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Sleep problem trajectories and well-being in children with attention-deficit hyperactivity disorder: a prospective cohort study

journal contribution
posted on 01.06.2016, 00:00 authored by Kate LycettKate Lycett, Emma SciberrasEmma Sciberras, H Hiscock, F K Mensah
Objective: Sleep problems affect up to 70% of children with attention-deficit/hyperactivity disorder
(ADHD) and are associated with poorer child and family well-being in cross-sectional studies. However,
whether these associations hold longitudinally is unclear. The authors aimed to examine the longitudinal
relationship between sleep problem trajectories and well-being in children with ADHD. Method: Children
with ADHD (n 5 186), aged 5 to 13 years, were recruited from 21 pediatric practices across the state of
Victoria, Australia. Sleep problem severity data were collected at 3 time points (baseline, 6, and 12 mo) and
were used to classify sleep problem trajectories. Child and family well-being (e.g., child emotional and behavioral
problems, quality of life [QoL]) were measured at baseline and 12 months by teacher and/or
caregiver-report. The well-being of children with “transient” and “persistent” sleep problems was compared
with those “never” experiencing sleep problems using a series of hierarchical linear regression models.
Results: After accounting for socio-demographic factors, children with transient and persistent sleep trajectories
experienced more caregiver-reported behavioral and emotional problems (effect size [ES] both 0.7)
and poorer child QoL (ES: 20.7 and 21.2, respectively). These associations remained after also accounting for
ADHD medication and symptom severity and comorbidities, but after accounting for baseline measures many
associations weakened to the point of nonsignificance. In the fully adjusted model—transient sleep problems
were associated with behavioral and emotional problems (ES: 0.2). These associations were not evident by
teacher-report. Conclusion: Children with ADHD experiencing transient or persistent sleep problems have
poorer caregiver-reported well-being. Managing sleep problems in children with ADHD may improve child



Journal of developmental and behavioral pediatrics






405 - 414


Wolters Kluwer


Philadelphia, Pa.







Publication classification

C Journal article; C1 Refereed article in a scholarly journal

Copyright notice

2016, Wolters Kluwer