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Lindholm A, Jarbin H, Aili K, Nygren JM, Svedberg P, Larsson I. Sex Differences in Children with Uncomplicated Attention Deficit/Hyperactivity Disorder and Sleep Problems. CHILDREN (BASEL, SWITZERLAND) 2024; 11:636. [PMID: 38929216 PMCID: PMC11201524 DOI: 10.3390/children11060636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Approximately 7.6% of children are diagnosed with attention deficit/hyperactivity disorder (ADHD), and sleep impairments affect 25-85%. There is a noticeable lack of research on girls and sex differences. The aim of this study was to examine sex differences in children with uncomplicated ADHD and sleep problems. METHODS Cross-sectional baseline data were retrieved from a randomized controlled trial with weighted blankets (55 boys and 41 girls, 6-14 years) on a cohort recently diagnosed with uncomplicated ADHD and sleep problems. Differences between boys and girls in ADHD symptoms, objectively and subjectively measured sleep, anxiety, and functioning were examined via parent- or self-reported validated instruments. RESULTS Girls reported significantly lower (worse) satisfaction with well-being, life overall, and school, but not for family. Parents reported more sleep anxiety and night-time wakings among boys, but no sex differences in other measures and also not in self-reported measures or objective sleep measures. Children who reported worry, sadness, or unhappiness had more sleep problems. CONCLUSIONS Boys with ADHD and sleep problems may need support with sleep-related anxiety and night-time wakings, while girls may require support with overall functioning. Additionally, children who express feelings of worry, sadness, or unhappiness alongside their ADHD symptoms should have attention given to their sleep.
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Affiliation(s)
- Annelie Lindholm
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Håkan Jarbin
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, SE-22184 Lund, Sweden;
- Child and Adolescent Psychiatry, Region Halland, SE-30185 Halmstad, Sweden
| | - Katarina Aili
- Department of Health and Sport, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden;
| | - Jens M. Nygren
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Petra Svedberg
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Ingrid Larsson
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
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Lönn M, Svedberg P, Nygren J, Jarbin H, Aili K, Larsson I. The efficacy of weighted blankets for sleep in children with attention-deficit/hyperactivity disorder-A randomized controlled crossover trial. J Sleep Res 2024; 33:e13990. [PMID: 37452697 DOI: 10.1111/jsr.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
Weighted blankets are a non-pharmacological intervention for treating sleep and anxiety problems in children with attention-deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention-deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention-deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T-tests were used to evaluate efficacy. The study included 94 children with attention-deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. -2.79 min, p = 0.015, Cohen's d = -0.27), but not on sleep-onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11-14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention-deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions.
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Affiliation(s)
- Maria Lönn
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Psychiatry Halland, Region Halland, Halmstad, Sweden
| | - Petra Svedberg
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jens Nygren
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Håkan Jarbin
- Department of Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden
- Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
| | - Katarina Aili
- Department of Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ingrid Larsson
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties. Occup Ther Int 2023; 2023:1945290. [PMID: 36824380 PMCID: PMC9943603 DOI: 10.1155/2023/1945290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/14/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children's individual needs in connection with sleep and daytime functioning. Aim To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets. Methods An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis. Results Children's experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep. Conclusions Using weighted blankets promoted children's management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves.
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Alhossein A, Abaoud AA, Becker D, Aldabas R, Bakhiet SF, Al Jaffal M, Alsufyani M, Abdu Elrahim NM, Alzrayer N. Psychometric Properties of ADHD Rating Scale-5 for Children and Adolescents in Sudan-School Version. Front Psychol 2022; 13:883578. [PMID: 35832925 PMCID: PMC9272821 DOI: 10.3389/fpsyg.2022.883578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/03/2022] [Indexed: 11/24/2022] Open
Abstract
The ADHD Rating Scale-5 for Children and Adolescents, School Version, has been adopted and validated to be used in assessing ADHD among school children within Western contexts. However, there are few assessment tools in use for identifying ADHD characteristics in children in Sudan. Therefore, this study aimed to investigate the psychometric properties of this rating scale in the context of Sudan. To accomplish this, data were collected on a sample of 3,742 school-aged children and adolescents as reported by their teachers. Psychometric properties can be classified as very good, with very high reliability (>0.90), and high construct validity tested by exploratory and confirmatory factor analysis. Thus, the ADHD Rating Scale-5 for Children and Adolescents, School Version, is valid, reliable, and suitable to use for assessing ADHD symptoms among children and adolescents in the Sudanese context.
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Affiliation(s)
- Abdulkarim Alhossein
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia
| | | | - David Becker
- Department of Psychology, Chemnitz University of Technology, Chemnitz, Germany
| | - Rashed Aldabas
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia
| | - Salaheldin Farah Bakhiet
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Al Jaffal
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia
| | - Manar Alsufyani
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia
| | - Nagda Mohamed Abdu Elrahim
- Department of Psychology, College of Education, Sudan University of Science and Technology, Khartoum, Sudan
| | - Nouf Alzrayer
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia
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Larsson I, Aili K, Nygren JM, Johansson P, Jarbin H, Svedberg P. SLEEP: intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems: study protocol for a randomised control trial. BMJ Open 2022; 12:e047509. [PMID: 34983749 PMCID: PMC8728406 DOI: 10.1136/bmjopen-2020-047509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sleep problems. Weighted blankets are one possible non-pharmacological intervention for these problems in this group of children. However, the effectiveness of weighted blankets is insufficiently investigated. This study aims to investigate the effectiveness of weighted blankets in terms of sleep, health-related outcomes and cost-effectiveness as well as to explore children's and parents' experiences of a sleep intervention with weighted blankets. METHODS AND ANALYSIS This study is a randomised placebo-controlled crossover trial comparing the effect of weighted fibre blankets (active) with fibre blankets without weight (control). Children aged 6-13 years, recently diagnosed with uncomplicated ADHD with verified sleep problems, were included in the study. The study period is 4 weeks for each condition, respectively, and then an 8-week follow-up. A total of 100 children diagnosed with ADHD and sleep problems will enter the study. The primary outcomes are sleep and cost per quality-adjusted life years. The secondary outcomes are health-related quality of life, ADHD symptoms, psychological distress and anxiety. Interviews with a subsample of the participating children and parents will be conducted for exploring the experiences of the intervention. ETHICS AND DISSEMINATION Ethical approval of the trial has been obtained from the Swedish Ethical Review Authority (number 2019--2158) and conforms to the principles outlined in the Declaration of Helsinki (WMA, 2013). Results will be reported as presentations at peer-review conferences, in articles in peer-review journals and meetings with healthcare providers. TRIAL REGISTRATION NUMBER NCT04180189.
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Affiliation(s)
- Ingrid Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Katarina Aili
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Pia Johansson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Håkan Jarbin
- Faculty of Medicine, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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