Abstract 90

Sleep problems are commonly reported in school-aged children, but are seldom the focus of a pediatric visit. We investigated the prevalence and behavioral and medical correlates of sleep problems in children, ages 4-18 (M= 9.2, SD =3.7) referred to an ADHD clinic (n = 111) and contrasted those findings with data from children coming to their pediatric clinic (n = 81). Parents of children in both groups were administered a revised children's sleep questionnaire developed by the investigators, the Child Behavior Checklist (CBCL), and a medical history questionnaire. The sleep questionnaire yields a total sleep problems score plus four sleep problem factors: tired sleep, noisy sleep, immature sleep, and disturbed sleep/parasomnias.

Insomnia and tiredness were more common in the psychiatric clinic patients than in the pediatric patients (t = 2.5, p < .01), but there were no differences in the frequency of other sleep problems. There were also no differences in sleep problems between children with ADHD taking stimulant medication (n = 34) versus ADHD children not on stimulant medications (n = 35). However, when compared to pediatric controls, ADHD children taking medications had higher rating of insomnia and tiredness (F = 4.2, p < .5). Linear regression analyses were conducted to determine how well sleep problems, medications, and age predicted attention and behavior problems on the CBCL. Attention problems were predicted by insomnia, tiredness and medication use (F = 9.1, p < .001). These variables accounted for 12% of the variance in Attention problems. Internalizing symptoms were also predicted by insomnia and tiredness (R2 = .21; F = 38.7, p < .001), as was Aggressive Behavior (R2 = .10; F = 15.09, p < .001). These results highlight the importance of assessing sleep and sleep behaviors in school-aged children. and suggested that children with ADHD and other forms of psychopathology are particularly vulnerable to insomnia and non-restful sleep independent of stimulant medication. The importance of good sleep hygiene and preventive behavioral interventions in children with ADHD and behavioral problems requires further evaluation.