Relationship between subtypes and symptoms of ADHD, insomnia, and nightmares in connection with quality of life in children

Abstract

ObjectivesThis study examined the links between sleep disorders and subtypes of attention deficit-hyperactivity disorder (ADHD-inattention, ADHD-combined, ADHD-hyperactive/impulsive) in childhood. We set up a hypothetical model linking different symptoms of both disorders to construct the underlying and shared pathways. By examining a sample of children with ADHD we firstly tested parts of the model.MethodsA total of 72 children with symptoms of ADHD (aged 6–13 years; 79.2% boys) were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and the International Classification of Sleep Disorders, third edition in regards to ADHD and sleep disorders via standardized parent-rated questionnaires. Additionally, quality of life (QoL) was assessed. Overall, 46 children fulfilled the criteria of ADHD and were medication-naive.ResultsOn average, the whole sample had clinically elevated total scores of the Children’s Sleep Habits Questionnaire in the validated German version (CSHQ-DE), indicating an increased prevalence of sleep disorders in children with ADHD. In accordance to our hypothetical model, children with primarily hyperactive–impulsive ADHD showed the highest CSHQ-DE scores. Moreover, we found a high impact for insomnia in this subgroup and a high comorbid load for the mutual occurrence of insomnia and nightmares. Furthermore, QoL was reduced in our whole sample, and again intensified in children with comorbid insomnia and nightmares.ConclusionWe verified an elevated occurrence of sleep disorders in children with ADHD and were able to link them to specific subtypes of ADHD. These results were in line with our hypothetical model. Moreover, we found a clinically reduced QoL in mean for the whole sample, indicating the strong impact of ADHD in the lives of affected children, even intensified if children exhibited comorbid insomnia and nightmares. These results should be kept in mind regarding the treatment and therapy of this subgroup of children. Specific treatment strategies should be considered for these children.

Sleep disorders in patients with ADHD: impact and management challenges

“…School-age children. Quality of life scores were reduced in children with insomnia and ADHD compared with healthy controls 100. Adolescents.…”

“…Parental reports described longer sleep onset delay,97,99 shorter sleep duration, and more restless sleep in children with ADHD compared with healthy controls 97. Children with ADHD hyperactive/impulsive subtype scored higher on measures of insomnia compared with individuals with an inattentive type,100 and no differences in insomnia scores between children with ADHD and healthy controls were found in another study 99. Adolescents.…”

“…There is a dearth of empirical studies examining emotional impairments related to disrupted sleep in individuals with ADHD and primary sleep disorders. Lower perceived quality of life was reported in children with ADHD and SDB,80 insomnia100 and narcolepsy,106 and adults with ADHD and SDB74 compared with healthy controls. Higher level of depression and anxiety symptoms were reported in adults with ADHD and OSA74 and narcolepsy107 alone compared with healthy controls.…”

Disturbing Dreams and Psychosocial Maladjustment in Children: A Prospective Study of the Moderating Role of Early Negative Emotionality

“…However, other studies did not find these associations ( 38 , 59 ). Some studies also reported significant associations between DD frequency and attention deficit hyperactivity disorder (ADHD) ( 60 ) as well as with ADHD subtypes ( 61 , 62 ), and one prospective study found that parent-rated DDs at 10–19 years of age predicted symptoms of inattention and direct/indirect aggression at 18–32 years of age ( 55 ).…”

The association between attention-deficit/hyperactivity disorder and Atopic dermatitis: A study among Iranian children

“…[8] Because of serious consequences of ADHD for the patients and their families such as inattention, hyperactivity, and impulsivity, the patients face with impaired learning abilities at school, sleep disorder, social isolation, and thus with reduced quality of life for the patient and his/her family members. [9] Over the last century, several studies have focused the association between AD and ADHD. Unfortunately, we did not have any perspective on this relationship in our country.…”