Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders worldwide, with a prevalence among children and adolescents of around 5.9% and in adults 2.5%. This thesis aimed (i) to investigate the acceptability of using remote measurement technology (RMT) with adolescents and adults with ADHD; (ii) to use RMT to explore sleep disturbances and sleep hygiene behaviours in individuals with ADHD; and (iii) to capture real-world consequences of ADHD medication treatment. RMT enables detailed, frequent, long-term, real-time, real-world continuous monitoring and includes two main data streams: active (questionnaires, cognitive tasks) and passive (smartphone sensors, wearable devices) monitoring data. The first part of this thesis used qualitative methods to identify the barriers to and facilitators of using RMT in the long-term monitoring of individuals with and without ADHD. Individuals with ADHD agreed that RMT can provide useful objective data. While there was some overlap in the barriers and facilitators of engagement to RMT in individuals without ADHD, unique considerations also emerged for people with ADHD, such as the impact that their ADHD symptoms had on taking part, the perceived cost of completing the cognitive tasks, and experienced more technical challenges. The second part of this thesis examined sleep features and sleep hygiene behaviours in individuals with and without ADHD. Results from a 10-week remote monitoring period suggest that while individuals with and without ADHD did not differ on their mean levels of sleep features or sleep hygiene behaviours, the groups differed on the variability of sleep duration, sleep onset and offset, sleep efficiency, and social app usage two hours prior to sleep onset. The third part of this thesis used RMT to examine adherence behaviours and side effects in adults with ADHD, and consequences of ADHD medication treatment initiation, by comparing a 28-day period off medication to a 28-day period on stable medication within the same individual. Even though adults with ADHD took their medication on most days during the first month on stable ADHD medication, they also chose not to, or forgot, to take medication on 13% of the days. ADHD symptoms and impairments, as well as depressive and anxiety symptoms, improved following the initiation of ADHD medication, but several side effects were also reported using the smartphone Active App. Overall, this thesis provides novel insights into the acceptability of using RMT with individuals with ADHD and shows that inconsistency and high variability in behaviour – a hallmark of ADHD – also extend to sleep features of adolescents and adults with ADHD. The research reported here shows promise that using RMT in individuals with ADHD can be helpful in collecting real-world data on health behaviours and consequences of medication treatment initiation.
Investigating the acceptability of remote measurement technology and its uses in capturing sleep behaviours and real-world consequences of medication treatment of individuals with ADHD
Denyer, H. (Author). 1 Oct 2024
Student thesis: Doctoral Thesis › Doctor of Philosophy