What is the relationship between ADHD and sleep? Children who have sleep disorders and attention deficit hyperactivity disorder (ADHD) may have similar symptoms, such as inattentiveness, overactivity and restlessness. Unlike adults who become drowsy and less active when sleep is disturbed, children may have the opposite response. The interplay between these disorders is significant, and diagnoses may be mistaken because of the overlap.
Defining ADHD
ADHD is a neurodevelopmental disorder affecting about 5% of people, both children and adults. Those who are affected experience inattention, hyperactivity, forgetfulness, poor impulse control or impulsivity and distractibility. Each of these criteria may manifest in different ways:
- Inattention: careless mistakes, not seeming to listen, trouble keeping attention on tasks, not following instructions, trouble organizing, avoiding mental effort for a long period of time, losing things, easy distraction or forgetfulness
- Hyperactivity-impulsivity: fidgeting, squirming, getting up, running about, trouble enjoying quiet leisure (they are often “on the go") or talking excessively
- Impulsivity: blurting out answers, trouble waiting his turn, interrupting or intruding
Relationship to Sleep Disorders
There are many sleep disorders that may affect children. Most of the disorders found in adults can also occur in children, including: insomnia, bruxism, periodic limb movement syndrome, somniloquy, obstructive sleep apnea, somnambulism and circadian rhythm disorders. Children more commonly experience night terrors than adults.
Children who have ADHD may be expected to have disrupted sleep. There is a behavioral component to sleep, and parenting difficulties often will extend to bedtime. In addition, there may be psychiatric symptoms, such as anxiety or depression, that can disrupt sleep. Studies have consistently shown higher rates of sleep disorders among children with ADHD.
It is proposed that sleep problems may relate to ADHD in four ways:
- Uniquely related to ADHD
- Related to another disorder that co-occurs with ADHD (e.g., anxiety)
- Result of stimulant medication
- Not related, just common in general
More than 25% of all children, not just those with ADHD, will have a sleep disorder at some point. These have enormous and varying impacts on family dynamics, school success and other health issues.
