Sleep deprivation alters early event-related potentials during emotional face processing in adults with ADHD

The impact of sleep deprivation on cognitive and emotional processing is well-documented, but its effect on neural activity patterns in individuals with attention deficit/hyperactivity disorder (ADHD) remains unclear. This study examined how sleep deprivation influences facial and non-facial stimulus processing in young males with ADHD using behavioral and neural measures. Nineteen ADHD participants and 14 neurotypical controls completed a visual oddball task involving emotional and neutral facial expressions and geometric shapes before and after 25 h of wakefulness. The task assessed neural activity using event-related potentials (ERPs). Behaviorally, sleep deprivation significantly increased commission errors, omission errors, reaction time variability, and reaction time in the ADHD group, particularly for emotional stimuli, whereas the control group showed minimal or no significant changes across these measures. Sleep deprivation significantly altered early ERP components (P1 and N170) in response to emotional facial expressions: P1 activity decreased in the control group, whereas in the ADHD group it remained unchanged in the frontal region and increased in the posterior-parietal region. N170 activity increased in the control group but remained unchanged in the ADHD group, indicating distinct neural processing patterns under sleep deprivation. These findings indicate that sleep deprivation exacerbates deficits in processing emotional facial expressions in ADHD. Addressing sleep-related issues could be instrumental in managing ADHD symptoms.