Sleep in adults with attention-deficit/hyperactivity disorder: a controlled polysomnographic study including spectral analysis of the sleep EEG.
OBJECTIVE
Previous studies in children with attention-deficit/hyperactivity disorder and attention deficit disorder (ADHD/ADD) have shown impaired sleep quality with increased nocturnal motor activity. However, polysomnographic findings are not unequivocal. Up to now, in adults with ADHD, only 1 case-control polysomnographic study with small sample size has been performed. We investigated objective and subjective sleep quality in adultADHD, including an electroencephalogram spectral power analysis.


METHODS
Single-blind comparative study.


METHODS
University medical center.


METHODS
Twenty adult unmedicated ADHD patients without current comorbid major depression, drug abuse, or comorbid axis-II disorder and 20 sex- and age-matched control subjects.


METHODS
N/A.


METHODS
Conventional polysomnographic parameters and sleep electroencephalogram spectral power analysis was calculated for the 2 laboratory nights. Subjective sleep parameters were estimated by sleep questionnaires to assess the relationship between objective and subjective sleep measurements.


RESULTS
Adult ADHD patients showed increased nocturnal motor activity (as indicated by heightened indexes of periodic leg movements in sleep), which was significantly inversely correlated with subjective total sleep time. Although ADHD patients displayed significantly increased objective total sleep time, the subjective ratings documented impaired sleep quality in those with ADHD. Other polysomnographic sleep patterns and spectral electroencephalogram parameters did not differ between ADHD patients and normal controls.


CONCLUSIONS
Similar to children, adults with ADHD show increased nocturnal motor activity. Otherwise, sleep does not seem to be impaired in ADHD patients. However, the dissociation between objective and subjective sleep parameters points to a misinterpretation of sleep quality in patients with ADHD.
Philipsen
Alexandra
A
Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Germany. alexandra_philipsen@psyallg.ukl.uni-freiburg.de
Feige
Bernd
B
Hesslinger
Bernd
B
Ebert
Dieter
D
Carl
Christine
C
Hornyak
Magdolna
M
Lieb
Klaus
K
Voderholzer
Ulrich
U
Riemann
Dieter
D
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D016037:Single-Blind Method; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*