title: Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in healthy 7- to 8-year-old children.
abstract: OBJECTIVE
  It has been hypothesized that sleep deprivation may manifest in children as behavioral symptoms rather than as tiredness, but only a few studies have investigated this hypothesis. The objective of our study was to evaluate whether short sleep is associated with behavioral symptoms of attention-deficit/hyperactivity disorder in 7- to 8-year-old children.
  
  
  METHODS
  We performed a cross-sectional study of children born in 1998 in Helsinki, Finland. The participants included 280 (146 girls, 134 boys) children with a mean age of 8.1 years (SD: 0.3; range: 7.4-8.8). Sleep quality was measured by using actigraphs. The Sleep Disturbance Scale for Children and the Attention-Deficit/Hyperactivity Disorder Rating Scale IV were administered to parents.
  
  
  RESULTS
  Children whose average sleep duration as measured by actigraphs was short (<10th percentile, ie, <7.7 hours) and had a higher hyperactivity/impulsivity score (9.7 vs 7.8 or 7.5) and a higher attention-deficit/hyperactivity disorder total score (17.3 vs 14.5 or 13.1) but a similar inattention score (7.6 vs 6.7 or 5.6) compared with children sleeping 7.7 to 9.4 hours or >9.4 hours. In multivariate statistical models, short sleep duration remained a statistically significant predictor of hyperactivity/impulsivity, and sleeping difficulties were associated with hyperactivity/impulsivity, inattention, and the total score. There were no significant interactions between short sleep and sleeping difficulties.
  
  
  CONCLUSIONS
  Children's short sleep duration and sleeping difficulties increase the risk for behavioral symptoms of attention-deficit/hyperactivity disorder.
authors.affiliation: Departments of Psychology, University of Helsinki, Helsinki, Finland. juulia.paavonen@helsinki.fi
authors.forename: E Juulia
authors.initials: EJ
authors.lastname: Paavonen
authors.forename: Katri
authors.initials: K
authors.lastname: Räikkönen
authors.forename: Jari
authors.initials: J
authors.lastname: Lahti
authors.forename: Niina
authors.initials: N
authors.lastname: Komsi
authors.forename: Kati
authors.initials: K
authors.lastname: Heinonen
authors.forename: Anu-Katriina
authors.initials: AK
authors.lastname: Pesonen
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Järvenpää
authors.forename: Timo
authors.initials: T
authors.lastname: Strandberg
authors.forename: Eero
authors.initials: E
authors.lastname: Kajantie
authors.forename: Tarja
authors.initials: T
authors.lastname: Porkka-Heiskanen
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012893:Sleep Wake Disorders / Q000453:epidemiology*