Sleep quality in children and adolescents with attention-deficit and hyperactivity disorder
Yıldız Miniksar D, Özdemir M.
Arch Pediatr. 2021 Oct 20:S0929-693X(21)00173-1.
Commentary* by Dr. Margaret Weiss: This replicates many previous studies demonstrating the association between sleep quality and ADHD but is the first study I am aware of that also demonstrates a relationship between sleep quality and socio-economic status.
Sleep disturbances are associated with an increased risk of attention-deficit and hyperactivity disorder (ADHD), which can also lead to sleep problems. In this study we aimed to determine the variables that affect the relationship between ADHD and sleep quality. Moreover, we aimed to compare these variables in children and adolescents with ADHD and healthy controls.
This cross-sectional study was conducted using a random sample of 122 ADHD patients and 100 healthy children in Turkey. A self-administered questionnaire was distributed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The risk of impairment in sleep quality was associated with the presence of ADHD (OR: 13.3; 95% CI: 6.1-29.1), the presence of somatic disease (OR: 4.9; 95% CI: 1.9-12.2), and a family history of the psychiatric disorder (OR: 4.2; 95% CI: 1.3-13.1).
The PSQI total score was higher in children with parental separation compared to those without parental separation (p=0.006). As the economic level of the participants decreased, the PSQI total score increased significantly (p=0.006). It was determined that combined-type ADHD was associated with impairment in sleep quality more than the other subtypes (p<0.001 and p=0.031, respectively).
Our findings show that children with ADHD have significantly more sleep problems than healthy controls and that sociodemographic variables and familial characteristics affect sleep quality in healthy children and children with ADHD.
* Abstracts are selected for their clinical relevance by Dr. Margaret Weiss, Director of Clinical Research, Child Psychiatry, Cambridge Health Alliance, Harvard University. Her commentary reflects her own opinion. It is not approved or necessarily representative of the CADDRA board.