Does Delivery Mode Matter? A Randomised Controlled Trial of the Sleeping Sound Intervention: Predicting Sleep Outcomes in Children With ADHD.

OBJECTIVE

The effectiveness of behavioural interventions to improve sleep in children with ADHD has been demonstrated, although most treatments are conducted in-person, with limited evidence for paediatric telehealth approaches. Study 1 is a randomised controlled trial evaluating the ADHD Sleeping Sound intervention to compare outcomes between in-person and telehealth modalities. Study 2 examined whether baseline sleep problems and treatment response were predicted by baseline symptom presentation, attachment security, and family functioning.

METHOD: Children aged 5 to 12 years (65.4% male) with ADHD received either in-person (n = 40) or telehealth (n = 38) treatment. Subjective (Children's Sleep Habits Questionnaire) and objective (actigraphy) sleep variables were assessed at baseline, post-intervention (1 week), and follow-up (3 months).

RESULTS

As expected, subjectively measured sleep disturbance significantly improved post-treatment, with no significant difference in rate of change between in-person and telehealth modalities. For Study 2, baseline measures comprised the Conners CBRS, Attachment Insecurity Screening Inventory, Security Scale, and Family Assessment Device. Latent growth curve modelling analysed data via intention-to-treat (primary) and per protocol (secondary) methods. Higher attachment insecurity and lower family functioning were significantly associated with greater (subjective) baseline sleep problems. Additionally, attachment security predicted changes in sleep duration over time, highlighting the importance of considering relational family factors when designing sleep interventions.

CONCLUSION

Telehealth ADHD sleep interventions represent a promising approach to enhancing health equity and access for families experiencing geographical and/or structural barriers to in-person treatment.Trial RegistrationANZCTR, ACTRN12621001681842. Registered 9 December 2021 - https://anzctr.org.au/ACTRN12621001681842.aspx.