Poster #5 - The Young and the Restless: Restless Sleep, Executive Function, and ADHD in Youths

• In Event: Poster Session 01

Abstract

Adolescence is a tumultuous period for youths, where disruptions in daily routines and biological changes can often be reflected in sleep patterns, such as sleep phase shifts where children start to become tired later. With later bedtimes and early school starting times, youths on average get an insufficient amount of sleep (~7 hours), resulting in poor sleep quality. Poor sleep quality negatively influences cognitive functions such as academic achievement, attention, and executive function (EF). EF is a set of higher order cognitive processes that control moment-to-moment behavior towards the pursuit of goals. EFs can be measured, in part, by tasks that inhibit a prepotent response, hold and manipulate items in memory, and respond flexibly to changes in the environment. Poor sleep quality in youths can impact EF, and often results in symptoms that mimic attention deficit hyperactivity disorder (ADHD). Of note, up to 55% of youths with ADHD have reported some type of sleep difficulty, which may exacerbate the phenotype of ADHD by amplifying inattention, hyperactivity, and impulsivity symptoms. In this study we examined the impact of different aspects of sleep (duration, activity, and latency) and ADHD, on EF accuracy and response time measures.

This work examines data from 119 youths (47 F), ages 8-18 years (M=12.5). The sample included 48 typically developing youths and 71 diagnosed with ADHD (31% with comorbidities). Sleep metrics were collected using Phillips Respironics Actiwatch-2 worn on the non-dominant hand. The data were recorded in 1-minute epochs and watches were worn 24 hours a day, for at least 3 days (range 3-12 days, M= 5). Eight average variables were created to measure different aspects of sleep and standard deviations of these mean variables were used to measure within subject variability. Principal components analysis (PCA) resulted in 3 independent sleep components (duration, activity, and latency) each for average and variability measures. A composite EF score for each participant was created from 8 EF behavioral tasks: 2 inhibition tasks, 3 working memory, and 3 cognitive flexibility tasks; composite scores were also created for each EF task subdomain.

Interactions between average sleep activity and ADHD diagnosis, along with sleep activity variability and ADHD diagnosis predicted general EF for both accuracy and response time (corrected p’s <.04). The interaction between average sleep activity and ADHD diagnosis was also significant in predicting both accuracy (r2= .43, corrected p= .004) and response time (r2= .18, corrected p= .015) for the inhibition subcomponent of general EF (Figure 1a). The same was seen for the interaction between sleep activity variability and ADHD in predicting both inhibition accuracy (r2= .42, corrected p= .015) and response time (r2= .12, corrected p= .014) (Figure 1b). In all models the diagnosed group appear to be less impacted by increased sleep activity or increased variability in sleep activity. We explore how the relationship between sleep movements and inhibition ability might differ by diagnosis due to widespread use of medication in the diagnosed group.

Authors

• Tyler L Larguinho, University of Texas at Austin
  Presenting Author

• Damion Demeter, University of Texas at Austin

• Blaire Porter, University of Texas at Austin

• Alice Aizza, Columbia University Medical Center/New York State Psychiatric Institute

• Jessica A Church, University of Texas at Austin