Stéphanie Bioulac, Pierre Philip et al. inJ Clin Psy

Excessive daytime sleepiness in adult patients with ADHD as measured by the Maintenance of Wakefulness Test, an electrophysiologic measure.
Bioulac S, Chaufton C, Taillard J, Claret A, Sagaspe P, Fabrigoule C, Bouvard MP, Philip P. J Clin Psychiatry. 2015 Jan 6

Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric disorder. It may persist into adulthood in 50 to 65 % of the cases. Sleep disorders are frequent in ADHD and these patients were at risk for driving.
The aim of this study was to quantify the objective level of sleepiness in adult ADHD patients and to determine the relationship between excessive daytime sleepiness and their simulated driving performance.
Forty adult ADHD patients and 19 healthy control subjects were included. Subjects performed a Maintenance of Wakefulness Test (MWT) to explore sleepiness and a one hour driving session.

ADHD patients were divided into 3 groups defined by their MWT scores:

– sleepy ADHD with a mean sleep latency on the MWT inferior to 19 minutes,
– intermediate ADHD with MWT score between 20 to 33 minutes
– and alert ADHD with MWT score superior to 34 minutes

Based upon the MWT scores, 14 (35%) of our patients were in the sleepy group, 20 were in the intermediate group, and only 6  in the alert group. Moreover, sleepy ADHD patients exhibited significantly deteriorated driving performance compared to the other groups.

To conclude, our study shows that a significant proportion of adult ADHD patients exhibit an objective excessive daytime sleepiness. It is therefore crucial that sleepiness be screened in this population by psychiatrists or sleep specialists. Since sleepiness has an impact on driving simulated performance, it is important to screen and treat it.

This study was supported by a grant from Bordeaux University Hospital.