Effects of a brief parent-based sleep intervention on sleep and clinical symptoms in children with attention deficit hyperactivity disorder,and parental sleep and mental health

Abstract

Sleep problems are very common in children with attention deficit hyperactivity disorder (ADHD) and often pose significant challenges and stress to the families, such as through the exacerbation of daytime symptoms. It was less well established as to whether sleep problems in ADHD children also affected the child’s quality of life and parental sleep and mental health, beyond what would be expected of their ADHD and comorbid symptoms. In Study 1, ADHD children with insomnia (n = 32) were compared with ADHD children without insomnia (n = 32). ADHD children with insomnia had more severe ADHD symptoms, more externalizing behaviour and emotional symptoms, as well as poorer emotional functioning. Parents of ADHD children with insomnia had poorer overall sleep quality, more severe insomnia, more depressive and stress symptoms, as well as greater parenting stress and fatigue. Associations still held after controlling for confounding psychological symptoms in terms of ADHD and behavioural and emotional symptoms. Subsequently, Study 2 investigated whether a brief parent-based behavioural intervention could alleviate insomnia symptoms and functional impairment in ADHD children and their parents. As a pilot study, 18 families received intervention on behavioural sleep management. Questionnaires were completed at baseline and post-intervention. Both the children and their parents showed significant improvement in their sleep and functioning after the intervention. Findings suggested that sleep disruption may increase behavioural problems in ADHD children. In turn, a brief parent-based intervention could improve the sleep and quality of life for both child and parent.