Examining school climate and sleep in adolescents with and without ADHD.

OBJECTIVES

Adolescents with attention-deficit/hyperactivity disorder are at high risk for sleep difficulties, though sleep problems are widely recognized as a public health concern for adolescents broadly. School climate represents a potentially critical but understudied influence on sleep difficulties, given growing evidence supporting its association with health outcomes. The present study is the first to utilize a multimethod, multi-informant approach, including adolescent-report, parent-report, and actigraphy, to examine associations between school climate and different aspects of sleep functioning among adolescents with and without attention-deficit/hyperactivity disorder.

METHODS

Participants included a well-characterized sample of adolescents (45.1% female, 82.6% White) with attention-deficit/hyperactivity disorder (n = 151) and without attention-deficit/hyperactivity disorder (n = 137) between 13 and 15 years old (M = 14.09).

RESULTS

Multigroup path analyses controlling for demographic characteristics, internalizing symptoms, and medication use indicated better-perceived school climate was associated with less adolescent-reported daytime sleepiness and fewer sleep/wake problems, regardless of attention-deficit/hyperactivity disorder status, though stronger associations were found in the non-attention-deficit/hyperactivity disorder group. In contrast, for both adolescents with and without attention-deficit/hyperactivity disorder, school climate was not significantly associated with adolescent- or actigraphy-measured sleep duration, actigraphy-assessed sleep efficiency, or parent-reported sleep quality.

CONCLUSIONS

Collectively, findings indicate school climate is associated with specific vs. broad-based aspects of sleep, and that associations may differ based on how sleep is assessed. Findings also contribute to an emerging evidence base supporting the importance of school climate to adolescent sleep quality.