Comparing subjective measures of behavioral sleep problems in children with ADHD: a cross-sectional study.
OBJECTIVE
Behavioral sleep problems are ideally measured using a combination of objective and subjective measures. However, this is not always feasible. Thus, a global subjective measure has been used to assess sleep problems in children with attention deficit hyperactivity disorder (ADHD), yet it is unclear how this relates to more detailed multidimensional measures of sleep problems. In children with ADHD, parent report of a global measure of sleep problem severity (classified no/mild versus moderate/severe) is compared with the following: (1) a 7-Day Sleep Log and (2) the validated Children's Sleep Habits Questionnaire (CSHQ).


METHODS
This study recruited 392 children with ADHD (aged 5-13 years) from 50 pediatric practices across Victoria, Australia. All caregivers completed the CSHQ, and 257 children prospectively completed the 7-Day Sleep Logs.


RESULTS
Sleep log data identified distinct sleep patterns according to parent-reported sleep problem severity; children with moderate/severe sleep problems slept 30 min less per day, took longer to fall asleep, and experienced more night awakenings. This pattern was also repeated across the CSHQ, where children with moderate/severe sleep problems experienced more problematic sleep symptoms across all domains (effect sizes: 0.5-1.1; all p < 0.001).


CONCLUSIONS
A subjective, global measure of sleep problem severity appears to be a useful tool for the initial assessment of sleep problems in children with ADHD when more extensive measures are not feasible, as it is reflective of well-established multidimensional measures. However, further research is required to determine its validity.
Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Vic., Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Vic. 3010, Australia. Electronic address: kate.lycett@mcri.edu.au.
Kate
K
Lycett
Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Vic., Australia; The Royal Children's Hospital, 50 Flemington Road, Parkville, Vic., Australia.
Fiona K
FK
Mensah
Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Vic., Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Vic. 3010, Australia; The Royal Children's Hospital, 50 Flemington Road, Parkville, Vic., Australia.
Harriet
H
Hiscock
Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Vic., Australia; The Royal Children's Hospital, 50 Flemington Road, Parkville, Vic., Australia.
Emma
E
Sciberras
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014739:Victoria
Attention deficit hyperactivity disorder; Child; Children's Sleep Habits Questionnaire; Sleep; Sleep diary