title: Variable sleep schedules and outcomes in children with psychopathological problems: preliminary observations.
abstract: BACKGROUND
  Night-to-night variability in sleep of children with attention deficit hyperactivity disorder (ADHD) may be a mediator of behavioral phenotype. We examined the potential association between alertness, sleep, and eating behaviors in children with ADHD and comorbid problems.
  
  
  METHODS
  Sleep was monitored by actigraphy for 7 days. Questionnaires were used to assess sleep complaints, habits and food patterns by parental report, and sleep complaints and sleepiness by child report.
  
  
  RESULTS
  The group comprised 18 children, including 15 boys, aged 9.4 ± 1.7 years, 88.9% Caucasian, who took one or multiple medications. Children slept on average for 6 hours and 58 minutes with a variability of 1 hour 3 minutes relative to the mean, and their sleepiness scores were highly variable from day to day. Most children had a normal body mass index (BMI). Sleepiness and BMI were associated with sleep schedules and food patterns, such that they accounted for 76% of variance, predominantly by the association of BMI with mean wake after sleep onset and by bedtime sleepiness, with wake after sleep onset variability. Similarly, 97% of variance was shared with eating behaviors, such as desserts and snacks, and fast food meals were associated with morning sleepiness.
  
  
  CONCLUSIONS
  Disrupted sleep and sleepiness appears to favor unhealthy food patterns and may place children with ADHD at increased risk for obesity.
authors.affiliation: Department of Pediatrics and Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL.
authors.forename: Karen
authors.initials: K
authors.lastname: Spruyt
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Raubuck
authors.forename: Katie
authors.initials: K
authors.lastname: Grogan
authors.forename: David
authors.initials: D
authors.lastname: Gozal
authors.forename: Mark A
authors.initials: MA
authors.lastname: Stein
keywords: actigraphy; attention deficit hyperactivity disorder; child; sleep