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ADHD Attention Deficit and Hyperactivity Disorders

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Open Access 01-03-2015 | Review Article

Associations of sleep disturbance with ADHD: implications for treatment

Author: Allan Hvolby

Published in: ADHD Attention Deficit and Hyperactivity Disorders | Issue 1/2015

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is commonly associated with disordered or disturbed sleep. The relationships of ADHD with sleep problems, psychiatric comorbidities and medications are complex and multidirectional. Evidence from published studies comparing sleep in individuals with ADHD with typically developing controls is most concordant for associations of ADHD with: hypopnea/apnea and peripheral limb movements in sleep or nocturnal motricity in polysomnographic studies; increased sleep onset latency and shorter sleep time in actigraphic studies; and bedtime resistance, difficulty with morning awakenings, sleep onset difficulties, sleep-disordered breathing, night awakenings and daytime sleepiness in subjective studies. ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian-rhythm sleep disorders). Psychostimulant medications are associated with disrupted or disturbed sleep, but also ‘paradoxically’ calm some patients with ADHD for sleep by alleviating their symptoms. Long-acting formulations may have insufficient duration of action, leading to symptom rebound at bedtime. Current guidelines recommend assessment of sleep disturbance during evaluation of ADHD, and before initiation of pharmacotherapy, with healthy sleep practices the first-line option for addressing sleep problems. This review aims to provide a comprehensive overview of the relationships between ADHD and sleep, and presents a conceptual model of the modes of interaction: ADHD may cause sleep problems as an intrinsic feature of the disorder; sleep problems may cause or mimic ADHD; ADHD and sleep problems may interact, with reciprocal causation and possible involvement of comorbidity; and ADHD and sleep problems may share a common underlying neurological etiology.

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Title: Associations of sleep disturbance with ADHD: implications for treatment
Author: Allan Hvolby
Publication date: 01-03-2015
Publisher: Springer Vienna
Published in: ADHD Attention Deficit and Hyperactivity Disorders / Issue 1/2015
Print ISSN: 1866-6116
Electronic ISSN: 1866-6647
DOI: https://doi.org/10.1007/s12402-014-0151-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Associations of sleep disturbance with ADHD: implications for treatment

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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