title: No objectively measured sleep disturbances in children with attention-deficit/hyperactivity disorder.
abstract: The main goal of this study was to gain more insight into sleep disturbances in children with attention-deficit/hyperactivity disorder, using objective measures of sleep quality and quantity. The evidence for sleep problems in children with attention-deficit/hyperactivity disorder thus far is inconsistent, which might be explained by confounding influences of comorbid internalizing and externalizing problems and low socio-economic status. We therefore investigated the mediating and moderating role of these factors in the association between attention-deficit/hyperactivity disorder and sleep problems. To control for the effects of stimulant medication use, all participants were tested free of medication. Sixty-three children with attention-deficit/hyperactivity disorder and 61 typically developing children, aged 6-13 years, participated. Sleep was monitored for one to three school nights using actigraphy. Parent and teacher questionnaires assessed symptoms of attention-deficit/hyperactivity disorder, internalizing behaviour, oppositional defiant disorder and conduct disorder. Results showed no differences between the attention-deficit/hyperactivity disorder and typically developing group in any sleep parameter. Within the attention-deficit/hyperactivity disorder group, severity of attention-deficit/hyperactivity disorder symptoms was not related to sleep quality or quantity. Moderation analyses in the attention-deficit/hyperactivity disorder group showed an interaction effect between attention-deficit/hyperactivity disorder symptoms and internalizing and externalizing behaviour on total sleep time, time in bed and average sleep bout duration. The results of our study suggest that having attention-deficit/hyperactivity disorder is not a risk factor for sleep problems. Internalizing and externalizing behaviour moderate the association between attention-deficit/hyperactivity disorder and sleep, indicating a complex interplay between psychiatric symptoms and sleep.
authors.affiliation: Clinical Neuropsychology section, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. c.e.bergwerff@vu.nl.
authors.forename: Catharina E
authors.initials: CE
authors.lastname: Bergwerff
authors.affiliation: Clinical Neuropsychology section, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Luman
authors.affiliation: Clinical Neuropsychology section, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: Jaap
authors.initials: J
authors.lastname: Oosterlaan
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D005178:Faculty / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: actiwatch; childhood; methylphenidate; sleep latency