Adults with Attention Deficit Hyperactivity Disorder Report High Symptom Levels of Troubled Sleep, Restless Legs, and Cataplexy

Abstract

Objective: To compare the occurrence of a spectrum of different self-reported sleep problems in adults with ADHD and a control group, and to study the impact of current ADHD medication use and clinical ADHD subtype.Method: Cross-sectional study of 268 clinically ascertained adult ADHD patients (DSM-IV criteria) and 202 randomly selected controls. Sleep problems were self-reported using validated questions, partly from Global Sleep Assessment Questionnaire.Results: ADHD patients reported more sleep problems than controls: Lifetime occurrence of sleep problems (82.6 vs. 36.5%), hypnotics use (61.4 vs. 20.2%), current sleep duration below 6 h (26.6 vs. 7.6%), and symptoms/signs during the past 4 weeks of excessive daytime sleepiness, cataplexy, loud snoring, breathing pauses during sleep, restless legs, and periodic limb movements in sleep (significant odds ratios ranged from 1.82 to 14.55). Current ADHD medication use was associated with less cataplexy compared with not using medication. Patients with inattentive subtype reported better sleep quality and less restless legs than patients with hyperactive/impulsive subtypes.Conclusions: Adults with ADHD reported a very high occurrence of many different self-reported sleep problems, underlining the importance of screening for sleep disorders. Among the ADHD patients, medication use was not associated with more sleep-related symptoms, but in fact less cataplexy. When comparing ADHD subtypes, the inattentive subtype was associated with less sleep problems.

The key role of daytime sleepiness in cognitive functioning of adults with attention deficit hyperactivity disorder

“…Therefore, a simple brain mechanism underlying sleep deprivation and the resulting daytime sleepiness in ADHD emerges. As adults with ADHD are more severely sleep deprived compared to neurotypical control subjects [5] and are more vulnerable to sleep deprivation [11], in various neurocognitive tasks, they should manifest larger sleepiness-related reductions in cognitive performance. Many of the cognitive performance deficits might be linearly related to the level of daytime sleepiness.…”

“…A total of 50-70% of adults with ADHD experience sleep disorders [3,4]. They also report higher daytime sleepiness [5] and lower sleep quality [6][7][8][9] compared to neurotypical controls. These difficulties have a negative influence on quality of life [10] and make management of ADHD and diagnostic differentiation much more challenging, as they result in ADHD-like symptoms [11][12][13].…”

The effects of emotional lability, mind wandering and sleep quality on ADHD symptom severity in adults with ADHD

“…Excessive daytime sleepiness due to disrupted sleep is extremely common in the general population [31] as well as in children and adults with ADHD [32, 33]. Furthermore, adults with ADHD report higher excessive daytime sleepiness relative to healthy controls [34]. A variety of sleep problems are associated with ADHD [35].…”

Leg Movement Activity During Sleep in Adults With Attention-Deficit/Hyperactivity Disorder

“…The complex relationship between sleep and attention-deficit/hyperactivity disorder (ADHD) has been widely investigated, especially in children ( 1 , 2 ). Given the high prevalence of sleep disturbances subjectively reported by these patients ( 2 – 4 ), researchers have been encouraged to further investigate the characteristics of sleep in ADHD by using instrumental tools, such as actigraphy and polysomnography (PSG) ( 2 ). While a number of PSG studies highlighted some differences in sleep macro- and/or microstructure between ADHD and healthy control subjects ( 5 – 8 ), others could not find robust evidence of a different sleep pattern in the two groups ( 9 – 13 ).…”