Does bad sleep make ADHD homework problems worse?

A study of adolescents with ADHD, some of whom also experienced sleep problems, found that sleep problems are not associated with homework problems. Weaker neuropsychological functioning was associated with increased homework problems in adolescents with ADHD in general, but not specifically in those with sleep problems. The paper was published in the Journal of Attention Disorders.

Attention-deficit/hyperactivity disorder or ADHD is a neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning. It typically begins in childhood (most often when a child starts school) but symptoms can continue into adolescence and adulthood.

Common signs of inattention include difficulty sustaining focus, forgetfulness, and being easily distracted. Hyperactivity may manifest as excessive fidgeting, restlessness, or an inability to stay seated when expected. Impulsivity involves hasty actions without considering consequences, such as interrupting others or making decisions too quickly. Statistics indicate that around 5.6% of adolescents worldwide have ADHD.

Study author Liv Smets and her colleagues note that many adolescents with ADHD also experience sleep problems. They wanted to explore whether sleep problems are associated with homework problems in adolescents with ADHD and whether issues with neuropsychological functioning explain this link. In this study, homework was “any task that teachers assign to their students that is intended to be completed outside of school hours”.

Homework is generally very important for academic achievement in school, and previous studies indicated that problems with doing homework might be associated with sleep problems. The idea is that sleep problems adversely impact adolescents’ neuropsychological functioning, and this would make them less able to do homework. Neuropsychological functioning, in this case, refers to how well adolescents can stay focused, remember things, manage their impulses, and keep themselves motivated in everyday life.

Study participants were 53 adolescents with ADHD who also had sleep problems, 24 adolescents with ADHD without sleep problems, and 53 adolescents without ADHD. Their age ranged between 13 and 17 years. They were all attending secondary school. Participants were recruited across Flanders, Belgium via academic hospitals, secondary schools, general practitioners, psychiatrists, psychologists, social media, and the network of the researchers.

The study authors assessed participants’ homework problems (reported by parents using the Homework Problems Checklist), behavioral indicators of neuropsychological functioning (again reported by parents using the Cognition and Motivation in Everyday Life questionnaire), and pubertal status (using the Pubertal Developmental Scale).

Results showed that participants with ADHD who also had sleep problems did not have more homework problems than their peers with ADHD but without sleep problems. These two groups also did not differ in most aspects of neuropsychological functioning. As expected, adolescents with poorer neuropsychological functioning were reported to have more homework problems, but this was not specifically linked to sleep problems. Also as expected, adolescents with ADHD, regardless of whether they had sleep problems or not, had more homework problems than adolescents without the disorder.

“In adolescents with ADHD, sleep problems were not associated with more homework problems by weaker behavioral indicators of neuropsychological functioning. However, regardless of sleep problems, the behavioral indicators of neuropsychological functioning relate to the homework problems in adolescents with ADHD,” the study authors concluded.

The study sheds light on the specificities of adolescents with ADHD. However, the study authors note that mothers of the study participants tended to be better educated than the general population of Belgium, indicating that participating adolescents, on average, come from families with higher socioeconomic status. Children from such families generally receive good support for school activities, leading to better academic achievements. Because of this, studies focusing on adolescents from families with lower socioeconomic status might report different results.

The paper, “Exploring the Association Between ADHD, Sleep, and Homework Problems: The Role of Behavioral Indicators of Neuropsychological Functioning,” was authored by Liv Smets, Finja Marten, Lena Keuppens, Dieter Baeyens, Bianca E. Boyer, and Saskia Van der Oord.