Sleep deprivation in early childhood may promote ADHD in subsequent years
Preschool-aged children who are not getting enough sleep at night are at increased risk of developing attention-deficit/hyperactivity disorder (ADHD) in middle childhood, a study has found.
Researchers enrolled 514 kindergarteners, among whom only 408 (mean age at preschool [K3], 5.52 years; 51.5 female) were available for reassessment at the 3-year follow-up when the children were in the third grade in primary school (P3; mean age, 9.35 years). Pertinent data were obtained from the parents and health records.
In K3, four children (1.0 percent) were diagnosed with obstructive sleep apnoea, 26 (6.4 percent) had persistent snoring and 20 (4.9 percent) received methylphenidate medication. Only 43 children (10.5 percent) were getting the recommended sleep duration of 11–12 hours per day.
In P3, 126 children (30.9 percent) had the recommended sleeping duration of ≥10 hours per day, 38 (9.3 percent) had regular sleep patterns and 176 (43.1 percent) had good sleep quality. Meanwhile, 61 children (15.0 percent) had probable ADHD, 70 (17.2 percent) had probable ADHD with predominantly inattentive symptoms and 66 (16.2 percent) had probable ADHD with predominantly hyperactive symptoms.
Adjusted Poisson regression models revealed a significant association between sleep duration in K3 and subsequent probable ADHD in P3. The resulting risk ratios vs children with 11–12 hours of sleep were 14.62 in those with <8 hours of sleep (p=0.02), 10.61 in those with 8 to <9 hours of sleep (p=0.02) and 9.29 in those with 9 to <11 hours of sleep (p=0.03). This association was robust to sensitivity analysis (p<0.001).
In light of the findings, researchers highlighted the potential of extending sleep education to parents and caregivers and alert them of the deleterious impact of early childhood sleep deprivation on long-term development. Paediatricians should also acknowledge the potential adverse effect of sleep deprivation on ADHD and provide appropriate treatment and advice for children with sleep problems.