Short Sleep Duration and Behavioral Symptoms of Attention-Deficit/Hyperactivity Disorder in Healthy 7- to 8-Year-Old Children
Abstract
OBJECTIVE. It has been hypothesized that sleep deprivation may manifest in children as behavioral symptoms rather than as tiredness, but only a few studies have investigated this hypothesis. The objective of our study was to evaluate whether short sleep is associated with behavioral symptoms of attention-deficit/hyperactivity disorder in 7- to 8-year-old children. METHODS. We performed a cross-sectional study of children born in 1998 in Helsinki, Finland. The participants included 280 (146 girls, 134 boys) children with a mean age of 8.1 years (SD: 0.3; range: 7.4–8.8). Sleep quality was measured by using actigraphs. The Sleep Disturbance Scale for Children and the Attention-Deficit/Hyperactivity Disorder Rating Scale IV were administered to parents. RESULTS. Children whose average sleep duration as measured by actigraphs was short (<10th percentile, ie, <7.7 hours) and had a higher hyperactivity/impulsivity score (9.7 vs 7.8 or 7.5) and a higher attention-deficit/hyperactivity disorder total score (17.3 vs 14.5 or 13.1) but a similar inattention score (7.6 vs 6.7 or 5.6) compared with children sleeping 7.7 to 9.4 hours or >9.4 hours. In multivariate statistical models, short sleep duration remained a statistically significant predictor of hyperactivity/impulsivity, and sleeping difficulties were associated with hyperactivity/impulsivity, inattention, and the total score. There were no significant interactions between short sleep and sleeping difficulties. CONCLUSIONS. Children's short sleep duration and sleeping difficulties increase the risk for behavioral symptoms of attention-deficit/hyperactivity disorder.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The effect of sleep impairment differs greatly from one individual to another, but can be distressing to both the child and the family and may give rise to behavioural and learning difficulties in the daytime.
“The effect of sleep impairment differs greatly from one individual to another, but can be distressing to both the child and the family and may give rise to behavioural and learning difficulties in the daytime [103, 107].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [103]
Cites
Sleep Schedules and Daytime Functioning in Adolescents
Wolfson, A. R., & Carskadon, M. A. (1998) · Child Development · doi:10.1111/j.1467-8624.1998.tb06149.x · Cited by 1,676 · see citing works
Bruni, O., Ottaviano, S., Guidetti, V., ROMOLI, M., Innocenzi, M., Cortesi, F., & Giannotti, F. (1996) · Journal of Sleep Research · doi:10.1111/j.1365-2869.1996.00251.x · Cited by 1,385 · see citing works
Sleep Duration From Infancy to Adolescence: Reference Values and Generational Trends
Iglowstein, I., Jenni, O. G., Molinari, L., & Largo, R. H. (2003) · PEDIATRICS · doi:10.1542/peds.111.2.302 · Cited by 1,318 · see citing works
Kushida, C. A., Chang, A., Patil, C. G., Guilleminault, C., Carrillo, O., & Dement, W. C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00098-8 · Cited by 997 · see citing works
The Role of Actigraphy in the Evaluation of Sleep Disorders
Sadeh, A., Hauri, P., Kripke, D. F., & Lavie, P. (1995) · SLEEP · doi:10.1093/sleep/18.4.288 · Cited by 900 · see citing works
Sadeh, A., Gruber, R., & Raviv, A. (2003) · Child Development · doi:10.1111/1467-8624.7402008 · Cited by 742 · see citing works
Sleep, neurobehavioral functioning, and behavior problems in school-age children
Sadeh, A., Gruber, R., & Raviv, A. (2002) · Child Development · doi:10.1111/1467-8624.00414 · Cited by 740 · see citing works
Acebo, C., Sadeh, A., Seifer, R., Tzischinsky, O., Wolfson, A. R., Hafer, A., & Carskadon, M. A. (1999) · Sleep · doi:10.1093/sleep/22.1.95 · Cited by 721 · see citing works
Littner, M. R., Kushida, C. A., Anderson, W. M., Bailey, D. R., Berry, R. B., Davila, D., Hirshkowitz, M., Kapen, S., KRAMER, M. L., Loube, D. I., et al. (2003) · SLEEP · doi:10.1093/sleep/26.3.337 · Cited by 688 · see citing works
Symptoms of Sleep Disorders, Inattention, and Hyperactivity in Children
Chervin, R. D., Dillon, J. E., Bassetti, C. L., Ganoczy, D. A., & Pituch, K. (1997) · SLEEP · doi:10.1093/sleep/20.12.1185 · Cited by 577 · see citing works
The impact of inadequate sleep on children's daytime cognitive function
Dahl, R. E. (1996) · Seminars in Pediatric Neurology · doi:10.1016/s1071-9091(96)80028-3 · Cited by 566 · see citing works
Sleep and Behavior Problems in School-Aged Children
Stein, M. A., Mendelsohn, J., Obermeyer, W. H., Amromin, J., & Benca, R. (2001) · Pediatrics · doi:10.1542/peds.107.4.e60 · Cited by 558 · see citing works
Sleep-Disordered Breathing, Behavior, and Cognition in Children Before and After Adenotonsillectomy
Chervin, R. D., Ruzicka, D. L., Giordani, B. J., Weatherly, R. A., Dillon, J. E., Hodges, E. K., Marcus, C. L., & Guire, K. E. (2006) · Pediatrics · doi:10.1542/peds.2005-1837 · Cited by 477 · see citing works
Smaldone, A. M., Honig, J., & Byrne, M. W. (2007) · PEDIATRICS · doi:10.1542/peds.2006-2089f · Cited by 474 · see citing works
DuPaul, G. J., Anastopoulos, A. D., Power, T. J., Reid, R. R., Ikeda, M. J., & McGoey, K. E. (1998) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/a:1023087410712 · Cited by 445 · see citing works
Cognitive Function Following Acute Sleep Restriction in Children Ages 10–14
(1998) · Sleep · doi:10.1093/sleep/21.8.861 · Cited by 430 · see citing works
Short sleep duration in middle childhood: risk factors and consequences
Nixon, G. M., Thompson, J. M. D., Han, D. Y., Becroft, D. M., Clark, P. M., Robinson, E., Waldie, K. E., Wild, C. J., Black, P. N., & Mitchell, E. A. (2008) · SLEEP · doi:10.1093/sleep/31.1.71 · Cited by 414 · see citing works
Agreement Rates Between Actigraphy, Diary, and Questionnaire for Children's Sleep Patterns
Werner, H., Molinari, L., Guyer, C., & Jenni, O. G. (2008) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.162.4.350 · Cited by 384 · see citing works
Experimental Restriction of Sleep Opportunity in Children: Effects on Teacher Ratings
Fallone, G., Acebo, C., Seifer, R., & Carskadon, M. A. (2005) · SLEEP · doi:10.1093/sleep/28.12.1561 · Cited by 319 · see citing works
Fallone, G., Acebo, C., Arnedt, J. T., Seifer, R., & Carskadon, M. A. (2001) · Perceptual and Motor Skills · doi:10.2466/pms.2001.93.1.213 · Cited by 305 · see citing works
Sleep and Psychiatric Symptoms in School-Age Children
Aronen, E. T., Paavonen, E. J., Fjällberg, M., Soininen, M., & Törrönen, J. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200004000-00020 · Cited by 265 · see citing works
Self-citationCorkum, P. V., Moldofsky, H., Hogg‐Johnson, S., Humphries, T., & Tannock, R. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199910000-00018 · Cited by 252 · see citing works
Sadeh, A., Pergamin, L., & Bar-Haim, Y. (2006) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2006.03.004 · Cited by 250 · see citing works
Cortese, S., Konofal, É., Yateman, N., Mouren, M., & Lecendreux, M. (2006) · SLEEP · doi:10.1093/sleep/29.4.504 · Cited by 236 · see citing works
Starting Times of School: Effects on Daytime Functioning of Fifth-grade Children in Israel
Epstein, R., Chillag, N., & Lavie, P. (1998) · Sleep · doi:10.1093/sleep/21.3.250 · Cited by 208 · see citing works
Sleep Loss in Young Adolescents
Mary, A. C., Harvey, K., & William, C. D. (1981) · SLEEP · doi:10.1093/sleep/4.3.299 · Cited by 207 · see citing works
Cohen-Zion, M., & Ancoli-Israel, S. (2004) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2004.06.002 · Cited by 203 · see citing works
Smedje, H., Broman, J., & Hetta, J. E. (2001) · European Child & Adolescent Psychiatry · doi:10.1007/s007870170041 · Cited by 201 · see citing works
Sleep problems of school-aged children: a complementary view
Paavonen, E. J., Aronen, E., Moilanen, I., Piha, J., Räsänen, E., Tamminen, T., & Almqvist, F. (2000) · Acta Paediatrica · doi:10.1111/j.1651-2227.2000.tb01220.x · Cited by 188 · see citing works
Self-citationAcute restriction of nocturnal sleep in children
Carskadon, M. A., Harvey, K., & Dement, W. C. (1981) · Perceptual and Motor Skills · doi:10.2466/pms.1981.53.1.103 · Cited by 149 · see citing works
Validation of actigraphy for determining sleep and wake in children with sleep disordered breathing
HYDE, M., O’Driscoll, D. M., BINETTE, S., GALANG, C., TAN, S. K., Verginis, N., Davey, M. J., & Horne, R. S. C. (2007) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2007.00588.x · Cited by 149 · see citing works
Birth Outcome in Relation to Licorice Consumption during Pregnancy
Strandberg, T. E. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.11.1085 · Cited by 142 · see citing works
Self-citationParental Report of Sleep Problems in Children with Attentional and Learning Disorders
Marcotte, A. C., Thacher, P. V., Butters, M. A., Bortz, J. J., Acebo, C., & Carskadon, M. A. (1998) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-199806000-00005 · Cited by 127 · see citing works
SUSAN SHUR‐FEN, G. (2006) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2006.00552.x · Cited by 118 · see citing works
Sleep disorders in Taiwanese children with attention deficit/hyperactivity disorder
Huang, Y., Chen, N., Li, H., Wu, Y., Chao, C., & Guilleminault, C. (2004) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2004.00408.x · Cited by 114 · see citing works
Prevalence and Correlates of Sleep Problems in Chinese Schoolchildren
Liu, X., Zhenxiao, S., Uchiyama, M., Shibui, K., Kim, K., & Okawa, M. (2000) · SLEEP · doi:10.1093/sleep/23.8.1e · Cited by 111 · see citing works
Gruber, R., & Sadeh, A. (2004) · Sleep · doi:10.1093/sleep/27.2.267 · Cited by 106 · see citing works
Mitchell, R. B., & Kelly, J. P. (2006) · Otolaryngology · doi:10.1016/j.otohns.2005.11.035 · Cited by 63 · see citing works
Are some motives more linked to suicide proneness than others?
Holden, R. R., Kerr, P. S., Mendonca, J. D., & Velamoor, V. R. (1998) · Journal of Clinical Psychology · doi:10.1002/(sici)1097-4679(199808)54:5 · Cited by 59 · see citing works
Actigraph Placement and Sleep Estimation in Children
Paavonen, E. J., Fjällberg, M., Steenari, M.-R., & Aronen, E. T. (2002) · SLEEP · doi:10.1093/sleep/25.2.235 · Cited by 46 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Astill, R. G., Van der Heijden, K. B., Van IJzendoorn, M. H., & Van Someren, E. J. W. (2012) · Psychological Bulletin · doi:10.1037/a0028204 · Cited by 707 · see citing works
Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents
Beebe, D. W. (2011) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2011.03.002 · Cited by 638 · see citing works
European guidelines on managing adverse effects of medication for ADHD
(for the European Guidelines Group), Graham, J., Banaschewski, T., Buitelaar, J., Coghill, D., Danckaerts, M., Dittmann, R. W., Döpfner, M., Hamilton, R., Hollis, C., et al. (2011) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-010-0140-6 · Cited by 374 · see citing works
Associations of sleep disturbance with ADHD: implications for treatment
Hvolby, A. (2015) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-014-0151-0 · Cited by 339 · see citing works
Sleep-dependent memory consolidation – What can be learnt from children?
Wilhelm, I., Prehn-Kristensen, A., & Born, J. (2012) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2012.03.002 · Cited by 161 · see citing works
Sleep Duration and Regularity are Associated with Behavioral Problems in 8-year-old Children
Pesonen, A.-K., Räikkönen, K., Paavonen, E. J., Heinonen, K., Komsi, N., Lahti, J., Kajantie, E., Järvenpää, A.-L., & Strandberg, T. (2010) · International Journal of Behavioral Medicine · doi:10.1007/s12529-009-9065-1 · Cited by 110 · see citing works
Self-citationHysing, M., Lundervold, A. J., Posserud, M.-B., & Sivertsen, B. (2016) · Behavioral Sleep Medicine · doi:10.1080/15402002.2015.1048448 · Cited by 72 · see citing works
Prehn-Kristensen, A., Molzow, I., Munz, M., Wilhelm, I., Müller, K., Freytag, D., Wiesner, C. D., & Baving, L. (2011) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2011.06.021 · Cited by 62 · see citing works
Circadian rhythm disruption as a link between Attention-Deficit/Hyperactivity Disorder and obesity?
Vogel, S. W. N., Bijlenga, D., Tanke, M., Bron, T. I., van der Heijden, K. B., Swaab, H., Beekman, A. T. F., & Sandra Kooij, J. J. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.10.002 · Cited by 57 · see citing works
The role of sleep in the relation between young children's mobile media use and effortful control
Nathanson, A. I., & Beyens, I. (2018) · British Journal of Developmental Psychology · doi:10.1111/bjdp.12196 · Cited by 47 · see citing works
- Authors
- Paavonen, E. J., Räikkönen, K., Lahti, J., Komsi, N., Heinonen, K., Pesonen, A.-K., Järvenpää, A.-L., Strandberg, T., Kajantie, E., & Porkka-Heiskanen, T.
- Affiliations
- Finnish Institute for Health and Welfare (FI)
- Departments of Psychology
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
- Oulu University Hospital (FI)
- Helsinki University Hospital (FI)
- Physiology, University of Helsinki, Helsinki, Finland
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2009-05-01
- Volume
- 123
- Issue
- 5
- Pages
- e857-e864
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2128739394
- Cited by
- 192
- References
- 40
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 7 · 2022: 11 · 2021: 7 · 2020: 12 · 2019: 4 · 2018: 8 · 2017: 13 · 2016: 12 · 2015: 17 · 2014: 14 · 2013: 12 · 2012: 16
- FWCI
- 23.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- WOS
- Funders
- John D. and Catherine T. MacArthur Foundation
- Lastentautien Tutkimussäätiö
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- short sleep duration, attention deficit hyperactivity disorder, hyperactivity/impulsivity, inattention, sleep disorders, sleep deprivation, children, actigraphy, behavioral symptoms
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Cross-Sectional Studies, Female, Humans, Male, Sleep Wake Disorders, Comorbidity, Multivariate Analysis
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 ›
Are you an author, or do you see a problem with this page? Request a review