Moderate-to-vigorous physical activity and behavioral outcomes in adolescents with attention deficit and hyperactivity disorder: The role of sleep

Background: Attention deficit and hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has a worldwide prevalence of 7.2%. Individuals with ADHD often have sleep and behavioral problems. Objective: This cross-sectional survey aims to investigate the relationships between moderate-tovigorous physical activity (MVPA), sleep, bullying, and school engagement in adolescents with ADHD. Methods: Data were obtained from the 2011-2012 National Survey of Children?s Health. A subsample (n 1/4 272) that fit the inclusion criteria was included. Path analysis was used to test the hypothesized model (i.e., MVPA -> sleep -> bullying/school engagement). Results: The proposed model fit the data well. MVPA was found to be associated with sleep, bullying, and school engagement. In addition, sleep mediated the relationship between MVPA and bullying/school engagement. Conclusions: MVPA and sleep play an important role in understanding behavioral outcomes in adolescents with ADHD. Longitudinal or intervention studies are needed to support the present findings. ? 2020 Elsevier Inc. All rights reserved.