Sleep Problems as Predictors in Attention-Deficit Hyperactivity Disorder: Causal Mechanisms, Consequences and Treatment

Abstract

Attention-deficit hyperactivity disorder (ADHD) is notorious for its debilitating consequences and early age of onset. The need for early diagnosis and intervention has frequently been underscored. Previous studies have attempted to clarify the bidirectional relationship between ADHD and sleep problems, proposing a potential role for sleep problems as early predictors of ADHD. Sleep deprivation, sleep-disordered breathing, and circadian rhythm disturbances have been extensively studied, yielding evidence with regard to their induction of ADHD-like symptoms. Genetic-phenotypic differences across individuals regarding the aforementioned sleep problems have been elucidated along with the possible use of these characteristics for early prediction of ADHD. The long-term consequences of sleep problems in individuals with ADHD include obesity, poor academic performance, and disrupted parent-child interactions. Early intervention has been proposed as an approach to preventing these debilitating outcomes of ADHD, with novel treatment approaches ranging from melatonin and light therapy to myofunctional therapy and adjustments of the time point at which school starts.

Increased attention‐deficit/hyperactivity symptoms in atopic dermatitis are associated with history of antihistamine use

“…This finding further supports the suspected key role of sleeping problems in infancy related to AD and also potentially for the subsequent development of ADHD in later childhood . One possible explanation for this finding is to assume a causal role of early life sleeping problems (with or without antihistamine treatment) for subsequent ADHD development . This hypothesis is strengthened by a study that found an association between sleeping problems at 3‐4 years of age in twins and ADHD symptoms and other mental health problems at 7 years of age .…”

The key role of daytime sleepiness in cognitive functioning of adults with attention deficit hyperactivity disorder

“…They also report higher daytime sleepiness [5] and lower sleep quality [6][7][8][9] compared to neurotypical controls. These difficulties have a negative influence on quality of life [10] and make management of ADHD and diagnostic differentiation much more challenging, as they result in ADHD-like symptoms [11][12][13]. However, although verbally reported sleep problems can be robustly linked to ADHD (with effect sizes ranging from medium to very large), there is only very limited evidence from objective sleep measures [14].…”

Impact of Omega-3 Fatty Acids Among Other Nonpharmacological Interventions on Behavior and Quality of Life in Children with Compromised Conduct in Spain

“…The increase in rest time observed in the study was a notable finding, particularly given that treated and untreated children with certain behavioral disorders display more sleep problems than their typically developing peers (Kirov and Brand 2014). For example, a meta-analysis found that children with ADHD, the most common neurobehavioral disorder of childhood (AAP 2000), experience more sleep difficulties than children without ADHD, including insomnia, sleep-disordered breathing, and circadian rhythm disturbances (Cortese et al 2013;Um et al 2017). Our comparison of children included in the study with children from the general population demonstrated that behavior-related problems have a negative effect on children's mental health and their QOL.…”