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March 3, 1999


Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(9):797. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-9-jbk0303

In Reply: While sleep disorders in general and sleep apnea in particular should always be considered in the differential diagnosis of adult-onset difficulties with alertness and attention, this is not necessarily the case with ADHD. Our discussion of Mr L pertains to a childhood onset and persistent syndrome of inattention, distractibility, and impulsivity with associated academic and interpersonal difficulties.1,2 It is precisely the childhood history of such difficulties that carry over into adulthood that differentiates adults with ADHD from other forms of adult-onset cognitive deficits, including sleep disorders.1,2