Sleep problems and profiles in attention deficit hyperactivity disorder assessed by the Children Sleep Habits Questionnaire-Abbreviated in Colombia

Abstract

Introduction. Sleep problems are frequent in patients with attention deficit hyperactivity disorder (ADHD), but often underestimated in clinical settings. Objective. To describe the main characteristics of sleep habits in an ADHD outpatient population using the Children Sleep Habits Questionnaire-Abbreviated (CSHQ-A) to compare ADHD groups according to the presence of comorbidity and the presence of current treatment, and to determine sleep profiles by using latent class analysis (LCA). Method. A sample of 228 ADHD patients (Mage = 11.5 years old, (IR = 9 -15) were enrolled. ADHD comorbidities and treatments were registered. Parents/caregivers filled out the questionnaire. Participants groups were compared, and LCA was used to classify profiles of similar sleep patterns. Results. The ADHD group with treatment had a higher score in the CSHQ-A than the group without treatment. Four classes emerge: Class 1 only children, males, half with comorbid ADHD, many with treatment, and with many sleep problems (CSHQ-A mean: 25.98). Class 2: mostly adolescents, female, with comorbid anxiety disorder, and who did not show sleep problems (CSHQ-A mean: 12.78). Class 3: only adolescents, males, comorbid with major depressive disorder and CSHQ-A who showed many sleep problems. Class 4: only children, males, the majority with treatment, with some sleep problems. Discussion and conclusion. In this ADHD sample, patients with psychopharmacological treatment have a greater report of sleep problems by the CSHQ-A compared to those who do not receive treatment. RESUMENIntroducción. Los problemas del sueño son frecuentes en pacientes con trastorno por déficit de atención con hiperactividad (TDAH), pero a menudo se subestiman en la consulta. Objetivo. Describir las principales características de los hábitos de sueño en una población de pacientes ambulatorios con TDAH utilizando el Cuestionario de Hábitos de Sueño de Niños-Abreviado (CSHQ-A), comparar los grupos con TDAH según la presencia de comorbilidad y de tratamiento actual y determinar los perfiles del sueño mediante el análisis de clase latente (ACL). Método. Se recogió una muestra de 228 pacientes con TDAH (edad M = 11.5 años, (RI = 9 -15). Los padres / cuidadores completaron el cuestionario. Se compararon los grupos de participantes y se utilizó el ACL para clasificar los perfiles de patrones de sueño similares. Resultados. El grupo con TDAH con tratamiento tuvo una puntuación más alta en CSHQ-A que el grupo sin tratamiento. Surgieron cuatro clases: Clase 1 sólo niños varones, mitad con TDAH comórbido, muchos con tratamiento y con muchos problemas de sueño (media CSHQ-A: 25.98). Clase 2: la mayoría mujeres adolescentes con trastorno de ansiedad comórbido y sin problemas de sueño (CSHQ-A media: 12.78). Clase 3: adolescentes, varones, con depresión comorbida: el CSHQ-A mostró muchos problemas de sueño. Clase 4: sólo niños, hombres, la mayoría con tratamiento, con algunos problemas de sueño. Discusión y conclusión. En esta muestra de TDAH, los pacientes con tratamiento psicofarmacológi...

Effect of Screen Time on Physical and Mental Health and Eating Habits During COVID-19 Lockdown in Lebanon

“…“Always” is referred if the abnormal sleep behavior occurs seven times in the past week, “usually” if the behavior occurs 5–6 times in the past week, “sometimes” for 2–4 times that week, “rarely” for once a week, and “never” for zero times a week. An abnormal sleep behavior is indicated by a total score of more than 30 on the CSHQ [ 19 ].…”

Sleep, Function, Behaviour and Cognition in a Cohort of Children with Down Syndrome

“…This was a key consideration for our participants, who were completing multiple detailed questionnaires, and this therefore reduced the questionnaire burden for parents in this group. Despite no formal validation studies, this version has been successfully used in studies of children with developmental disabilities including children with Autism Spectrum Disorder (ASD) [35], Attention Deficit Hyperactivity Disorder (ADHD) [36] and Duchenne Muscular Dystrophy (DMD) [37]. Items are rated on a five-point scale (score 1-5) ranging from "always" if the sleep behaviour occurred 7 times in the past week, "usually" if the behaviour occurred 5-6 times in the past week, "sometimes" for 2-4 times that week, "rarely" for 1 time that week and "never" for 0 times that week.…”

“…Five questions (Q1, 2, 3, 10 and 19) are reverse scored, with 1 indicating "always" and 5 indicating "never". The cut-off for clinically relevant sleep problems used in other studies with the CSHQ-A was 41 in one study and 30 in another [35,36]. In the current study, a total score of more than 41 was taken as abnormal and indicative of sleep problems [31,32].…”

Clock Genes Profiles as Diagnostic Tool in (Childhood) ADHD—A Pilot Study

“…The authors themselves discussed the comorbidities as confounding factors for their result while we explicitly excluded patients with comorbidities. Palacio-Ortiz et al (2018) described significantly higher scores (total score, bedtime resistance, sleep onset delay, sleep anxiety, parasomnias, sleep-disordered breathing, daytime sleepiness, night wakings) for a group of n = 228 children with ADHD (n = 142 without medication, n = 86 with medication) and discussed medication as well as comorbidities as important confounding factors [ 30 ]. In our study, all subjects were drug naive.…”

“…The Children’s Sleep Habits Questionnaire (CSHQ) is a parent-report screening survey published by Owens et al in 2000, which has been validated for school-aged children [ 28 ]. It has been translated into many languages [ 29 , 30 , 31 ] and used in multiple studies on children of different ages and neuro-developmental conditions [ 10 , 32 , 33 ]. In our study, we used the German version translated and validated by Schlarb et al (2010).…”