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Prevalence of sleep disorder diagnoses and sleep medication prescriptions in individuals with ADHD across the lifespan: a Swedish nationwide register-based study
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-4206-8401
Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0002-4811-2330
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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2023 (English)In: BMJ Mental Health, E-ISSN 2755-9734, Vol. 26, no 1, article id e300809Article in journal (Refereed) Published
Abstract [en]

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 (ORrange=6.4-16.1) and any sleep medication prescription (ORrange=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.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023. Vol. 26, no 1, article id e300809
Keywords [en]
Adult psychiatry, Child & adolescent psychiatry
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-108032DOI: 10.1136/bmjment-2023-300809ISI: 001062126100001PubMedID: 37657817Scopus ID: 2-s2.0-85169514679OAI: oai:DiVA.org:oru-108032DiVA, id: diva2:1793897
Funder
Swedish Research Council, 2018-02599 2022-01119 2017-00788The Swedish Brain Foundation, FO2021-0115 FO2022-0327Forte, Swedish Research Council for Health, Working Life and Welfare, 2022-00126Stiftelsen Söderström - Königska sjukhemmet, SLS-969059Region Stockholm, 2018-0718Swedish Society for Medical Research (SSMF), PD20-0036
Note

Funding agency:

Ingrid Thurings Stiftelse 2021-0063

The Strategic Research Area in Epidemiology and Biostatistics (SFOepi)

European Research Agency 101095568 -HORIZON-HLTH-2022-DISEASE-07-03

National Institute for Health and Care Research NIHR203684 NIHR203035 NIHR130077 NIHR128472 RP-PG-0618-20003

Available from: 2023-09-04 Created: 2023-09-04 Last updated: 2024-02-28Bibliographically approved

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