The association between insomnia and sleep duration in adults with attention-deficit hyperactivity disorder: Results from a general population study

Dora Wynchank, Margreet ten Have, Denise Bijlenga, Brenda W. Penninx, Aartjan T. Beekman, Femke Lamers, Ronde Graaf, J. J.Sandra Kooij

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Insomnia and short or long sleep duration are important comorbid conditions in adults with attention-deficit hyperactivity disorder (ADHD), but reports of the association vary. In a general population study, we evaluated the relationship between ADHD symptom severity, insomnia symptoms, and sleep duration in adults. Methods: Data were from the third wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 4,618). ADHD symptom severity and symptom dimensions (hyperactivity and inattention) were assessed using the Adult ADHD Self-Report Scale screener. Self-reported insomnia symptoms (Insomnia Rating Scale; IRS) were defined as clinically relevant if IRS ≥9. Self-reported short sleep duration was defined as ≤6 hours, and long sleep duration as ≥10 hours. Results: Within the group with clinically relevant ADHD symptoms, 43% reported significant insomnia symptoms (odds ratio [OR] = 2.66, 95% confidence interval [CI] 1.74-4.07); 41% short sleep duration (relative risk ratio [RRR] = 1.94, 95% CI 1.31-2.85) and 6% long sleep (RRR = 5.87, 95% CI 1.97-17.45). Increased inattention symptoms were associated with IRS ≥9, short and long sleep duration in fully adjusted models (OR = 1.10, 95% CI 1.06-1.14; RRR = 1.06, 95% CI 1.02-1.09; RRR = 1.16, 95% CI 1.05-1.28, respectively). Increased hyperactivity symptoms were associated with IRS ≥9 (OR = 1.17, 95% CI 1.11-1.23) and short sleep duration (RRR = 1.12, 95% CI 1.05-1.19). Conclusions: Both clinically significant ADHD symptoms and inattention and hyperactivity symptom dimensions were consistently associated with insomnia symptoms and altered sleep duration. These associations confirm that sleep disturbances should be assessed and given appropriate clinical attention in adults with ADHD.

Original languageEnglish
Pages (from-to)349-357
Number of pages9
JournalJournal of Clinical Sleep Medicine
Volume14
Issue number3
DOIs
Publication statusPublished - 15 Mar 2018

Cite this

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title = "The association between insomnia and sleep duration in adults with attention-deficit hyperactivity disorder: Results from a general population study",
abstract = "Insomnia and short or long sleep duration are important comorbid conditions in adults with attention-deficit hyperactivity disorder (ADHD), but reports of the association vary. In a general population study, we evaluated the relationship between ADHD symptom severity, insomnia symptoms, and sleep duration in adults. Methods: Data were from the third wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 4,618). ADHD symptom severity and symptom dimensions (hyperactivity and inattention) were assessed using the Adult ADHD Self-Report Scale screener. Self-reported insomnia symptoms (Insomnia Rating Scale; IRS) were defined as clinically relevant if IRS ≥9. Self-reported short sleep duration was defined as ≤6 hours, and long sleep duration as ≥10 hours. Results: Within the group with clinically relevant ADHD symptoms, 43{\%} reported significant insomnia symptoms (odds ratio [OR] = 2.66, 95{\%} confidence interval [CI] 1.74-4.07); 41{\%} short sleep duration (relative risk ratio [RRR] = 1.94, 95{\%} CI 1.31-2.85) and 6{\%} long sleep (RRR = 5.87, 95{\%} CI 1.97-17.45). Increased inattention symptoms were associated with IRS ≥9, short and long sleep duration in fully adjusted models (OR = 1.10, 95{\%} CI 1.06-1.14; RRR = 1.06, 95{\%} CI 1.02-1.09; RRR = 1.16, 95{\%} CI 1.05-1.28, respectively). Increased hyperactivity symptoms were associated with IRS ≥9 (OR = 1.17, 95{\%} CI 1.11-1.23) and short sleep duration (RRR = 1.12, 95{\%} CI 1.05-1.19). Conclusions: Both clinically significant ADHD symptoms and inattention and hyperactivity symptom dimensions were consistently associated with insomnia symptoms and altered sleep duration. These associations confirm that sleep disturbances should be assessed and given appropriate clinical attention in adults with ADHD.",
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author = "Dora Wynchank and {ten Have}, Margreet and Denise Bijlenga and Penninx, {Brenda W.} and Beekman, {Aartjan T.} and Femke Lamers and Ronde Graaf and Kooij, {J. J.Sandra}",
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The association between insomnia and sleep duration in adults with attention-deficit hyperactivity disorder : Results from a general population study. / Wynchank, Dora; ten Have, Margreet; Bijlenga, Denise; Penninx, Brenda W.; Beekman, Aartjan T.; Lamers, Femke; Graaf, Ronde; Kooij, J. J.Sandra.

In: Journal of Clinical Sleep Medicine, Vol. 14, No. 3, 15.03.2018, p. 349-357.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - The association between insomnia and sleep duration in adults with attention-deficit hyperactivity disorder

T2 - Results from a general population study

AU - Wynchank, Dora

AU - ten Have, Margreet

AU - Bijlenga, Denise

AU - Penninx, Brenda W.

AU - Beekman, Aartjan T.

AU - Lamers, Femke

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AB - Insomnia and short or long sleep duration are important comorbid conditions in adults with attention-deficit hyperactivity disorder (ADHD), but reports of the association vary. In a general population study, we evaluated the relationship between ADHD symptom severity, insomnia symptoms, and sleep duration in adults. Methods: Data were from the third wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 4,618). ADHD symptom severity and symptom dimensions (hyperactivity and inattention) were assessed using the Adult ADHD Self-Report Scale screener. Self-reported insomnia symptoms (Insomnia Rating Scale; IRS) were defined as clinically relevant if IRS ≥9. Self-reported short sleep duration was defined as ≤6 hours, and long sleep duration as ≥10 hours. Results: Within the group with clinically relevant ADHD symptoms, 43% reported significant insomnia symptoms (odds ratio [OR] = 2.66, 95% confidence interval [CI] 1.74-4.07); 41% short sleep duration (relative risk ratio [RRR] = 1.94, 95% CI 1.31-2.85) and 6% long sleep (RRR = 5.87, 95% CI 1.97-17.45). Increased inattention symptoms were associated with IRS ≥9, short and long sleep duration in fully adjusted models (OR = 1.10, 95% CI 1.06-1.14; RRR = 1.06, 95% CI 1.02-1.09; RRR = 1.16, 95% CI 1.05-1.28, respectively). Increased hyperactivity symptoms were associated with IRS ≥9 (OR = 1.17, 95% CI 1.11-1.23) and short sleep duration (RRR = 1.12, 95% CI 1.05-1.19). Conclusions: Both clinically significant ADHD symptoms and inattention and hyperactivity symptom dimensions were consistently associated with insomnia symptoms and altered sleep duration. These associations confirm that sleep disturbances should be assessed and given appropriate clinical attention in adults with ADHD.

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KW - General Population Survey

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