Sleep insufficiency and bedtime irregularity in children with attention deficit hyperactivity disorder: A population-based analysis

Article

Leman, Talia Y., Barden, Sophia, Swisher, Valerie S., Joyce, Daniel S., Kaplan, Katherine A., Zeitzer, Jamie M., Loo, Sandra K. and Ricketts, Emily J.. 2024. "Sleep insufficiency and bedtime irregularity in children with attention deficit hyperactivity disorder: A population-based analysis." Sleep Medicine. 121, pp. 117-126. https://doi.org/10.1016/j.sleep.2024.06.015
Article Title

Sleep insufficiency and bedtime irregularity in children with attention deficit hyperactivity disorder: A population-based analysis

ERA Journal ID16867
Article CategoryArticle
AuthorsLeman, Talia Y., Barden, Sophia, Swisher, Valerie S., Joyce, Daniel S., Kaplan, Katherine A., Zeitzer, Jamie M., Loo, Sandra K. and Ricketts, Emily J.
Journal TitleSleep Medicine
Journal Citation121, pp. 117-126
Number of Pages10
Year2024
PublisherElsevier
Place of PublicationNetherlands
ISSN1389-9457
1878-5506
Digital Object Identifier (DOI)https://doi.org/10.1016/j.sleep.2024.06.015
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S1389945724002983
Abstract

Background
Sleep is impaired in children with attention-deficit/hyperactivity disorder (ADHD). However, population-based examination of indicators of sleep insufficiency and bedtime irregularity is limited. This investigation examined associations between ADHD, weeknight sleep insufficiency, and bedtime irregularity in a nationally-representative child sample, and indicators of these sleep outcomes in ADHD.

Methods
Parents of children aged 3–17 years with ADHD (n = 7671) were surveyed through the 2020–2021 National Survey of Children's Health. Inverse probability of treatment weighting generated a weighted matched control sample (n = 51,572). Weighted generalized linear models were performed without and with age-stratification to examine associations between ADHD and sleep, adjusting for sociodemographics in the full sample, and between nineteen sociodemographic and clinical variables and sleep in ADHD.

Results
Having ADHD was associated with increased odds of sleep insufficiency and bedtime irregularity relative to controls, even after adjusting for sociodemographic variables. In ADHD, older age was associated with lower sleep insufficiency and greater bedtime irregularity. Black race, increased poverty, higher ADHD severity, depression, and increased screen time were associated with greater sleep insufficiency and bedtime irregularity. Adverse childhood experiences (ACEs) were associated with greater sleep insufficiency. Behavioral/conduct problems, female sex, and absence of both ADHD medication use and ASD diagnosis were associated with poorer bedtime irregularity. Age-stratified results are reported in text.

Conclusions
Children with ADHD face heightened risk for insufficient sleep and irregular bedtimes. Findings suggest intervention targets (e.g., Black race, poverty, depression, screen time) to improve both sleep insufficiency and bedtime irregularity. Results highlight ACEs and behavioral/conduct problems as targets to improve sleep insufficiency and bedtime regularity, respectively. Age-stratified findings are discussed.

KeywordsAfrican-american ; Oppositional defiant disorder ; Impulsivity; Adolescents
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020520207. Social and affective neuroscience
529999. Other psychology not elsewhere classified
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Byline AffiliationsUniversity of Iowa, United States
University of California Los Angeles, United States
School of Psychology and Wellbeing
Centre for Health Research
Stanford University, United States
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