Attention Deficit Hyperactivity Disorder (ADHD) has become one of the more prevalent psychological disorders in the country. It is commonly characterized by inattention, impulsivity, and hyperactivity. Further, children with ADHD also display a number of sleep difficulties. These sleep problems mainly consist of difficulty initiating sleep (sleep onset) and maintaining sleep throughout the night.
There are several speculations as to why sleep problems are so common in children with ADHD. These include, but are not limited to, use of stimulant medication (such as Ritalin and Adderall), comorbid psychiatric disorders (i.e. anxiety), and poor sleep hygiene behaviors. However, it is not known whether ADHD leads to poor sleep, or whether poor sleep leads to ADHD. Moreover, not all children with diagnosed ADHD experience sleep difficulties.
One recent study examined whether treating sleep problems in children in ADHD would improve both their sleep and ADHD symptomology. Researchers recruited 244 children who were diagnosed with ADHD and were also presenting sleep problems. Since ADHD also affects the parents’ quality of life, they were also involved in the interventions.
Parents had several sessions with clinicians, in which they learned about the basics of sleep, and also sleep hygiene. Further, parents were taught standard management strategies on how to provide an effective sleep environment for the children. Children then underwent sleep testing, and received a tailored treatment to their specific sleep problems.
Compared to the control group (children with ADHD who did not receive the intervention), there were many significant improvements. The children showed improvements in all ADHD symptomology, particular inattentiveness. They also showed significant improvements in health related quality of life, daytime functioning, memory, and classroom behavior (reported by their teacher). The children’s sleep also improved throughout the study period. Lastly, there were improvements in the quality of life for the parents (i.e. showed up late for work at a lower rate).
These results have some pretty important implications. First, these improvements were consistent at a 6-month follow up period, which is very good in intervention research. The results from this study were similar to previous interventions, which used exhaustive methods to target ADHD symptoms. Further, these improvements are above and beyond what is provided by medication treatment.
This is a step in a direction to a potentially cost effective, and exceptionally beneficial intervention strategy for children with ADHD. One of the more important findings of this study was that this intervention was more effective than treatment with Ritalin or Adderall. Use of these stimulants may help alleviate some symptoms, but also have the potential to exacerbate sleep problems.
Hiscock, H., Sciberras, E., Mensah, F., Gerner, B., Efron, D., Khano, S., & Oberklaid, F. (2015). Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial. bmj, 350, h68.