1. Results
The Effects of ADHD Symptomology on Sleep
Leah Doghramji
Faculty Mentor: Dr. Knouse
Department of Psychology, University of Richmond
Background
Recruitment and Procedure
Discussion
 Because depression is commonly comorbid with ADHD, we conducted a multiple
regression analysis to see if depressive symptoms could account for the relationship
between hyperactive symptoms at time 1 and ISI score at time 2.
 In Step 1, depressive symptoms at time 1 predicted insomnia at time 2 (F(1, 6) = 5.8, p
= .05, R2 = .49, R2
adjusted = .41).
 In Step 2, symptoms of depression and hyperactive symptoms at time 1 explained a
marginally significant amount of variance in the ISI total at time 2, although the
relationship was moderate in magnitude in this small sample (F(2, 5) = 5.2, p = .06, R2
= .68, R2
adjusted = .55).
 Importantly, with depressive symptoms in the model, hyperactive symptoms no longer
predicted insomnia.
RV DHD
 ADHD affects 4.4% of adults (Kessler et al., 2006)
 Chronic insomnia affects 54.5% of adults with ADHD, which is higher than the
rate in the general population (Voinescu, Szentagotai, & David, 2012).
 Some symptoms of ADHD include restlessness, feeling as if “driven by a
motor,” fidgeting, losing everyday objects often, easily distracted, unable to
keep attention, and unable to wait turn.
 Insomnia leads to cognitive deficits in working memory, episodic memory,
problem solving, and, most importantly, executive functioning (Fortier-Brochu,
Beaulieu-Bonneau, Iversm, & Morin, 2012).
 Both ADHD and Insomnia negatively affects the prefrontal cortex, which is
home to executive functioning and many related cognitive functions, including
attention and organization (Barkley, Murphy, & Fischer, 2008; Fortier-Brochu et
al., 2012).
 Research question 1: Do hyperactive/impulsive and/or inattentive symptoms
relate to risky behaviors, e.g. risky drinking?
 Research question 2: Do hyperactive/impulsive and/or inattentive symptoms
relate to sleep problems?
 Participants were recruited from the community through flyers, newspaper ads, Craiglist, and
Facebook.
 Potential participants completed an online screening in order to determine eligibility, which looked
for a prior clinical diagnosis of ADHD, current symptoms above the clinical cutoff for inattentive or
combined ADHD, and no disorders that would interfere with participation (e.g. schizophrenia).
 We recruited a total of 12 participants at time 1 (3 men, 9 women). Four months later, 8 of these
participants completed the follow-up self-report survey online (Time 2).
 At Time 1, eligible participants came in for a three-hour session that consisted of structured clinical
interviews, subscales assessing for processing speed, abstract thinking, and reasoning skills using the
Weschler Adult Intelligence Scale, and a self-report survey battery.
 Included in the self-report surveys were the Barkley Adult ADHD Rating Scale (BAARS), Pittsburg
Sleep Quality Index (PSQI), Center for Epidemiological Studies – Depression (CES-D), Alcohol Use
Disorder Identification Test (AUDIT), and the Insomnia Severity Index (ISI).
 Examples
 BAARS (α=.87)
 Inattentive: “Prone to daydreaming when I should be concentrating
on something or working”
 Hyperactive/Impulsive: “Interrupt or intrude on others”
 PSQI
 Efficiency: “How many hours of actual sleep did you get at night?”
 CES-D (α=.87)
 “I felt everything I did was an effort”
 AUDIT
 “How often during the last year have you failed to do what was
normally expected of you because of drinking?”
 ISI (α T1=.82, α T2=.64)
 “To what extent do you consider your sleep problem to interfere with
your daily functioning?”
 Hyperactive/impulsive symptoms significantly, positively correlated with AUDIT scores,
showing the relationship between impulsivity and risky drinking.
 Both H/I and inattentive symptoms were significantly related to poor sleep efficiency,
indicating the negative relationship between ADHD symptoms and sleep quality.
 Although only marginally significant, inattentive symptoms were positively correlated
with sleep disturbance, the overall PSQI score, and insomnia at time 1, which was not
found for H/I symptoms, elucidating the stronger negative relationship between
inattentive symptoms and sleep quality at the same point in time.
 An interesting relationship was found between H/I symptoms at Time 1 and insomnia at
time 2, which we hypothesized might be accounted for by a relationship between ADHD
and depression.
 Depression partially accounted for the relationship between H/I symptoms at time 1 and
insomnia at time 2.
 Further research with a larger sample size would clarify this surprising relationship.
 In light of the findings from this research, it would be important to assess for sleep
problems in the ADHD population, as correcting any sleep deficiencies might ultimately
help with both types of symptoms of ADHD as well as depressive symptoms.
Insomnia
Time 2
Depression Time 1
Hyperactivity Time 1
BAARS_HI_T1 BAARS_Inatt_T1 AUDIT_Total ISI_Total PSQI_EFF PSQI_DISTB PSQI_LATE PSQI_DayDys PSQI_Total ISI_Score_T2
Pearson
Correlatio
n
1 .663
**
.597
*
.156 .552
*
.175 -.179 -.049 .239 -.757
*
Sig. (1-
tailed)
.009 .016 .314 .031 .293 .289 .440 .227 .015
N 13 12 13 12 12 12 12 12 12 8
Pearson
Correlatio
n
.663
**
1 .232 .435 .563
*
.491 -.048 .156 .489 -.484
Sig. (1-
tailed)
.009 .234 .079 .028 .052 .441 .314 .053 .136
N 12 12 12 12 12 12 12 12 12 7
Correlations
BAARS_HI_T1
BAARS_Inatt_T1
Standardized
Coefficients
B Std. Error Beta
(Constant)
-10.468 9.948 -1.052 .333
CESD_tot_T1
.570 .237 .701 2.408 .053
(Constant) 14.203 17.060 .833 .443
CESD_tot_T1
.319 .255 .393 1.250 .267
BAARS_HI_T1
-.612 .364 -.528 -1.682 .153
Model
Unstandardized
Coefficients
t Sig.
1
2
Illustration of overlapping variance among Insomnia at Time 2 and Depression and
Hyperactivity/Impulsivity at Time 1