Research Reports - Sleep and quality of life in children with traumatic brain injury and ADHD

Int J Psychiatry Med. 2017 Jan;52(1):72-87. doi: 10.1177/0091217417703288. Epub
2017 Apr 6.

Ekinci O(1), Okuyaz Ç(2), Günes S(1), Ekinci N(1), Örekeci G(3), Teke H(1),
Çobanoğulları Direk M(2).

Author information:
(1)1 Department of Child and Adolescent Psychiatry, Medical Faculty, Mersin
University, Mersin, Turkey. (2)2 Department of Pediatric Neurology, Medical
Faculty, Mersin University, Mersin, Turkey. (3)3 Department of Biostatistics and
Medical Informatics, Medical Faculty, Mersin University, Mersin, Turkey.
Objective Attention problems are common in children who sustain a traumatic brain
injury (TBI). The differential features of TBI-related Attention Deficit
Hyperactivity Disorder (ADHD) and primary ADHD are largely unknown. This study
aimed to compare sleep problems and quality of life between children with TBI and
ADHD and children with primary ADHD. Methods Twenty children with TBI (mean
age = 12.7 ± 3.1 years) who had clinically significant ADHD symptoms according to
the structured diagnostic interview and rating scales and a control group with
primary ADHD (n = 20) were included. Parents completed Children's Sleep Habits
Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of
Life Questionnaire-revised (KINDL-R). Neurology clinic charts were reviewed for
TBI-related variables. Results When compared to children with primary ADHD, the
Total Score and Sleep Onset Delay, Daytime Sleepiness, Parasomnias, and Sleep
Disordered Breathing subscores of CSHQ were found to be higher in children with
TBI and ADHD. The Total Score and Emotional Well-Being and Self-Esteem subscores
of the KINDL-R were found to be low (poorer) in children with TBI and ADHD. The
Total Score and certain subscores of KINDL-R were found to be lower in TBI
patients with a CSHQ > 56 (corresponds to significant sleep problems) when
compared to those with a CSHQ < 56. CSHQ Total Score was negatively correlated
with age. Conclusion Children with TBI and ADHD symptoms were found to have a
poorer sleep quality and quality of life than children with primary ADHD. ADHD in
TBI may be considered as a highly impairing condition which must be early
diagnosed and treated. 

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