Sleep Problems and Daily Functioning in Children With ADHD: An Investigation of the Role of Impairment, ADHD Presentations, and Psychiatric Comorbidity

Virring, Anne; Lambek, Rikke; Jennum, Poul; Møller, Lene Ruge; Thomsen, Per Hove

doi:10.1177/1087054714542001

Cited by 35 publications

(43 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of findings emerged. First, results from questionnaire‐based measures and a 1‐week parent diary suggested that sleep problems are highly prevalent among children with ADHD and that it takes longer for children with ADHD than control children to fall asleep, which parallels what is reported generally in questionnaire studies of sleep in ADHD (Cortese et al ., ; Virring et al ., ; Yoon et al ., ). When sleep was measured through objective sleep measures, a higher numbers of sleep cycles, less total sleep time, less NREM 1 and NREM 3 sleep and more REM sleep were found in ADHD compared to controls.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies using questionnaire data have investigated the influence of ADHD presentation or psychiatric comorbidity on sleep in ADHD. The few studies that exist conclude that the presence of comorbid psychiatric disorders such as autism spectrum disorders or internalizing disorders seem to influence sleep, whereas the different ADHD presentations do not appear to differ with respect to sleep disturbance (Chiang et al ., ; Hansen et al ., ; LeBourgeois et al ., ; Mayes et al ., ; Virring et al ., ; Wagner et al ., ; Willoughby et al ., ).…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Disturbed sleep in attention‐deficit hyperactivity disorder (ADHD) is not a question of psychiatric comorbidity or ADHD presentation

Virring

Lambek

Thomsen

et al. 2016

Journal of Sleep Research

Self Cite

View full text Add to dashboard Cite

SUMMARYAttention-deficit hyperactivity disorder (ADHD) is a heterogeneous psychiatric disorder with three different presentations and high levels of psychiatric comorbidity. Serious sleep complaints are also common, but the role of the presentations and comorbidity in sleep is underinvestigated in ADHD. Consequently, the goal of the study was to investigate sleep problems in medicine-naive school-aged children (mean age = 9.6 years) with ADHD compared to controls using objective methods and to examine the role of comorbidity and presentations. Ambulatory polysomnography results suggested that children with ADHD (n = 76) had significantly more sleep disturbances than controls (n = 25), including a larger percentage of rapid eye movement (REM) sleep and more sleep cycles, as well as lower mean sleep efficiency, mean non-REM (NREM) sleep stage 1 and mean NREM sleep stage 3. No significant between-group differences were found on the multiple sleep latency test. Stratifying for comorbidity in the ADHD group did not reveal major differences between groups, but mean sleep latency was significantly longer in children with ADHD and no comorbidity compared to controls (36.1 min; SD = 30.1 versus 22.6 min; SD = 15.2). No differences were found between ADHD presentations. Our results support the presence of night-time sleep disturbances in children with ADHD. Poor sleep does not appear to be attributable to comorbidity alone, nor do sleep disturbances differ within ADHD presentations.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Disturbed sleep in attention‐deficit hyperactivity disorder (ADHD) is not a question of psychiatric comorbidity or ADHD presentation

Virring

Lambek

Thomsen

et al. 2016

Journal of Sleep Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…This is especially important since sleep problems predict functional impairment in youth with ADHD 17,29,31,70,71 . Appreciably, recent interventions have been developed that aim to directly target sleep problems in children with ADHD 72,73 .…”

Section: Discussionmentioning

confidence: 99%

“…Anxiety symptoms may be especially detrimental to the sleep functioning of children with ADHD 14,30 . It is less clear if externalizing behaviors such as oppositionality are associated with sleep functioning in children with ADHD 16,17,31–33 .…”

Section: Introductionmentioning

confidence: 99%

Sleep habits in children with attention-deficit/hyperactivity disorder predominantly inattentive type and associations with comorbid psychopathology symptoms

et al. 2016

View full text Add to dashboard Cite

Objectives Much of what is currently known about the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) is based on samples of children with ADHD Combined Type, and no study to date has examined the association between sluggish cognitive tempo (SCT) and sleep functioning in children diagnosed with ADHD. Accordingly, the objectives of this study were to (1) describe the sleep habits of children diagnosed with ADHD Predominantly Inattentive Type (ADHD-I), and (2) examine whether comorbid internalizing, oppositional, and/or sluggish cognitive tempo (SCT) symptoms are associated with poorer sleep functioning in children with ADHD-I. This study extends the current literature by using a large, clinical sample of children with ADHD-I to examine the association between SCT and other psychopathology symptoms with children’s sleep functioning. Methods Participants were 147 children (ages 6–11; 59% male; 55% White) diagnosed with ADHD-I using a semi-structured diagnostic interview. Parents completed measures assessing their child’s sleep habits as well as comorbid anxiety, depression, oppositionality, and SCT symptoms. Results Fourteen percent of children obtain less sleep than recommended and 31% have a sleep onset latency of greater than 20 minutes. The few children taking medication for ADHD had a longer sleep onset latency than unmedicated children. Twenty-seven percent of parents indicated that it is “difficult” to get their child out of bed on school days and 41% of parents indicated that their child needs to catch-up on sleep on the weekend “at least a little”. Regression analyses found anxiety and SCT sleepy/tired symptoms to be the most consistent dimensions of psychopathology associated with sleep functioning, with little support for depression or oppositionality being associated with sleep. Conclusions A sizeable minority of children with ADHD-I experience impaired sleep. Comorbid anxiety, in addition to SCT sleepy/tired symptoms, were most consistently associated with poorer sleep functioning in children with ADHD-I. Importantly, SCT daydreaming and SCT working memory symptoms were unassociated with sleep functioning, and the size of the effects between SCT sleepy/tired and sleep functioning indicates that these are not overlapping constructs. Longitudinal studies are needed to evaluate the interrelations of sleep problems and comorbid psychopathology symptoms and their impact on the daytime functioning of children with ADHD-I.

show abstract

“…For example, meta-analytic studies suggest high rates of sleep disturbance occur in both medicated and unmedicated children with ADHD (Cohen-Zion & Alcoli-Israel, 2004). Moreover, while sleep problems and impaired daily functioning are common among children with ADHD, theoverall associations between sleep problems and impaired daily functioning are similar in clinical and nonclinical children (Virring et al, 2014). …”

Section: Introductionmentioning

confidence: 99%

Sleep disturbance and neuropsychological function in young children with ADHD

Schneider

Lam

Mahone

2015

Child Neuropsychology

View full text Add to dashboard Cite

Sleep disturbance, common among children with ADHD, can contribute to cognitive and behavioral dysfunction. It is therefore challenging to determine whether neurobehavioral dysfunction should be attributed to ADHD symptoms, sleep disturbance, or both. The present study examined parent-reported sleep problems (Children’s Sleep Habits Questionnaire) and their relationship to neuropsychological function in 64 children, ages 4-7 years, with and without ADHD. Compared to typically developing controls, children with ADHD were reported by parents to have significantly greater sleep disturbance—including sleep onset delay, sleep anxiety, night awakenings, and daytime sleepiness—(all p≤0.01), and significantly poorer performance on tasks of attention, executive control, processing speed, and working memory (all p<0.01). Within the ADHD group, total parent-reported sleep disturbance was significantly associated with deficits in attention and executive control skills (all p≤0.01); however, significant group differences (relative to controls) on these measures remained (p<0.01) even after controlling for total sleep disturbance. While sleep problems are common among young children with ADHD, these findings suggest that inattention and executive dysfunction appear to be attributable to symptoms of ADHD, rather than to sleep disturbance. The relationships among sleep, ADHD symptoms, and neurobehavioral function in older children may show different patterns as a function of the chronicity of disordered sleep.

show abstract

Sleep Problems and Daily Functioning in Children With ADHD: An Investigation of the Role of Impairment, ADHD Presentations, and Psychiatric Comorbidity

Cited by 35 publications

References 33 publications

Disturbed sleep in attention‐deficit hyperactivity disorder (ADHD) is not a question of psychiatric comorbidity or ADHD presentation

Disturbed sleep in attention‐deficit hyperactivity disorder (ADHD) is not a question of psychiatric comorbidity or ADHD presentation

Sleep habits in children with attention-deficit/hyperactivity disorder predominantly inattentive type and associations with comorbid psychopathology symptoms

Sleep disturbance and neuropsychological function in young children with ADHD

Contact Info

Product

Resources

About