Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News

Icon

Lack of sleep seen to cause sluggish cognitive tempo (SCT) in adolescents with attention deficits

___

It is esti­mat­ed that up to 75% of youth with ADHD have sleep prob­lems. And, exper­i­men­tal stud­ies that manip­u­late sleep quan­ti­ty have demon­strat­ed a causal link between sleep and ADHD behav­ior in chil­dren.

How­ev­er, there has been no pri­or work in which sleep dura­tion has been manip­u­lat­ed in ado­les­cents diag­nosed with ADHD. Evi­dence of a causal link between sleep quan­ti­ty and ADHD symp­toms in ado­les­cents would pro­vide addi­tion­al sup­port for includ­ing sleep as an inter­ven­tion tar­get in teens with ADHD, espe­cial­ly for those with known sleep dif­fi­cul­ties.

This issue was addressed in a study pub­lished online recent­ly in the Jour­nal of the Amer­i­can Acad­e­my of Child and Ado­les­cent Psy­chi­a­try.

The New Study

Par­tic­i­pants were 72 14–17-year olds diag­nosed with ADHD. The study involved a 3-week sleep pro­to­col with an exper­i­men­tal cross over design. After a one-week base­line peri­od, youth par­tic­i­pat­ed in one-week of sleep restric­tion and one-week of sleep exten­sion.

Dur­ing the restric­tion week, teens adjust­ed their bed­time to allow no more than 6.5 hours in bed. Dur­ing the exten­sion week, bed­time was adjust­ed to pro­vide 9.5 hours in bed. The order of restric­tion and exten­sion weeks was coun­ter­bal­anced across par­tic­i­pants.

Sleep was mea­sured using a wrist-mount­ed acti­graph. This con­firmed that par­tic­i­pants obtained 1.6 more hours of sleep on aver­age dur­ing the exten­sion week com­pared to the restric­tion week.

Day­time sleepi­ness and ADHD symp­toms were mea­sured at the end of each week using rat­ing scales com­plet­ed by par­ents and by ado­les­cents.

Par­ents and teens also com­plet­ed rat­ings of slug­gish cog­ni­tive tem­po (SCT), a set of atten­tion­al symp­toms reflect­ed by men­tal con­fu­sion, day­dream­ing, and ‘slowed’ behav­ior and think­ing. SCT over­laps with, but is not iden­ti­cal to, the inat­ten­tive symp­toms that char­ac­ter­ize ADHD.

Final­ly, par­ents also com­plet­ed rat­ings of their teen’s oppo­si­tion­al behav­ior.

The Results

As expect­ed, large dif­fer­ences in day­time sleepi­ness were found in both par­ent and ado­les­cent rat­ings, with greater sleepi­ness report for the sleep restric­tion week. Ado­les­cents also report­ed more day­time nap­ping dur­ing this week.

Par­ents report­ed that their teen showed sig­nif­i­cant­ly more atten­tion prob­lems and oppo­si­tion­al behav­ior dur­ing the sleep restric­tion week com­pared to the sleep exten­sion week.; they also observed large dif­fer­ences relat­ed to slug­gish cog­ni­tive tem­po. Dif­fer­ences in hyper­ac­tive-impul­sive behav­ior dur­ing restric­tion and exten­sion weeks were not found.

The teens them­selves did not report dif­fer­ences in atten­tion prob­lems between the restric­tion and exten­sion weeks. How­ev­er, they report­ed more symp­toms of slug­gish cog­ni­tive tem­po and more hyper­ac­tive-impul­sive behav­ior dur­ing the sleep restric­tion week.

The Key Takeaway

This study pro­vides clear exper­i­men­tal evi­dence that how much teens with ADHD sleep has a sig­nif­i­cant impact on their atten­tion and behav­ior. An addi­tion­al 1.6 hours per night — the aver­age dif­fer­ence in sleep dur­ing restric­tion and exten­sion weeks — had impacts that were dis­cernible to par­ents and, for some out­comes, to teens them­selves.

The fact that these results are not sur­pris­ing does not dimin­ish their poten­tial sig­nif­i­cance. Increas­ing sleep is a safe, free, inter­ven­tion that can make a mean­ing­ful dif­fer­ence.

What is sur­pris­ing, how­ev­er, is that that assess­ing sleep and inter­ven­ing where indi­cat­ed is not done for many youth with ADHD. While the impact of increas­ing sleep did not have as large an effect, on aver­age, as med­ica­tion, there is no rea­son not to include sleep assess­ment and inter­ven­tion for near­ly all youth with ADHD. There is vir­tu­al­ly no cost to doing this and it can make a dif­fer­ence.

The study would have been stronger if data was also obtained from teach­ers to learn whether the ben­e­fits that par­ents observed were also observed at school. This is par­tic­u­lar­ly true since par­ents were not ‘blind’ to sleep con­di­tion and their rat­ings may thus have been influ­enced by knowl­edge of whether their child was in the restric­tion or exten­sion por­tion of the study. This could be addressed in sub­se­quent research.

This lim­i­ta­tion not with­stand­ing, the study high­light a safe, inex­pen­sive, and poten­tial­ly valu­able tar­get for inter­ven­tion in youth with ADHD that may often be over­looked.

– Dr. David Rabin­er is a child clin­i­cal psy­chol­o­gist and Direc­tor of Under­grad­u­ate Stud­ies in the Depart­ment of Psy­chol­o­gy and Neu­ro­science at Duke Uni­ver­si­ty. He pub­lish­es the Atten­tion Research Update, an online newslet­ter that helps par­ents, pro­fes­sion­als, and edu­ca­tors keep up with the lat­est research on ADHD.

The Study in Context:

Leave a Reply...

Loading Facebook Comments ...

Leave a Reply

Categories: Attention and ADD/ADHD, Cognitive Neuroscience, Education & Lifelong Learning, Health & Wellness

Tags: , , , , , ,

Watch All Recordings Now (40+ Speakers, 12+ Hours)

About SharpBrains

As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters and more, SharpBrains is an independent market research firm tracking health and performance applications of brain science.

Follow us and Engage via…

twitter_logo_header
RSS Feed

Search for anything brain-related in our article archives