Attention-Deficit/hyperactivity Disorder and Sleep Disturbances: Consideration of Familial Influences

Abstract

The present study examined the extent to which parenting influences problems with sleep in children referred for an evaluation of Attention-Deficit/Hyperactivity Disorder (ADHD). Data was collected from parents and/or legal guardians of sixty-three 4- to 12-year old children referred for assessment at an ADHD Evaluation Clinic located at a Midwestern university. Previous literature linking sleep problems to ADHD has typically derived from community and pediatric sleep clinic samples and has largely overlooked children with sub-clinical sleep impairments and/or those whose sleep problems stem from alternate etiologies. More than 60% of parents/caregivers in the current study reported significant child sleep difficulties. As hypothesized, parenting (as related to the implementation of daily routines) added to the explained variance in sleep problems above and beyond the variance explained by an ADHD diagnosis. However, neither parent use of routines nor parenting stress were significant individual predictors of child sleep problems. Parent report of child internalizing symptomology, but not externalizing symptomology, was significantly correlated with reported problems with sleep. The present results suggest that children who display behaviors associated with anxiety and depression may be particularly likely to exhibit sleep difficulties and that evaluation of sleep difficulties should include consideration of parenting practices (i.e., lack of consistent sleep routines). Given the high percentage of sleep problems reported, current results also suggest that screening for sleep disturbances should be a routine part of child assessment.