Insomnia Is Pervasive in Adult Neurodevelopmental Disorders

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Key clinical point: Clinically significant insomnia is extremely common in adults with ADHD or autism spectrum disorder.

Major finding: 44% of adults with ADHD, autism spectrum disorder, or both diagnoses had moderate or severe insomnia on the validated Insomnia Severity Index.

Data source: This was a cross-sectional study of insomnia in 164 adults with neurodevelopmental disorders.

Disclosures: The presenter reported having no financial conflicts regarding this study, which was conducted without commercial support.




DENVER – Adults with ADHD or autism spectrum disorder experience a high burden of sleep disturbances, especially insomnia, Dr. Anastasios Galanopoulos reported at the annual meeting of the Associated Professional Sleep Societies.

This has previously been established to be the case in pediatric patients with these neurodevelopmental disorders. However, sleep pathology hasn’t previously been well studied in affected adults, according to Dr. Galanopoulos, a consulting psychiatrist at Maudsley Hospital and King’s College London.

Bruce Jancin/Frontline Medical News

He presented a cross-sectional study of insomnia in a clinically representative sample comprising 164 adult patients: 98 with a DSM-5 diagnosis of ADHD, 30 with autism spectrum disorder, and 34 carrying both diagnoses.

Fully 91% of participants fell into the “poor” sleep category on the Pittsburgh Sleep Quality Index. Moreover, 44% of subjects had either moderate or severe clinical insomnia as reflected in a score of 15 or more on the Insomnia Severity Index. The rate of high sleep disruption scores was similar, regardless of whether the diagnosis was ADHD, autism spectrum disorder, or both.

Anxiety but not depression ratings on the Hospital Anxiety and Depression Scale correlated with insomnia scores, regardless of neurodevelopmental diagnosis. Insomnia scores also increased in concert with higher levels of hyperactivity symptoms as scored on the Barkley Adult ADHD Rating Scale. In contrast, inattentiveness scores were unrelated to insomnia.

Hyperactivity scores on the Barkley scale were significantly higher in adults with ADHD than in those with autism spectrum disorder. On the other hand, anxiety scores were higher in adults with autism spectrum disorder.

While the burden of sleep disturbances is similarly high in adults with ADHD and autism spectrum disorder, the underlying mechanism may well be different. For this reason, Dr. Galanopoulos and coinvestigators have begun studies systematically looking at various possible interventions for sleep disorders in adults with neurodevelopmental disorders.

He reported having no financial conflicts regarding this study, which was conducted without commercial support.

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