Sleep problems, social jetlag, and cognitive functioning in children with ADHD

This short video discusses a research paper that was recently mentioned in the mainstream media on the topic of social jetlag in children with ADHD and how it may affect their cognitive functioning. The study assessed the extent of sleeping difficulties in children with ADHD and found that at least half had some sleeping problems. It then computed the difference between the midpoint of their sleeping on school nights versus the midpoint of sleep on weekends, referring to this as social jetlag. The study found that the extent of such bedtime differences was significantly related to various measures of cognitive functioning and especially executive functioning.
Mainstream media reference:
PsyPost - www.psypost.org/2024/01/socia...
Actual journal article:
Qu, X. et al. (2023). Association of time in bed, social jetlag, and sleep disturbances with cognitive performance in children with ADHD. Journal of Attention Disorders, 28(1). journals.sagepub.com/doi/10.1...

[@ThomasToPC]

It would be great to see a similar study for adults with ADHD. I suspect the findings won't be all that different. Wishing you all the best in 2024, Dr Barkley!

[@jaeshasway]

Agreed, because despite medication and psychotherapy, I’m struggling with all of this as an adult. I now have sleep deprivation, and the social jet lag is definitely a thing in adults. Lack of sleep impact work and social life. Can’t take sleeping meds. I’m meditating and doing all the other holistic stuff to try and help my ADHD.

[@weaviejeebies]

That consistent bedtime is such a hard thing to be consistent on due to the ADHD repugnance felt for all things mundane. Even as an adult, I have a hard time talking myself into sticking with the same time every night, feeling oppositional about this self-imposed control. Then there's the insomnia component. Sometimes my brain just won't shut off, and even though I'm in bed, I'm not falling asleep at the consistent time.

[@ttul]

One accommodation I’d like to see take hold in the school system for kids with ADHD is a recognition of their differing sleep schedule. Try as they might, kids with ADHD have a harder time getting to sleep and are often zombies in the morning. Yet school still starts at the same time for everyone. It makes no sense to me to not recognize the need for sleep accommodations as we already do for the other common deficits associated with ADHD such as slow processing speed or poor fine motor skills.

[@Heidi123]

A London school experimented with later start times for teenagers (high school). The results showed improved performance and I understand they kept the later start time after the pilot study.

[@weaviejeebies]

If they'd let me come in at 10 am, I'd have done a lot better, I know it.

[@s.m.4948]

I believe that the majority of school children, ADHD or not, would fare better with a later start time. Unfortunately, with parents' work schedules, it could get them to school at a later start time.

[@tsamurphy]

I agree! The biological rhythm would be closer to weekends, and the "socially factored" sleep schedule would be school/work nights, since so many of us are forced out of our more natural sleep cycles to suit the existing infrastructures. Unfortunately weekends for me also included overcompensating for sleep I didn't get during the week. I love the term "social jetlag" though!

[@Kinari_91]

I came here to say this. There is definitely a correlation between ADHD and DSPS. My thoughts are that, in some folks (as it was for me), it could actually be reversed - chronic sleep deprivation from sleeping out of phase can mimic the struggles associated with ADHD symptoms and social jet lag. First thing I always ask people is, "How do you sleep?" If they are going to bed at a "normal" time and getting 8+hrs of sleep but still struggling with an alarm and getting to work on time, there is very likely something else going on. I won't post mu whole life story om here, but I didn't figure this out until I was in my late twenties when my new supervisor didn't care what time I came in. I eventually found my "natural " wake time (9am) and all the "crazy" went away. I never knew what mental clarity was until I started sleeping on my own schedule. I am also an advocate for "Start School Later."

[@drrodopszin]

During high school I struggled a lot. I had classes at 8 and sometimes at 7:15 am in the morning and it was a total waste of time. I barely copied what was written on the blackboard and then my afternoon was all about fantasizing and actually doing napping. Later in university my normal wake up time was in between 10am and noon. But I regained the ability to focus and understand again. I'm still angry with the school system for being inflexible, uncompromising and being unable to spot the problems.

[@PeanutsDadForever]

I thought all ADHD people had delayed onset of sleep. Poor sleep quality would only exacerbate ADHD symptoms the following day. A Canadian Psychiatrist, Margaret Weiss, wrote an excellent article on this called “ADHD, 24 hour disorder”.🇦🇺👴🏻

[@Kelinarrr]

Hello sir, I am currently writing my psychology thesis on adhd in women and I wanted to say I very much appreciate all your videos. They are very informative and give knowledge in very simple and understandable language and the studies compiled and explained in more easier way is just what I was looking for. Thank you for your lectures and keep up the work :)

[@alessazoe]

I wonder what was going on with sleep in my childhood (in the 90s) ... during the week, we had to get up quite early to go to school, like 6 am, we were sooo freaking tired, even when our parents tried to fix that with sending us to bed earlier (but we just wouldn’t fall asleep earlier). On the week-end, sleep schedule WAS more relaxed, our parents themselves enjoyed sleeping longer, having a later breakfast, but we instead woke up even earlier like 4 or 5 am and we would get up and watch the super early cartoon tv program on our own. I don’t know how we absolutely routinely(!) managed to do that without an alarm, while we were dead tired during the week and maybe we even were allowed to stay up longer on Fridays and Saturdays since we didn’t HAVE to get up early for school the next day.

[@insidiatori9148]

I finished dutch VWO (12 to 18 years old, at least 115 iq estimate) undiagnosed, weed addicted and sleep deprived. I used to be seen as a bright kid. When diagnosed I was asked to make an WAIS IQ test because it could tell me more my capabilities. After post-poning for as long as possible I would finaly make it. Nevertheless I was still sleep deprived and nervous for the test. The test was very early in the morning and there was an extra person to learn about the intelligence test.... I was really tired that week too. When making the test I: answered the last 3 questions of working memory correct but all slightly out of time; after the first processing speed task she instructed the following task had to be done as fast as possible, I answered irritated: Was this just the case as well? She: Yes. another psychologist told me there was indeed a difference noticed between those tasks; was tired and threw the cubes away one time because it drained me for the rest of the test xD; gave with similarities and definitions simple or poor answers that could have been a lot better answered if I was more present. Gave the right answer once but would doubt because of the silence after and just said another answer instead.... Result: 115 verbal, 85 non verbal, 90 working memory, 80 processing speed. Then this person made the report and stated the most random conclusions and mostly about my personality without knowing me yet... In my opinion IQ tests are discriminatory to ADHD along with comorbid issues in regard to intelligence, especially when monitered by the wrong person. I do not care about IQ tests at all for ADHD unless it's completely treated, so sleep and such too.

[@ivana61681]

Interesting study, thanks for bringing it to our attention. My 4-year-old ADHD son is still doing OK when it comes to his bedtime and wake up hours as we really insist he stick to a healthy routine (bath around 8 PM followed by sleep, even on weekends) but in recent months I have noticed that he is becoming resistant to this routine. I suppose there might be more troubles with this in the future. On the other hand, I, as an adult with ADHD and delayed circadian rhythm, am terrible when it comes to going to sleep at a normal hour. Unless someone points a gun at my head, there is no way I will go to sleep before 2 AM. I usually wake up around 7 AM so on average I get around 5 hours of shut-eye every night. I wake up every morning feeling tired and promise myself that I will go to sleep early that evening, but I never do. I am already used to exhaustion, irritability, and all the other things this poor sleep pattern entails but in the last year or so I have noticed that it had started to affect my immune system - now I develop complications (ear infections, sinus infections etc.) from something as harmless as the common cold. The adverse health consequences of ADHD are really mind-boggling and diverse.

[@insidiatori9148]

Dude you sound like me, it's hard man. I now got prescribed dymista for my tinitus caused by middle ear congestion, but it makes me more sleepy and increases adhd issues so my dexedrine doesn't work. Ear problems are so hard. :( Edit: And it made my sleep schedule worse.

[@Hambone_FN]

Great info as always. I appreciate your channel!

[@KVVUZRSCHK]

Watching this at 6:40 AM because my sleep schedule is royally fucked up

[@thefalsecritic9520]

Thank you, very insightful study. I wonder how long these effects were maintained and how long it would take to reverse them if the child reverted to 0 social jetlag.

[@HyperFocusMarshmallow]

Yet another interesting aspect to consider. I really appreciate your channel. Two quick thoughts on the presentation. I often watch on the phone so the plots can be a bit hard to read due to being small. (Pretty big screen but still). Not a huge issue, just thought I’d give the feedback. The next point is that I sometimes put my phone in my pocket and just listen. I don’t expect you to change the way you present just because of that, you’re making videos after all. For someone who only listens statistics can still work if some of the numbers are read when they’re referred to, but if you just refer indirectly like “compare the first and second bar in this histogram”, I totally miss the point. That’s fine, just saying how it is =) Putting the phone down helps me in two ways though. Either, I want to do something else at the same time and the visuals are too distracting. Or I’m trying to focus on the video fully but find myself scrolling through comments or tapping on other videos. So it’s a mode I do like as an option. Thanks for what you do! Happy new year!

[@farooqbinadam]

It's said that this is why most adults don't like Mondays. It's because we stay up later and sleep in on the weekends, causing us to be more tired when waking up.

[@emilerichard1377]

Great channel. Thank you. Do the authors discuss causality? That is, whether the symptom severities observed (cognitive, etc.) are due to the sleep pattern irregularities, or vice versa? And what does previous related literature find or hypothesise about the causality?

[@russellbarkleyphd2023]

You can read the entire article at the journal website using the link that I provided in the thumbnail sketch for this video. Be well.

[@AndreaCrisp]

This totally matches my life experience. My entire family is neurodivergent and we are all naturally late night people and prefer to sleep in. HS was hell for me. I had dyscalxula, but didn't know it and math was extremely difficult despite being in Honors classes for everything else. Also math was always 1st period and school started at 7:15 AM! Torture!

[@freedbygsus]

It would be really interesting to see if a follow-up study could examine cognitive disengagement syndrome as a possible confounder here. Social jetlag could prove useful to understanding CDS hypoactivity, and maybe even offer a promising venue for novel CDS interventions. Of the 5 neurocognitive domains measured in this study, one would expect that ADHD-implicated sleep issues would correspond to performance impacts in working memory and attention. However, this study found no impact on attention even prior to their adjustment and no impact on working memory after their adjustment. Instead, they found the other 3 domains were the only ones significantly impacted after their adjustments, and the most impacted domains were processing speed and language-based reasoning. CDS mental confusion would seem to predict those cognitive deficits which would implicate CDS as a likely confounder in this study, especially given the expected prevalence of CDS in the ADHD sample population (note that Inattentive and Combined clinical presentations represented 85% of the sample population). The studies that have been done on the relationship between CDS and sleep have found a clearly extant relationship, but mixed results regarding the nature of that relationship. Given the findings of this study, social jetlag may be a promising avenue for future research into CDS sleepiness.

[@languagelearning4beginners]

russel barkley re: adhd and bed wetting. is therapee a recommended brand? paediatrician says to do 3 steps: 1 stool softener in case of constipation 2 buy a pad alarm more then $100 aid to avoid cheap one and nit use an underwear one 3 use minorom at night to limit urine production but not 7 days a week or when it is over 30 C to affect hydration. would love a suggestion for our 9 year old wish add level 2 & adhd to master this for school camps and friend sleep overs in the future.

[@dalelane1948]

lazy comment for the algo

[@miehiep1977]

Reply to the comment

[@alessazoe]

some more interaction over here

[@waqasusmans]

+1

[@insidiatori9148]

Funny joke related to the comment thread.

[@sonyaparkin7841]

💚

[@yarntoast]

Social jetlag! There’s a term for it! Like many things ADHD, not only children.

[@petitfww]

Hello, I love your contents. I refer to you as THE ADHD guy. If I were to voice a tiny complaint, I'd ask you to upgrade your microphone.

[@russellbarkleyphd2023]

Thanks! And I will look into getting a better microphone.

[@petitfww]

Thank you so much ! You're awesome !

[@Ouiofcourse]

Dr you should clearly asked for the certificate of authenticity offert by KZbin There are so many scammer and fake Dr out here... you are clearly the real deal you should ask for it👍

[@edmo1982]

My sleep onset improved, coming earlier, after ritalin. Believe it not

[@lilitudeamnocte248]

I always call it a social hangover. Haga