ADHD (Attention Deficit Hyperactivity Disorder)

ADHD (Attention Deficit Hyperactivity Disorder) and sleep

Jason is a 6 year old boy who is having a little trouble since he began school as first grader. At home his parents assumed he is an active child but when he started school, Jason had trouble following the teacher’s instructions or rules of games with other kids. Jason was diagnosed with ADHD. A year later, he had a sleep study because his parents noticed that he snored loudly and his sleep was restless. The study confirmed that he had mild sleep apnea. His large tonsils were removed and Jason’s behavior actually showed gradual improvement. He was able to be attentive in class and his grades improved.

The causes of hyperactivity and inattentiveness are numerous but sleep problems need to be considered in a child or adult with symptoms of ADHD. Studies show that many children and adults with the diagnosis of ADHD have symptoms of sleep problems such as insomnia, daytime sleepiness, restless legs syndrome and sleep disordered breathing such as sleep apnea or snoring.

Adults with ADHD experience forgetfulness, distractibility, inattentiveness and impulsivity. They have disorganized habits at work or home, often labeled as “messy”. They miss appointments. They cannot finish a task and get distracted by noises and irrelevant stimuli. Individuals may experience problems in their interpersonal relationship and at work.

Children and adolescents with ADHD share many features with adult who have ADHD. They tend to be hyperactive and restless. They have trouble following direction. They might underperform in school and have trouble following rules.

There is a strong relationship between ADHD and restless legs syndrome (RLS) in adolescents. Also those with RLS and sleeping difficulty are more likely to be hyperactive. About 64% of children with ADHD also have periodic limb movements of sleep (PLMS). These finding are found in studies by Yilmaz which was published in 2011 in Developmental Medicine and Child Neurology and Picchietti and coworders which was published in the 1999 Movement Disorders journal.

Attention deficits have been reported in up to 95% of individuals with obstructive sleep apnea. Vice versa, those with ADHD had a high incidence (20% to 30%) of sleep apnea. This is according to a study published in Annals of Clinical Psychiatry in 2011’ s August issue. What is more important, 6 interventional studies reported improvements in behavior, inattention, and overall ADHD after treatment of sleep apnea.

Recommendation for ADHD and sleep:

  • If there is suspicion of ADHD in your child or yourself, there is a possibility of a sleep disorder either causing or exacerbating the ADHD symptoms. Talk to your healthcare provider to be screened for a sleep disorder.
  •  Snoring, stop breathing at night and daytime sleepiness or fatigue are signs of sleep apnea. An urge to move your legs in the evenings and nights and/or leg jerks during sleep are signs of restless legs syndrome. Ty to explore the possibility of a sleep disorder since most are easily treatable and can certainly improve your quality of life by having more energy and vitality and better outcomes at work and home.