Sleep Habits and Behavioral Problems among Children with Attention Deficit Hyperactivity Disorder
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Objective: To explore the relationship between behavioral problems and sleep habits in children with ADHD.
Methods and Materials: A descriptive correlational study was conducted from October 30, 2024, to June 30, 2025, at two specialized centers in Kerbala. A convenience sample of 100 parents of children with ADHD aged 3–12 years completed the CSHQ and the SDQ. Data were analyzed in SPSS 25 using descriptive statistics, Pearson correlations, group comparisons, and multivariable linear regression.
Findings: The sample was predominantly male (78%). The mean total CSHQ score was 68.17±4.67; 80% screened positive for sleep problems. Subscale means included bedtime resistance 12.02±1.51, sleep onset delay 2.15±0.45, sleep anxiety 10.44±1.27, and daytime sleepiness 15.54±1.63. Bedtime resistance correlated with conduct problems, hyperactivity, and total difficulties (p=0.002, <0.001, <0.001). Sleep onset delay correlated with emotional problems (p=0.027). Sleep duration correlated with conduct problems and total difficulties (p=0.041, 0.005). Night waking correlated with emotional and peer problems (p=0.015, 0.007). Daytime sleepiness correlated with hyperactivity (p=0.001). Total CSHQ correlated with emotional problems, conduct problems, hyperactivity, and total difficulties (p=0.001, 0.008, 0.005, 0.012). In regression, lower parental income and kindergarten attendance were associated with higher SDQ scores; combined ADHD type predicted higher difficulties.
Conclusion: Sleep disturbances are highly prevalent in children with ADHD and show domain-specific associations with behavioral difficulties. Routine sleep screening and integrated behavioral–sleep interventions are warranted in clinical and educational settings.
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