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Adults With Untreated ADHD May Spend Longer in Deep Sleep Stage
Adults living with untreated attention-deficit/hyperactivity disorder (ADHD) may spend more time in slow wave sleep (SWS) than their non-ADHD counterparts. Retrospective study results were published in the Journal of Attention Disorders.
“Polysomnographic findings in neurodevelopmental disorders have been reported, but previous studies have had several limitations,” wrote Takao Kato, MD, PhD candidate, Department of Neuropsychiatry, Kurume University School of Medicine, Japan, and co-authors. “The purpose of this study was to characterize sleep structure in untreated adults diagnosed with ADHD, excluding ADHD-related sleep disorders as determined by polysomnography and multiple sleep latency testing.”
The authors recruited 55 patients who visited the Kurume University Hospital Sleep Clinic between April 2015 and March 2020. Of the group, 28 had been diagnosed with ADHD and 27 had not. No participant had a history of mental illness or pharmacological treatment for ADHD.
During their visit to the sleep clinic, the individuals were evaluated through multiple sleep scale instruments as well as polysomnography (PSG) and multiple sleep latency tests following a 1-week actigraphy sleep assessment. Researchers compared differences in outcome between the ADHD group and control group.
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On subjective sleep measures, the 2 groups differed on the Japanese version of the Epworth Sleepiness Scale (ESS) (mean, 16 vs 13.1 points; P=0.0307), the Pittsburg Sleep Quality Index (PSQI) (mean, 2.6 vs 1.9 points; P=0.0367) and the Morningness-Eveningness Questionnaire Self-Assessment (MEQ-SA) (mean, 39.6 vs 44.9; P=0.0457).
As for PSG measures, the ADHD group exhibited a significantly shorter time to wake following sleep onset compared with controls (mean, 38.4 vs 64.4 minutes; P=0.0127). The ADHD group also spent a greater amount of time in sleep stage 3 (mean, 42.2 vs 24.8 minutes; P=0.0005) and SWS (mean, 68.3 vs 43.4 minutes; P=0.065), compared with controls.
The researchers also observed among the ADHD group significant correlations between SWS time and PSQI sleep quality (r, 0.5073; P=0.0224, PSG sleep quality (r, 0.7885; P=0.0014, and ESS scores (r, 0.4324; P=0.0348).
“Sleep structure problems may provide powerful insights for understanding the pathogenesis of ADHD. The increased amount of SWS in untreated adult patients with ADHD identified in this study may suggest the immaturity of the central nervous system in ADHD,” the study authors wrote in the conclusion. “In the future, we believe that a longitudinal study of SWS in untreated patients, especially focusing on stage 3, could contribute to a better understanding of the pathogenesis of ADHD.”
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