Document Type

Article

Publication Date

2024

DOI

10.1007/s10803-024-06623-9

Publication Title

Journal of Autism and Developmental Disorders

Pages

10 pp.

Abstract

Children with attention deficit hyperactivity disorder (ADHD) experience high rates of sleep problems and are at increased risk for developing internalizing problems. This study aimed to examine the association of sleep problems and physical activity with internalizing symptoms in children with ADHD. This cross-sectional study included 188 children with ADHD (M age = 8.60 ± 1.38, 78.7% boys). Self-reported questionnaires were used to assess sleep problems (Pittsburgh Sleep Quality Index [PSQI]) and internalizing symptoms (Depression Anxiety Stress Scale 21 [DASS 21]). The presence of sleep problems was defined as a PSQI score > 5. Physical activity was recorded by an ActiGraph GT9X Link accelerometer for 7 consecutive days. In total, 111 children with ADHD presented with sleep problems (59%). Compared with their counterparts without sleep problems, children with sleep problems spent less time in daily moderator-to-vigorous physical activity (MVPA) (F = 15.35, η2 = .079), had a lower proportion of meeting the WHO-recommended 60 min of daily MVPA guideline (F = 9.57, η2 = .050), and showed more internalizing symptoms: depression (F = 10.09, η2 = .053), anxiety (F = 15.84, η2 = .081), and stress (F = 6.98, η2 = .037). BMI, daytime dysfunction of PSQI, and MVPA guideline attainment were significantly associated with internalizing symptoms in children with ADHD. Daytime dysfunction of PSQI is associated with more severe internalizing symptoms, and MVPA guideline attainment may reduce the likelihood of developing depression and anxiety in children with ADHD. Future studies are needed to examine the long-term effects of sleep on internalizing symptoms and the effects of PA-based interventions on sleep and internalizing symptoms in children with ADHD, respectively.

Rights

© The Authors 2024.

This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original authors and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Original Publication Citation

Liang, X., Zhao, M., Su, L., Haegele, J. A., Xu, R. H., Li, J., Guo, J., Tse, A. C., Li, S. X., & Shum, D. H. K. (2024). Sleep problems in children with ADHD: Associations with internalizing symptoms and physical activity. Journal of Autism and Developmental Disorders. Advance online publication. https://doi.org/10.1007/s10803-024-06623-9

ORCID

0000-0002-8580-4782 (Haegele)

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