Effects of transdiagnostic group treatment for sleep disturbances in adult attention-deficit/hyperactivity disorders and autistic spectrum disorder: a pilot study

Miho Ishii; Wakako Ito; Yuki Karube; Yuko Ogawa; Anna Tagawa; Shunta Maeda; Hideki Sato; Toru Takahashi; Natsumi Inomata; Hajime Narisawa; Yoshikazu Takaesu; Koichiro Watanabe; Isa Okajima

doi:10.1007/s41105-021-00351-8

Effects of transdiagnostic group treatment for sleep disturbances in adult attention-deficit/hyperactivity disorders and autistic spectrum disorder: a pilot study

Sleep Biol Rhythms. 2021 Nov 10;20(2):173-180. doi: 10.1007/s41105-021-00351-8. eCollection 2022 Apr.

Authors

Miho Ishii^{1

2}, Wakako Ito³, Yuki Karube⁴, Yuko Ogawa⁵, Anna Tagawa^{3

6}, Shunta Maeda⁷, Hideki Sato^{8

9}, Toru Takahashi¹⁰, Natsumi Inomata¹¹, Hajime Narisawa¹², Yoshikazu Takaesu¹³, Koichiro Watanabe¹, Isa Okajima^{3

14}

Affiliations

¹ Department of Neuropsychiatry, School of Medicine, Kyorin University, Tokyo, Japan.
² Senzoku Stress Coping Support Office, Tokyo, Japan.
³ Institute of Neuropsychiatry, Tokyo, Japan.
⁴ Department of Clinical Psychology, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan.
⁵ Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan.
⁶ Department of Neuropsychiatry, NTT Medical Center Tokyo, Tokyo, Japan.
⁷ Graduate School of Education, Tohoku University, Miyagi, Japan.
⁸ Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁹ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
¹⁰ Faculty of Human Sciences, Waseda University, Saitama, Japan.
¹¹ Medical Corporation Johohkai, Tokyo, Japan.
¹² Department of Psychology, Aichi Shukutoku University, Aichi, Japan.
¹³ Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
¹⁴ Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan.

Abstract

Although adult patients with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often have sleep problems, few studies have verified the effect of a psychological approach specific to sleep-wake rhythms on these sleep disturbances. Therefore, the aim of this pilot study was to develop a trans-diagnostic approach with sleep scheduling and regularity of sleep duration as core modules, and to examine the effect of the intervention in adult ADHD and/or ASD subjects with sleep disturbances. This was a within-group pilot study. Ten patients with adult ADHD and/or ASD with sleep disturbances (10 males, age: 27.4 ± 5.6 years) took part in a 90-min weekly group intervention for 5 weeks. All participants were assessed on scales for sleep complaints, anxiety, depression, and symptoms of ADHD and ASD before and after the intervention, and at 3-month follow-up. The results showed that the intervention significantly improved sleep disturbances at post-intervention (p = 0.003, d = 1.30, 95% CI 0.31-2.28) and at the 3-month follow-up (p = 0.035, d = 0.41, 95% CI - 0.48 to 1.30). In addition, attention switching for ASD symptoms was significantly reduced post-intervention (p = 0.031, d = 1.16, 95% CI 0.19-2.13). This is the first pilot study of a trans-diagnostic group approach for adult ADHD and/or ASD with sleep disturbances. The intervention primarily led to an improvement of sleep disturbances, followed by improvement of disease-specific symptoms in adult subjects with ADHD and ASD.

Keywords: Anxiety; Attention switching; Attention-deficit hyperactivity disorder; Autism spectrum disorder; Cognitive behavioral therapy; Sleep–wake rhythms.