A new study has reported that behavioural sleep intervention in children and adolescents with ADHD positively impacts across a variety of parameters, including ADHD symptoms, school attendance, and quality of life.
Attention deficit hyperactivity disorder (ADHD) is characterized by hyperactivity, inattention, and impulsivity. ADHD affects approximately 5% of children and adolescents. The long term effects of ADHD include academic underachievement, risky behavior, and psychiatric issues. Usual treatment for ADHD includes both psychotherapy and medication, however there are concerns regarding the use of medications in children from a harm versus benefit perspective.
Previous studies have demonstrated beneficial effects of sleep interventions in children who do not have ADHD. In addition, children with ADHD have a higher rate of sleep difficulties, suggesting that sleep interventions may have a beneficial effect in this subset of children.
Sleep problems include trouble with initiating, and maintaining sleep and have been associated with behavioural problems, reduction in quality of life, daily functioning, and school attendance. Sleeping problems can also lead to mental health issues.
The ‘Sleeping Sound with ADHD Study’, a trial assessing behavioural sleep intervention in children with ADHD and sleeping difficulties, has reported in the British Medical Journal. There were 244 children who participated in the study, between the ages of 5-12 years, who had been diagnosed with ADHD. Parents of children in the intervention group were coached by psychologists or pediatricians on sleep practices over the phone, while children in the control group continued with their usual care.
Sleep problems were reduced at 3 and 6 months in the intervention group compared with the control group. Overall, a reduction in ADHD symptoms was seen at three and six months in the intervention group, compared with the control group. The families in the intervention group reported overall improvements in ADHD symptoms, sleep, behaviour, health related quality of life, and daily functioning. In addition, the teachers of the children in the treatment group also reported an improvement in behaviour. The study suggests that the improvements seen in the children in the intervention group was mediated through an increase in duration and/or quality of sleep.
The authors report that addressing sleep problems in children with ADHD results in significant, prolonged benefits, suggesting that clinically addressing sleep disturbances can result in meaningful improvement across a variety of parameters. The authors plan to follow up on this study in order to assess long-term benefits and costs of intervention. They will also address whether a community-based program can be successful.
Hiscock, H, Sciberras, E, Mensah, F, Gerner, B, Efron, D, Khano, S, Oberklaid, F. “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 2015;350:h68
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Written by Deborah Tallarigo, PhD