Sleep Disorders and Attention-Deficit/ Hyperactivity Disorder in Children: A HospitalBased Observational Study from a Regional Early Intervention Centre in Kerala, India

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most extensively studied neurobehavioural disorders of childhood. The association of sleep disorders with ADHD is multidimensional, and understanding them is important in effectively managing patients with ADHD.

Aim: To examine the presence of sleep disorders in children with ADHD, to correlate it with parameters of age and ADHD subtypes, and to find out the association between sleep disorders and other socio-demographic, and clinical factors.

Materials and Methods: The study sample of this hospital-based observational study consisted of 70 subjects who presented to the Regional Early Intervention Centre (REIC), Thrissur, diagnosed with ADHD based on Diagnostic and Stastistical Manual of Mental Disorders (DSM)-5 criteria and belonging to the age group 5-16 years. Subjects were interviewed using a structured questionnaire to assess socio-demographic and clinical details. The ‘Sleep Disturbance Scale for Children’ (SDS-C) was used to assess sleep disorders in children. The information thus obtained was analysed using SPSS software version 23.

Results: Out of the 70 subjects with ADHD, 49 (70%) had sleep disorders. The mean age of study population was 8.66±2.72 years, and the male:female ratio was 4:1. There was co-morbid behavioural disorder in 32 subjects (45.7%), and parental history of ADHD in 33 subjects (47.1%). There was a significant association between sleep disorders and behavioural disorders (p-value=0.003) and parental history of ADHD (p-value=0.042). There was a significant negative correlation between age and sleep disorder (p-value=0.033).

Conclusion: The prevalence of sleep disorders in ADHD is high in the study population. The relationship between sleep disorders and the presence of co-morbid behavioural disorders in ADHD suggests that recognition and management of sleep disorders may require more attention. The association between sleep disorder and parental history of ADHD may enhance the understanding of genomic variants associated with ADHD.