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A new study, titled, Associations between parenting stress, parent mental health and child sleep problems for children with ADHD and ASD, looked at whether sleep problems experienced by children with Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are connected to parenting stress.

"There was an expectation of a possible link between child sleep problems and parenting stress and mental health difficulties," study author Christina Martin told us. "This is because existing research had shown that children with ADHD and ASD have high rates of sleep problems that have been linked to poorer child functioning such as poorer quality of life. We thought the negative impacts of sleep problems might extend to the wellbeing of parents."

According to the Centers for Disease Control and Prevention, over six million children were diagnosed with ADHD in a parent survey in 2016. The neurodevelopmental disorder is more common in boys than girls. Children with ADHD often have co-morbid disorders such as anxiety and ASD. Up to 70 per cent of children with ADHD and ASD have sleep problems and very little research has focused on how to best help families. Martin and her colleagues wanted to understand whether sleep problems impacted parents' wellbeing and how they might use this information to better treat sleep problems in children with ADHD and ASD. 

About one in 59 children in the U.S. has been diagnosed with ASD and like ADHD, and it’s more common in boys than girls, about four times more common. One in 37 boys and one in 151 girls were diagnosed with ASD in 2018.

The current study was undertaken using strict rules to identify all existing research that included children aged five to 18 with a formal diagnosis of ADHD or ASD and which looked at the connection between the child’s sleep problems and their parents' mental health and/or their parents' parenting stress. Researchers identified 11 studies from MEDLINE Complete, EMBASE, PsycINFO and CINAHL Complete. Their study included 1,435 participants.

"The review showed there was evidence of a connection between the sleep problems experienced by children with ADHD and ASD and their parents' mental health difficulties," Martin told us. "The review also showed there was evidence of a connection between child sleep problems in children with ASD and parenting stress."

The connection between parenting stress and sleep problems in children with ADHD could not be investigated as no studies had been undertaken which met the requirements of the review. It must be stressed that these results suggest a link but not a cause-and-effect relationship, Martin explained to us. Further research is needed in this area.

"The results were broadly in line with our expectations," Martin told us. "Current mental health treatment approaches largely treat adults and children individually. Given that children and parents live within a family unit, not in isolation, it is important that we move towards a mental health treatment model that takes a family systems approach to treatment. We know that parents experiencing mental health difficulties can find it challenging to implement interventions."

Martin explained that the study results highlight the need to modify behavioural sleep interventions for children in ways that increase the ability of all parents to successfully implement them.

"This may lead to improvements in the child’s sleep, which in turn could lead to improvements in parenting stress and parent mental health," Martin told us. "The results also highlight that mental health interventions should include screening for child sleep problems when parents seek assistance for parenting stress or mental health difficulties."