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Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial

BMJ 2015; 350 doi: (Published 20 January 2015) Cite this as: BMJ 2015;350:h68

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The evidence revealed that, in children, sleep is associated with cognitive performance and development (Kelly, Kelly, & Sacker, 2013), reducing ADHD symptoms (e.g. inattention, hyperactivity, and impulsivity) which has benefits for both children and their families in improving the quality of life.

Children differ in sleep patterns such as sleep duration, sleep onset, wakening times, and number of sleep episodes. It is more important that these patterns change over time and it is different between individual (Price et al., 2014). We therefore, should determine the optimal sleep patterns for children’s behavioral, emotional and cognitive outcomes, and parents’ mental health outcome.

The quantity and quality of sleep were reported to be affected by several environmental factors such as parenting style, sleeping space, atmosphere, and music (Mindell, Meltzer, Carskadon, & Chervin, 2009). Thus, different environments should be created for different individuals with different conditions, such as music, wall color, quietness, privacy, and temperature. In addition, a behavioral sleep intervention should be integrated with other programs, for instance, physical activities and diet.

Health literacy is strongly related to parents' and children’s health outcomes. Therefore, improving health literacy is not just improving the health in general but also helps to increase the interaction between health providers and patients, and the understanding of the content of intervention for better implementation and improved efficiency.

Kelly, Y., Kelly, J., & Sacker, A. (2013). Time for bed: associations with cognitive performance in 7-year-old children: a longitudinal population-based study. Journal of Epidemiology and Community Health, 67(11), 926-931. doi: 10.1136/jech-2012-202024
Mindell, J. A., Meltzer, L. J., Carskadon, M. A., & Chervin, R. D. (2009). Developmental aspects of sleep hygiene: Findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Medicine, 10(7), 771-779. doi:
Price, A. M. H., Brown, J. E., Bittman, M., Wake, M., Quach, J., & Hiscock, H. (2014). Children's sleep patterns from 0 to 9 years: Australian population longitudinal study. Archives of Disease in Childhood, 99(2), 119-125. doi: 10.1136/archdischild-2013-304150

Competing interests: No competing interests

23 January 2015
Van Tuyen Duong
Public Health Researcher
Taipei Medical University
No 250, Wuxing Street, Taipei City, Taiwan, 110