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

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.

Is Attention-Deficit/Hyperactivity Disorder (ADHD) a Dimension or a Category? What Does the Relationship Between ADHD Traits and Psychosocial Quality of Life Tell Us?

“…This finding is in line with the two previous general population studies of children consisting of a validation study of the PedsQL in a sample of 238 children by Stevanović et al (2011) and a study of QoL and emotional/behavioral problems in 1,022 children by Magai and Koot (2019). Our finding is also in line with general population studies of adults where a significant association between higher ADHD traits and lower psychosocial or mental QoL have been reported (Das et al, 2012; Krauss & Schellenberg, 2022; van Andel et al, 2022; Vogel et al, 2018). However, none of these previous studies have examined the level of QoL at different points over the entire continuum or whether ADHD traits and QoL are related in a linear or nonlinear fashion.…”

“…Here, children with ADHD have quite consistently been found to have significantly lower psychosocial QoL at a group level compared to their peers without ADHD. However, the relationship between psychosocial (or mental) QoL and ADHD traits in the general population has only been addressed in two studies of children (Magai & Koot, 2019; Stevanović et al, 2011) and, for comparison reasons, in three studies of adults (Das et al, 2012; Krauss & Schellenberg, 2022; two publications from different study waves; van Andel et al, 2022; Vogel et al, 2018). These studies found higher ADHD trait levels to be associated with poorer psychosocial/mental QoL.…”

Sleep characteristics in health workers exposed to the COVID-19 pandemic

“…Adaptive failure of these stress response mechanisms can lead to the development of chronic insomnia, as well as other sleep disorders impacting on health of individuals. Chronic insomnia has an impact at several levels, negatively affecting the perception of subjective quality of life, mental health, occupational and cognitive performance, among others [ 7 ]. In addition, insomnia has been linked to an increased risk of myocardial infarction, coronary heart disease, heart failure, high blood pressure, diabetes, and death, especially when accompanied by a decreased total sleep time [ 8 ].…”

Income and economic productivity loss associated with comorbidity: longitudinal analysis of linked individual-level data for a whole country

“…These comorbidities can increase the cost to the health system, increase clinical complexity and amplify social inequalities 1–3. Previous research has suggested that comorbidities increase productivity loss 4–13. Patients with diabetes are more likely to be absent from work if they also have depression,5 9 while absentees and productivity loss in asthma patients is higher with increased number and severity of comorbidities 4.…”