0176 Sleep Restriction in Adolescents Alters Caregiver-Child Discrepancy in Detecting Adolescent Fatigue

Abstract Introduction Adolescents are susceptible to insufficient sleep due to competing bioregulatory and social pressures, with consequences for daytime fatigue. In the context of attention-deficit/hyperactivity disorder (ADHD), caregivers may misconstrue fatigue and ADHD traits. We examined how caregivers and youth differ in detecting the impact of sleep restriction on adolescent fatigue and sleep disturbances. Methods Data were analyzed from 50 adolescents (range: 10.1-15.7 [12.3±1.6] years; 25F) who completed two counterbalanced at-home 5-night sleep conditions: sleep optimization (SO; 10h TIB) vs. sleep restriction (SR; 7.5h TIB). Both caregiver and child completed the PROMIS short form evaluating youth fatigue and sleep disturbances after each sleep schedule. ADHD traits were indexed by Conners 3 T-scores for inattention (range: 40-90; 64.28±14.29) and hyperactivity-impulsivity (range: 40-90; 65.59±17.35). Linear mixed models assessed interactions and main-effects of condition (SO vs. SR), respondent (caregiver vs. child), and ADHD traits (separate models for inattention and hyperactivity-impulsivity), on PROMIS T-scores. Results We identified a significant condition-by-rater interaction for fatigue T-scores (F(1,130.6)=4.54, β=4.04, p=.035). After SR, caregivers rated child fatigue higher than adolescent self-report (caregiver: 49.05±8.83; adolescent: 44.19±7.83; (F(1,130.7)=9.30, β=-4.91, p<.01); this distinction was not present after SO (caregiver: 43.82±7.30; adolescent: 42.95±8.85; (F(1,130.7)=9.30, β=0.87, p>.05). For sleep disturbances, we only identified a main-effect of rater (adolescent>caregiver; caregiver: 52.62±8.52, adolescent: 62.72±3.25; (F(1,132.8)=139.6, β=-10.09, p<.001) with no interaction of rater by condition or main-effect of condition (ps>.05). ADHD symptoms did not moderate any findings (all ps>.05). Conclusion Caregivers rated higher adolescent fatigue after sleep restriction compared to adolescents’ self-report; raters did not differ after sleep optimization. Caregivers rated lower levels of sleep disturbances compared to youth overall. These effects indicate that sleep restriction amplifies a discordance between adolescents’ experience of fatigue and their caregivers’ perception of that experience. These data join a larger literature indicating potentially incongruent self-perception of the consequences of sleep loss. Support (if any) R01HD103665 (PI: JMS), P20GM139743 (PI: MAC)