Objective:

To examine the relationship between subjective sleepiness and objective sleep propensity in adults with ADHD compared to a clinical group with excessive daytime sleepiness but without ADHD.

Approach:

• Study Design: Retrospective cross-sectional study analyzing medical records of 130 adults who underwent Multiple Sleep Latency Test (MSLT) in 2021.
• Participants: Included 68 adults in the ADHD group and 62 in the EDS-only group, aged 18 years or older.
• Assessment Tools: Subjective sleepiness assessed using the Epworth Sleepiness Scale (ESS); objective sleep propensity measured by mean MSLT sleep latency.

Key Findings:

• ESS scores were similar between ADHD (median 14.0) and EDS-only groups (median 13.0, p = 0.45).
• Mean sleep latency was significantly longer in the ADHD group (432.0 s) compared to the EDS-only group (322.0 s, p = 0.008).
• MSLT positivity was less frequent in the ADHD group (61.8%) compared to the EDS-only group (87.1%, p = 0.001).
• No significant correlation between ESS scores and mean sleep latency in the ADHD group; a significant inverse correlation was found in the MSLT-positive EDS-only subgroup (p < 0.05).

Interpretation:

Subjective sleepiness complaints and objective sleep propensity may not align in adults with ADHD.

Limitations:

• Retrospective design may limit the ability to establish causality and the generalizability of findings due to the exclusion of individuals with other primary psychiatric disorders.

Conclusion:

The study highlights a discrepancy between subjective sleepiness and objective sleep propensity in adults with ADHD.