TY - JOUR
T1 - A 10-week remote monitoring study of sleep features and their variability in individuals with and without ADHD
AU - Denyer, Hayley
AU - Carr, Ewan
AU - Deng, Qigang
AU - Asherson, Philip
AU - Bilbow, Andrea
AU - Folarin, Amos
AU - Groom, Madeleine
AU - Hollis, Chris
AU - Sankesara, Heet
AU - Dobson, Richard J.B.
AU - Kuntsi, Jonna
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/3/27
Y1 - 2025/3/27
N2 - BackgroundPeople with attention deficit hyperactivity disorder (ADHD) often report disturbed sleep, as well as co-occurring symptoms of anxiety and depression. Yet studies employing objective assessments often do not show as many sleep disturbances compared to subjective measures. These discrepancies may relate to subjective reports capturing problematic nights, which may not be captured in a single night’s sleep or by averaging objective measurements over several nights. Given that variability in behaviours is in general strongly linked to ADHD, individuals with ADHD could have greater sleep variability than individuals without ADHD. Using active and passive remote monitoring, we investigate differences in the level and variability of daily sleep behaviours between individuals with and without ADHD and explore if sleep is associated with changes in anxiety and depressive symptoms across a 10-week remote monitoring period.MethodsForty individuals (20 with ADHD, 20 without) took part in a 10-week remote monitoring study. Active monitoring involved participants completing questionnaires on ADHD and co-occurring psychiatric symptoms at weeks 2, 6 and 10. Passive monitoring involved participants wearing a wearable device (Fitbit) that measured sleep each night.ResultsIndividuals with and without ADHD were similar in the levels of sleep recorded each night. However, compared to those without ADHD, participants with ADHD had more variable sleep duration, sleep onset and offset, and sleep efficiency over 10 weeks. Within-individual associations of co-occurring anxiety and depressive symptoms with the sleep features were non-significant.ConclusionsIn a 10-week remote monitoring study of sleep using a wearable device, we show that what distinguishes individuals with ADHD from those without is their greater variability in sleep features: participants with ADHD had a more variable sleep duration, sleep onset and offset, and sleep efficiency. Inconsistency and high variability are hallmarks of ADHD, and we show that this characteristic extends also to sleep among adolescents and adults with ADHD.Trial registrationClinical trial number: not applicable.
AB - BackgroundPeople with attention deficit hyperactivity disorder (ADHD) often report disturbed sleep, as well as co-occurring symptoms of anxiety and depression. Yet studies employing objective assessments often do not show as many sleep disturbances compared to subjective measures. These discrepancies may relate to subjective reports capturing problematic nights, which may not be captured in a single night’s sleep or by averaging objective measurements over several nights. Given that variability in behaviours is in general strongly linked to ADHD, individuals with ADHD could have greater sleep variability than individuals without ADHD. Using active and passive remote monitoring, we investigate differences in the level and variability of daily sleep behaviours between individuals with and without ADHD and explore if sleep is associated with changes in anxiety and depressive symptoms across a 10-week remote monitoring period.MethodsForty individuals (20 with ADHD, 20 without) took part in a 10-week remote monitoring study. Active monitoring involved participants completing questionnaires on ADHD and co-occurring psychiatric symptoms at weeks 2, 6 and 10. Passive monitoring involved participants wearing a wearable device (Fitbit) that measured sleep each night.ResultsIndividuals with and without ADHD were similar in the levels of sleep recorded each night. However, compared to those without ADHD, participants with ADHD had more variable sleep duration, sleep onset and offset, and sleep efficiency over 10 weeks. Within-individual associations of co-occurring anxiety and depressive symptoms with the sleep features were non-significant.ConclusionsIn a 10-week remote monitoring study of sleep using a wearable device, we show that what distinguishes individuals with ADHD from those without is their greater variability in sleep features: participants with ADHD had a more variable sleep duration, sleep onset and offset, and sleep efficiency. Inconsistency and high variability are hallmarks of ADHD, and we show that this characteristic extends also to sleep among adolescents and adults with ADHD.Trial registrationClinical trial number: not applicable.
KW - Humans
KW - Attention Deficit Disorder with Hyperactivity/physiopathology
KW - Male
KW - Female
KW - Adult
KW - Depression/physiopathology
KW - Young Adult
KW - Sleep Wake Disorders/physiopathology
KW - Anxiety/physiopathology
KW - Sleep/physiology
KW - Wearable Electronic Devices
KW - Adolescent
KW - Surveys and Questionnaires
UR - http://www.scopus.com/inward/record.url?scp=105002020340&partnerID=8YFLogxK
U2 - 10.1186/s12888-025-06729-z
DO - 10.1186/s12888-025-06729-z
M3 - Article
C2 - 40148870
SN - 1471-244X
VL - 25
JO - BMC Psychiatry
JF - BMC Psychiatry
IS - 1
M1 - 294
ER -