Poor Sleep Has Negative Implications for Children With and Without ADHD, but in Different Ways

Background: Sleep problems are commonly reported in attention deficit
hyperactivity disorder (ADHD), and are also a familiar characteristic of
typical development (TD). We sought to elucidate the relationship between
sleep, ADHD trait behaviors, and cognitive inattention, and how it manifests
between ADHD and TD children. Participants: Eighteen children diagnosed
with ADHD and 20 age-matched TD controls aged 5 to 11 years old
participated in the study. Methods: Sleep profiles were assessed using
Children’s Sleep Habits Questionnaire and actigraphy measures. Behavioral
functioning was examined using Conners’ Parent Report Scale and attention
using the computerized Conners’ Continuous Performance Task.
Results: We found evidence of (a) poorer sleep quality in the ADHD group,
despite no difference in actual sleep time, (b) poor sleep quality in TD
children predicting increased ADHD-trait behaviors, despite no association
with attention, and (c) a consistent trend for poor sleep quality predicting
reduced attentional control in ADHD children, despite no association with
behavior. Conclusions: Poor sleep quality affects developmental subgroups
in different ways. For ADHD children, poor sleep worsens their predisposed
attentional deficit, while for TD children it mimics ADHD behaviors. These
findings have important implications for the debate on overdiagnosis of
childhood ADHD, and the use of sleep-based interventions. Above all, they
highlight the importance of promoting good sleep hygiene in all children.