Results of structural equation modeling show that household chaos and sleep hygiene were significant mediators of the relationship between ADHD symptoms and poor sleep quality. The results suggest that improving the daily routine and stability of the household is an important strategy to consider when seeking to improve sleep quality in adolescents with symptoms of attention-deficit/hyperactivity disorder.

“These results begin to explicate some contextual factors that may help explain the increase in sleep difficulties observed in youth with higher symptoms of ADHD,” said lead author and co-principal investigator Jamie Flannery, who is a doctoral candidate in developmental psychology at the University of Notre Dame in South Bend, Indiana. “It suggests that when ADHD symptoms are high, aspects of the individual — poor sleep hygiene — and the familial environment — household chaos — are associated with poor sleep quality in adolescents.”

The American Academy of Sleep Medicine recommends that teenagers 13 to 18 years of age should sleep 8 to 10 hours. Healthy sleep is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health.

The researchers collected data from 259 pairs of mothers and adolescents from across the U.S. Mothers used a scale to rate the severity of their adolescent’s ADHD symptoms, while adolescents completed three separate surveys about sleep quality, home environment and sleep hygiene.

Flannery noted that it’s important for adolescents and their families to know that it is more than just individual characteristics that can impact their sleep.

“While improving sleep hygiene in youths with ADHD may be beneficial, a household characterized by a lack of structure, routine and stability may undermine the adolescent’s sleep quality,” Flannery said.