Sleep in adults with ADHD: Systematic review and meta-analysis of subjective and objective studies

Amparo Díaz-Román; Raziya Mitchell; Samuele Cortese

doi:10.1016/j.neubiorev.2018.02.014

Sleep in adults with ADHD: Systematic review and meta-analysis of subjective and objective studies

Neurosci Biobehav Rev. 2018 Jun:89:61-71. doi: 10.1016/j.neubiorev.2018.02.014. Epub 2018 Mar 2.

Authors

Amparo Díaz-Román¹, Raziya Mitchell², Samuele Cortese³

Affiliations

¹ Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain.
² Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, UK.
³ Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK; Solent NHS Trust, Southampton, UK; New York University Child Study Center, New York, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK. Electronic address: samuele.cortese@soton.ac.uk.

PMID: 29477617
DOI: 10.1016/j.neubiorev.2018.02.014

Abstract

Sleep alterations associated with adulthood ADHD are poorly understood. Here, we conducted the first meta-analysis of sleep studies in adults with ADHD. Based on a pre-registered protocol (PROSPERO-CRD42017065407), we searched Pubmed, Ovid and Web of Knowledge databases through August 3rd, 2017, with no language or publication type restrictions, and contacted study authors for unpublished data/information. From a pool of 8812 references, we retained 13 studies. Random-effects models were performed and study quality was rated using the Newcastle-Ottawa Scale. Compared to adults without ADHD, those with ADHD significantly differed in seven out of nine subjective parameters (Standardized Mean Difference, SMD, ranging from 0.56 to 1.55) and two out of five actigraphic parameters [SMD (95% CI): sleep onset latency: 0.80 (0.46-1.14); sleep efficiency: -0.68 (-1.03, -0.34)]. No significant differences were detected for polysomnographic parameters. We conclude that, whereas subjectively reported sleep problems are significantly associated with ADHD in adults and should be systematically screened during the clinical interview, additional research is needed to understand if they are underpinned by objective sleep alterations.

Keywords: ADHD; Actigraphy; Adults; Meta-analysis; PSG; Questionnaires; Sleep.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity / complications
Attention Deficit Disorder with Hyperactivity / physiopathology
Attention Deficit Disorder with Hyperactivity / psychology*
Clinical Trials as Topic
Goals*
Humans
Sleep / physiology*
Sleep Wake Disorders / complications
Sleep Wake Disorders / psychology*
Surveys and Questionnaires