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Sleep problems in children with attention-deficit hyperactivity disorder: associations with parenting style and sleep hygiene

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Abstract

We aimed to examine the association between sleep problems and parenting and sleep hygiene in children with attention-deficit/hyperactivity disorder (ADHD). Participants included 5–13-year-old children with DSM 5 defined ADHD and a parent-reported moderate-to-severe sleep problem (N = 361). Sleep was assessed using the parent-reported Children’s Sleep Habits Questionnaire. Parents also completed checklists assessing sleep hygiene, parenting consistency, and parenting warmth. Linear regression established prediction models controlling for confounding variables including child age and sex, ADHD symptom severity, comorbidities, medication use, and socio-demographic factors. More consistent parenting was associated with decreased bedtime resistance (β = −0.16) and decreased sleep anxiety (β = −0.14), while greater parental warmth was associated with increased parasomnias (β = +0.18) and sleep anxiety (β = +0.13). Poorer sleep hygiene was associated with increased bedtime resistance (β = +0.20), increased daytime sleepiness (β = +0.12), and increased sleep duration problems (β = +0.13). In conclusion, sleep hygiene and parenting are important modifiable factors independently associated with sleep problems in children with ADHD. These factors should be considered in the management of sleep problems in children with ADHD.

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Acknowledgements

This study was funded by the Australian National Health and Medical Research Council (NHMRC Grant 1058827). ES is supported by an NHMRC Early Career Fellowship (1037159) and NHMRC Career Development Award (1110688). TS is supported by funding from the Royal Children’s Hospital Foundation to the Melbourne Children’s Trial Centre. HH is supported by an NHMRC Career Development Award (607351). MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program. Data were collected and managed using the REDCap electronic data capture tools hosted at MCRI. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies.

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Authors and Affiliations

  1. Deakin University, Geelong, VIC, Australia

    Emma Sciberras

  2. Murdoch Childrens Research Institute, Parkville, VIC, Australia

    Emma Sciberras, Jie Cheng Song, Melissa Mulraney, Tibor Schuster & Harriet Hiscock

  3. The University of Melbourne, Parkville, VIC, Australia

    Emma Sciberras, Melissa Mulraney & Harriet Hiscock

  4. Centre for Community Child Health, The Royal Children’s Hospital, Flemington Rd, Parkville, VIC, 3052, Australia

    Harriet Hiscock

  5. Department of Family Medicine, McGill University, Montreal, QC, Canada

    Tibor Schuster

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  1. Emma Sciberras
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  2. Jie Cheng Song
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  3. Melissa Mulraney
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  4. Tibor Schuster
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  5. Harriet Hiscock
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Correspondence to Harriet Hiscock.

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The authors declare that they have no conflict of interest.

Ethical standards

Ethics approval was granted by the Human Research Ethics Committees of The Royal Children’s Hospital (#34072). The research has been conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

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Sciberras, E., Song, J.C., Mulraney, M. et al. Sleep problems in children with attention-deficit hyperactivity disorder: associations with parenting style and sleep hygiene. Eur Child Adolesc Psychiatry 26, 1129–1139 (2017). https://doi.org/10.1007/s00787-017-1000-4

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  • DOI: https://doi.org/10.1007/s00787-017-1000-4

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