Study: ADHD, Diet, Exercise, Screen Time All Directly or Indirectly Impact Sleep
A child with ADHD is more likely to experience sleep problems, in part because ADHD symptoms influence diet and physical activity — two factors that directly impact sleep. This finding comes from a new study that also shows how screen time impacts exercise, which in turn impacts sleep. Understanding these interwoven lifestyle factors may help caregivers and practitioners better treat children with ADHD.
July 27, 2020
Children with ADHD commonly experience sleep problems. New research suggests that caregivers can best mediate the negative effects of ADHD on sleep by using three levers: improved diet, increased physical activity, and decreased screen time. The study, which recognizes the complex relationship between ADHD and these three levers, as well as the impact of parental ADHD, was published in the Journal of Attention Disorders1
These findings come from an analysis of lifestyle factors that impact sleep in school-aged children with and without attention deficit hyperactivity disorder (ADHD or ADD). Researchers used data from an online, multi-country, survey that included 309 English speaking caregivers reporting on their child’s various lifestyle factors. 255 caregivers had children with ADHD; 54 had children without ADHD. A brief food frequency questionnaire was used to gauge dietary patterns; physical activity was assessed using the Children’s Leisure Activities Study Survey-Parent Questionnaire; sleep quality was assessed with Children’s Sleep Habits Questionnaire; and screen time was assessed using five questions developed by the researchers. Multiple regression and Structural Equation Modeling (SEM) were used to identify significant correlates and mediators of ADHD in explaining lifestyle differences.
Multiple regression models found that only sleep problems were significantly explained by an ADHD diagnosis. The impact of an ADHD diagnosis on a child’s sleep was about equal to the impact of ADHD on that child’s diet. Diet, in turn, influenced both sleep and physical activity. Physical activity directly influenced sleep as well, and screen time was a significant factor determining how much physical activity a child engaged in. In other words, decreasing a child’s screen time and improving their diet both led to greater physical activity, which improved sleep.
The findings suggest that mediation effects may be most significant for the impact paths:
- ADHD symptom control leading to better dietary patterns
- Better dietary patterns leading to more engagement in physical activity
- Limited screen time leading to physical activity that, in turn, may explain the variance in sleep problems
The researchers suggest that better understanding of the relationship between a child’s lifestyle factors, their ADHD symptoms, and their quality of sleep can help practitioners develop more informed and effective treatments.
1Hong, G. C. C., Conduit, R., Wong, J., Di Benedetto, M., & Lee, E. (2020). Diet, Physical Activity, and Screen Time to Sleep Better: Multiple Mediation Analysis of Lifestyle Factors in School-Aged Children with and without Attention Deficit Hyperactivity Disorder. Journal of Attention Disorders. https://doi.org/10.1177/1087054720940417