The Relationship Between Sleep and Problem Behaviours in Children with Attention Deficit/Hyperactivity Disorder

Purpose Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that is commonly associated with sleep disturbances. Sleep disruption can contribute to difficulties in a child’s life and; therefore, can be an important determinant of their quality of life. This study uses data from the large multisite Adolescent Brain Cognitive Development (ABCD) database to examine the relationship between sleep and behaviour in children with ADHD. We hypothesized that shorter and more interrupted sleep would relate to increased problem behaviours such as inattention and social difficulties. Methods Sleep data was obtained using commercially available actigraphy (Fitbit) measures, and The Parent Sleep Disturbance Scale (SDS) for 212 children ages, 10 to 13 years, with ADHD and an age and sex matched control group (n = 212). Behavioural and emotional subscores were obtained from the Child Behavior Checklist (CBCL). Results SDS sleep data was significantly different between ADHD and control groups, while Fitbit actigraphy data was not. ADHD diagnosis, family income, sleep latency (measured by Fitbit) and 3 out of 6 of the SDS subscores were significantly related to problem behaviour scores. Conclusion The results of this study indicate that family report of sleep difficulties but not Fitbit actigraphy measures of sleep were associated with behaviour and emotional responses in children with ADHD. Family report of sleep difficulties, direct measures of sleep parameters, as well as behaviour and quality of life, should be considered when evaluating or investigating sleep in children to better understand the influence on health and functioning.