The Role of Sleep Duration and Sleep Problems During Childhood in the Development of ADHD in Adolescence: Findings From a Population-Based Birth Cohort

Abstract

Objective: We aimed to investigate the association between sleep in early life and ADHD in adolescence. As a secondary analysis, we tested whether the associations may be specific to ADHD. Method: Data from 3,467 participants of the 2004 Pelotas Birth Cohort were used. Information on their sleep duration and problems was collected at 12, 24, and 48 months of age. ADHD diagnosis and hyperactivity/inattention problems were assessed with the Development and Well-Being Assessment (DAWBA) and the Strengths and Difficulties Questionnaire (SDQ) among participants at 11 years of age. Results: Difficulty going to sleep at 24 months, nightmares at 24 months and at 48 months, and restless sleep at 48 months were consistently associated with ADHD as well as with other mental disorders. Conclusion: The results suggest that sleep disturbances may be more important ADHD predictors than sleep duration or sleep duration trajectories. However, it may also be considered early markers of other mental disorders.

Decoupling sleep and brain size in childhood: An investigation of genetic covariation in the ABCD study

“…45 Importantly, pediatric GWAS of sleep duration have found the largest (although not significant) genetic correlations between sleep duration and ADHD, 45 mirroring our findings of genetic pleiotropy between childhood insomnia and ADHD. Our findings of positive genetic correlations between childhood sleep disturbance and ADHD are also in agreement with previous research documenting behavioral comorbidity 46,47 and overlapping affected neural systems. 18 Further, we found that ADHD PRS predicted insomnia, suggesting that childhood insomnia may be an extension of pediatric ADHD/externalizing disorders.…”

Sleep-related traits and attention-deficit/hyperactivity disorder comorbidity: Shared genetic risk factors, molecular mechanisms, and causal effects

“…So far there is no consensus about the direction of the sleep-ADHD association, despite evidence showing that sleep deprivation and sleep disturbances have known cognitive emotional and behavioral effects that mimic ADHD 3,26,31 , and that early sleep disturbances are associated with an increased risk of ADHD later in life 28,29,31,33,77 . The TSMR analyses we carried out showed a causal effect of insomnia, daytime napping, and short sleep duration on ADHD.…”

“…Several observational studies have reported that sleep disturbances and short sleep duration are likely predisposing to ADHD 32,34,35 , whilst others have uncovered effects in the opposite direction 28,29,33,83 . However, inferring causality in observational studies is problematic due to unmeasured confounding, reverse causality, and other unknown biases 84,85 .…”

“…On the other hand, ADHD-like behaviors may also lead to altered patterns of sleep 26,27 . Early sleep disturbances predicting ADHD in the future are supported by longitudinal evidence [28][29][30][31][32] . In addition, the opposite direction, in which ADHD may precede sleep disturbances and sleep deprivation is also reported in the literature [33][34][35] .…”

Polygenic risk score analysis revealed shared genetic background in attention deficit hyperactivity disorder and narcolepsy

“…To date, the association of ADHD PRS has been reported with depressive symptoms 4 , body mass index 5 , substance use disorder 6 , and educational attainment 7 , but no examination has thus far been conducted with sleep disorders. Nevertheless, patients with ADHD frequently show excessive daytime sleepiness (EDS) 8 . Narcolepsy is characterized by EDS with or without cataplexy (sudden and uncontrollable muscle weakness or paralysis triggered by a strong emotion), hypnagogic hallucinations, and sleep paralysis (vivid and dream-like hallucinations and muscle paralysis while falling asleep), and disturbed nocturnal sleep.…”