Background: ADHD commonly occurs with sleep problems and secondary cognitive impairments such as inhibitory control. Sleep problems may explain attentional lapses and inhibition performance variability in children with ADHD. This study applied Bayesian analyses to examine the relationship between ADHD symptoms, sleep problems, and inhibition. Methods: Participants included 73 children with ADHD and 73 non-ADHD controls, aged 10.5 to 13.5 years. The Stop Signal Task measured inhibition. Sleep problems were measured with the Adolescent Sleep Wake Scale and parent-report. Results: ADHD symptoms are associated with sleep problems and reaction time variability, however, sleep problems accounted for more variance in inhibition performance than both hyperactive and inattentive symptoms. Conclusion: Sleep problems account for inhibition performance over and above ADHD symptom severity in children with and without ADHD diagnoses. This suggests clinical utility in assessing sleep in children with manifestations of ADHD, and interventions targeting sleep problems concurrently with behavioral symptoms. This further adds to the discussion on overdiagnosis of ADHD due to behavioral presentations of underlying sleep disorders. Treatment for phenotypes of ADHD could be enhanced by targeting sleep problems, in addition to inhibition deficits and attentional lapses.

背景：多动症通常伴有睡眠问题和继发性认知障碍，例如抑制控制。睡眠问题可以解释 ADHD 儿童的注意力不集中和抑制表现变异性。本研究应用贝叶斯分析来检查 ADHD 症状、睡眠问题和抑制之间的关系。方法：参与者包括 73 名 ADHD 儿童和 73 名非 ADHD 对照组，年龄在 10.5 至 13.5 岁之间。停止信号任务测量抑制。睡眠问题是通过青少年睡眠觉醒量表和家长报告来衡量的。结果：ADHD 症状与睡眠问题和反应时间变异性有关，但是，与多动和注意力不集中的症状相比，睡眠问题对抑制性能的影响更大。结论：睡眠问题是导致患有和未患有 ADHD 诊断的儿童的抑制表现超过 ADHD 症状严重程度的原因。这表明在评估具有 ADHD 表现的儿童的睡眠方面的临床效用，以及针对同时存在行为症状的睡眠问题的干预措施。由于潜在睡眠障碍的行为表现，这进一步增加了对 ADHD 过度诊断的讨论。除了抑制缺陷和注意力不集中之外，还可以通过针对睡眠问题来加强对 ADHD 表型的治疗。