Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature

Dora Wynchank, Denise Bijlenga, Aartjan T. Beekman, J. J.Sandra Kooij, Brenda W. Penninx

Research output: Contribution to journalReview articleAcademicpeer-review

39 Citations (Scopus)


Purpose of Review: Insomnia is diagnosed when there is dissatisfaction with sleep quantity or quality. It has a prevalence in the general population ranging from 31 to 56%. Insomnia has previously been associated with adult attention-deficit/hyperactivity disorder (ADHD). In this review, we address three topics: (1) the cross-sectional relationship between ADHD and insomnia in adulthood, (2) the longitudinal relationship between ADHD and insomnia, and (3) insomnia as a side effect of pharmacological treatments for adult ADHD. Recent Findings: Three cross-sectional, clinical, and population studies report a prevalence of insomnia in ADHD adults ranging from 43 to 80%. Longitudinal evidence for a link between childhood-onset ADHD and insomnia at later age is mixed, with one study confirming and another study not supporting such a longitudinal association. In randomized, placebo-controlled trials, insomnia is reported significantly more often in the treatment arm than in the placebo arm. In varying percentages of trial participants, insomnia is a treatment-emergent adverse effect in triple-bead mixed amphetamine salts (40–45%), dasotraline (35–45%), lisdexamfetamine (10–19%), and extended-release methylphenidate (11%). Ten to seventeen percent of subjects in placebo-controlled trials of atomoxetine report insomnia, possibly related to poor metabolizer status. The mechanisms explaining the relationship between ADHD and sleep problems are incompletely understood, but both genetic and non-shared environmental influences may be involved. Summary: Adults with ADHD should be assessed for insomnia, which is frequently comorbid, and both conditions should be treated.

Original languageEnglish
Article number98
JournalCurrent psychiatry reports
Issue number12
Publication statusPublished - 1 Dec 2017


  • Adult attention-deficit/hyperactivity disorder
  • Insomnia
  • Psychostimulants
  • Sleep

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