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Sleep Loss Impairs Cognition More in People With Subclinical ADHD Symptoms

January 06, 2021

After losing a night’s sleep, people with high but subclinical attention-deficit/hyperactivity disorder (ADHD) traits performed worse on tasks involving attentional regulation and emotional control than people with low ADHD traits did.

Researchers published the findings online in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 

“One of the reasons why these results are important is that we know that young people are getting much less sleep than they did just 10 years ago,” said researcher Predrag Petrovic, MD, PhD, of the Karolinska Institutet, Stockholm, Sweden. “If young people with high ADHD-traits regularly get too little sleep, they will perform worse cognitively and, what's more, their symptoms might even end up at a clinically significant level.”

The study included 180 healthy participants aged 17 through 45 years without an ADHD diagnosis. Researchers assessed tendencies toward inattentiveness and emotional instability using the Brown Attention-Deficit Disorder scale.

Participants were then randomized to a night of normal sleep or total sleep deprivation. Afterward, they performed a computerized Stroop task that measured executive function and emotional control using neutral and emotional faces.

Following Healthy Lifestyle Recommendations May Reduce ADHD Risk

Overall, participants who were sleep deprived performed worse on the tasks, according to the study. Those with high ADHD traits were more vulnerable to sleep deprivation and demonstrated greater impairment compared with those low ADHD traits.

In addition, participants with high ADHD traits who had more everyday problems with emotional instability had greater difficulty with the emotional regulation task, researchers reported. On the other hand, participants who struggled more with everyday inattention symptoms had more trouble with the nonemotional cognitive task.

“In conclusion, this study indicates that phenotypes with subclinical ADHD and emotional instability symptoms can help explain why some individuals show cognitive impairments after sleep loss, whereas others are hardly affected—a question that has not yet been resolved,” researchers wrote.

“The data also indicate that the consequence of sleep loss is domain specific, i.e., it depends on an individual’s underlying vulnerability, and that the impairments are manifested as variable behavioral performance across time.” 

—Jolynn Tumolo


Floros O, Axelsson J, Almeida R, et al. Vulnerability in executive functions to sleep deprivation is predicted by subclinical attention-deficit/hyperactivity disorder symptoms. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 2020 October 29;[Epub ahead of print.]

Individuals with high ADHD-traits are more vulnerable to insomnia [press release]. Stockholm, Sweden: Karolinska Institutet; December 18, 2020.

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