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These results contribute to improving the treatment of ADHD and insomnia, as well as to better understanding the interactions between these two complex disorders.
Insomnia is the most common sleep disorder in the population, especially in people with attention-deficit/hyperactivity disorder (ADHD). In fact, 1 in 3 adults have insomnia symptoms, while this frequency doubles in people with ADHD. A study led by the Psychiatry, Mental Health and Addictions Group of the Vall d'Hebron Research Institute (VHIR) and the CIBER of Mental Health (CIBERSAM) has studied the relationship between both disorders. It has found that improved sleep quality is associated with less severity of ADHD symptoms. The results are published in Psychiatry Research.
The study involved 92 adult patients with ADHD and insomnia disorder, who were followed at three points in time over six months: at baseline, after 3 months, and after 6 months. At the beginning of the study, researchers assessed the severity and type of ADHD (presentation with predominance of attention deficit, hyperactivity/impulsivity, or combined), as well as the sleep problems and other psychiatric disorders. 74% of the patients had problems falling asleep and 70% had other disorders such as anxiety or depression. Both at baseline and during the 3-month follow-up, they were given sleep hygiene recommendations, such as maintaining a routine schedule, not drinking beverages or other stimulating substances, sleeping in relaxed spaces or avoiding the use of cell phones and other screens before going to sleep. If necessary, they were also prescribed pharmacological treatment to improve sleep quality, such as melatonin, benzodiazepines or antidepressants.
After 3 months, thanks to the recommendations and prescribed medication, insomnia had improved or disappeared in 44.6% of the cases. This percentage rose to 72.4% of cases after 6 months. A decrease in the use of the cell phone before going to sleep or a good implementation of sleep hygiene guidelines were associated with better sleep quality. "We observed that the remission of insomnia was related to an improvement in ADHD symptoms, as well as in the general health of patients, both physical and mental," explains Dr. Christian Fadeuilhe Grau, psychiatrist of the Mental Health Service of the Vall d'Hebron University Hospital and researcher of the Psychiatry, Mental Health and Addictions group of VHIR and CIBERSAM, and first author of the study.
Insomnia persistance was associated with the presence of other psychiatric disorders, such as depression, or with a greater severity of ADHD symptoms. It was not related, however, to the type of ADHD presentation.
These results contribute to improved treatment of ADHD and insomnia, as well as a better understanding of the interactions between these two complex disorders. "Thanks to this longitudinal study, in which we have followed up patients, we have confirmed that insomnia treatment could have an important role in improving ADHD symptoms", concludes Dr. Josep Antoni Ramos-Quiroga, head of the Mental Health Service at Vall d'Hebron University Hospital and of the Psychiatry, Mental Health and Addictions group at VHIR and head of the CIBERSAM research group.
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