Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD), from childhood to adulthood, often experience sleep difficulties and disorders. These include shorter sleep time, difficulty falling or staying asleep, racing thoughts, and bursts of energy at night. Other issues include sleep apnea and restless leg syndrome.
Possible causes of sleep problems associated with ADHD include:
Disruptions to the parts of the brain involved in arousal, alertness, and regulation
Hormone dysfunction, including melatonin production, that may affect circadian rhythms
Side effects of ADHD medications
Co-occurring disorders, such as anxiety and depression, can cause sleep problems
Research has not yet fully explained the connection between sleep and ADHD, partly due to the nature of sleep itself. While it may seem simple on the surface, sleep is a complicated activity. Many factors go into a good night’s sleep: the timing of falling asleep and waking, sleep cycles (including dreaming), hormone levels, and the environment, to name a few.
New Research on Sleep and ADHD
Because sleep involves so many factors, it is difficult to pinpoint which ones are most influential on adolescents with ADHD. However, new research out of Duke University Medical Center suggests that two in particular—sleep timing and regularity—can have a big impact.
For their study, the researchers looked at sleep regularity and sleep timing in 90 adolescents, mean age of 14. They looked at possible connections between these factors and the severity of the adolescents’ ADHD symptoms, as well as their academic and social functioning.
The participants received seven days and nights of actigraphy, a type of monitoring that measures motor activity and rest/activity cycles. The participants and their parents or guardians also reported and commented on the severity of their ADHD symptoms and their academic and social functioning.
After controlling for factors such as sex and race, results indicate that the participants who experienced delayed sleep timing were more likely to report more ADHD symptoms and lower social functioning. Irregular sleep was associated with more ADHD symptoms and lower social and academic functioning, reported by both participants and their parents.
The study, “Sleep Regularity and Timing Associated With ADHD Severity and Academic/Social Performance in Adolescents,” was presented at The American Professional Society of ADHD and Related Disorders 2021 Annual Conference.
Importance of Sleep in ADHD
These new findings could provide a more specific target for improving the sleep of adolescents with ADHD. This is especially critical due to the negative effects of poor sleep quality on those with ADHD:
More severe ADHD symptoms
Lower quality of life
Negative impact on school or work performance
Increased risk of additional mental health concerns such as depression, anxiety, hyperactivity, inattention, and cognitive impairment
Physical health problems, such as a higher BMI and cardiovascular risks
Hazards caused by sleepiness while driving
Strained relationships and family life
Just as mental and physical health influence each other, sleep quality is closely linked to both. Addressing sleep problems in adolescents with ADHD could help decrease symptoms, increase social functioning, and improve quality of life.
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