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Combined impact of ADHD and insomnia symptoms on quality of life, productivity, and health care use in the general population

Published online by Cambridge University Press:  29 June 2020

Emma van Andel Open the ORCID record for Emma van Andel [Opens in a new window] ,
Margreet ten Have ,
Denise Bijlenga ,
Aartjan T. F. Beekman ,
Ron de Graaf  and
J. J. Sandra Kooij
Emma van Andel*
Affiliation:
PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands
Margreet ten Have
Affiliation:
Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Da Costakade 45, 3521 VSUtrecht, The Netherlands
Denise Bijlenga
Affiliation:
PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands
Aartjan T. F. Beekman
Affiliation:
Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, A.J. Ernststraat 1187, 1081 HLAmsterdam, The Netherlands
Ron de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Da Costakade 45, 3521 VSUtrecht, The Netherlands
J. J. Sandra Kooij
Affiliation:
PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR The Hague, The Netherlands Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, A.J. Ernststraat 1187, 1081 HLAmsterdam, The Netherlands
*
Author for correspondence: Emma van Andel, E-mail: e.vanandel@psyq.nl
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Abstract

Background

Both attention-deficit/hyperactivity disorder (ADHD) and insomnia have been independently related to poorer quality of life (QoL), productivity loss, and increased health care use, although most previous studies did not take the many possible comorbidities into account. Moreover, ADHD and insomnia often co-occur. Symptoms of ADHD and insomnia together may have even stronger negative effects than they do separately. We investigated the combined effects of symptoms of ADHD and insomnia, in addition to their independent effects, on QoL, productivity, and health care use, thereby controlling for a wide range of possible comorbidities and confounders.

Methods

Data from the third wave of the Netherlands Mental Health Survey and Incidence Study-2 were used, involving N = 4618 from the general population. Both the inattention and the hyperactivity ADHD symptom dimensions were studied, assessed by the ASRS Screener.

Results

Mental functioning and productivity were negatively associated with the co-occurrence of ADHD and insomnia symptoms, even after adjusting for comorbidity and confounders. The results show no indication of differences between inattention and hyperactivity. Poorer physical functioning and health care use were not directly influenced by the interaction between ADHD and insomnia.

Conclusions

People with both ADHD and sleep problems have increased risk for poorer mental functioning and productivity loss. These results underscore the importance of screening for sleep problems when ADHD symptoms are present, and vice versa, and to target both disorders during treatment.

Keywords

ADHDgeneral populationhealth care useinsomniaproductivityquality of life
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 1 , January 2022 , pp. 36 - 47
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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