Associations Between Sleep Problems and Attentional and Behavioral Functioning in Children With Anxiety Disorders and ADHD

Abstract

This study examined associations between sleep problems and attentional and behavioral functioning in 137 children aged 7 to 13 years with anxiety disorders (n = 39), attention deficit hyperactivity disorder (ADHD; n = 38), combined anxiety disorder and ADHD (n = 25), and 35 controls. Diagnoses were made using the semistructured diagnostic interview Schedule for Affective Disorders and Schizophrenia for School-age Children-Present and Lifetime Version. Sleep problems were assessed using the Children's Sleep Habits Questionnaire, attention was measured by the Attention Network Test, and behavioral problems were measured by teacher ratings on the Achenbach System of Empirically Based Assessment, Teacher Report Form. Sleep problems were associated with reduced efficiency of the alerting attention system for all children and with increased internalizing problems in children with anxiety disorders.

Just five more minutes please: electronic media use, sleep and behaviour in young children

“…This finding is consistent with previous research that shows sleep difficulties are associated with higher levels of anxiety (Hansen, Skirbekk, Oerbeck, Wentzel-Larsen, & Kristensen, 2014;Jackson, Sztendur, Diamond, Byles, & Bruck, 2014;Kelly, 2002;Leahy & Gradisar, 2012). Sleep disruptions (such as longer night-time awakenings) can lead to sleep deprivation.…”

Sleep Difficulties are Associated with Parent Report of Sluggish Cognitive Tempo

“…24 Finally, studies have also found a relationship between sleep-disordered breathing problems (e.g., snoring, sleep apnea) and ADHD symptoms. 25 These difficulties have been documented in both parent report 7,11,26 and actigraphy 27 studies. These 4 key areas of concern were adapted into questions for use as a succinct sleep problem screening tool as part of pediatric previsit symptom assessment in an outpatient clinic setting.…”

Advancing a Biopsychosocial and Contextual Model of Sleep in Adolescence: A Review and Introduction to the Special Issue

“…Several recent studies (Accardo et al 2012;Hansen et al 2011Hansen et al , 2014 have found that youth with comorbid ADHD and internalizing problems (i.e., anxiety, depression) have more sleep problems than youth with ADHD alone, including greater daytime sleepiness in addition to shorter sleep duration and more frequent night awakenings. For example, Moreau et al (2014) found that youth with comorbid ADHD and anxiety had the longest sleep onset delay, shortest sleep duration, and greatest daytime sleepiness in comparison to typically developing youth or youth with ADHD alone.…”

“…Taken together, studies examining sleep and comorbidity in ADHD samples point to potential bidirectional associations. However, all of these studies were conducted in school-aged children/young adolescents Hansen et al 2011Hansen et al , 2014Lycett et al 2014a, b;Moreau et al 2014) or in samples with a wide age range (ages 5/6-18) (Accardo et al 2012;Sung et al 2008), leaving it unclear how sleep and mental health are interconnected in youth with ADHD during middle and older adolescence when rates of certain mental health problems such as conduct disorder (Merikangas et al 2010), substance use , and depression/ suicidal ideation (Hinshaw et al 2012) are higher. Further, aside from the recent 1-year longitudinal studies by Becker et al (2014) and Lycett et al (2014a), all of the studies completed to date have been cross-sectional, leaving it unclear if comorbidities predict increases in sleep problems (and vice versa) over longer developmental periods or whether comorbid mental health symptoms differentially impact the sleep of adolescents with and without ADHD.…”