Melissa Mulraney1, Rebecca Giallo2, Kate Lycett3, Fiona Mensah4, Emma Sciberras5. 1. Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Victoria, Australia. Electronic address: melissa.mulraney@mcri.edu.au. 2. Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Victoria, Australia. 3. Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, Australia. 4. Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia. 5. Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, Australia; The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia; School of Psychology, Deakin University, Burwood Highway, Burwood, Victoria, Australia.
Abstract
BACKGROUND:Behavioral sleep problems are common in children with attention deficit hyperactivity disorder (ADHD), and longitudinal studies have found sleep problems to be both a predictor and outcome of internalizing and externalizing problems. We investigated the potential bidirectional relationship between sleep problems and internalizing/externalizing problems. METHODS:Children with ADHD, aged 5-13 years, were recruited from 21 pediatric practices across Victoria, Australia (N = 270). Across a 12-month period, at three time points, parents reported on their child's sleep problems (Children's Sleep Habits Questionnaire) and emotional and behavioral functioning (Strengths and Difficulties Questionnaire). Data were analyzed using autoregressive cross-lagged panel models. RESULTS:Sleep problem severity and emotional/behavioral problem severity were very stable across the 12-month period. Sleep problems at baseline predicted emotional problems at six months (r = 0.17, p < 0.01), and emotional problems at baseline predicted sleep problems at six months (r = 0.07, p < 0.05). However, there was no predictive relationship between sleep problems and emotional problems from 6-12 months. No bidirectional relationship was observed between sleep problems and conduct problems. CONCLUSIONS: In children with ADHD, there is weak evidence of a bidirectional relationship between sleep problems and emotional problems. These symptoms are also very stable over time; therefore, the best treatment approach to improve overall functioning may be to target both sleep and emotional functioning in these children.
RCT Entities:
BACKGROUND: Behavioral sleep problems are common in children with attention deficit hyperactivity disorder (ADHD), and longitudinal studies have found sleep problems to be both a predictor and outcome of internalizing and externalizing problems. We investigated the potential bidirectional relationship between sleep problems and internalizing/externalizing problems. METHODS:Children with ADHD, aged 5-13 years, were recruited from 21 pediatric practices across Victoria, Australia (N = 270). Across a 12-month period, at three time points, parents reported on their child's sleep problems (Children's Sleep Habits Questionnaire) and emotional and behavioral functioning (Strengths and Difficulties Questionnaire). Data were analyzed using autoregressive cross-lagged panel models. RESULTS: Sleep problem severity and emotional/behavioral problem severity were very stable across the 12-month period. Sleep problems at baseline predicted emotional problems at six months (r = 0.17, p < 0.01), and emotional problems at baseline predicted sleep problems at six months (r = 0.07, p < 0.05). However, there was no predictive relationship between sleep problems and emotional problems from 6-12 months. No bidirectional relationship was observed between sleep problems and conduct problems. CONCLUSIONS: In children with ADHD, there is weak evidence of a bidirectional relationship between sleep problems and emotional problems. These symptoms are also very stable over time; therefore, the best treatment approach to improve overall functioning may be to target both sleep and emotional functioning in these children.
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Authors: Cecilia Marino; Brendan Andrade; Susan C Campisi; Marcus Wong; Haoyu Zhao; Xin Jing; Madison Aitken; Sarah Bonato; John Haltigan; Wei Wang; Peter Szatmari Journal: JAMA Netw Open Date: 2021-03-01