title: A prospective study of sleep problems in children with ADHD.
abstract: BACKGROUND
  Behavioral sleep problems are common in children with attention-deficit/hyperactivity disorder (ADHD), yet their persistence or otherwise is unknown. We examined behavioral sleep problem trajectories, types of sleep problems experienced, and associated risk/protective factors.
  
  
  METHODS
  
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Twenty-one pediatric practices across Victoria, Australia.
  
  
  METHODS
  A total of 195 children with ADHD (5-13 years).
  
  
  RESULTS
  Sleep problem trajectories classified as never, transient, or persistent on the basis of sleep problem severity measured at baseline, 6, and 12 months. Explanatory variables: Types of sleep problems, internalizing and externalizing comorbidities, ADHD symptom severity and medication use, autism spectrum disorder, caregiver mental health, and sociodemographic factors.
  
  
  METHODS
  Multinomial logistic regression models.
  
  
  RESULTS
  Sleep problems fluctuated over 12 months, but for 10% of children they persisted. In adjusted analyses, co-occurring internalizing and externalizing comorbidities were a risk factor for persistent (odds ratio (OR) 9.2, 95% confidence interval (CI) 1.6, 53.9, p = 0.01) and transient (OR 3.7, 95% CI 1.5, 8.8, p = 0.003) sleep problems, while greater ADHD symptom severity and poorer caregiver mental health were risk factors for persistent and transient sleep problems, respectively.
  
  
  CONCLUSIONS
  Sleep problems in children with ADHD are commonly transient, but in a subgroup they are characterized as persistent. Early preventive/intervention strategies should target children at risk of persistent sleep problems.
authors.affiliation: Community Child Health, Murdoch Childrens Research Institute, Department of Paediatrics, The University of Melbourne; 50 Flemington Road, Parkville, VIC, Australia. Electronic address: kate.lycett@mcri.edu.au.
authors.forename: Kate
authors.initials: K
authors.lastname: Lycett
authors.affiliation: Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia.
authors.forename: Fiona K
authors.initials: FK
authors.lastname: Mensah
authors.affiliation: Community Child Health, Murdoch Childrens Research Institute, Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, Australia.
authors.forename: Harriet
authors.initials: H
authors.lastname: Hiscock
authors.affiliation: Community Child Health, Murdoch Childrens Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Sciberras
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000209:etiology*
keywords: Attention-deficit disorder with hyperactivity; Child; Longitudinal studies; Risk factors; Sleep disorders; Sleep initiation and maintenance disorder