Objectively measured sleep continuity in children and adolescents with ADHD: A systematic review and meta-analysis

Sleep disturbances are often linked to attention-deficit/hyperactivity disorder (ADHD). Consistent findings document that children and adolescents with ADHD report more sleep problems than their typically developing (TD) peers across subjective sleep domains. However, few differences between these groups were observed in objectively measured sleep parameters, such as polysomnography (PSG) and actigraphy. This study synthesized empirical studies to identify objectively measured sleep continuity differences between children and adolescents with ADHD and TD. We included observational research and baseline data from intervention studies between 5- to 18-year-old individuals with ADHD and their TD peers at five databases from inception and September 2022. This systematic review and meta-analysis of 45 articles, including 1622 children and adolescents with ADHD and 2013 TD, found that compared with TD, children and adolescents with ADHD have higher sleep latency and moderately decreased sleep efficiency measured by actigraphy. Polysomnography-measured differences between ADHD and TD were not significant. Medication status and comorbid psychiatric status significantly moderated the group differences in sleep efficiency between ADHD and TD. Also, the group differences in sleep latency between ADHD and TD were moderated by actigraphy recorded nights. These findings highlight the importance of reducing disparities in sleep parameters among children and adolescents with and without ADHD.