Abstract
BACKGROUND: Previous studies have reported eating and sleep issues in children with attention deficit hyperactivity disorder (ADHD), but few have focused on those comorbid with overweight/obesity. This study aimed to investigate eating behavior and sleep habit problems in children with ADHD and comorbid overweight/obesity, and their relationship with ADHD core symptoms in such children. METHODS: The study included 124 children with ADHD and overweight/obesity and 145 children with ADHD and normal weight. The Children's Eating Behavior Questionnaire, Children's Sleep Habit Questionnaire, and Vanderbilt ADHD Diagnostic Parent Rating Scale were used to assess eating behavior problems, sleep habit problems, and core ADHD symptoms, respectively. RESULTS: Compared to the normal-weight children with ADHD, those with overweight/obesity scored higher in food responsiveness, enjoyment of food, night waking, sleep-disordered breathing, and daytime sleepiness, while lower in satiety responsiveness, slowness in eating, and emotional undereating. Lower scores of satiety responsiveness and slowness in eating were associated with the presence of overweight or obesity among children with ADHD. In the ADHD overweight/obesity group, shorter sleep duration was correlated with higher body mass index (BMI), and higher food responsiveness was associated with more severe attention deficit symptoms. CONCLUSIONS: Children with ADHD and overweight/obesity reported more eating and sleep problems than those with normal weight. Lower satiety response and faster eating rate may be potential risk factors for overweight/obesity in children with ADHD. Among those with comorbid overweight/obesity, shorter sleep duration associates with higher BMI, and greater food responsiveness relates to more severe attention deficit symptoms. These findings suggest eating and sleep behaviors should be considered in ADHD management, with further research needed on targeted interventions.