Early sleep deprivation and attention-deficit/hyperactivity disorder

Pediatr Res. 2019 Mar;85(4):449-455. doi: 10.1038/s41390-019-0280-4. Epub 2019 Jan 17.


Background: This study aims to study prospectively specific sleep patterns and risk of ADHD after adjusting for potential confounders such as obstructive sleep apnoea (OSA) and methylphenidate use.

Methods: A population-representative sample of 514 Chinese preschool children was recruited when in kindergarten (K3). Parents reported on their socioeconomic status and children's sleep duration. The cohort was reassessed 3 years later when the children were in Grade 3 (P3). Parents reported on children's sleep patterns and ADHD symptoms. Information on OSA diagnosis and methylphenidate use was retrieved from health records.

Results: Among the 514 parent-child dyads (mean [SD] age, 5.52 [0.33] years), 411 were reassessed (80.0% retention; 9.35 [0.33] years) at follow-up. There were no significant baseline differences between follow-up and drop-out groups. A gradient relationship was observed between probable ADHD in P3 and sleep duration in K3. The risk of probable ADHD was 15.5 per 100 for children with <8 h of sleep in K3, whereas it was 1.1 per 100 for children with 11-12 h of sleep in K3. The adjusted risk ratio was 14.19 (p = 0.02).

Conclusions: Sleep deprivation in early childhood is associated with higher risk of ADHD in middle childhood.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / complications*
  • Child
  • Child, Preschool
  • China
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Sleep Deprivation*
  • Socioeconomic Factors