title: Contributions of circadian tendencies and behavioral problems to sleep onset problems of children with ADHD.
abstract: BACKGROUND
  Children with attention-deficit/hyperactivity disorder (ADHD) are two to three times more likely to experience sleep problems. The purpose of this study is to determine the relative contributions of circadian preferences and behavioral problems to sleep onset problems experienced by children with ADHD and to test for a moderation effect of ADHD diagnosis on the impact of circadian preferences and externalizing problems on sleep onset problems.
  
  
  METHODS
  After initial screening, parents of children meeting inclusion criteria documented child bedtime over 4 nights, using a sleep log, and completed questionnaires regarding sleep, ADHD and demographics to assess bedtime routine prior to PSG. On the fifth night of the study, sleep was recorded via ambulatory assessment of sleep architecture in the child's natural sleep environment employing portable polysomnography equipment. Seventy-five children (26 with ADHD and 49 controls) aged 7-11 years (mean age 8.61 years, SD 1.27 years) participated in the present study.
  
  
  RESULTS
  In both groups of children, externalizing problems yielded significant independent contributions to the explained variance in parental reports of bedtime resistance, whereas an evening circadian tendency contributed both to parental reports of sleep onset delay and to PSG-measured sleep-onset latency. No significant interaction effect of behavioral/circadian tendency with ADHD status was evident.
  
  
  CONCLUSIONS
  Sleep onset problems in ADHD are related to different etiologies that might require different interventional strategies and can be distinguished using the parental reports on the CSHQ.
authors.affiliation: McGill University, Montreal, QC, Canada. reut.gruber@douglas.mcgill.ca
authors.forename: Reut
authors.initials: R
authors.lastname: Gruber
authors.forename: Laura
authors.initials: L
authors.lastname: Fontil
authors.forename: Lana
authors.initials: L
authors.lastname: Bergmame
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Wiebe
authors.forename: Rhonda
authors.initials: R
authors.lastname: Amsel
authors.forename: Sonia
authors.initials: S
authors.lastname: Frenette
authors.forename: Julie
authors.initials: J
authors.lastname: Carrier
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory; D017286:Polysomnography; D011569:Psychiatric Status Rating Scales; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000503:physiopathology*; D011795:Surveys and Questionnaires