Assessment of Sleep disturbances in children with Attention-deficit hyperactivity disorder

Introduction: A high prevalence of sleep disturbances have been found in children with Attention deficit hyperactivity disorder (ADHD) and these impact daytime behavior and cognitive functioning. Previous studies have assessed these on subjective measures by parent and self report and by means of objective measures using actigraphy and polysomnography. This study aimed to find the subjective and objective impairments in sleep using parental report and actigraphy. Methodology: 20 children attending the Child and Adolescent Psychiatry Clinic, AIIMS diagnosed as ADHD were assessed using Conners' Parent Rating Scale-Revised (CPR-SR) and Conners' Global Index-Parent (CGI-P) for ADHD and for sleep problems using Child Sleep Habits Questionnaire (CSHQ) and Pediatrics Sleep Questionnaire (PSQ). Actigraphy was carried out for objective assessment of sleep. The control group consisted of 20 age and gender matched normal children. Results: 60% of children with ADHD had at least one sleep problem as compared to 30% of controls. Significant differences were seen on bedtime resistance, night wakings, parasomnias, day time sleepiness. 40% children with ADHD were found to have restless legs symptoms compared to 15% of controls. On actigraphy, sleep onset latency was significantly greater with mean of 25 min as compared to 15 min in control group. Sleep efficiency was significantly lower in children with ADHD. Conclusions: Sleep disturbances are common in ADHD children and hence, must be actively evaluated. Further studies using larger sample size and other objective measures like polysomnography can be used in future Indian studies.