Sleep disorders in patients with ADHD: impact and management challenges

Abstract

Attention deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders in childhood, enduring through adolescence and adulthood and presenting with symptoms of inattention, hyperactivity, and/or impulsivity and significantly impairing functioning. Primary sleep disorders such as sleep-disordered breathing, restless leg syndrome, circadian rhythm sleep disorder, insomnia, and narcolepsy are commonly comorbid in these individuals but not often assessed and are therefore often left untreated. Sleep disturbances in individuals with ADHD can result in significant functional impairments that affect mood, attention, behavior, and ultimately school/work performance and quality of life. Previous reviews have described findings related to sleep but have neglected to examine potential impacts of these sleep disorders and ADHD on daytime functioning. This review investigates empirical findings pertaining to sleep abnormalities and related cognitive, behavioral, emotional, and physical impairments in individuals with ADHD and comorbid primary sleep disorders across the life span. It discusses implications to management and highlights existing limitations and recommended future directions.

Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

“…ADHD was reported to increase disease burden and worsen QoL in people with various comorbidities [40] because of symptoms of inattention, hyperactivity, and/ or impulsivity, mood, attention, behavior and sleep disorders, impaired function, and reduced school/work performance [41]. In keeping with this view, we documented that higher education and being employed ameliorated some SF-36 dimensions, suggesting these factors may mitigate the impact of ADHD through some compensatory effects.…”

Afternoon School Start Times Are Associated with a Lack of Both Social Jetlag and Sleep Deprivation in Adolescents

“…In fact, a global meta-analysis of more than 200 publications reported a steady decrease in teenage sleep over the past century, with teens sleeping more than an hour less per night than in 1905 (Matricciani et al., 2012). This epidemic of chronic sleep deprivation leads to significant negative health outcomes that include mental disorders such as attention-deficit hyperactivity disorder, anxiety, and depression as well as physical ailments including metabolic disease, obesity, and a higher propensity for sports injuries (for recent reviews, see Copenhaver and Diamond, 2017; Galvan, 2020; Jamieson et al., 2020; Marver and McGlinchey, 2019; Shochat et al., 2014; Sugaya et al., 2019; Tarokh et al., 2016; Wahlstrom and Owens, 2017; Wajszilber et al., 2018).…”

Risk factors for low adherence to methylphenidate treatment in pediatric patients with attention-deficit/hyperactivity disorder

“…However, only hypnotics exhibited a statistically significant association with adherence. Sleep disturbances can appear as ADHD symptoms 51 – 53 . Therefore, patients with concomitant hypnotic use in the early stage are presumed to originally have had moderate or severe sleep problems.…”