Sleep problems common in kids with ADHD

Children with attention-deficit/hyperactivity disorder often have difficulties sleeping, and this can lead to problems not only for them but also for their caregivers, according to an Australian study.

The effects of sleep problems among children with ADHD have received little attention, Dr. Valerie Sung, of the Royal Children's Hospital in Parkville, Victoria, and colleagues point out in the Archives of Pediatrics and Adolescent Medicine.

However, they note, sleep problems in general are often readily treatable without medication, so "strategies for effective sleep management could potentially have important implications in reducing adverse outcomes of ADHD."

For the study, 239 families of schoolchildren 5 to 18 years of age with ADHD completed a survey.

Sleep problems affected 175 children with ADHD; the difficulties were moderate or severe in 107 and mild in 68 children. The most common sleep problems included difficulty falling asleep, resisting going to bed, and tiredness on waking.

Moderate or severe sleep problems were associated with poorer psychosocial quality of life and daily functioning of the child. Compared with children without sleep problems, those with moderate or severe problems were more likely to miss or be late for school.

"Primary caregivers of children with ADHD who have moderate or severe sleep problems were more likely to have poorer mental health than those without sleep problems," Sung and colleagues continue. "There was a higher percentage of primary caregivers of children with moderate or severe sleep problems who were late for work compared with those without sleep problems, and their spouses were more likely to be late to work."

Moderate or severe sleep problems were also associated with poorer family functioning.

"Implementation of a sleep intervention in children with ADHD could feasibly improve outcomes beyond treatment of ADHD alone," Sung commented in a journal statement. These interventions could also possibly allow some children to lower their medication dosage.

In the meantime, she urged doctors who care for kids with ADHD to ask about their sleep, "and if a problem is present, this should be addressed."

SOURCE: Archives of Pediatrics and Adolescent Medicine, April 2008.