Sleep Dysfunction and Neurocognitive Outcomes in Adolescent ADHD

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Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescence is frequently predictive of detrimental academic and social outcomes. In part, poor functioning may be due to neurocognitive deficits observed in ADHD; however, the extent of these deficits is variable and the mechanisms contributing to greater impairment in some youth and not others are poorly understood. Sleep disturbance represents one potential contributor to the neurocognitive deficits observed in a subset of youth with ADHD. Specifically, disturbed sleep is prevalent in ADHD and there is considerable overlap between core ADHD features and the neurocognitive correlates of sleep impairment. However, associations between sleep physiology and variable clinical and neurocognitive outcomes in adolescents with ADHD have yet to be investigated. The parent project uses polysomnography to assess sleep disturbance and neurocognitive outcomes in adolescents with ADHD and healthy controls (HC). The primary hypothesis predicts that adolescents with ADHD will display reduced duration, increased latency, increased nocturnal awakenings, reduced delta power, and disrupted sleep spindles compared to HC. Variability within groups is predicted, and we will explore whether there are distinct subgroups with and without sleep problems within the ADHD group. In addition, sleep disturbance is predicted to be associated with poorer neurocognitive and clinical presentations in adolescents with ADHD. If these hypotheses are supported, sleep disturbance may represent a biomarker for phenotypic subtypes of ADHD. Examining this construct may also inform development of prevention and intervention strategies with the potential to impact sleep disturbance and core symptoms of ADHD in adolescents. The career development goal of the parent K23 Mentored Patient- Oriented Research Career Development Award is to broaden Dr. Jessica Lunsford-Avery's expertise in sleep disturbance and neurocognition in adolescents with ADHD. Training objectives include gaining expertise in advanced laboratory-based administration, scoring, and analysis of polysomnographic data; assessment of neurocognitive and clinical correlates of sleep impairment in ADHD; and enhanced understanding of developmental trajectories of sleep in typically developing adolescents and those with ADHD. These objectives are underway through mentoring, research, and coursework, which will result in an independently funded program of research to elucidate the biological mechanisms underlying sleep problems and neurocognitive impairment in ADHD and develop innovative sleep-based interventions targeting core symptoms in this population. The proposed supplement addresses both research and career development objectives and will allow for 1) provision of essential training in scoring of polysomnographic data for spectral analysis and translational research, 2) data processing and analysis, and 3) preparation of manuscripts and R01 grant applications. Moreover, the proposed supplement will offset the loss of time and effort associated with COVID- 19 and will provide the necessary resources to support Dr. Lunsford-Avery's transition to independence.