Centre for Community Child Health

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Sleeping Sound with ADHD

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    Sleeping Sound Studies:

    Sleeping Sound with ADHD Translational Trial (2015-2017)

    Given the success of our efficacy trial (above) in improving child and family functioning, we now propose to test the translation of this program at the population level by training community paediatricians and psychologists in delivering this behavioural sleep intervention to families of children with ADHD and sleep problems. If this intervention can be translated successfully, then this would have the real potential to improve outcomes for children with ADHD and their families at a populational level. 

    Aim

    The aims of this cluster-randomised, translational trial are to determine the following in a sample of 5 to 12 year old children with Attention-Deficit/Hyperactivity Disorder (ADHD):

    1. Whether a brief, behavioural sleep intervention improves child sleep problems, ADHD symptoms, psychosocial quality of life (QoL), and behaviour, as well as primary caregiver mental health; and
    2. The costs and cost-effectiveness of this behavioural sleep intervention.  

    Project Outline

    The Sleeping Sound Translational Trial involves the following stages across two waves in 2015 and 2016:

    Stage 1     Information about the study will be sent out to parents of children with ADHD through their treating Paediatrician. We plan to recruit a total of 70 paediatricians from Victoria and 20 from Queensland.

    Stage 2     Interested families will be contacted to screen for specific behavioural sleep difficulties. We will then invite eligible families and their paediatricians to participate in the study.

    Stage 3     Enrolled paediatricians will be randomised to either the Sleep Program Group or the Usual Care Group:

    Paediatricians (and referral psychologists) in the Sleep Program Group will receive training to deliver the intervention across two 45 minute sessions with their patients. Clinicians will be provided with an intervention manual and checklist to complete after each intervention session.

    Paediatricians in the Usual Care Group do not receive training in the sleep intervention program and thus treat their patients as they usually do.

    All families will be followed-up at 3, and 6 months post-intervention, to measure child and families outcomes.

    Project Update

    44 Victorian paediatricians have consented to being a part of the project and agreed for us to visit their clinics to complete an ADHD search of their records. So far, we have found 1090 children with ADHD to screen in January 2015. Families will be sent a letter by the end of this year inviting them to participate in next year’s enrolment. 

    Funding

    This project is funded by the Australian National Health and Medical Research Council.

    Methodology:                  Cluster randomised controlled trial

    Date:                             January 2015 to December 2017

    Project email:                  sleeping.sound@mcri.edu.au

    Chief investigator:          Associate Professor Harriet Hiscock

    Project phone:                (03) 9936 6628

    Contact/Staff involved:    Dr Melissa Mulraney  

    Sleeping Sound with ADHD (2010-2012)

    Up to 70% of children with ADHD have sleep problems, such as difficulty falling asleep, resisting going to bed and being tired in the morning. In our 2006 survey, we found that sleep problems in children with ADHD were related to poorer child and family functioning.

    We piloted a sleep program for children with ADHD in 2008/09 and found that it was acceptable to parents and feasible to deliver. In this pilot we found that an extended intervention (2-3 sessions) appeared to be more helpful than a brief intervention (1 session).

    Aim

    The Sleeping Sound with ADHD project was a randomised trial that aimed to determine whether treating sleep problems in children with ADHD improves :

    1. Child wellbeing including sleep, ADHD symptoms, behaviour, working memory, quality of life and school attendance;and               
    2. Parent wellbeing including  mental health and work attendance.

    Project Outline

    The Sleeping Sound with ADHD project involves four stages:

    Stage 1   Information about the study was sent to the parents of children with ADHD through their treating Paediatrician. We recruited 50 Paediatricians across Victoria to assist us with the study.

    Stage 2   Interested families were contacted to screen for specific sleep difficulties. We then invited eligible families to participate in the study.

    Stage 3   Families were randomised to the Sleep Program Group or the Usual Care Group.

                   Families in the Sleep Program Group received two 45 minute sessions with a trained clinician (e.g., psychologist, trainee paediatrician) to assess and treat their child's sleep problems.

                   Families in the Usual Care Group did not receive these sessions. However, they were able to seek help for their child's sleep from other services, including their child's Paediatrician, if they wished to do so.

    Stage 4   All families were followed up at 3, 6, and 12 months using questionnaires to see if our sleep program has made a difference to child and family functioning.

    Project Update

    Concluding in 2012, this behavioural sleep intervention study improved child ADHD symptom severity in a community sample of children with ADHD, the majority of whom were taking stimulant medication. The intervention also improved child sleep, behaviour, quality of life, and functioning, with most benefits sustained to six months post-randomisation.

    Funding

    This project was funded by the Australian National Health and Medical Research Council.

    Methodology:                     Randomised controlled trial

    Date:                                January 2010 to December 2012

    Project email:                      sleeping.sound@mcri.edu.au

    Chief investigator:               Associate Professor Harriet Hiscock

    Project phone:                    (03) 9345 7025

    Contact/Staff involved:        Dr Emma Sciberras

    Publications:

    • Sciberras E, Fulton M, Efron D, Oberklaid F, Hiscock H. (2011). Managing sleep problems in school aged children with ADHD: A pilot randomised controlled trial. Sleep Medicine. 11: 932-935.
    • Sciberras E, Efron D, Gerner B, Davey M, Mensah F, Oberklaid F, Hiscock H. (2010).Study protocol: The sleeping sound with attention-deficit/hyperactivity disorder project. BMC Paediatrics.10:101.
    • Sung V, Hiscock H, Sciberras E, Efron D. (2008). Sleep problems in children with ADHD: prevalence and comorbidities. Archives of Pediatrics & Adolescent Medicine. 162(4):336-342.

    Presentations:

    • Sciberras, E. Efron D, Gerner B, Davey M, Mensah F, Oberklaid F. Hiscock H. The Sleeping Sound with ADHD study: An evaluation of a behavioural sleep intervention. 22nd Eunethydis (the European Network for Hyperkinetic Disorders) meeting, Budapest, September 2011.
    • Fulton, M, Sciberras E, Efron, D, Oberklaid, F, Hiscock, H. Treating sleep problems in school-aged children with ADHD: A pilot study. Royal Australasian College of Physicians Conference, Melbourne, 2010.
    • Fulton, M, Sciberras E, Efron, D, Oberklaid, F, Hiscock, H. Treating sleep problems in school-aged children with ADHD: A pilot study. Australian Sleep Association Conference, Melbourne, September 2009.
    • Sung V, Hiscock H, Sciberras E, Efron D. Sleep Problems in children with ADHD. Royal Australasian College of Physicians, Melbourne, May, 2007.Efron D, Sung V, Hiscock H, Sciberras E. Sleep problems in children with ADHD: associations with child quality of life, daily functioning, caregiver mental health, and family functioning. 13th International Conference of the European Society for Child and Adolescent Psychiatry, Florence, 2007.

 

Murdoch Childrens Research Institute

The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.