0785 Naturalistic Sleep Patterns Across 12 Weeks Reflect ADHD Symptomatology in Children. (12th April 2019)

• Record Type: Journal Article
• Authors: Campos, Gabriela de Queiroz; Edson, Zachary; Dickstein, Daniel P; Carskadon, Mary A; Saletin, Jared M
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A315
• Page End: A315
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.783
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: In children, attention-deficit/hyperactivity disorder (ADHD) has been associated with poor sleep, yet few studies have objectively measured sleep patterns in this population. Our goal was to test the hypothesis that reduced sleep regularity indexes ADHD symptoms in children. Methods: The sleep-wake patterns of thirteen middle-school students (8F; 12.6±0.7 years; varying in ADHD severity) were monitored for twelve weeks using wrist-worn actigraphy and daily diaries. ADHD symptoms were assessed at the beginning of the recording period using Conners-3 rating scales completed by teachers and parents. Sleep variables of interest (duration, timing, regularity) were calculated from actigraphy. Regularity was assessed through the Sleep Regularity Index, a 24-hour autoregressive prediction of sleep-wake scores. Multiple regression analyses assessed associations between sleep outcomes and ADHD symptoms, controlling for gender and age. Results: Our sample captured a broad range of ADHD severity (hyperactivity T-scores : [teacher range=43-90; median=60.0±14.0]; [parent range=39-85; median=57.0±12.9]). More irregular sleep was associated with higher teacher-rated hyperactivity ( b =-0.0025; t =-2.54; p =.032; η 2 =0.42). Unlike teacher ratings, no associations were found with parental report ( b =-0.0011; t =-0.88; p =.402; η 2 =0.14). Regardless of reporter, no significant associations (all p 's>.05) were present between symptoms and other sleep variables of interest: duration (i.e., total sleep time) and timing (i.e., bedtime, sleep midpoint). Conclusion: These data indicate sleep regularity as a potential novel index of ADHD severity. More irregular sleep across the 12-week interval was associated with more hyperactive and impulsive behaviors in youth, as rated by their classroom teachers. This effect was specific to sleep regularity, with variables pertaining to sleep length or timing not associated with symptoms. The effect's specificity to teacher report may reflect the unique on-task behaviors present in the classroom, underscoring the importance of considering multiple reporters when assessing youth. Finally, whether heightened hyperactivity is driving more erratic sleep, or whether poor sleep is leading to hyperactive behavior cannot be determined from these cross-sectional analyses. Ongoing data collection with longitudinal measurements of behavior and brain function may better untangle the directionality of these relationships. Support (If Any): Rhode Island Foundation Grant & K01MH109854 (JMS); Brown University Undergraduate Teaching and Research Award (GdQC).