A – 34 Does Better Sleep Reserve More Executive Functions for Children and Adolescents with ADHD?

Abstract Objective Attention-Deficit/Hyperactivity Disorder (ADHD) is commonly associated with deficits in executive functions (EF), yet findings on potential protective factors such as sleep quantity and quality remain mixed. This study aimed to examine the effects of sleep quantity and quality on EF among children and adolescents with ADHD. Method This archival study utilized quantitative data from 121 children and adolescents (ages 8–17) diagnosed with ADHD from San Francisco Neuropsychology PC database. Participants were included based on diagnostic criteria and excluded if they had comorbid conditions such as neurocognitive disorders, autism spectrum disorder, severe psychiatric disorders, or sleep apnea. Average sleep duration and sleep quality were extracted from intake form and clinical interviews. Global EF was calculated by aggregating 25 standardized subtest scores targeting EF domains from instruments including the WISC/WAIS, D-KEFS, NEPSY, WCST, CPT-III, etc. Standard scores were used to harmonize data across measures. Results With controlling for gender, no significant differences in global EF between children with normal versus abnormal sleep quality, t(114) = -1.34, p = .18. However, longer sleep duration was significantly associated with poorer performance on global EF (B = -2.83, β = -0.44, p < .001). Conclusion Findings suggest that sleep quality was not associated with EF, longer sleep duration was linked to poorer performance on EF tasks. This result highlights that more sleep is not necessarily protective for children with ADHD, aligning with prior research suggesting that longer sleep may reflect poor sleep quality or compensatory patterns rather than cognitive benefit, which may contribute to future targeted intervention strategies.