title: Sleep Difficulties are Associated with Parent Report of Sluggish Cognitive Tempo.
abstract: OBJECTIVE
  Sleep disturbance is considered both a behavioral symptom of and a contributor to functional difficulties in children with attention-deficit/hyperactivity disorder (ADHD). The construct of sluggish cognitive tempo (SCT) has also been linked to ADHD; however, little is known regarding the effects of sleep specifically on SCT symptoms. This study examined the association between parent-reported sleep disturbance and parent- and teacher-reported SCT, while controlling for the effects of ADHD and mood symptoms.
  
  
  METHODS
  Participants included 746 clinically referred children (65% male, age range: 5-18 years) with both parent and teacher ratings assessing symptoms of ADHD, mood symptoms (depression, anxiety), and SCT. Parents/caregivers also rated their child's sleep problems with regard to 4 core concerns: falling asleep, sleep restlessness, difficulty waking, and breathing difficulties. The SCT scale included three empirically derived subscales: sleepy/sluggish, low initiation/persistence, and daydreamy.
  
  
  RESULTS
  After accounting for age, medication status, ADHD symptoms, depressive symptoms, and anxiety, sleep problems accounted for a small but significant proportion of additional variance in the prediction of parent-reported sleepy/sluggish SCT. Difficulty waking showed the strongest associations with parent-reported SCT. There were no significant relationships found between parent-reported sleep difficulties and teacher-reported SCT.
  
  
  CONCLUSIONS
  Some elements of sluggishness and lethargy inherent to the SCT construct may be associated with sleep difficulties, even after accounting for ADHD and mood symptoms; however, these associations are not consistent across SCT subscales and sleep problem domains.
authors.affiliation: *Kennedy Krieger Institute; and †The Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Taylor A
authors.initials: TA
authors.lastname: Koriakin
authors.forename: E Mark
authors.initials: EM
authors.lastname: Mahone
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Jacobson
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires