Sleep problems and disorders among adolescents with persistent and subthreshold attention-deficit/hyperactivity disorders.
OBJECTIVE
To investigate the sleep schedules, problems, and disorders among adolescents with persistent attention-deficit/hyperactivity disorder (ADHD) and those with partially remitted ADHD symptoms.


METHODS
A case-control study.


METHODS
National Taiwan University and schools in Taipei Patients or Participants: The sample included 281 adolescents (male, 85.4%; 145 with persistent ADHD, 136 with subthreshold ADHD), aged 11 to 17, who were diagnosed with ADHD, according to DSM-IV criteria, at the mean age of 6.7 years (SD = 3.0) and 185 unaffected control subjects.


METHODS
N/A.


RESULTS
We conducted psychiatric interviews of participants and their mothers using the Chinese Kiddie-Schedule for Affective Disorders and Schizophrenia-Epidemiology version for making the diagnoses of ADHD, other psychiatric disorders, and sleep problems or disorders. We also collected the medication treatment data and parent and teacher reports of ADHD-related symptoms. Our results showed that adolescents with a childhood diagnosis of ADHD according to DSM-IV criteria, regardless of persistent ADHD, were more likely to have current and lifetime sleep problems and sleep disorders according to DSM-IV (insomnia, sleep terrors, nightmares, bruxism, and snoring). The presence of at least 1 psychiatric comorbid condition increased the risks for insomnia and nightmares. The use of methylphenidate was not associated with further increased risk of sleep problems, except bruxism.


CONCLUSIONS
Our findings support a relationship between ADHD and sleep problems, which can be partially explained by the psychiatric comorbidities, but did not support a disturbed sleep schedule. Our study suggests that mental health professionals should screen for sleep problems and psychiatric comorbidities among adolescents with a childhood diagnosis of ADHD regardless of the severity of current ADHD symptoms.
Gau
Susan Shur-Fen
SS
Department ofPsychiatry, National Taiwan University Hospital & College of Medicine, Taipei. gaushufe@ntu.edu.tw
Chiang
Huey-Ling
HL
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013624:Taiwan
D000697:Central Nervous System Stimulants; D008774:Methylphenidate