Original Article
Moderate-to-vigorous physical activity and behavioral outcomes in adolescents with attention deficit and hyperactivity disorder: The role of sleep

https://doi.org/10.1016/j.dhjo.2020.100970Get rights and content

Abstract

Background

Attention deficit and hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has a worldwide prevalence of 7.2%. Individuals with ADHD often have sleep and behavioral problems.

Objective

This cross-sectional survey aims to investigate the relationships between moderate-to-vigorous physical activity (MVPA), sleep, bullying, and school engagement in adolescents with ADHD.

Methods

Data were obtained from the 2011–2012 National Survey of Children’s Health. A subsample (n = 272) that fit the inclusion criteria was included. Path analysis was used to test the hypothesized model (i.e., MVPA → sleep → bullying/school engagement).

Results

The proposed model fit the data well. MVPA was found to be associated with sleep, bullying, and school engagement. In addition, sleep mediated the relationship between MVPA and bullying/school engagement.

Conclusions

MVPA and sleep play an important role in understanding behavioral outcomes in adolescents with ADHD. Longitudinal or intervention studies are needed to support the present findings.

Section snippets

Data source and participants

Ethical approval of the present research was obtained from the Institutional Review Board, Nanyang Technological University (no. IRB-2019-06-043). Although newer National Survey of Children’s Health (NSCH) datasets are available, survey questions were changed after the 2011–2012 dataset, and variables of interest for the present study were not available (e.g., MVPA). Thus, the 2011–2012 NSCH dataset was used in the present study. The 2011–2012 NSCH includes a nationally representative,

Results

Table 2 presents the results of the descriptive analysis and zero-order correlations. Age and gender were associated with some of the major study variables and they were therefore entered as covariates in the path analysis. MVPA was weakly and positively related to both sleep (r = 0.23, p < 0.001) and school engagement (r = 0.19, p = 0.002). Sleep had a weak and negative association with bullying (r = −0.27, p < 0.001) and showed a weak positive relationship with school engagement (r = 0.29,

Discussion

The aim of the present research was to examine the relationships between MVPA, sleep, and behavioral outcomes (i.e., bullying and school engagement) among adolescents with ADHD. Overall, the data showed good fit to the hypothesized model, and supported all the hypotheses. Specifically, our results showed that MVPA was positively related to sleep (β = 0.17). This result is consistent with H1 and a recent meta-analysis, in which regular physical activity participation was found to bring small to

Conclusions

In conclusion, MVPA has a positive association with sleep, which is negatively associated with bullying and positively related to school engagement among adolescents with ADHD. Further, sleep partially explains the relationship between MVPA and the two behavioral outcomes. While the findings are promising in regard to the potential positive relationship that MVPA and sleep may have for youth with ADHD, it is also known that those with ADHD tend not to engage in recommended amounts of MVPA or

Funding

This research was funded by the Key Project of the Shanghai Committee of Science and Technology, grant number 18080503300.

Declaration of competing interest

None declared.

Acknowledgments

The authors thank the Data Resource Center for Child & Adolescent Health for making the 2011–2012 NSCH data available for this research.

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