Research: Increased Sleep Helps Children with ADHD Control Inhibitions
Inhibitory control, a primary cognitive deficit associated with attention deficit hyperactivity disorder, improved by 13% in children with ADHD who received 48 minutes of additional sleep each night, on average, in a small new study.
July 23, 2019
Extended sleep improves inhibitory control in children with ADHD by 13%, according to a small study1 conducted by researchers at the University of Massachusetts Amherst and published in the Journal of Attention Disorders.
The sleep study, performed on 11 children with attention deficit hyperactivity disorder (ADHD or ADD) (average age: 8.27) and 15 children without ADHD (average age: 8.23 years), asked caregivers to put their children to bed 90 minutes earlier than normal for five consecutive days. Actiwatch Spectrum wristwatches and PSG electrode caps were worn by the child during the night to measure sleep, and caregivers also completed sleep diaries regarding sleep onset and wake times. On average, children with ADHD extended their actual sleep time by 48 minutes. Both before and after the period of sleep extensions, the study participants engaged in an exercise designed to measure inhibitory control.
Children without ADHD, who extended their sleep duration by 56 minutes on average, experienced no significant improvements in inhibitory control either in the morning or in the evening. For children with ADHD, however, “the beneficial effect of sleep extension was robust, and the effect size comparable with those of many stimulants used to treat ADHD (Faraone, Biederman, Spencer, & Aleardi, 2006), suggesting that sleep-based interventions may be an effective means of managing impairments in inhibitory control,” the study reports. “An effect size of this magnitude is particularly noteworthy given that this intervention assessed changes in behavior after only 5 days of experimental manipulation.”
Notably, the scientists behind this study say that more research is needed to conclude whether observed improvements in inhibitory control are due to more sleep or, rather, due to a more regular and consistent sleep routine. “For example, the sleep extension condition may have improved ‘household chaos’ — the level of routine and structure in a home — that is associated with ADHD symptomology (Auerbach, Zilberman-Hayun, Atzaba-Poria, & Berger, 2017),” the study reports. “Additional studies with multi-informant or multi-setting observations of inhibition and other outcomes (i.e., household chaos) are needed to explore this hypothesis.”
The researchers also acknowledge that the study sample size is very small and that 6 of the 11 children with ADHD were taking medications for ADHD symptom management during the study duration; further study is needed to determine the impact, if any, of medication on inhibition control when sleep duration is increased.
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1 Cremone-Caira, A., Root, H., Harvey, E. A., McDermott, J. M., & Spencer, R. M. C. “Effects of Sleep Extension on Inhibitory Control in Children With ADHD: A Pilot Study.” Journal of Attention Disorders (May 2019). https://doi.org/10.1177/108705471985157