The Associations Between Sleep and Externalizing and Internalizing Problems in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

Dimakos, Jenny; Gauthier-Gagné, Gabrielle; Lin, Lanyi; Scholes, Samantha; Gruber, Reut

doi:10.1016/j.chc.2020.08.001

Cited by 17 publications

(4 citation statements)

References 88 publications

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“…Consistent with previous studies [ 5 ], our findings confirm that sleep problems might exert an influence on internalizing and externalizing behaviors; inter-group comparisons highlight how the presence of sleep problems (“maintained” and “onset” groups) plays a role on mood-behavioral functioning.…”

Section: Discussionsupporting

confidence: 91%

“…Altogether the results suggest that sleep problems could contribute to exacerbate or promote the externalizing behaviors considering that, other studies highlighted a positive association with the externalizing behaviors but not with the internalizing ones [ 33 ]. Conversely, the hypothesis of a bidirectional relationship between some sleep problems and internalizing symptoms reported in recent studies seems also to be supported [ 5 ].…”

Section: Discussionmentioning

confidence: 94%

“…Sleep plays a central role in regulating emotions and behavior in the general population; this function is crucial in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) since the brain areas involved (dorsolateral prefrontal, anterior cingulate, and parietal cortices) are strongly vulnerable to inadequate or disturbed sleep. Up to 70% of children with ADHD have sleep problems [ 1 ] and important associations between sleep quality and emotional and behavioral functioning in ADHD patients have been reported [ [2] , [3] , [4] , [5] ]. In particular, reduced sleep duration and sleep problems play a critical role on internalizing and externalizing behaviors of children and adolescents with ADHD [ 2 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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“…There is mounting evidence that physical activity is beneficial for behavior and cognitive performance of children and adolescents with ADHD [ 24 , 25 , 48 ]. In addition to physical activity, other lifestyle factors such as sleep and sedentary behavior may also be related to the symptomatology associated with ADHD [ 26 – 29 ]. For example, in the general population, lower levels of sedentary behaviors, mainly recreational screen time [ 30 ], and optimal sleep duration [ 31 ] have been positively and independently related to academic achievement in children and adolescents [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder

Taylor

Kong

Zhang

et al. 2023

Child Adolesc Psychiatry Ment Health

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Background Evidence-based 24-h movement behavior (24-HMB) guidelines have been developed to integrate recommendations for the time spent on physical activity, sedentary behavior, and sleep. For children and adolescents, these 24-HMB guidelines recommend a maximum of two hours of recreational screen time (as part of sedentary behavior), a minimum of 60 min per day of moderate to vigorous physical activity (MVPA), and an age-appropriate sleep duration (9–11 h for 5 to 13-year-olds; 8–10 h for 14 to 17-year-olds). Although adherence to the guidelines has been associated with positive health outcomes, the effects of adhering to the 24-HMB recommendations have not been fully examined in children and adolescents with attention eficit/hyperactive disorder (ADHD). Therefore, this study examined potential associations between meeting the 24-HMB guidelines and indicators of cognitive and social difficulties in children and adolescents with ADHD. Methods Cross-sectional data on 3470 children and adolescents with ADHD aged between 6 and 17 years was extracted from the National Survey for Children’s Health (NSCH 2020). Adherence to 24-HMB guidelines comprised screen time, physical activity, and sleep. ADHD-related outcomes included four indicators; one relating to cognitive difficulties (i.e., serious difficulties in concentrating, remembering, or making decisions) and three indicators of social difficulties (i.e., difficulties in making or keeping friends, bullying others, being bullied). Logistic regression was performed to determine the associations between adherence to 24-HMB guidelines and the cognitive and social outcomes described above, while adjusting for confounders. Results In total, 44.8% of participants met at least one movement behavior guideline, while only 5.7% met all three. Adjusted logistic regressions further showed that meeting all three guidelines was associated with lower odds of cognitive difficulties in relation to none of the guidelines, but the strongest model included only screen time and physical activity as predictors (OR = 0.26, 95% CI 0.12–0.53, p < .001). For social relationships, meeting all three guidelines was associated with lower odds of difficulty keeping friends (OR = 0.46, 95% CI 0.21–0.97, p = .04) in relation to none of the guidelines. Meeting the guideline for screen time was associated with lower odds of being bullied (OR = 0.61, 95% CI 0.39–0.97, p = .04) in relation to none of the guidelines. While screen time only, sleep only and the combination of both were associated with lower odds of bullying others, sleep alone was the strongest predictor (OR = 0.44, 95% CI 0.26–0.76, p = .003) in relation to none of the guidelines. Conclusion Meeting 24-HMB guidelines was associated with reduced likelihood of cognitive and social difficulties in children and adolescents with ADHD. These findings highlight the importance of adhering to healthy lifestyle behaviors as outlined in the 24-HMB recommendations with regard to cognitive and social difficulties in children and adolescents with ADHD. These results need to be confirmed by longitudinal and interventional studies with a large sample size.

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ADHD and Sleep Problems

Corkum,

Bertrand,

Ilie

et al. 2023

Clinical Handbook of ADHD Assessment and Treatment Across the Lifespan

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The Associations Between Sleep and Externalizing and Internalizing Problems in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

Cited by 17 publications

References 88 publications

Changes in sleep duration and disturbances during Covid-19 lockdown and internalizing-externalizing behaviors in children with attention deficit hyperactivity disorders

Changes in sleep duration and disturbances during Covid-19 lockdown and internalizing-externalizing behaviors in children with attention deficit hyperactivity disorders

Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder

ADHD and Sleep Problems

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