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

• Published in: Archives of disease in childhood 2019-05, Vol.104 (Suppl 2), p.A265
• Main Authors: Yemula, C, Musgrave, E, Ajmal, S, Khan, A, Sesham, R
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescents; Anxiety; Attention deficit hyperactivity disorder; Autism; Children & youth; Comorbidity; Enuresis; Females; Gender differences; Latency; Males; Melatonin; Mental disorders; Polls & surveys; Sex differences; Sleep; Sleep disorders; Teenagers
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2019-rcpch.633

BackgroundTeenagers require 8–10 hours 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.AimsTo ascertain the sleep habits of teenagers with ADHD, including sleep onset and duration of sleepTo determine the use of gadgets before bedtimeTo evaluate the impact of poor sleep during the dayTo learn if any gender differences existMethodsWe 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.Results52 teenagers aged 13 to 18 years (boys=40 and 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 hours on their gadgets, while 7 (13.7%) spent more than 4 hours. 36 participants (69.2%) experienced sleep onset of more than 30 min, 7 of whom (13.5%) took more than 2 hours. Inadequate sleep (less than 8 hours) 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%).ConclusionsIn our survey, over 40% teenagers with ADHD spent more than 2 hours 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.