Prevalence of sleep disorder diagnoses and sleep medication prescriptions in individuals with ADHD across the lifespan: a Swedish nationwide register-based study
Prevalence of sleep disorder diagnoses and sleep medication prescriptions in individuals with ADHD across the lifespan: a Swedish nationwide register-based study
Background: consistent evidence suggests a strong association between attention-deficit/hyperactivity disorder (ADHD) and subjectively reported sleep problems. However, the prevalence of clinically ascertained sleep disorder diagnoses and sleep medication prescriptions in individuals with ADHD remains unclear.
Objective: to determine the rates of sleep disorder diagnoses and sleep medication prescriptions in children, adolescents and adults with ADHD.
Methods: we linked Swedish national registers to create a cohort of individuals born 1945-2008. We estimated the absolute and relative risks (using logistic regression models) of different sleep disorder diagnoses and medication prescriptions in individuals with and without ADHD. The analyses were performed across five different age groups: children (5-11 years), adolescents (12-17 years), young adults (18-30 years), middle-aged adults (31-45 years) and older adults (46-60 years).
Findings: among individuals with ADHD (N=145 490, 2.25% of the cohort), 7.5% had a sleep disorder diagnosis and 47.5% had been prescribed sleep medication. Individuals with ADHD, across all age groups, had a statistically significantly increased risk of having any sleep disorder diagnosis (OR range =6.4-16.1) and any sleep medication prescription (OR range =12.0-129.4) compared with individuals without ADHD. While rates of sleep disorders were highest in older adults, the relative risks were highest in youth.
Conclusions: individuals with ADHD have a substantially increased risk of sleep disorder diagnoses and sleep medication prescriptions, from childhood into older adulthood.
Clinical implications: more clinical efforts are needed to tackle impairing sleep problems in individuals with ADHD via systematic sleep assessment, appropriate diagnosis, and pharmacological and non-pharmacological interventions. Sleep medication use should be informed by sleep disorder diagnosis.
Adult psychiatry, Child & adolescent psychiatry, Prevalence, Middle Aged, Humans, Child, Preschool, Sleep Wake Disorders/diagnosis, Longevity, Drug Prescriptions, Young Adult, Sleep, Adolescent, Aged, Child, Sweden/epidemiology, Attention Deficit Disorder with Hyperactivity/diagnosis
Ahlberg, Rickard
69b097f7-e31a-49d3-88ec-e719888cee94
Garcia-Argibay, Miguel
b3dfd2f5-d33d-4e8e-8b44-540cbc5abb4c
Taylor, Marc
d7c80828-2beb-4081-88f6-baf6c5ebb990
Lichtenstein, Paul
1e1573e3-7442-4d1f-969f-17dc9b7edaa4
D'Onofrio, Brian M.
c0b7aed7-382b-46e8-8256-03346bb3a5d7
Butwicka, Agniezska
2bf1df91-709e-4bb6-85f5-903eccc653e0
Hill, Catherine
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Larsson, Henrik
4132f7c6-5d52-43a1-be38-d343e67107cf
Du Rietz, Ebba
34c90185-a596-42c2-8e67-f9c6a4669847
1 September 2023
Ahlberg, Rickard
69b097f7-e31a-49d3-88ec-e719888cee94
Garcia-Argibay, Miguel
b3dfd2f5-d33d-4e8e-8b44-540cbc5abb4c
Taylor, Marc
d7c80828-2beb-4081-88f6-baf6c5ebb990
Lichtenstein, Paul
1e1573e3-7442-4d1f-969f-17dc9b7edaa4
D'Onofrio, Brian M.
c0b7aed7-382b-46e8-8256-03346bb3a5d7
Butwicka, Agniezska
2bf1df91-709e-4bb6-85f5-903eccc653e0
Hill, Catherine
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Larsson, Henrik
4132f7c6-5d52-43a1-be38-d343e67107cf
Du Rietz, Ebba
34c90185-a596-42c2-8e67-f9c6a4669847
Ahlberg, Rickard, Garcia-Argibay, Miguel, Taylor, Marc, Lichtenstein, Paul, D'Onofrio, Brian M., Butwicka, Agniezska, Hill, Catherine, Cortese, Samuele, Larsson, Henrik and Du Rietz, Ebba
(2023)
Prevalence of sleep disorder diagnoses and sleep medication prescriptions in individuals with ADHD across the lifespan: a Swedish nationwide register-based study.
BMJ Mental Health, 26 (1), [e300809].
(doi:10.1136/bmjment-2023-300809).
Abstract
Background: consistent evidence suggests a strong association between attention-deficit/hyperactivity disorder (ADHD) and subjectively reported sleep problems. However, the prevalence of clinically ascertained sleep disorder diagnoses and sleep medication prescriptions in individuals with ADHD remains unclear.
Objective: to determine the rates of sleep disorder diagnoses and sleep medication prescriptions in children, adolescents and adults with ADHD.
Methods: we linked Swedish national registers to create a cohort of individuals born 1945-2008. We estimated the absolute and relative risks (using logistic regression models) of different sleep disorder diagnoses and medication prescriptions in individuals with and without ADHD. The analyses were performed across five different age groups: children (5-11 years), adolescents (12-17 years), young adults (18-30 years), middle-aged adults (31-45 years) and older adults (46-60 years).
Findings: among individuals with ADHD (N=145 490, 2.25% of the cohort), 7.5% had a sleep disorder diagnosis and 47.5% had been prescribed sleep medication. Individuals with ADHD, across all age groups, had a statistically significantly increased risk of having any sleep disorder diagnosis (OR range =6.4-16.1) and any sleep medication prescription (OR range =12.0-129.4) compared with individuals without ADHD. While rates of sleep disorders were highest in older adults, the relative risks were highest in youth.
Conclusions: individuals with ADHD have a substantially increased risk of sleep disorder diagnoses and sleep medication prescriptions, from childhood into older adulthood.
Clinical implications: more clinical efforts are needed to tackle impairing sleep problems in individuals with ADHD via systematic sleep assessment, appropriate diagnosis, and pharmacological and non-pharmacological interventions. Sleep medication use should be informed by sleep disorder diagnosis.
Text
e300809.full
- Version of Record
More information
Accepted/In Press date: 9 August 2023
Published date: 1 September 2023
Additional Information:
Funding Information:
HL acknowledges financial support from the Swedish Research Council (2018-02599; 2022-01119) and the Swedish Brain Foundation (FO2021-0115; FO2022-0327). AB is supported by the Swedish Research Council for Health, Working Life and Welfare (2022-00126), Stiftelsen Söderström-Königska Sjukhemmet (SLS-969059), the Swedish Research Council (2017-00788) and Stockholm Region (FoUU clinical research appointment 2018-0718). EDR received financial support from the Swedish Society for Medical Research (SSMF) (PD20-0036), Fredrik & Ingrid Thurings Stiftelse (2021-00638) and The Strategic Research Area in Epidemiology and Biostatistics (SFOepi). SC recieved financial support from 101095568-HORIZON- HLTH-2022-DISEASE-07-03)(European Research Agency) and NIHR203684, NIHR203035, NIHR130077, NIHR128472, RP-PG-0618-20003 (National Institute for Health and Care Research).
Keywords:
Adult psychiatry, Child & adolescent psychiatry, Prevalence, Middle Aged, Humans, Child, Preschool, Sleep Wake Disorders/diagnosis, Longevity, Drug Prescriptions, Young Adult, Sleep, Adolescent, Aged, Child, Sweden/epidemiology, Attention Deficit Disorder with Hyperactivity/diagnosis
Identifiers
Local EPrints ID: 482543
URI: http://eprints.soton.ac.uk/id/eprint/482543
ISSN: 2755-9734
PURE UUID: 8ed31c3b-58b0-49d1-b122-c07abd23ec47
Catalogue record
Date deposited: 10 Oct 2023 16:51
Last modified: 18 Mar 2024 03:31
Export record
Altmetrics
Contributors
Author:
Rickard Ahlberg
Author:
Miguel Garcia-Argibay
Author:
Marc Taylor
Author:
Paul Lichtenstein
Author:
Brian M. D'Onofrio
Author:
Agniezska Butwicka
Author:
Henrik Larsson
Author:
Ebba Du Rietz
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
