Sleep Restriction Worsens Daily Life Executive Functioning in Adolescents with ADHD

Abstract

Attention‐deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder characterized by inattention and/or hyperactivity‐impulsivity. Adolescents with ADHD commonly experience deficits in areas of executive function (EF). These deficits are associated with academic, social, and emotional impairments. Experimental research shows shortened sleep duration to cause poorer daily life EF in typically developing adolescents. However, no previous research has looked at the casual relationship between inadequate sleep and executive functioning deficits in teenagers with ADHD. The objective of this study was to investigate whether sleep duration impacted daily life executive functioning. The hypothesis was that restricted sleep would negatively impact daily life executive functioning in adolescents with ADHD. A three‐week at home sleep manipulation protocol was implemented, using an experimental crossover design. Participants completed a phase stabilization week, followed by a sleep restriction (SR) week (6.5 hours) and sleep extension (SE) week (9.5). SR and SE conditions were counterbalanced across participants. Each week, participants attended laboratory visits at the medical center where executive functioning was measured with a validated rating scale, the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2). The BRIEF2 measured different areas of EF domains such as working memory, inhibition, planning/organization, emotional control, and initiation. Sleep duration was monitored with actigraphy and sleep diaries. Analyses looked at 48 participants who successfully adhered to the study protocol and who had complete actigraphy data. The results of a paired sample t‐test showed significantly (ps <.05) more deficits in most daily life EF domains during the sleep restriction phase compared to the sleep extension phase. This study provides the first evidence for shortened sleep duration as a causal contributor to worsened executive functioning in adolescents with ADHD. Increased sleep may significantly impact academic, social, and emotional functioning in adolescents with ADHD, and sleep may be an important future target for future intervention.Support or Funding InformationThis research was supported by the National Institute of Mental Health (NIMH; grant R03MH109787; Dr. Becker). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.