Attention-Deficit/Hyperactivity Disorder, Insomnia, and Sleepiness Symptoms among a Community Adult Sample: The Mediating Effect of Executive Behavioral Regulation and Metacognition Abilities. (15th February 2022)

• Record Type: Journal Article
• Authors: Madiouni, Clarisse; Broc, Guillaume; Cindy, Lebrun; Bayard, Sophie
• Is Part Of: Archives of clinical neuropsychology. Volume 37:Number 5(2022)
• Page Start: 916
• Page End: 928
• Publication Date: 2022-02-15
• Subjects: Adult ADHD -- Behavioral regulation -- Hypersomnolence -- Metacognition -- Sleep; Clinical neuropsychology -- Periodicals; 616.805
• DOI: 10.1093/arclin/acac006
• Languages: English
• ISSNs: 0887-6177

Abstract

Abstract: Objective: Adult attention-deficit/hyperactivity disorder (ADHD) is characterized by a dysexecutive syndrome reflected in cognitive, emotional, and behavioral areas. Independently of a formal diagnosis of ADHD, higher ADHD symptoms are associated with higher levels of insomnia and sleepiness symptoms in adult population-based samples. Insomnia and sleepiness are sleep disorders that are both associated with deficits in several aspects of executive functions which in turn are likely to mimic a range of ADHD symptoms. Our objective was to explore the interrelationships between ADHD, insomnia, and sleepiness symptoms and executive functioning in community-dwelling adults. Method: A total of 442 participants (18–89 years, 56% females) underwent a semistructured clinical interview and completed questionnaires for insomnia, sleepiness, and everyday behaviors in which executive functions are implicated. Mediation Models were applied. Results: Insomnia and sleepiness symptoms did not play a mediating role between ADHD symptoms and executive functioning. Conversely, our results highlighted a mediating effect of daytime insomnia consequences and sleepiness on ADHD symptoms via behavioral regulation executive symptoms (respectively, β = −0.32, p < .001, 95% CI [−0.46, −0.20]; β = 0.09, p < .05, 95% CI [0.02, 0.16]) and metacognitive executive symptoms (respectively, β = −0.30, p < .001, 95% CI [−0.44, −0.18]; β = 0.12, p < .01, 95% CI [0.04, 0.22]). Conclusions: Daytime insomnia consequences and sleepiness symptoms could lead to ADHD-like symptoms through their associated executive symptoms expressed in daily life. When faced with symptoms suggestive of ADHD in adults, insomnia and sleepiness should be systematically screened with standardized instruments.