Sleep Disturbances in Childhood May Predict Future Symptoms of Attention-Deficit/Hyperactivity Disorder

Parent-reported sleep disturbances predicted increased symptomology of attention-deficit/hyperactivity disorder (ADHD) in the future, according to study results published in the Journal of the American Academy of Child & Adolescent Psychiatry.

A random set of French telephone numbers were called in 2008. A total of 1055 individuals with children aged 6-12 years consented to participate in this study. Participants underwent a structured interview about symptoms of ADHD and sleep disturbances of their child in 3 waves. Symptoms of ADHD were related with parent-reported sleep.

The children were aged mean 9.37 (SD, 1.80) years at baseline and 18.2 (SD, 1.81) years at the final follow-up, 51.7% were boys, 20.0% of children had repeated a grade, the average number of siblings was 2.24 (SD, 0.826), 53.3% of parents were college educated, and 80.7% of parents were married at baseline.

Sleep disturbances at each survey wave were correlated (all coefficients, >0.24; all P <.001) as were symptoms of ADHD (all coefficients, >0.29; all P <.001).

At each wave, sleep disturbances were correlated with ADHD symptoms (all coefficients, >0.14; all P <.05). In addition, a cross-lagged association was observed between sleep disturbance at wave 2 and ADHD symptoms at wave 3 (β, 0.15; P =.045).

Significant between-person effects were observed for sleep disturbances (σ², 0.21; P =.020) and significant within-person effects were observed for ADHD symptoms (all P <.050).

Stratified by symptoms, trends relating to inattentive symptoms were similar to the main analysis. For hyperactive-impulsive symptoms, the cross-lagged association between sleep disturbance at wave 2 and ADHD symptoms at wave 3 was no longer significant (β, 0.06; P =.06).

When missing data were imputed the cross-lagged association was no longer significant in the main analysis (β, 0.10; P =.071), however, in an analysis which removed individuals with missing data, the significant effect was maintained (β, 0.14; P =.046).

The major limitation of this study was the proportion of missing data, in which 75% of participants had at least 1 missing datum.

The study authors concluded, “Our main finding shows that sleep disturbances during adolescence predict increased ADHD symptoms some years later. An additional analysis suggests, in line with a previous study, that ADHD symptoms in late childhood predict increased sleep disturbances in adolescence. These results, combined with those of previous randomized controlled trials showing that brief sleep interventions can improve ADHD symptoms, suggest the need for regular and frequent follow-up from childhood until early adulthood to assess the emergence of ADHD symptoms in individuals who present with sleep disturbances in childhood and vice versa.”

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Gosling CJ, Cortese S, Konofal E, Lecendreux M, Faraone SV. Association of parent-rated sleep disturbances with attention-deficit/hyperactivity disorder symptoms: 9-year follow-up of a population-based cohort study. J Am Acad Child Adolesc Psychiatry. 2022;S0890-8567(22)00305-7. doi:10.1016/j.jaac.2022.05.013