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Childhood Sleep Issues May Signal ADHD Symptoms in Preadolescence

In 3 pediatric cohorts in Spain, children with sleep problems at ages 8 and 9 were at increased risk of attention-deficit/hyperactivity disorder (ADHD) symptoms in preadolescence. Researchers published their findings in the European Journal of Pediatrics.

“[O]ur evidence is not strong [enough] to establish a causal mechanism, but sleep problems could be considered an alarm sign for general health, and specifically, for ADHD symptoms,” wrote corresponding author Paula Carrasco, Jaume I University, Castelló, Spain, and study coauthors.

The investigation included data for 1244 children from the Gipuzkoa, Sabadell, and Valencia cohorts from the INMA Study in Spain (a “population-based mother-and-child multicenter cohort established in 2003 in 7 areas”). Children were assessed for sleep problems at age 8 or 9 using the Child Behavior Checklist. At age 10 or 11, they were screened for ADHD symptoms using the Conners’ Parent Rating Scale–Revised Short Form.

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Models investigating the relationship between sleep problems and ADHD symptoms found incident rate ratios of 1.14 for opposition, 1.20 for inattention, 1.18 for hyperactivity, and 1.18 for ADHD, according to the study.

The association between sleep problems and increased ADHD symptom risk remained strong even after the analyses excluded children born preterm, small for their gestational age, and who had symptoms compatible with an ADHD diagnosis before or at the same time their sleep issues began.

“These findings must be interpreted with caution,” advised study leader Llúcia González-Safont, of the University of Valencia, Valencia, Spain, and a visiting lecturer at the Universitat Jaume I. “Although not all children with sleep disorders will develop symptoms of ADHD, detecting them at an early stage, with questionnaires that are easy to apply in pediatric consultations, could contribute to preventing or mitigating future symptoms of behavioral problems like ADHD.”

 

References

González-Safont L, Rebagliato M, Arregi A, et al. Sleep problems at ages 8-9 and ADHD symptoms at ages 10-11: evidence in three cohorts from INMA study. Eur J Pediatr. 2023;182(11):5211-5222. doi:10.1007/s00431-023-05145-3

Sleep disorders in childhood increase the risk of developing symptoms of attention deficit disorder and hyperactivity. News release. Universitat Jaume I; June 17, 2024. Accessed August 9, 2024.