Sleep, executive functions, and functional impairment in children with specific learning disorder: An investigation of the mediating pathways

Abstract

Objective

Sleep problems and executive dysfunction are associated with functional impairment in children with neurodevelopmental disorders. In this study, we aimed to investigate these aspects in children with Specific Learning Disorders (SLD) and SLD with comorbid Attention-Deficit Hyperactivity Disorder (ADHD), while also evaluating differences with typically developing (TD) children. Our study hypothesizes that children with SLD, especially those with comorbid ADHD, face greater sleep disturbances and executive function challenges compared to TD peers. We also propose that sleep disturbances aggravate functional impairment and that executive functions mediate this relationship.

Method

The data obtained from psychiatric evaluations, semi-structured interviews and questionnaires filled out by parents were analyzed.

Results

SLD + ADHD group had worse scores in all scales, followed by SLD and TD groups. Mediator analysis demonstrated that executive functions had a mediator role in the relationship between sleep problems and functional impairment.

Conclusion

Our findings suggest that children with SLD experience more significant difficulties in daily living than their typically developing peers and having ADHD comorbidity, poor executive functions, and additional sleep problems can further exacerbate impairment. Notably, our mediation analysis suggests that executive functions mediate the relationship between sleep disturbances and the severity of functional impairments.

Keywords:

• Attention-Deficit hyperactivity disorder
• executive functions
• functional impairment
• specific learning disorder

Acknowledgments

We would like to thank all the children and their families who participated in the study. In addition, we would like to thank F. Yağmur Evcil for her help with the statistical analysis. The authors declare that this study received no external funding in any way. Margaret D. Weiss has received consulting fees from Ironshore, Revibe, and Peri. The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Disclosure statement

The authors have no competing interests to declare that are relevant to the content of this article. The authors did not receive support from any organization for the submitted work. Participants (both children and parents) gave informed consent for the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.