Sleep disturbances associated with attention deficit hyperactivity disorder: The impact of psychiatric comorbidity and pharmacotherapy

Objective: To estimate the relative risk of sleep problems associated with attention deficit hyperactivity disorder (ADHD), its pharmacotherapy, and its comorbid psychopathology. Method: Standard sleep questionnaires were used to assess sleep problems and characteristics in ADHD (n = 122) and non-ADHD (n = 105) comparison youths. Results: ADHD was associated with 10 of 19 sleep problems assessed. However, after controlling for psychiatric comorbidity and pharmacotherapy with stimulants, the majority of these differences were no longer evident. Rather, treatment with stimulants and comorbidity with anxiety and behavior disorders were significantly associated with sleep disturbances. Positive family history of ADHD was associated with none of the sleep problems assessed here after adjusting for age, psychiatric comorbidity, and treatment with anti-ADHD medication. Conclusions: Although subjective sleep difficulties are common in ADHD youths, they are frequently accounted for by comorbidity and pharmacotherapy. Furthermore, the lack of an association between a positive family history of ADHD and sleep difficulties suggests that ADHD is not a misdiagnosis of the consequences of disruption of normal sleep.