The COVID-19 pandemic has turned the routine of many upside down in a number of ways, including sleep, diet and exercise. While many have struggled with this change, it has been especially challenging for patients with ADHD (attention deficit hyperactivity disorder).
A team, led by Rose Swansburg, MBT, Cumming School of Medicine, Department of Pediatrics, University of Calgary, examined the impact of the pandemic on lifestyle habits and mental health symptoms for pediatric patients with ADHD in Canada.
In the study, the researchers conducted an online survey across Canada among caregivers of pediatric patients with ADHD ages 5-18. The surveys assessed depression (PHQ-9), anxiety (GAD-7), ADHD (SNAP-IV), and lifestyle behaviors.
The data was analyzed by gender and age group: 5-8, 9-12 and 13-18. The researchers also conducted Spearman’s correlations between lifestyle habits and mental health outcomes.
A total of 587 surveys were analyzed from respondents with an average age of 10.14 years.
The researchers found that 17.4% and 14.1% of respondents met criteria for moderate to severe depression and anxiety symptoms, respectively. The pediatric patients who met the SNAP-IV cut-off scores for inattention (73.7%), hyperactivity/impulsivity (66.8%) and oppositional defiant (38.6%) behavior.
The caregiver respondents reported changes in sleep (77.5%), eating (58.9%), exercise (83.7%) and screen use (92.9%) in their ADHD child.
However, the researchers found that greater depression, anxiety and ADHD symptoms were associated with sleeping fewer hours a night, eating more processed foods, and watching TV or playing video games for more than 3.5 hours a day, while spending less than 1 hour a day. sports correlated with depression symptoms only (P < 0.01).
“The COVID-19 pandemic has resulted in less healthy lifestyle habits and increased psychological symptoms in Canadian children with ADHD,” the authors wrote. “Longitudinal studies to better understand the relationship between these factors are recommended.”
In data presented in a poster at the American Psychiatric Association’s 2021 annual meeting, researchers suggest a better understanding of why patients with ADHD are more likely to experience sleep problems, including insomnia and excessive sleepiness.
Decreased sleep is a known risk factor for several negative health outcomes, such as deficits in executive function, attention, and impulse control, all of which are symptoms of ADHD. About half of ADHD patients report sleep disturbances, with delayed sleep onset being the most commonly reported symptom.
Sleep deprivation has also been linked to decreased dorsolateral prefrontal activity, as well as difficulty regulating attentional sources. This could help explain the inability to pay attention to a stimulus in the presence of distraction or to engage in goal-directed behavior.
Overall, the patients with ADHD reported greater deterioration in sleep quality (P = 0.009), insomnia (P = 0.004) and sleepiness (P = 0.029).
The patients with higher sleep quality scores also had lower SHAPS scores, regardless of the ADHD diagnosis (β = -0.235; P = 0.012).
The association of ADHD diagnosis and sleepiness scores was influenced by SHAPS scores (b = 0.199, P = 0.039), with the significance of the relationships increasing with higher SHAPS scores.
The study, “Impact of COVID-19 on Lifestyle Habits and Mental Symptoms in Children with Attention Deficit/Hyperactivity Disorder in Canada,” was published online in Pediatrics & Child Health.