(PS1-B49) Unique Associations of ADHD and Cognitive Disengagement Syndrome Symptoms with Sleep Problems and Circadian Preference in a Community Sample of Adults

There is growing evidence that people with attention-deficit/hyperactivity disorder (ADHD) experience higher rates of sleep difficulties coupled with a circadian preference for eveningness (Becker, 2020; Bondopadhyay et al., 2022). However, most studies have been conducted with children, with a recent meta-analysis identifying only 13 studies of sleep in adults with ADHD (Díaz-Román et al., 2018), with many of these studies examining college student samples (e.g., Gau et al., 2007). As both ADHD symptoms and sleep/circadian function change across adulthood, it is important to examine ADHD dimensions of inattention (ADHD-IN) and hyperactivity-impulsivity (ADHD-HI) and sleep in community-based samples spanning a wide age range. In addition, emerging evidence suggests that symptoms of cognitive disengagement syndrome (CDS; until recently “sluggish cognitive tempo”), characterized by excessive daydreaming, mental confusion, and hypoactivity, may be independently associated with adults’ sleep difficulties and eveningness preference above and beyond ADHD symptoms (Fredrick et al., 2022; Lunsford-Avery et al., 2021). Accordingly, the present study examined the unique associations between ADHD-IN, ADHD-HI, and CDS symptoms and sleep problems and circadian preference in a community sample. 106 adults (ages 18-75 years; Mage = 38.69 years) completed assessments of ADHD and CDS symptoms using the Barkley Adult ADHD Rating Scale-IV (Barkley, 2011), sleep quality and functioning using the multi-dimensional Pittsburgh Sleep Quality Index (Buysse et al., 1989), and circadian preference on the Morningness-Eveningness Questionnaire (Horne & Östberg, 1976). Bivariate correlation analyses indicated that ADHD-IN, ADHD-HI, and CDS symptoms were generally each significantly associated with sleep functioning domains (rs = .17-.64, ps < .05); however, only CDS symptoms were associated with lower sleep efficiency (r = .21, p = .015). In addition, only greater CDS symptoms were significantly associated with eveningness preference (r = -.26, p = .003). Regression analyses, with age and gender as covariates, indicated that ADHD-IN, ADHD-HI, and CDS symptoms had differential unique associations with sleep functioning. Only ADHD-IN symptoms were uniquely associated with more frequent sleep medication use (β = .44, p = .002), only ADHD-HI symptoms were uniquely associated with shorter sleep duration (β = .23, p = .042) and greater nighttime sleep disturbance (e.g., bad dreams, feeling too hot/too cold; β = .35, p = .001), and only CDS symptoms were uniquely associated with poorer sleep quality (β = .40, p = .005), longer sleep onset latency (β = .38, p = .01), daytime dysfunction (β = .58, p < .001), and PSQI total score of poor sleep (β = .43, p = .001). Only CDS symptoms were uniquely associated with greater eveningness preference (β = -.31, p = .023). Findings indicate that ADHD and CDS symptoms are differentially associated with sleep and circadian functioning in adults, pointing to the need for careful assessment of these dimensions in research and clinical care settings for adults with ADHD and/or sleep difficulties and consideration of the potentially complex role of sleep problems and circadian preferences in ADHD-related impairment.