Winnie Tso1, Meanne Chan2, Frederick K Ho1, Nirmala Rao3, Albert M Li4, Ko Ling Chan5, Agnes Tiwari6, Ian C K Wong7, Yun Kwok Wing8, Benjamin Van Voorhees9, Sophia Ling Li1, Winnie H S Goh10, Patrick Ip11. 1. Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong. 2. Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong. 3. Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong. nrao@hku.hk. 4. Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30 Ngan Shing Street, Sha Tin, Hong Kong. 5. Department of Applied Social Science, The Hong Kong Polytechnic University, Pokfulam, Hong Kong. 6. School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong. 7. Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong. 8. Department of Psychiatry, The Chinese University of Hong Kong, Shatin Hospital, 33A Kung Kok Street, Ma On Shan, Hong Kong. 9. Department of Paediatrics, College of Medicine at Chicago, University of Illinois, Chicago, IL, USA. 10. Division of Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Kallang, Singapore. 11. Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong. patricip@hku.hk.
Abstract
BACKGROUND: This study aims to study prospectively specific sleep patterns and risk of ADHD after adjusting for potential confounders such as obstructive sleep apnoea (OSA) and methylphenidate use. METHODS: A population-representative sample of 514 Chinese preschool children was recruited when in kindergarten (K3). Parents reported on their socioeconomic status and children's sleep duration. The cohort was reassessed 3 years later when the children were in Grade 3 (P3). Parents reported on children's sleep patterns and ADHD symptoms. Information on OSA diagnosis and methylphenidate use was retrieved from health records. RESULTS: Among the 514 parent-child dyads (mean [SD] age, 5.52 [0.33] years), 411 were reassessed (80.0% retention; 9.35 [0.33] years) at follow-up. There were no significant baseline differences between follow-up and drop-out groups. A gradient relationship was observed between probable ADHD in P3 and sleep duration in K3. The risk of probable ADHD was 15.5 per 100 for children with <8 h of sleep in K3, whereas it was 1.1 per 100 for children with 11-12 h of sleep in K3. The adjusted risk ratio was 14.19 (p = 0.02). CONCLUSIONS: Sleep deprivation in early childhood is associated with higher risk of ADHD in middle childhood.
BACKGROUND: This study aims to study prospectively specific sleep patterns and risk of ADHD after adjusting for potential confounders such as obstructive sleep apnoea (OSA) and methylphenidate use. METHODS: A population-representative sample of 514 Chinese preschool children was recruited when in kindergarten (K3). Parents reported on their socioeconomic status and children's sleep duration. The cohort was reassessed 3 years later when the children were in Grade 3 (P3). Parents reported on children's sleep patterns and ADHD symptoms. Information on OSA diagnosis and methylphenidate use was retrieved from health records. RESULTS: Among the 514 parent-child dyads (mean [SD] age, 5.52 [0.33] years), 411 were reassessed (80.0% retention; 9.35 [0.33] years) at follow-up. There were no significant baseline differences between follow-up and drop-out groups. A gradient relationship was observed between probable ADHD in P3 and sleep duration in K3. The risk of probable ADHD was 15.5 per 100 for children with <8 h of sleep in K3, whereas it was 1.1 per 100 for children with 11-12 h of sleep in K3. The adjusted risk ratio was 14.19 (p = 0.02). CONCLUSIONS: Sleep deprivation in early childhood is associated with higher risk of ADHD in middle childhood.
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