ADHD
Conditions
Brief summary
Many adolescents go to bed late and wake up early for school. Science is only beginning to understand how sleep schedules can affect them. The investigators are interested in whether changing adolescents' sleep patterns affects their functioning, attention, and how they feel. The investigators are especially interested in the effects of changing both how much sleep adolescents get and when that sleep happens. This study focuses on healthy 13-17-year-olds with ADHD. This study asks adolescents to systematically change their sleeping habits across a 3 week span. The first week, they follow a sleep schedule that fits reasonably well with the schedule they keep when they do not have to wake up early for any specific obligation (e.g., for school). The second week, they spend several nights in a "short sleep" condition, during which they get 6.5 hours in bed per night. The final week, they enter a sleep condition that allows for healthy sleep duration, but with a timing that is randomly assigned to either fit well with their preferred schedule or fit poorly with that schedule. During each week, they and their parents complete measures of their attention and other factors. At the end of each week, they attend an evening session to measure their internal body clock ("circadian phase"), as well as measures of attention and other thinking skills. The goal is to understand whether the benefits of healthy sleep duration depend on the timing of when that sleep occurs.
Interventions
BEHAVIORALAligned sleep extension
Timing of extended sleep condition is randomly assigned to fit with participant's chronotype
BEHAVIORALMisaligned sleep extension
Timing of extended sleep condition is randomly assigned to fit poorly with participant's chronotype
Sponsors
Children's Hospital Medical Center, Cincinnati
National Institute of Mental Health (NIMH)
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
13 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
* Ages 13-17 years at time of informed consent/assent * Based on semi-structured clinical interview, participants must meet full DSM-5 criteria for ADHD inattentive or ADHD combined presentation.
Exclusion criteria
* Non-traditional school setting (morning-afternoon Monday-Friday). * Exclusionary diagnoses. We will exclude adolescents with known intellectual disability, autism spectrum disorder, psychosis, bipolar disorder, or neurologic conditions (e.g., epilepsy), per caregiver-report. * Exclusionary sleep disorders. We will exclude adolescents with symptoms of obstructive sleep apnea or periodic limb movement disorder based on published cutoffs on a validated questionnaire. * High caffeine intake. To promote adherence to directives not to consume caffeine the day of office visits without withdrawal effects, adolescents with daily intake of \>1 coffee or "energy drink" or \>2 caffeinated sodas per day based on caregiver- and adolescent-report will be excluded. * Unwillingness or inability to take part in study procedures (e.g., visits, prescribed sleep conditions). * Medication use or unwillingness to discontinue melatonin and/or stimulant medications during the 3-week study protocol. * Refusal to refrain from automobile driving during the sleep restriction condition. * "Intermediate" Chronotypes (neither morning larks nor night owls) based on habitual sleep timing on nights when adolescent has no morning obligations such as school or work.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Caregiver- and Adolescent-Reported Symptoms of Inattention | Daily throughout each participant's involvement in the study, up to 3 weeks | Daily diary listing symptoms of inattention adapted from the IOWA Conners Questionnaire. Adolescents will self-report their own symptoms for the previous day. Parents/caregivers will report on their observations of the adolescents' symptoms for the previous day. Higher scores indicate greater inattention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Caregiver- and Adolescent-Reported Internalizing Symptoms (depression, anxiety) | Each office visit during the participant's involvement. Office visits are spaced 1 week apart, for up to three visits. | Retrospective report of internalizing symptoms based on the Vanderbilt questionnaire across 5 days the previous week. Adolescents will self-report their own symptoms. Parents/caregivers will report on their observations of the adolescents' symptoms. Higher scores indicate greater internalizing symptoms. |
| Caregiver- and Adolescent-Reported Emotional Dysregulation | Each office visit during the participant's involvement. Office visits are spaced 1 week apart, for up to three visits. | Retrospective report of symptoms of Emotion Dysregulation (e.g., emotional responses stronger than is called for by a situation) across 5 days the previous week. Previously validated by the investigators against established measures of long-term emotion regulation, this form focuses on a shorter (5-day) period. Adolescents will self-report their own symptoms. Parents/caregivers will report on their observations of the adolescents' symptoms. Higher scores indicate greater dysregulation. |
| Caregiver- and Adolescent-Reported Impulsivity | Each office visit during the participant's involvement. Office visits are spaced 1 week apart, for up to three visits. | Retrospective report of internalizing symptoms based on the Vanderbilt questionnaire across 5 days the previous week. Adolescents will self-report their own symptoms. Parents/caregivers will report on their observations of the adolescents' symptoms. Higher scores indicate greater internalizing symptoms. |
| Sleep Period Duration | Nightly throughout study participation (around 3 weeks) | Nightly sleep period, defined as the simple difference between sleep onset and offset, based on a wrist-mounted accelerometer (wristwatch). |
| Inattention | Twice daily during weeks 2 and 3 of study participation. | Adolescent-reported attention will me assessed via Ecological Momentary Assessment (EMA) |
| Inattention, as objectively measured via the NASA PVT+ application (aka Psychomotor Vigilance Test). | Four remote administrations: (1) the morning of a predetermined date during Week 2 of study participation; (2) the afternoon of that same Week 2 date; (3) the morning of a predetermined date during Week 3; (4) the afternoon of that same Week 3 date. | Remote-proctored administration via the NASA PVT+, loaded onto an iPhone. This is a computerized measure of sustained attention. Participants must attend to infrequent stimuli on screen as quickly as possible. Higher scores indicate slower or missed responses, and therefore greater inattention. |
Countries
United States
Contacts
CONTACTDean Beebe, Ph.D
CONTACTStephen Becker, Ph.D.
PRINCIPAL_INVESTIGATORDean Beebe, Ph.D.
Children's Hospital Medical Center, Cincinnati
PRINCIPAL_INVESTIGATORStephen Becker, Ph.D.
Children's Hospital Medical Center, Cincinnati
Outcome results
None listed