Management of sleep difficulties among a cohort of children with ADHD in a scottish local authority

What is it about?

We aimed to analyse the prevalence of ADHD and sleep problems among children and young people seen within local Community Child Health clinics of a Scottish NHS Trust over a 12 month period. A retrospective review of all patients seen in the outpatient clinics between June 2016 and May 2017 in two different clinics within NHS Fife was carried out. 93 (17%) out of 543 children reviewed had ADHD. Prevalence of sleep difficulties was higher among the ADHD children (52%) compared to 30% in the whole cohort (Table 1). A significantly higher proportion of ADHD patients with sleep problems were on treatment with Melatonin compared to those without ADHD (75% vs 56%). There was a statistically significant association between the degree of socioeconomic deprivation and the prevalence of ADHD and or sleep difficulties (Table 2). The proportion of children with either or both ADHD and sleep difficulties living in the most deprived (Quintile 1) areas was four times higher than those from the most affluent areas (11.2% vs 2.8%).

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Why is it important?

An estimated 25%–50% of children and adolescents with ADHD are known to experience problems with sleep, which is approximately five-fold that of healthy controls. ADHD-related sleep problems include high rates of daytime sleepiness, increased risk of sleep disordered breathing (50% vs 22% in controls), restless legs syndrome and periodic leg movement disorder. Sleep deprivation may mimic and exacerbate many symptoms of ADHD, impair scholastic performance and cause memory problems.

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