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Original Articles

Sleep, Alcohol and Cannabis Use in College Students With and Without Attention-Deficit/Hyperactivity Disorder

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Abstract

Background: Relations among attention-deficit/hyperactivity disorder (ADHD), sleep, and substance-related negative consequences are largely unknown. In this cross-sectional study, we examined associations among ADHD diagnosis, sleep, and alcohol-related consequences. We also evaluated the independent and interactive effects of sleep and ADHD on alcohol-related negative consequences, above and beyond levels of alcohol use. Methods: College students who drink alcohol with (n = 51) and without (n = 50) ADHD completed an assessment that included a diagnostic interview assessing ADHD, and questionnaire measures of sleep quality, substance use, and associated consequences. Analyses utilized a series of hierarchical linear regression models and explored these aims for cannabis use in a subset of participants (n = 52 participants that used cannabis). Results: College students who drink alcohol with ADHD reported significantly worse sleep quality and more alcohol-related consequences, relative to those without ADHD. When ADHD and sleep quality were included in the model, ADHD—but not sleep quality—was independently associated with alcohol consequences, but not cannabis consequences. There were no moderating effects of ADHD on the associations between sleep and substance-related consequences. Conclusions: Students who drank alcohol with ADHD may be particularly vulnerable to experiencing poor sleep and consequences from their substance use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Participants did not meet full diagnostic criteria for ADHD but had greater than three reported symptoms of ADHD to be included in the comparison group.

2 Analyses were conducted with and without covariates and no changes in results were found. Therefore, only the proposed analyses with covariates are reported.

3 Given the potential for stimulant medicine to interact with substances and increase negative consequences, stimulant medication use was examined about negative consequences. There was no significant relation between stimulant medication use and negative alcohol consequences (r = .110; p = .272, n = 101) or cannabis consequences (r = .144, p = .307, n = 52), thus, this was not added into the models as a covariate. Of participants with ADHD, approximately half (n = 26) self-reported currently being prescribed medication for ADHD.

Additional information

Funding

This work was supported by the National Institutes of Health (NIH) under Grant No. F31AA027937.

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