Multi-informant Examination of Cognitive Disengagement Syndrome in Relation to Sleep and Circadian Preference in Early Adolescents

Considerable research has documented an association between attention-deficit/hyperactivity disorder (ADHD) and poor sleep functioning, yet few studies have examined the potential role of frequently co-occurring cognitive disengagement syndrome (CDS). Further, extant studies have used non-optimal measures of CDS and/or sleep, small sample sizes, or rarely focus on adolescence when sleep problems often emerge and worsen, and few have controlled for depressive symptoms which are strongly associated with both CDS and poorer sleep functioning. Accordingly, we used a multi-informant design to examine CDS, ADHD, and depressive symptoms in relation to sleep disturbance, daytime sleep-related impairment, and circadian preference in a sample of 341 early adolescents (ages 10-12). Adolescents, caregivers, and teachers completed measures of CDS, ADHD, and depression. Adolescents and caregivers completed the patient-reported outcome measurement information system (PROMIS) sleep disturbance and sleep-related impairment scales; adolescents also completed a measure of circadian preference. Multivariate regression analyses examined CDS, ADHD, and depressive symptoms in relation to sleep functioning. Across models with different informants, CDS symptoms were more consistently associated than ADHD dimensions with greater sleep-related impairment and sleep disturbance. In contrast, only self-reported ADHD inattentive symptoms were independently associated with greater eveningness preference. This study provides further evidence of the unique association between CDS and sleep disturbance and sleep-related impairment, raising the possibility that the established association between ADHD and sleep disturbance may be in part due to or exacerbated by co-occurring CDS. Additional longitudinal research is needed to examine the directionality of effects and impact of sleep interventions on CDS.