(PS1-C74) Influence of Sleep on Parenting Stress in Young Children Who Are At-risk for ADHD

Introduction: Sleep disturbance is common in children with ADHD, with up to 85% of caregivers reporting sleep problems (Sung et al., 2008; Yürümez & Kılıç, 2016). Heightened sleep problems can also intensify ADHD symptoms and problem behaviors (Craig et al., 2017). Relatedly, caregivers experience heightened stress when their children with ADHD experience sleep problems, such as bedtime resistance, insomnia, and night wakings (D’Agati et al., 2020; Martin et al., 2021). Considering that better sleep in children with ADHD may be associated with lower stress, the current study aimed to examine the moderating role of different sleep characteristics (i.e., sleep problems, bedtime resistance) in the relationship between ADHD symptoms and parenting stress.

Method: Participants included 105 caregivers of preschoolers at-risk for ADHD (Mage = 4.48 years; 70.5% male; 81.0% White). Data were collected as part of project Promoting Engagement with ADHD Pre-Kindergartners (PEAK), a behavioral parenting training program (DuPaul et al., 2018). Pre-treatment data were utilized from the following measures: Conners Early Childhood Rating Scale - Inattention/Hyperactivity (Conners, 2009), the Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF; Abidin, 2012), the Children’s Sleep-Wake Scale - Going to Bed (LeBourgeois & Harsh, 2016), and Children’s Sleep Habits Questionnaire-Toddler (CSHQ-T; Sneddon et al., 2013). Moderation analyses were conducted using SPSS PROCESS version 4.1 macro (Model 1; Hayes, 2022) to examine sleep characteristics as moderators between ADHD symptoms and parenting stress. Two sets of analyses were conducted for the hypothesized moderators (sleep problems [CSHQ-T] and bedtime resistance [GTB]).

Results: Skewness and kurtosis values were within acceptable limits for all variables. In the sleep problems model, ADHD symptoms, but not sleep problems, were a positive, significant predictor of parenting stress (b = .73, s.e.=.33, p = .03). No interaction effects emerged between ADHD symptoms and sleep problems on parenting stress. In the bedtime resistance model, ADHD symptoms were again a positive, significant predictor of parenting stress (b = .49, s.e. = .24, p = .04). Similarly, bedtime resistance was also a positive, significant predictor (b = 4.16, s.e. = 1.84, p = .03), showing a greater effect size than ADHD symptoms. However, the interaction effect again was not significant.

Conclusion: Overall, ADHD symptoms and bedtime resistance were significantly related to parenting stress. As no moderation relationships were found, ADHD symptoms were similarly related to parenting stress regardless of sleep characteristics for this sample. Thus, ADHD symptoms and bedtime resistance appear to be independent predictors of parenting stress. This highlights the potential benefits of targeting bedtime resistance for improving parenting stress. In conclusion, while bedtime resistance may predict parenting stress, further research is needed to better elucidate its role in the relationship between ADHD symptoms and parenting stress. Future studies should utilize more objective sleep measures (e.g., actigraphy, polysomnography), examine covariates, and assess relationships longitudinally.