Table 4.
Factors associated with sleep disorders in children with ADHD
| Associated factors | Sleep disorder, n (%) | Univariate analysis | Multivariate analysis | |||
|---|---|---|---|---|---|---|
| No (n = 189) |
Yes (n = 440) |
p-value | OR | 95% CI | ||
| Age group | ||||||
| School-age (6–9 years) (n = 550) | 174 (92.1) | 376 (85.5) | 0.02 | 1.48 | 0.61–3.56 | |
| Adolescents (10–12 years) (n = 79) | 15 (7.9) | 64 (14.5) | ||||
| ADHD subtypes | ||||||
| Hyperactive–impulsive subtype (n = 103) | 32 (16.9) | 71 (16.1) | 0.81 | – | – | |
| Inattentive subtype (n = 135) | 25 (13.2) | 110 (25.0) | 0.00 | 5.40 | 2.12–13.72 | |
| Combined subtype (n = 391) | 132 (69.8) | 259 (58.9) | 0.01 | 1.45 | 0.68–3.10 | |
| Comorbid mental disorders | ||||||
| At least 1 comorbid disorder (n = 421) | 76 (40.2) | 345 (78.4) | 0.00 | 2.76 | 1.31–5.85 | |
| At least 2 comorbid disorders (n = 180) | 15 (7.9) | 165 (37.5) | 0.00 | 3.76 | 2.12–6.64 | |
| Physical conditions | ||||||
| Overweight–obesity (n = 142) | 32 (16.9) | 110 (25.0) | 0.03 | 1.26 | 0.66–2.40 | |
| Malnutrition (n = 115) | 26 (13.8) | 89 (20.2) | 0.05 | – | – | |
| Tonsil/adenoid hypertrophy (n = 159) | 26 (13.8) | 133 (30.2) | 0.00 | 2.71 | 1.45–5.04 | |
| Asthma (n = 57) | 10 (5.3) | 47 (10.7) | 0.03 | 2.54 | 0.95–6.81 | |
| Allergic rhinitis (n = 143) | 26 (13.8) | 117 (26.6) | 0.00 | 1.56 | 0.81–3.02 | |
| Gastrointestinal disorders (n = 157) | 31 (16.4) | 126 (28.6) | 0.00 | 1.02 | 0.56–1.87 | |
| Iron-deficiency anemia (n = 57) | 3 (1.6) | 54 (12.3) | 0.00 | 7.86 | 1.85–33.29 | |
| Pre-sleep behavior | ||||||
| Irregular sleep schedule (n = 429) | 141 (74.6) | 288 (65.5) | 0.02 | 1.62 | 1.04–4.89 | |
| Noisy sleep environment (n = 26) | 2 (1.1) | 24 (5.5) | 0.01 | 2.37 | 0.95–5.88 | |
| Sleep onset delay (n = 361) | 80 (42.3) | 281 (63.9) | 0.00 | 2.04 | 1.19–3.51 | |
| Screen exposure > 2 h before sleep (n = 485) | 132 (69.8) | 353 (80.2) | 0.00 | 1.39 | 0.78–2.48 | |
| Eating before bedtime (n = 333) | 95 (50.3) | 238 (54.1) | 0.38 | – | – | |
| Needing a caregiver at bedtime (n = 258) | 54 (28.6) | 204 (46.4) | 0.00 | 1.73 | 1.03–3.01 | |
| Requiring night light (n = 87) | 12 (6.3) | 75 (17.0) | 0.00 | 2.37 | 1.01–5.11 | |
| During-sleep behavior | ||||||
| Bruxism (n = 207) | 36 (19.0) | 171 (38.9) | 0.00 | 1.91 | 1.03–3.52 | |
| Nocturnal enuresis (n = 124) | 22 (11.6) | 102 (23.3) | 0.00 | 1.15 | 0.56–2.35 | |
| Sleep talking (n = 274) | 37 (19.6) | 237 (53.9) | 0.00 | 3.57 | 2.03–6.29 | |
| Night awakenings (n = 240) | 23 (12.2) | 217 (49.3) | 0.00 | 4.55 | 2.40–8.63 | |
| Post-sleep behavior | ||||||
| Morning awakenings difficulty (n = 383) | 93 (49.2) | 290 (65.9) | 0.00 | 1.09 | 1.01–2.83 | |
| Daytime sleepiness (n = 140) | 3 (1.6) | 137 (31.3) | 0.00 | 26.04 | 7.30–92.79 | |
| Difficulty napping (n = 316) | 82 (43.4) | 234 (53.2) | 0.02 | 0.38 | 0.214–1.66 | |
ADHD attention deficit hyperactivity disorder