VCU news

By Brian McNeill

A Virginia Commonwealth University professor has received a $1.4 million grant to study the association between sleep problems and academic and social functioning among middle and high school age adolescents, with a particular focus on adolescents with attention deficit hyperactivity disorder.

Among all adolescents, roughly 15 percent exhibit clinically significant sleep problems, and around 25 percent report regularly falling asleep in class or while completing homework. In contrast, nearly 50 percent of adolescents diagnosed with ADHD report experiencing problems sleeping, and ADHD is associated with high rates of academic impairment and social problems.

The new four-year grant, “Longitudinal Evaluation of the Impact of Sleep Problems on the Academic and Social Functioning of Adolescents with and without ADHD,” from the Institute of Education Sciences at the U.S. Department of Education aims to shed light on how sleep problems contribute to the educational functioning of adolescents with ADHD and why prevalence rates are so high.

“At this point, we don't understand why adolescents diagnosed with ADHD report such high rates of sleep difficulties,” said the study’s principal investigator Joshua M. Langberg, Ph.D., an associate professor and co-director of the Center for ADHD Research, Education, and Service in theDepartment of Psychology in the College of Humanities and Sciences. “Is it stimulant medication use, comorbid problems with anxiety or depression, staying up late to complete homework, or screen use such as texting and Internet use near bedtime? Without this information, we cannot begin to help these students and their families improve sleep because we don’t know what to target.”

The grant also aims to better understand the broader impact of poor sleep on adolescents’ academic and social functioning.

We need to fully understand how sleep impacts academic and social functioning.

“For example, is a cumulative sleep deficit over time what is most important, or does sleeping a few hours less for a single night significantly impact performance in school the next day,” Langberg said. “Also, are we talking about the impact being a few careless mistakes the next day, or are we talking about scoring a full letter grade lower on a test? This type of detailed, clinically meaningful information is needed for schools and families to be able to prioritize and make informed decisions about bedtimes, amount of homework assigned and school start times.”

Currently, sleep difficulties are not targeted in existing interventions for middle and high school students with ADHD and are not assessed or targeted regularly in general middle and high school populations, Langberg said.

“We need to fully understand how sleep impacts academic and social functioning and at what level to determine whether interventions are warranted and, if so, what the focus should be,” he said.

As part of the study, which will be conducted at VCU and Cincinnati Children's Hospital Medical Center, the researchers will follow 300 adolescents — 150 with ADHD and 150 without — from eighth to 10th grade to assess sleep, academic and social functioning, and factors that may differentially predict the presence of sleep problems.

The study will include both objective measurements of sleep and subjective measurements (such as sleep diaries) as well as data from multiple reporters, such as the adolescents and their teachers.

The grant fits squarely within Langberg’s program of research, which focuses on improving the outcomes of adolescents with ADHD from middle school through college, with a particular focus on understanding what factors and behaviors are most important in predicting long-term academic outcomes.