Even a Mild Sleep Restriction Can Impact Daytime Functioning in Children with ADHD and Their Typically Developing Peers

ABSTRACT

Objectives/Background

Correlational studies show that short sleep is associated with negative daytime outcomes in school-aged children, but there are few experimental sleep manipulation studies to assess whether this is a causal relation. The aim of this study was to determine the impact of mild, cumulative sleep restriction on daytime functioning of typically developing (TD) children and children with attention-deficit/hyperactivity disorder (ADHD).

Participants

A total of 36 school-aged children (n = 18 TD; n = 18 ADHD), aged 6–11 years participated.

Methods

Children participated in two sleep conditions (order counter-balanced). The Restricted condition required a 1 h reduction of time in bed for one week, and the Controlled Typical condition was based on participant’s average baseline sleep. At the end of each condition, participants attended the sleep lab for overnight polysomnography and daytime functioning assessments.

Results

Children successfully reduced time in bed by ~1 h. Due to compensatory changes, total sleep time (TST) was reduced by only ~20 min, as children fell asleep faster and spent less time awake after sleep onset during the Restricted compared to Controlled Typical condition. Many daytime functions were not affected by this very mild sleep restriction, however, both groups showed significant changes in performance on an objective attention task and on a parent-rated emotional lability measure after six nights of minimal reductions in TST. There were no significant differences between groups.

Conclusions

Results suggest that a very mild sleep restriction can affect children’s attention and emotional regulation, even with evidence of compensatory sleep mechanisms.

Acknowledgments

We are grateful for the support of members of Corkum Labs, the trainees, and staff on the ‘Sleepy Children’ team, and most importantly to our participating families and teachers.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Canadian Institutes for Health Research [grant number FRN 111087]. Funding for Fiona Davidson was provided by the following agencies during the completion of this research: Social Sciences and Humanities Research Council, Nova Scotia Health Research Foundation, IWK Health Centre, and Dalhousie Psychiatry Research Fund.