Insomnia in adult attention-deficit/hyperactivity disorder: A comparison with borderline personality disorder population in a clinical setting and control participants

May 15, 2017Comprehensive psychiatry

Insomnia in adults with ADHD compared to those with borderline personality disorder and healthy people

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Abstract

ADHD patients reported higher insomnia and lower sleep quality compared to control subjects.

Individuals with ADHD and borderline personality disorder (BPD) experienced worse sleep quality and more severe insomnia than control participants.
No significant differences in overall sleep quality were found between ADHD and BPD patients.
Depression symptoms predominantly accounted for many sleep-related issues in both clinical groups.
ADHD sufferers exhibited longer sleep latency even after adjusting for depression.
Inattentive symptoms correlated with increased daytime sleepiness, while hyperactive/impulsive symptoms linked to insomnia and reduced sleep efficiency.

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OBJECTIVES: Many adults with attention-deficit/hyperactivity disorder (ADHD) report sleeping difficulties. The relationship between sleep and ADHD is poorly understood, and shows discrepancies between subjective and objective measures. In order to determine the specificity of sleep-associated symptoms in ADHD, subjective sleep assessments among ADHD adult patients were compared with control subjects and with individuals suffering from borderline personality disorder (BPD).

METHODS: 129 outpatients with ADHD, 70 with BPD (including 17 patients with BPD and ADHD comorbidity), and 65 control participants were assessed for sleep quality, insomnia, and sleepiness, using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS).

RESULTS: ADHD- and BPD-sufferers achieved higher insomnia and lower sleep quality scores than control subjects. Clinical groups did not differ in terms of sleep quality, although insomnia was more severe among BPD patients. Depression scores explained most of sleep symptoms, but even when controlling for depression, ADHD sufferers showed higher sleep latency. Inattentive symptoms were associated with somnolence, while hyperactive/impulsive symptoms were associated with insomnia and lower sleep efficiency.

CONCLUSION: Sleep-related symptoms associated with ADHD were partly explained by non-specific factors, especially depression symptoms. In a dimensional perspective, hyperactive and inattentive symptoms were associated with specific sleep symptoms.

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Insomnia in adult attention-deficit/hyperactivity disorder: A comparison with borderline personality disorder population in a clinical setting and control participants

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