Abstract Introduction Attention Deficit and Hyperactivity Disorder (ADHD) is becoming more acknowledged as a common problem among adults, garnering greater interest from researchers lately. The consequences of undiagnosed or untreated ADHD in adults can be significant. Numerous individuals face challenges in their work and everyday activities, resulting in increased stress. This, in turn, can cause sleep issues, making it harder to maintain concentration. Methods The initial study involved 15,929 participants across 15 US States. The longitudinal research took place in eight of the most densely populated states. During the first wave of interviews (W1), 12,218 subjects were contacted via phone, and 10,930 returned for the follow-up interview (W2) three years later. Analyses focused solely on those who participated in both W1 and W2 (N=10,930). ADHD was identified using DSM-5 criteria. Results At W1, 5.7% of participants met the ADHD criteria, but this percentage fell to 4.5% at W2. The disorder was more common in men than in women (6.6% compared to 5.0%; p< 0.001), and the rates decreased among individuals aged 55 and older (6.2% to 7.8% for those under 55, 5.3% for those aged 55 to 64, and 2.6% for those 65 and above; p< 0.001). ADHD was persistent in 47.4% of the cases across both interviews. After adjusting for age and gender, and controlling for the presence of a mental disorder and sleep duration, ADHD continued to be a strong indicator for insomnia symptoms (AOR: 1.69; 95% C.I.: 1.4-2.0), severe fatigue (AOR: 2.97; 95% C.I.: 2.2-4.0), and significant daytime sleepiness (AOR: 2.45; 95% C.I.: 1.9-3.2). At W2, a sleep duration of less than 7 hours (AOR: 1.66; 95% C.I.: 1.2-2.3), trouble falling asleep (AOR: 3.41; 95% C.I.: 2.0-5.8), and moderate (AOR: 3.39; 95% C.I.: 2.0-5.7) or severe fatigue (AOR: 4.5; 95% C.I.: 2.6-7.9) at the initial interview were predictors of ADHD incidence. Conclusion The rate of ADHD in adults within the general population started at 5.7%, but this figure declined over three years. There is a significant link to sleep issues, as it can predict insomnia, fatigue, and significant sleepiness, and is also related to reduced sleep duration. Support (if any)
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