] and a reduced sleep duration in both ADHD and ASD [ 9 , 10 , 13 , 15 , 22 ].…”

“…Since sleep patterns significantly changed during the lockdown in typically developing children and adolescents [ 2 , 5 , 6 , 12 ], similar or even worse changes in subjects with ADHD and ASD could be expected. Several studies [ 9 , 10 , 13 , 14 , 15 , 16 , 17 ] reported a high percentage of patients with ASD or ADHD that changed their sleep with a significant worsening of sleep quality and disturbances during the lockdown. Specifically, ASD children showed significant worsening of sleep disturbances, sleep duration, and sleep quality [ 14 , 15 ] and an increase in bedtime resistance, delay in falling asleep, and night awakenings [ 17 ].…”

“…Specifically, ASD children showed significant worsening of sleep disturbances, sleep duration, and sleep quality [ 14 , 15 ] and an increase in bedtime resistance, delay in falling asleep, and night awakenings [ 17 ]. Children with ADHD showed an alteration of sleep patterns in 85% of cases [ 16 ] and, unlike their healthy peers in the control group that experienced an increase in school night sleep duration, they did not benefit from the COVID-19 lockdown [ 13 ].…”

How does the COVID-19 affect mental health and sleep among Chinese adolescents: a longitudinal follow-up study

“…The cross-sectional COVID-19 studies have also demonstrated the relationship between the change of mental health and sleep due to the COVID-19 pandemic [ 21 , 26 , [33] , [34] , [35] , [36] ]. For instance, Hyun, Hahm [ 33 ] reported that the symptoms of depression and anxiety explained poor sleep quality in young adults during the COVID-19 pandemic.…”

“…For instance, Hyun, Hahm [ 33 ] reported that the symptoms of depression and anxiety explained poor sleep quality in young adults during the COVID-19 pandemic. Navarro-Soria and Real-Fernández [ 36 ] demonstrated that children and adolescents under home confinement had higher state anxiety than the non-confinement ones, and state anxiety could further impact sleep. Recently, a larger-scale study with 6882 participants (18–94 years) from 59 countries reported that poorer sleep health was highly associated with more severe depression and anxiety symptoms during the COVID-19 pandemic [ 35 ].…”