Prevalence and clinical correlates of insomnia in adults with attention‐deficit hyperactivity disorder

Abstract

Brevik EJ, Lundervold AJ, Halmøy A, Posserud MB, Instanes JT, Bjorvatn B, Haavik J. Prevalence and clinical correlates of insomnia in adults with attention-deficit hyperactivity disorder Objective: To investigate the prevalence of insomnia in adults with Attention-deficit hyperactivity disorder (ADHD) and its association with clinical subtypes, current ADHD symptoms, and stimulant treatment. Method: We obtained diagnostic information, symptom rating scales and treatment history from clinically ascertained adult ADHD patients diagnosed according to DSM-IV criteria (n = 268, mean age 38.1 years) and randomly selected population controls (n = 202, mean age 36.5 years). The Bergen Insomnia Scale (BIS) was used to measure insomnia. ADHD symptom domains were self-rated using the Adult ADHD Self-Rating Scale. Results: Insomnia was far more frequent among adults with ADHD (66.8%) than in the population controls (28.8%) (P < 0.001). Insomnia was more common in adults with the combined subtype than in those with the inattentive subtype (79.7% and 55.6%, respectively) (P = 0.003). For self-reported current ADHD symptoms, inattention was strongly correlated to insomnia. Patients currently using stimulant treatment for ADHD reported a lower total insomnia score compared to patients without medication (P < 0.05). Conclusion: Insomnia was highly prevalent among adults with ADHD. The lower insomnia score in patients on current stimulant treatment suggests that stimulant treatment is not associated with worsening of insomnia symptoms in adult ADHD patients. Significant Outcomes• Insomnia is highly relevant in adult ADHD, with a fivefold increased risk compared with controls • Stimulant treatment of ADHD in adults is not associated with worsening of insomnia, and may potentially even be helpful in alleviating insomnia symptoms• Insomnia was more common in the combined and hyperactive/impulsive subtypes than in the inattentive subtype 220

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

“…In line with this, as many as 61.5% of ADHD patients reported having used hypnotics, which was three times more often than among controls. We recently published data on insomnia in this sample, showing that 66.8% of the ADHD patients compared with 28.8% of the controls fulfilled the DSM-IV criteria for insomnia disorder (Brevik et al, 2017 ). These findings clearly indicate that sleep problems are common and clinically severe among adults with ADHD, and corroborate findings from other studies (Surman et al, 2009 ; Fisher et al, 2014 ; Hvolby, 2015 ; Instanes et al, 2016 ).…”

“…The data were collected between 2011 and 2015. More details about the study can be found elsewhere (Brevik et al, 2017 ).…”

Individualization of attention-deficit/hyperactivity disorder treatment: pharmacotherapy considerations by age and co-occurring conditions

“…189 Insomnia occurs in 55% to 80% of adults with ADHD, with the combined ADHD subgroup showing higher rates of insomnia than the inattentive subgroup. 190 Initial insomnia is a frequent side effect when starting an ADHD medication, although patients may experience an improvement in sleep quality with appropriate treatment over time. [191][192][193][194] In our experience, a medication with too long of a duration may exacerbate insomnia for some individuals, while, for others, a formulation with a small amount of medication released in the early evening may help to calm the brain, decrease restlessness, and improve sleep quality.…”

Health, lifestyle habits, and physical fitness among adults with ADHD compared with a random sample of a Swedish general population

“…Mood disorders and anxiety disorders are common in both men and women across all age groups Fayyad et al, 2016). Adult ADHD is also associated with sleep problems, especially insomnia (Brevik et al, 2017), which are well-known risk factors for increased risk of somatic health problems: e.g. being overweight, developing Type 2 diabetes or cardiovascular disease, and premature death in the general population (Clark et al, 2016;Ikehara et al, 2009;Medic, Wille, & Hemels, 2017).…”