Insomnia, Alcohol Consumption and ADHD Symptoms in Adults.

Astri J Lundervold,Jan Haavik,Daniel A Jensen

doi:10.3389/fpsyg.2020.01150

Abstract

IntroductionSubstance use disorders and insomnia are common in the general population, and particularly among adults with attention-deficit/hyperactivity disorder (ADHD). Here we investigated the relationship between insomnia, alcohol consumption and ADHD symptoms.MethodsAdults with an ADHD diagnosis (n = 235, 41.3% males) and controls (n = 184, 38% males) completed a questionnaire assessing insomnia (Bergen Insomnia Scale), alcohol consumption (Alcohol Use Disorders Identification Test), and current ADHD symptoms (Adult ADHD Self-report Scale). The majority of the sample (95%) gave additional information about childhood ADHD symptoms (Wender Utah Rating Scale), and information about lifetime occurrence of an internalizing disorder was included as part of background information.ResultsCompared to controls, the ADHD group reported a higher frequency of insomnia, a higher quantity of consumed alcohol and a higher frequency of internalizing disorders. Current and childhood ADHD symptoms were more severe in those with than without insomnia. Scores on ADHD symptom scales were explained by the presence of insomnia and internalizing disorders, while the contribution from alcohol consumption was restricted to the control group.DiscussionThe high functional impact of insomnia, alcohol misuse and internalizing disorders is well known. The present study contributed by focusing on their relations to ADHD symptoms, and by showing that strong relations were not restricted to adults with a clinical ADHD diagnosis. By this, the results put a critical light on a categorical delineation between adults with an ADHD diagnosis and population selected controls, and call for further studies including dimensional metrics of ADHD symptoms and co-occurring problems.

Highlights

Substance use disorders and insomnia are common in the general population, and among adults with attention-deficit/hyperactivity disorder (ADHD)
This implies that individuals with Attention-deficit/hyperactivity disorder (ADHD) may have high rates of comorbid insomnia and that insomnia patients may have ADHD, and makes it reasonable to expect that adults with sleep problems in the general population may display symptoms typically associated with ADHD
The present study indicated a strong impact of insomnia and the presence of lifetime internalizing disorders on core symptoms of ADHD, but the direction of the causality could not be stated from the available data

Summary

Introduction

Substance use disorders and insomnia are common in the general population, and among adults with attention-deficit/hyperactivity disorder (ADHD). The severity of sleep problems and ADHD symptoms are shown to be predictors of persistent sleep problems, Gregory et al.’s (2017) longitudinal twin study concluded that the risk for sleep problems in adulthood was restricted to those with an ADHD diagnosis persisting from childhood This result emphasizes the importance of including information about childhood symptoms in studies of sleep problems in adults with ADHD, and to be ready to explore associations between insomnia and ADHD symptoms in individuals without a formal ADHD diagnosis. In the ADHD group, the proportion of participants reporting insomnia and internalizing disorders were similar among adults who reported that they had been diagnosed with ADHD during childhood and participants who had been diagnosed as adults, and the symptom scores were not significantly different between the two ADHD subgroups (p > 0.01).

Methods

Discussion

Conclusion