Hande Emine Sabah Baris, Sibel Fatma Durak, Nagihan Cevher Binici, Mert Coban
Klinik Psikiyatri Dergisi - 2026;29(1):41-52
Objective: This study examined functional impairment, sleep disturbances, and chronotype characteristics in children with the Predominantly Inattentive Presentation of ADHD (ADHD-PI), the Restrictive ADHD phenotype (ADHD-R), and typically developing controls. Method: A cross-sectional study was conducted with 104 children aged 7-12 years: ADHD-PI (n=34), ADHD-R (n= 36), and Control group (n=34). Parent-rated measures included the CSHQ (The Children's Sleep Habits Questionnaire), CCQ ( Children's Chronotype Questionnaire) , and WFIRS-P (Weiss Functional Impairment Rating Scale - Parent Form). All participants had an IQ above 80 and were free of comorbid psychiatric or medical conditions. Subgroup analyses were performed based on functional impairment status, and group comparisons were made on sleep-related and chronotype variables. Results: Functional impairment was significantly more common in both ADHD groups (ADHD-PI: 67%, ADHD-R: 61%) compared to control group (5.9%) (p < .001). Both clinical groups showed greater daytime sleepiness. Although no statistically significant group differences were found in eveningness scores, the ADHD-R group exhibited higher eveningness tendencies compared to both the ADHD-PI and healthy control groups. In ADHD-PI, functional impairment was associated with delayed sleep onset, parasomnia, and sleep-disordered breathing. In ADHD-R, higher sleep disturbance, parasomnia, and longer sleep duration were observed in the impaired group. However, these variables did not significantly predict impairment. Oppositional defiant behavior scores significantly predicted functional impairment within the ADHD-R group. Discussion: Sleep problems-particularly parasomnias-are associated with greater functional impairment in ADHD. Addressing sleep disturbances may contribute to improving daily functioning and quality of life in affected children.
