The link between ADHD and sleep

Research Summary
Saurab Faruque
Research Assistant

6.4 million people are diagnosed with Attention Deficit Hyperactive Disorder (ADHD) in the United States alone. The impact of ADHD, and the drugs that are used to treat it, is a growing concern for many health professionals. Part of this uneasiness stems from the lack of evidence-based understanding of this disease, which blur the lines of its diagnosis. With over two million more children and adolescents between 4 and 17 years old diagnosed with ADHD in 2011 than in 2003, scientists urge for better ways to properly identify the disorder. One of these tools may be sleep monitoring.

During a recent conference on applied and translational neuroscience that drew in over 5000 experts from all over the world, scientists discussed the evidence supporting the connection between ADHD and sleep. Melatonin is a hormone that rules some of our daily bodily routines, including our sleeping and eating schedules. Citing studies that show that over 75% of ADHD patients suffer from abnormalities in their melatonin levels, as well as findings that connect many sleep disorders – such as sleep apnea, restless leg syndrome, circadian rhythm disturbance, and delayed sleep phase syndrome – to ADHD, scientists like Sandra Kooij, the founder and chair of the European Network Adult ADHD, urge for a deeper investigation of this disorder’s connection to sleep.

Dr. Syed Naqvi, a pediatrician and pediatric sleep expert at University of Texas Southwestern's Peter O'Donnell Jr. Brain Institute, sees the connection in his patients. In a recent article published in Science Daily, he mentions the different impact sleeplessness has on children versus adults: "If adults don't get enough sleep, they'll appear sleepy, but children don't do that. They show ADHD-like behavior instead – [children] are hyperactive or inattentive.” He has personally treated many children with ADHD whose symptoms only diminished after improving sleep quality and increasing sleep duration. Sometimes it is actually ADHD medication that is the root of the sleep and behavior problems, so he advises that pills may not be the best first intervention.

Dr. Naqvi recommends that parents first determine whether sleep disturbances are affecting their child by: 1) watching for signs of snoring or short pauses in breathing during sleep, 2) tracking the duration of nighttime sleep and any daytime sleepiness, and 3) monitoring academic performance after starting ADHD medications. If any abnormalities are identified, he strongly suggests seeking the help of a sleep expert.

Although a direct connection between sleep and ADHD has not yet been revealed in depth, it is important to understand that the potential connection should not be ignored because these two things may be deeply connected.