Association between sleep duration and attention-deficit hyperactivity disorder: A systematic review and meta-analysis of observational studies✰
Open accessAbstract
Background Several previous meta-analyses have investigated the association between sleep quality and attention-deficit/hyperactivity disorder (ADHD). To examine the relationship between short or long sleep duration and ADHD, a meta-analysis of observational studies was conducted.Methods The PubMed, EMBASE, and Cochrane Library databases were systematically searched in March 2019 to retrieve observational studies. A random-effects model was used to analyze meta-estimates of sleep duration. Three evaluators independently reviewed and selected the articles based on pre-determined selection criteria.Results Of 1466 articles retrieved, 10 observational epidemiological studies, comprising six case-control studies and four prospective cohort studies, were included in the final analysis. Short sleep duration was significantly linked to ADHD compared with average sleep duration (odds ratio [OR] or relative risk [RR] 1.28 [95% confidence interval (CI) 1.16-1.41]), and especially with hyperactivity (OR/RR 1.60 [95% CI 1.18-2.17]). Subgroup meta-analyses according to various factors, such as study design, number of participants, methodological quality, and adjustment for smoking status and education, yielded consistent results. A significant association between long sleep duration and ADHD was not observed.Limitations Publication bias and substantial heterogeneity due to the diverse measurement tools used to determine ADHD were observed. Lack of prospective cohort studies was another limitation.Conclusion Short sleep duration was associated with ADHD in the current meta-analysis. Clinicians may need to be more aware of this association.
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Short sleep duration increases prospective risk of ADHD (RR=2.61, 95% CI 1.36-5.00).
“A separate meta-analysis also indicated that short sleep duration increased the prospective risk of ADHD (n=3, N=2,386, RR=2.61, 95% CI: 1.36-5.00, I 2 =83.0%) 75”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [75]
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- Authors
- Lee, S.-H., Kim, H.-B., & Lee, K.-W.
- Affiliations
- Myongji Hospital (KR)
- Yonsei University (KR)
- Corresponding author
- Kim, Hong-Bae
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-09
- Volume
- 256
- Pages
- 62-69
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2947244702
- Cited by
- 41
- References
- 52
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 4 · 2019: 1
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- sleep duration, attention deficit hyperactivity disorder, short sleep duration, long sleep, hyperactivity
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Female, Humans, Male, Prospective Studies, Research Design, Sleep, Odds Ratio, Case-Control Studies, Observational Studies as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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