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Associations of ADHD symptom severity, sleep/circadian factors, depression and quality of life: Secondary analyses of the Netherlands Sleep Registry study

Associations of ADHD symptom severity, sleep/circadian factors, depression and quality of life: Secondary analyses of the Netherlands Sleep Registry study
Associations of ADHD symptom severity, sleep/circadian factors, depression and quality of life: Secondary analyses of the Netherlands Sleep Registry study
Study objectives: we investigated whether sleep disruption and circadian preference mediate the associations of ADHD symptom severity with depression symptom severity and quality of life.

Methods: 1364 participants (mean: 51.86 [SD = 0.37] years, 75% females) from a large-scale cross-sectional online survey (Netherlands Sleep Registry) completed a sociodemographic questionnaire, the Adult ADHD Rating Scale, Hospital Anxiety and Depression Scale (HADS), Satisfaction With Life Scale (SLS) and Cantril Ladder (CL) (quality of life measures), Insomnia Severity Index, Pittsburgh Sleep Quality Index, and Munich Chronotype Questionnaire.

Results: higher ADHD symptom severity was significantly associated with depression severity (p = 0.03), lower quality of life (p < 0.001), insomnia severity (p < 0.001), lower sleep quality (p < 0.001), and later circadian preference (p = 0.01). No sleep or circadian factor significantly mediated the association of the severity of symptoms of ADHD and depression (all p > 0.1). Conversely, only insomnia severity significantly mediated the association of the severity of symptoms of ADHD and quality of life (SLS: standardized beta = -0.10, 95% CI = [-0.12, -0.04]; CL: standardized beta = .103, 95% CI = [0.04, 0.16]).

Conclusion: ADHD symptom severity was associated with lower quality of life, primarily mediated by insomnia symptom severity. Future studies targeting insomnia complaints in this population may help mitigate their depression complaints and improve their quality of life.
medRxiv
Nair, Siddhi
67692960-e0bc-4db3-83a1-617daa9845b2
Deshpande, Neha
6dbb05cf-0c8d-41ce-8fe9-52c037c5f6b1
Hill, Catherine M.
172dc851-574e-4815-9c5e-4de4dae9fc35
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Someren, Eus Van
035b57d3-e470-410f-aa45-11df69c2e073
Chellappa, Sarah L.
516582b5-3cba-4644-86c9-14c91a4510f2
Nair, Siddhi
67692960-e0bc-4db3-83a1-617daa9845b2
Deshpande, Neha
6dbb05cf-0c8d-41ce-8fe9-52c037c5f6b1
Hill, Catherine M.
172dc851-574e-4815-9c5e-4de4dae9fc35
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Someren, Eus Van
035b57d3-e470-410f-aa45-11df69c2e073
Chellappa, Sarah L.
516582b5-3cba-4644-86c9-14c91a4510f2

[Unknown type: UNSPECIFIED]

Record type: UNSPECIFIED

Abstract

Study objectives: we investigated whether sleep disruption and circadian preference mediate the associations of ADHD symptom severity with depression symptom severity and quality of life.

Methods: 1364 participants (mean: 51.86 [SD = 0.37] years, 75% females) from a large-scale cross-sectional online survey (Netherlands Sleep Registry) completed a sociodemographic questionnaire, the Adult ADHD Rating Scale, Hospital Anxiety and Depression Scale (HADS), Satisfaction With Life Scale (SLS) and Cantril Ladder (CL) (quality of life measures), Insomnia Severity Index, Pittsburgh Sleep Quality Index, and Munich Chronotype Questionnaire.

Results: higher ADHD symptom severity was significantly associated with depression severity (p = 0.03), lower quality of life (p < 0.001), insomnia severity (p < 0.001), lower sleep quality (p < 0.001), and later circadian preference (p = 0.01). No sleep or circadian factor significantly mediated the association of the severity of symptoms of ADHD and depression (all p > 0.1). Conversely, only insomnia severity significantly mediated the association of the severity of symptoms of ADHD and quality of life (SLS: standardized beta = -0.10, 95% CI = [-0.12, -0.04]; CL: standardized beta = .103, 95% CI = [0.04, 0.16]).

Conclusion: ADHD symptom severity was associated with lower quality of life, primarily mediated by insomnia symptom severity. Future studies targeting insomnia complaints in this population may help mitigate their depression complaints and improve their quality of life.

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Published date: 5 February 2025

Identifiers

Local EPrints ID: 502831
URI: http://eprints.soton.ac.uk/id/eprint/502831
PURE UUID: f1f9d345-925d-4cab-8a7e-9026685cdfb7
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075
ORCID for Sarah L. Chellappa: ORCID iD orcid.org/0000-0002-6190-464X

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Date deposited: 09 Jul 2025 16:32
Last modified: 10 Jul 2025 02:09

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Contributors

Author: Siddhi Nair
Author: Neha Deshpande
Author: Catherine M. Hill
Author: Samuele Cortese ORCID iD
Author: Eus Van Someren
Author: Sarah L. Chellappa ORCID iD

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