G654\u2005A clinic-based survey of sleep habits among teenagers with attention deficit hyperactivity disorder: impact of poor sleep and gender differences

Abstract

Background Teenagers require 8–10\u2009hours of sleep. Poor sleep is common in teenagers with Attention Deficit Hyperactivity Disorder (ADHD). ADHD-related sleep problems including specific sleep disorders such as bedtime resistance, delayed latency of sleep onset, dim light melatonin onset delay, increased number of overnight awakenings, and sleep disturbances due to co-morbid psychiatric disorders or ADHD medications. Aims To ascertain the sleep habits of teenagers with ADHD, including sleep onset and duration of sleep To determine the use of gadgets before bedtime To evaluate the impact of poor sleep during the day To learn if any gender differences exist Methods We developed a sleep survey questionnaire for teenagers with ADHD to anonymously report their sleep habits, including use of gadgets before bedtime, sleep onset and total amount of sleep obtained. In addition, they were asked to state if they felt their sleep was adequate, and if they experienced tiredness/poor concentration or both during daytime hours. Further information including co-morbid conditions and the use of ADHD medication was also collated. Results 52 teenagers aged 13 to 18 years (boys=40\u2009and girls=12) completed the survey. 22 (42.3%) were on ADHD medication and 21 (40.3%) had one or more comorbid conditions (autism, anxiety, depression, ODD, mild learning disability, Tourette’s syndrome and enuresis). 51 teenagers (98.1%) used one or more gadgets (mobile phone/tablet/TV/computer) before bedtime; 14 (27.5%) spent 2–4\u2009hours on their gadgets, while 7 (13.7%) spent more than 4\u2009hours. 36 participants (69.2%) experienced sleep onset of more than 30\u2009min, 7 of whom (13.5%) took more than 2\u2009hours. Inadequate sleep (less than 8\u2009hours) was noted in 50% of girls and 75% of boys. 44 teenagers (84.1%) reported tiredness/poor concentration or both, including 32 boys (80%) and all the girls (100%). Conclusions In our survey, over 40% teenagers with ADHD spent more than 2\u2009hours on gadgets before bedtime. Whilst some teenagers had comorbidity and received ADHD medication, most teenagers experienced sleep onset delay and inadequate sleep. More boys experienced less than adequate sleep comparted to girls. Problems with poor concentration/tiredness were found in the majority of teenagers, with girls affected more than boys. Evaluation of teenagers’ sleep should be an essential part of a holistic ADHD assessment, enabling clinicians to develop an individualised care plan of psychoeducation and sleep management.