Associations between sleep problems in children with ADHD and parental insomnia and ADHD symptoms

Abstract

Sleep problems are common in children with attention deficit hyperactivity disorder (ADHD). Children's sleep problem may influence, and be influenced by, parents' sleep problems as well as parents' ADHD symptoms. In the current study we examined the associations of parent-rated sleep quality and sleep timing of pre-adolescent children with parental insomnia symptoms, parental ADHD symptoms and dysfunctional attitudes and beliefs about sleep in a convenience sample recruited by advertisement (N = 120). Childhood sleep problems were common in the sample, with 82% of children exceeding the threshold for the presence of a paediatric sleep disorder. Children's sleep quality showed minimal association with their sleep timing and chronotype. Parental insomnia symptoms, ADHD symptoms and dysfunctional beliefs and attitudes about sleep all associated with their children's sleep quality, and with the sleep subdomains of sleep anxiety and parasomnias. In multiple regression analysis only parental insomnia score was a significant predictor of children's sleep quality. Children's bedtimes, wake times, sleep duration, chronotype or social jetlag did not associate with parents' ADHD or insomnia symptoms. Sleep quality was significantly poorer in children whose parents scored as both consistent for adult ADHD and probable for insomnia disorder compared to parents who scored as either ADHD consistent or insomnia probable, or those who parents scored as neither. We discuss the putative nature of the relationships between sleep quality of children with ADHD and parental ADHD and insomnia symptoms, and suggest that clinicians consider parental sleep when attending to children with ADHD.

Fig 1

Scatterplots showing the associations of children’s total CSHQ scores and their (A) sleep duration, (B) M-E score, (C) MSF and (D) Social Jetlag. The filled line represents the regression line, and the dashed line the 95% confidence interval around it.

Fig 2

Scatterplots showing the associations of children’s total CSHQ with parental (A) SCI total scores, (B) DBAS total scores and (C) ASRS total scores. The filled line represents the regression line, and the dashed line the 95% confidence interval around it.

Fig 3. Scatterplots showing the associations of children’s CSHQ subscales scores and parental SCI and ASRS scores.

The filled line represents the regression line, and the dashed line the 95% confidence interval around it.

Fig 4

Raincloud plots showing groupwise comparisons of children’s total CSHQ scores according to parents’ ADHD consistency from ASRS scores (A) and insomnia probability from SCI scores (B), children’s sleep duration with parental ADHD-consistency (C) and insomnia probability (D), and children’s M-E scores with parental ADHD-consistency (E) and insomnia probability (F). ** denotes P<0.01 and * P<0.05 by independent t-test.

Fig 5. Raincloud plots showing groupwise comparisons of children’s total CSHQ scores according to parents’ combined status of ADHD consistency and insomnia probability.

*** denotes P<0.001 and ** P<0.01 by Tukey post-hoc test following one-way ANOVA.