1131 Sleep Disorder Complaints and Risks in Adults with Attention-Deficit Hyperactivity Disorder

Abstract Introduction Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder affecting 8.83% of adults worldwide. It is characterized by patterns of inattention and/or hyperactivity-impulsivity beginning in childhood, with symptoms often persisting into adulthood. Studies in pediatric ADHD demonstrate a high occurrence of comorbid sleep disorders. However, there is limited research on adult ADHD and comorbid sleep complaints and diagnoses. Methods Patients seen at the Stanford Sleep Medicine Center completed the Alliance Sleep Questionnaire (ASQ) as a standard of care (N=28,025). The ASQ is an online sleep questionnaire that collects standardized subjective sleep disorder data. It includes questions on demographics, current sleep complaints and disorders, medical history (e.g., ADHD diagnosis), and validated symptom questionnaires including the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and the Functional Outcomes of Sleep Questionnaire Short Version (FOSQ-10). Results Univariate logistic regression controlling for age, sex, body mass index (BMI), race, ethnicity, and other psychiatric diagnoses (anxiety, depression, obsessive-compulsive disorder [OCD], post-traumatic stress disorder [PTSD], bipolar, psychosis, and eating disorders [ED]) identified that people with ADHD (n=1,253 [4.5%]) were more likely to report complaints of snoring (OR=1.21[1.05,1.40]; p_adj=0.21), daytime sleepiness (OR=2.3[1.89,2.80]; p_adj=1.79e-15), insomnia (OR=2.0[1.70,2.37]; p_adj=9.94e-15), restless legs syndrome (RLS) (OR=1.49[1.28,1.73]p_adj=6.4e-6), and narcolepsy (OR=1.52[1.31,1.77]; p_adj=1.5e-6), and had a higher risk of sleep apnea (OR=1.58[1.35,1.85]; p_adj=3.18e-7) and bruxism (OR=1.74[1.44,2.12]; p_adj=4.16e-7). Individuals with ADHD reported higher scores for the ESS (OR=1.02[1.01,1.036]; p_adj=0.013) and ISI (OR=1.05[1.04,1.06]; p_adj=5.06e-18), and lower scores on the FOSQ-10(OR=0.89[0.87,0.90]; p_adj=1.35e-36). Multivariate forward stepwise regression demonstrated that compared to adults without ADHD (n=19,856), adults with ADHD (n=923[4.44%]) had a higher risk of comorbid psychiatric diagnoses, and certain sleep disorders such as RLS, bruxism, and sleep apnea. Adults with ADHD scored lower on the FOSQ-10 and reported higher complaints of insomnia. Conclusion Adult ADHD is associated with a higher risk of some sleep disorders independent of psychiatric diagnoses. Individuals report worse outcomes of sleepiness on daily functioning. Future research should investigate whether these co-occurences are due to common symptomatology leading to crossover diagnoses or whether this arises from distinct underlying mechanisms. Future research should also examine the impact of ADHD pharmacotherapy on functional outcomes and sleep disorder risks. Support (if any)