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Sleep problems and daytime sleepiness in children with ADHD: Associations with social, emotional, and behavioral functioning at school, a cross-sectional study.
Behav Sleep Med. 2019 Jul-Aug; 17(4):411-422.BS

Abstract

Background:

Sleep problems and daytime sleepiness are common in children with attention-deficit hyperactivity disorder (ADHD) and are associated with poor parent-reported functional outcomes. However, the potential impact of sleep problems or daytime sleepiness on the school functioning of children with ADHD remains unknown. We aimed to determine if sleep problems and daytime sleepiness were associated with the social, emotional, and behavioral school-based functioning of children with ADHD and comorbid sleep problems.

Methods:

Children aged 5-13 years with ADHD and a moderate-severe sleep problem (confirmed using American Academy of Sleep Medicine diagnostic criteria) were recruited from 43 pediatric practices across Victoria and Queensland, Australia (N = 257). Parent-rated sleep problems were assessed using the Children's Sleep Habits Questionnaire (CSHQ) and teacher-rated daytime sleepiness using the Teacher's Daytime Sleepiness Questionnaire. Teacher-rated social, emotional, and behavioral school functioning was assessed using three scales (peer problems, emotional problems, and conduct problems) from the Strength and Difficulties Questionnaire. Data was analyzed using Pearson correlations and linear regression models.

Results:

Teacher-rated daytime sleepiness was associated with higher levels of emotional (β = 0.39; 95% CI = 0.25-0.52) and behavioral problems (β = 0.47; CI = 0.36-0.58) in adjusted models. While total sleep duration and parent-rated sleep problems were not associated with daytime sleepiness or school functioning, the CSHQ subscale night wakings was correlated with teacher-rated daytime sleepiness (r = 0.21; p < 0.01).

Conclusions:

Daytime sleepiness (possibly as an indicator of sleep quality) may be a better predictor of school functioning in children with ADHD who have concomitant sleep problems than total sleep duration or parent-rated sleep problems.

Authors+Show Affiliations

a Department of Pediatrics, The University of Melbourne , Parkville , Victoria , Australia.a Department of Pediatrics, The University of Melbourne , Parkville , Victoria , Australia. b Community Health Services Research, Murdoch Childrens Research Institute , Parkville , Victoria , Australia.a Department of Pediatrics, The University of Melbourne , Parkville , Victoria , Australia. b Community Health Services Research, Murdoch Childrens Research Institute , Parkville , Victoria , Australia. c Deakin Child Study Centre, School of Psychology, Deakin University , Geelong , Victoria , Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28922019

Citation

Lucas, Isabelle, et al. "Sleep Problems and Daytime Sleepiness in Children With ADHD: Associations With Social, Emotional, and Behavioral Functioning at School, a Cross-sectional Study." Behavioral Sleep Medicine, vol. 17, no. 4, 2019, pp. 411-422.
Lucas I, Mulraney M, Sciberras E. Sleep problems and daytime sleepiness in children with ADHD: Associations with social, emotional, and behavioral functioning at school, a cross-sectional study. Behav Sleep Med. 2019;17(4):411-422.
Lucas, I., Mulraney, M., & Sciberras, E. (2019). Sleep problems and daytime sleepiness in children with ADHD: Associations with social, emotional, and behavioral functioning at school, a cross-sectional study. Behavioral Sleep Medicine, 17(4), 411-422. https://doi.org/10.1080/15402002.2017.1376207
Lucas I, Mulraney M, Sciberras E. Sleep Problems and Daytime Sleepiness in Children With ADHD: Associations With Social, Emotional, and Behavioral Functioning at School, a Cross-sectional Study. Behav Sleep Med. 2019 Jul-Aug;17(4):411-422. PubMed PMID: 28922019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sleep problems and daytime sleepiness in children with ADHD: Associations with social, emotional, and behavioral functioning at school, a cross-sectional study. AU - Lucas,Isabelle, AU - Mulraney,Melissa, AU - Sciberras,Emma, Y1 - 2017/10/13/ PY - 2017/9/19/pubmed PY - 2019/12/18/medline PY - 2017/9/19/entrez SP - 411 EP - 422 JF - Behavioral sleep medicine JO - Behav Sleep Med VL - 17 IS - 4 N2 - Background: Sleep problems and daytime sleepiness are common in children with attention-deficit hyperactivity disorder (ADHD) and are associated with poor parent-reported functional outcomes. However, the potential impact of sleep problems or daytime sleepiness on the school functioning of children with ADHD remains unknown. We aimed to determine if sleep problems and daytime sleepiness were associated with the social, emotional, and behavioral school-based functioning of children with ADHD and comorbid sleep problems. Methods: Children aged 5-13 years with ADHD and a moderate-severe sleep problem (confirmed using American Academy of Sleep Medicine diagnostic criteria) were recruited from 43 pediatric practices across Victoria and Queensland, Australia (N = 257). Parent-rated sleep problems were assessed using the Children's Sleep Habits Questionnaire (CSHQ) and teacher-rated daytime sleepiness using the Teacher's Daytime Sleepiness Questionnaire. Teacher-rated social, emotional, and behavioral school functioning was assessed using three scales (peer problems, emotional problems, and conduct problems) from the Strength and Difficulties Questionnaire. Data was analyzed using Pearson correlations and linear regression models. Results: Teacher-rated daytime sleepiness was associated with higher levels of emotional (β = 0.39; 95% CI = 0.25-0.52) and behavioral problems (β = 0.47; CI = 0.36-0.58) in adjusted models. While total sleep duration and parent-rated sleep problems were not associated with daytime sleepiness or school functioning, the CSHQ subscale night wakings was correlated with teacher-rated daytime sleepiness (r = 0.21; p < 0.01). Conclusions: Daytime sleepiness (possibly as an indicator of sleep quality) may be a better predictor of school functioning in children with ADHD who have concomitant sleep problems than total sleep duration or parent-rated sleep problems. SN - 1540-2010 UR - https://www.unboundmedicine.com/medline/citation/28922019/Sleep_problems_and_daytime_sleepiness_in_children_with_ADHD:_Associations_with_social_emotional_and_behavioral_functioning_at_school_a_cross_sectional_study_ L2 - https://www.tandfonline.com/doi/full/10.1080/15402002.2017.1376207 DB - PRIME DP - Unbound Medicine ER -