Excessive daytime sleepiness in adult patients with ADHD as measured by the maintenance of wakefulness test, an electrophysiologic measure
J. Clin. Psychiatry. 2015-01-06; : 943-948
DOI: 10.4088/JCP.14m09087
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1. J Clin Psychiatry. 2015 Jul;76(7):943-8. doi: 10.4088/JCP.14m09087.
Excessive daytime sleepiness in adult patients with ADHD as measured by the
Maintenance of Wakefulness Test, an electrophysiologic measure.
Bioulac S(1), Chaufton C, Taillard J, Claret A, Sagaspe P, Fabrigoule C, Bouvard
MP, Philip P.
Author information:
(1)USR CNRS 3413 SANPSY, Pellegrin University Hospital, 13ème étage, Place Amélie
Raba Léon, F-33076 Bordeaux Cedex, France .
OBJECTIVE: To quantify the objective level of sleepiness in adult
attention-deficit/hyperactivity disorder (ADHD) patients and to determine the
relationship between excessive daytime sleepiness and simulated driving
performance.
METHOD: Forty adult ADHD patients (DSM-IV criteria) and 19 matched healthy
control subjects were included between June 30, 2010, and June 19, 2013. All
participants completed the Epworth Sleepiness Scale and the Manchester Driving
Behavior Questionnaire. After nocturnal polysomnography, they performed 2
neuropsychological tests, a 4 × 40-minute Maintenance of Wakefulness Test, and a
1-hour driving session. The primary outcome measure was the mean sleep latency on
the Maintenance of Wakefulness Test. ADHD patients were divided into 3 groups
defined by their Maintenance of Wakefulness Test scores. Participants (patients
and control subjects) were allocated as follows: sleepy ADHD (0-19 min),
intermediate ADHD (20-33 min), alert ADHD (34-40 min), and control group (34-40
min). The driving performance outcome was the mean standard deviation of lateral
position of the vehicle during the simulated session.
RESULTS: The group mean (SD) Epworth Sleepiness Scale score was higher in ADHD
patients (12.1 [4.4]) than in controls (6.0 [2.7]) (P < .001). On the basis of
the Maintenance of Wakefulness Test scores, 14 patients (35%) were in the sleepy
group, 20 (50%) were in the intermediate group, and only 6 (15%) were in the
alert group. Sleepy ADHD patients exhibited significantly deteriorated driving
performance compared to the other 3 groups (P < .01).
CONCLUSIONS: Our study shows that a significant proportion of adult ADHD patients
exhibit an objective excessive daytime sleepiness, which, in addition, has an
impact on simulated driving performance. Excessive daytime sleepiness, therefore,
may be a key element needed to better evaluate these ADHD patients.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01160874.
© Copyright 2015 Physicians Postgraduate Press, Inc.
DOI: 10.4088/JCP.14m09087
PMID: 25610980 [Indexed for MEDLINE]