Recent studies suggest a role for sleep and sleep problems in the etiology of
attention deficit hyperactivity disorder (
ADHD) and a recent model about the working mechanism of sensori-motor rhythm (SMR)
neurofeedback, proposed that this intervention normalizes sleep and thus improves
ADHD symptoms such as inattention and hyperactivity/impulsivity. In this study we compared adult
ADHD patients (N = 19) to a control group (N = 28) and investigated if differences existed in sleep parameters such as Sleep Onset Latency (
SOL), Sleep Duration (DUR) and overall reported sleep problems (PSQI) and if there is an association between sleep-parameters and
ADHD symptoms. Secondly, in 37
ADHD patients we investigated the effects of SMR and Theta/Beta (TBR)
neurofeedback on
ADHD symptoms and sleep parameters and if these sleep parameters may mediate treatment outcome to SMR and TBR
neurofeedback. In this study we found a clear continuous relationship between self-reported sleep problems (PSQI) and inattention in adults with- and without-
ADHD. TBR
neurofeedback resulted in a small reduction of
SOL, this change in
SOL did not correlate with the change in
ADHD symptoms and the reduction in
SOL only happened in the last half of treatment, suggesting this is an effect of symptom improvement not specifically related to TBR
neurofeedback. SMR
neurofeedback specifically reduced the
SOL and PSQI score, and the change in
SOL and change in PSQI correlated strongly with the change in inattention, and the reduction in
SOL was achieved in the first half of treatment, suggesting the reduction in
SOL mediated treatment response to SMR
neurofeedback. Clinically, TBR and SMR
neurofeedback had similar effects on symptom reduction in
ADHD (inattention and hyperactivity/impulsivity). These results suggest differential effects and different working mechanisms for TBR and SMR
neurofeedback in the treatment of
ADHD.