Relationships of Subjective Insomnia and Sleep Duration with Depression, Anxiety, and Pain Problems in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

Abstract

Objective:This study examined the relationships of subjective insomnia and short and long nocturnal sleep duration with depression, anxiety, and pain problems in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods:A total of 469 children and adolescents (97 girls and 372 boys; age, 6-18 years) who had received a clinical diagnosis of ADHD completed the eight-item Athens Insomnia Scale, Children's Depression Inventory-Taiwan Version, Multidimensional Anxiety Scale for ChildrenTaiwanese Version, and a questionnaire about sleep duration, pain-related dysfunction, and the severity of perceived pain. Their parents provided information on the children's current ADHD and oppositional symptoms, rated on the abridged Chinese version of the Swanson, Nolan, and Pelham Scale, Version IV. Multiple regression was conducted to examine the relationships of subjective insomnia and sleep duration with depression and anxiety. Logistic regression was applied to examine the relationships of subjective insomnia and sleep duration with pain-related dysfunction and the severity of perceived pain. Results:Subjective insomnia was positively associated with depression, anxiety, pain-related dysfunction, and severe perceived pain in the study population. Short nocturnal sleep duration was positively associated with depression, anxiety, and perceived pain. Long nocturnal sleep duration was positively associated with anxiety and perceived pain. Conclusion:Insomnia and short and long nocturnal sleep duration are associated with depression, Neuropsychiatry (London) (2018) 8(1) 139Research Cheng-Fang Yen Sleep problems not only have negative impacts on quality of life and social functioning [16] but are also significantly associated with health problems. Previous cross-sectional studies have indicated that youth with comorbid ADHD and depression [17] and anxiety may have sleep problems that are more severe relative to those with ADHD alone [18,19]. Prospective studies have shown that sleep problems can significantly predict greater depressive but not anxiety symptoms 1 year later in young adolescents with ADHD [20], that transient or persistent sleep problems at the baseline can predict behavioral and emotional problems 1 year later in children with ADHD [21], and that sleep problems at the baseline can predict emotional problems at 6 months (and vice versa) [22]. These results indicate that sleep problems should be a treatment target for depression and anxiety symptoms in individuals with ADHD.Several issues concerning the association of insomnia and sleep duration with health problems in individuals with ADHD warrant further study. First, community-based studies have shown that compared with adolescents with average sleep duration, those with long nocturnal sleep duration were more prone to violence, alcohol and illicit drug use, and truancy [23], whereas long nocturnal sleep duration was found to be significantly associated with higher psychological well-being and quality of life [24]. Although one...

Sleep problems increase the risk of musculoskeletal pain in boys but not girls: a prospective cohort study

“…Psychological symptoms may also offer some explanation for the stronger risk effect in boys. Examination of the SDQ scores (Table 1) shows higher scores for boys, and prevalence of pain is elevated in children with ADHD, which is predominant in boys [37]. In addition, behaviour may also explain the sex difference reported in this study: although both girls and boys report similar individual sport participation (73%), boys participated in team sport more often than girls (girls = 54%, boys = 74%) and boys are more likely to sustain musculoskeletal injury from sport participation both as individuals and within team sports [38,39].…”