The role of inflammation in the prospective associations between early childhood sleep problems and ADHD at 10 years: findings from a UK birth cohort study.
ADHD
ALSPAC
Sleep
inflammatory markers
longitudinal
Journal
Journal of child psychology and psychiatry, and allied disciplines
ISSN: 1469-7610
Titre abrégé: J Child Psychol Psychiatry
Pays: England
ID NLM: 0375361
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
accepted:
28
11
2022
medline:
15
5
2023
pubmed:
5
1
2023
entrez:
4
1
2023
Statut:
ppublish
Résumé
Several underlying mechanisms potentially account for the link between sleep and attention deficit and hyperactivity disorder (ADHD), including inflammation. However, studies so far have been cross sectional. We investigate (a) the association between early childhood sleep and probable ADHD diagnosis in childhood and (b) whether childhood circulating inflammatory markers mediate these prospective associations. Data from the Avon Longitudinal Study of Parents and Children were available for 7,658 10-year-old children. Parent-reported sleep duration, night awakening frequency and regular sleep routines were collected at 3.5 years. The Development and Wellbeing Assessment was administered to capture children with clinically relevant ADHD symptoms, or probable ADHD diagnosis. Blood samples were collected at 9 years, from which two inflammatory markers were obtained [interleukin-6 (IL-6) and C-reactive protein (CRP)]. Logistic regression analyses were applied to investigate the associations between sleep variables at 3.5 years and probable ADHD diagnosis at 10 years. Further, path analysis was applied to examine the potential mediating role of inflammation at 9 years (as measured by CRP and IL-6) in the associations between early sleep and ADHD at 10 years. Less regular sleep routines (OR = 0.51, 95% CI = 0.28-0.93, p = .029), shorter nighttime sleep (OR = 0.70, 95% CI = 0.56-0.89, p = .004) and higher night awakening frequency (OR = 1.27, 95% CI = 1.06-1.52, p = .009) at 3.5 years were associated with higher odds of ADHD at 10 years. Further, IL-6 at 9 years, but not CRP, mediated the association between irregular sleep routines and ADHD (bias-corrected estimate, -0.002; p = .005) and between night awakening and ADHD (bias-corrected estimate, 0.002; p = .003). Several sleep problems in early childhood constitute a risk factor for probable ADHD diagnosis at 10 years. Further, these associations are partially mediated by IL-6 at 9 years. These results open a new research vista to the pathophysiology of ADHD and highlight sleep and inflammation as potential preventative targets for ADHD.
Sections du résumé
BACKGROUND
Several underlying mechanisms potentially account for the link between sleep and attention deficit and hyperactivity disorder (ADHD), including inflammation. However, studies so far have been cross sectional. We investigate (a) the association between early childhood sleep and probable ADHD diagnosis in childhood and (b) whether childhood circulating inflammatory markers mediate these prospective associations.
METHODS
Data from the Avon Longitudinal Study of Parents and Children were available for 7,658 10-year-old children. Parent-reported sleep duration, night awakening frequency and regular sleep routines were collected at 3.5 years. The Development and Wellbeing Assessment was administered to capture children with clinically relevant ADHD symptoms, or probable ADHD diagnosis. Blood samples were collected at 9 years, from which two inflammatory markers were obtained [interleukin-6 (IL-6) and C-reactive protein (CRP)]. Logistic regression analyses were applied to investigate the associations between sleep variables at 3.5 years and probable ADHD diagnosis at 10 years. Further, path analysis was applied to examine the potential mediating role of inflammation at 9 years (as measured by CRP and IL-6) in the associations between early sleep and ADHD at 10 years.
RESULTS
Less regular sleep routines (OR = 0.51, 95% CI = 0.28-0.93, p = .029), shorter nighttime sleep (OR = 0.70, 95% CI = 0.56-0.89, p = .004) and higher night awakening frequency (OR = 1.27, 95% CI = 1.06-1.52, p = .009) at 3.5 years were associated with higher odds of ADHD at 10 years. Further, IL-6 at 9 years, but not CRP, mediated the association between irregular sleep routines and ADHD (bias-corrected estimate, -0.002; p = .005) and between night awakening and ADHD (bias-corrected estimate, 0.002; p = .003).
CONCLUSIONS
Several sleep problems in early childhood constitute a risk factor for probable ADHD diagnosis at 10 years. Further, these associations are partially mediated by IL-6 at 9 years. These results open a new research vista to the pathophysiology of ADHD and highlight sleep and inflammation as potential preventative targets for ADHD.
Substances chimiques
Interleukin-6
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
930-940Subventions
Organisme : Medical Research Council
ID : MC_PC_19009
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_15018
Pays : United Kingdom
Organisme : Medical Research Council
ID : G9815508
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 217065/Z/19/Z
Pays : United Kingdom
Informations de copyright
© 2023 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Références
J Pediatr. 2009 May 1;154(5):I-S43
pubmed: 20596295
J Dev Behav Pediatr. 2019 Jul/Aug;40(6):432-440
pubmed: 31166249
Int J Epidemiol. 2013 Feb;42(1):111-27
pubmed: 22507743
Child Psychiatry Hum Dev. 2016 Jun;47(3):440-58
pubmed: 26266467
JAMA Netw Open. 2021 Mar 1;4(3):e210321
pubmed: 33646315
Sleep Med. 2011 Mar;12(3):203-4
pubmed: 21316296
Biol Psychiatry. 2022 Aug 15;92(4):275-282
pubmed: 35151465
J Atten Disord. 2020 Feb;24(4):590-600
pubmed: 31617436
Sleep Med Rev. 2012 Apr;16(2):129-36
pubmed: 21676633
Psychol Med. 2017 Jan;47(1):23-33
pubmed: 27476619
Brain Behav Immun. 2019 Feb;76:74-81
pubmed: 30414442
Biol Psychiatry. 2005 Jun 1;57(11):1313-23
pubmed: 15950004
J Child Psychol Psychiatry. 2000 Jul;41(5):645-55
pubmed: 10946756
Brain Behav Immun. 2020 Aug;88:105-113
pubmed: 32418647
Clocks Sleep. 2019 Dec 20;2(1):7-18
pubmed: 33089186
Front Psychiatry. 2017 Nov 09;8:228
pubmed: 29170646
Postgrad Med. 2010 Sep;122(5):97-109
pubmed: 20861593
J Child Neurol. 2019 Feb;34(2):61-67
pubmed: 30430896
J Atten Disord. 2022 Jan;26(2):149-224
pubmed: 33402013
J Am Acad Child Adolesc Psychiatry. 2009 Sep;48(9):894-908
pubmed: 19625983
Psychiatr Clin North Am. 2010 Jun;33(2):357-73
pubmed: 20385342
Behav Brain Res. 2002 Mar 10;130(1-2):65-71
pubmed: 11864719
Sleep Med Rev. 2007 Apr;11(2):113-33
pubmed: 17275369
J Atten Disord. 2016 Jan;20(1):34-40
pubmed: 23511553
Nat Sci Sleep. 2018 Dec 14;10:453-480
pubmed: 30588139
Biol Psychiatry. 2016 Jul 1;80(1):40-52
pubmed: 26140821
Cold Spring Harb Perspect Biol. 2014 Sep 04;6(10):a016295
pubmed: 25190079
J Adolesc Health. 2015 Feb;56(2):181-7
pubmed: 25448612
Acta Paediatr. 2007 Sep;96(9):1269-74
pubmed: 17718779
PLoS One. 2020 Mar 3;15(3):e0224343
pubmed: 32126073
Schizophr Res. 2021 Apr;230:69-76
pubmed: 33684738
Sleep Med. 2020 May;69:145-154
pubmed: 32087408
JAMA Psychiatry. 2022 May 1;79(5):498-507
pubmed: 35353173
J Am Acad Child Adolesc Psychiatry. 2006 May;45(5):512-519
pubmed: 16670647
JAMA Psychiatry. 2014 Oct;71(10):1121-8
pubmed: 25133871
Can Fam Physician. 2017 Jun;63(6):e316-e323
pubmed: 28615410
Arch Dis Child. 2012 Mar;97(3):260-5
pubmed: 21903599
Eur Child Adolesc Psychiatry. 2023 Jul;32(7):1253-1261
pubmed: 34994865
J Sleep Res. 2016 Jun;25(3):333-40
pubmed: 26762193
Brain Behav Immun. 2018 May;70:61-75
pubmed: 29499302
Int J Psychophysiol. 2020 Dec;158:331-339
pubmed: 33130179
J Clin Sleep Med. 2018 Jun 15;14(6):1083
pubmed: 29852914
Int J Epidemiol. 2013 Feb;42(1):97-110
pubmed: 22507742
Int J Epidemiol. 2014 Dec;43(6):1815-24
pubmed: 25355726
J Atten Disord. 2013 Oct;17(7):550-64
pubmed: 22982880
Pediatrics. 2012 Jul;130(1):e71-9
pubmed: 22711716
J Am Acad Child Adolesc Psychiatry. 2012 May;51(5):506-17
pubmed: 22525957
Pediatr Res. 2019 Mar;85(4):449-455
pubmed: 30679794
JAMA Psychiatry. 2020 Dec 1;77(12):1256-1265
pubmed: 32609357
Early Hum Dev. 2010 Jul;86(7):419-24
pubmed: 20646881
Lancet Psychiatry. 2018 Feb;5(2):175-186
pubmed: 29033005
Soc Psychiatry Psychiatr Epidemiol. 2011 Jun;46(6):521-32
pubmed: 20376427
J Affect Disord. 2020 Feb 15;263:267-273
pubmed: 31818788
J Am Acad Child Adolesc Psychiatry. 2002 Aug;41(8):964-71
pubmed: 12162632