ADHD and Sleep Disorders M - CHADD
cally, ADHD symptoms arise in early hood. According to the DSM-5, several ptoms are required to be present before ge of 12. Many parents report excessive r activity during the toddler years, but D symptoms can be hard to distinguish the impulsivity, inattentiveness and active vior that is typical for kids under the age of
National Resource Center on ADHD
A Program of CHADD
ADHD and1 Sleep Disorders
MANY CHILDREN AND ADULTS WHO HAVE ADHD ALSO HAVE A SLEEP DISORDER-- almost three out of four children and adolescents, and up to four out of five adults with ADHD. Not getting enough sleep, or needing to sleep at times that don't mesh with school or work obligations, can have significant long-term effects. Those can include physical illness, behavioral issues, and mood changes. While adults may seem obviously tired when they are behind on sleep, fatigue in children often looks like exaggerated ADHD symptoms: hyperactivity and impulsivity--sometimes even aggressiveness and acting out.
Causes of sleep problems Circadian rhythm disorders. Researchers have repeatedly found that sleep problems are common among people who have ADHD. They think that one reason is because ADHD can mess up what is considered to be a standard sleep-wake cycle, or circadian rhythm. If your circadian rhythm is off, you may have a hard time falling asleep at a standard bedtime, or your sleep may be regularly disrupted, with lots of wakeups throughout the night. Either of those can make it hard for you to wake when your alarm goes off or stay awake and think clearly at work or at school. In general, people
with ADHD feel more alert in the evening than they do in the morning. That is the opposite of the way it is for people who do not have ADHD.
For young children with ADHD, it can be difficult to settle down at the end of the day. It may be the child who is wound up from the day's events can't stop reliving them and talking about them, or the child who gets so lost in a book or a puzzle doesn't want to stop reading to brush her teeth and put on pajamas. Although these are not troubling behaviors, when they occur every night, they can frustrate both the child and his or
her parents, and in turn further mess with sleep habits.
Caffeine and ADHD medications. Caffeine in soda, coffee, and chocolate, as well as stimulant medications, can also get in the way of a good night's sleep. Yet even nonstimulant ADHD medications can affect sleep by making people sleepy after taking them--they may need a nap during the day.
Alcohol. Alcohol can make people fall asleep quickly but struggle to stay asleep.
ISTOCK / OCUSFOCUS
Other conditions. Many conditions that commonly coexist with ADHD, such as anxiety or depression, can have a significant effect on sleep as well.
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Electronics. For anyone, too much time on a smart- Restless Legs Syndrome. Another common coexisting
phone, playing video games, or watching television in condition is Restless Legs Syndrome (RLS). People
the evening can mess with the ability to fall asleep and with RLS have an almost uncontrollable need to move
stay asleep.
their legs. It is especially noticeable in the evenings and
when they are in bed. RLS is not common among the
Common sleep disorders. A number of diagnosable general population of children, but many children who
sleep disorders are associated with ADHD.
have ADHD also have RLS. Researchers aren't sure
why yet. It may just be that the symptoms of the two
Breathing disorders. Obstructive sleep apnea, snor- conditions are very similar and it's hard to tell them
About ADHD ing, and other sleep-related breathing disorders are
apart when a person is sleeping.
common among children and adults who have been di-
agnosed with ADHD, though doctors aren't really sure
why. When kids wiEthveAryDbHodDyacnadnshleaevpe-drieflfaicteudltybrseiatttihn-g still, Apalsyoinign this series:
ing disorders have athtteeirnttioonnsiolsr rceomntorvoelldin, gthiemypoufltseinvesebeehavioArDHD an improvement inosnycme pintoamwshoilfeb. oFtohr.some people, however, the
and
Sleep
Disorders Diagnosis and Management More than 75 percent of children with ADHD continue to experience
problems are so pervasive and persistent that
significant symptoms in adulthood.
they interfere with every aspect of their life:
In early adulthood, ADHD may be
References:
home, academic, social and work.
associated with depression, mood or conduct disorders and substance
ADHD: A 24-Hour DiAsotrtdeenrt.iPosny-cdheiaftircicitT/ihmyepse, Oraccttoivbeitry2d0i1s8o.rder Sedky, Karim et al. (Augusatb2u0s1e4.). Attention deficit
(rAicDtimHDes).ciosma /nsepuercoiadl-erveeploorptsm/aednhtda-l2d4i-sorderhyperactivity disorder and sleep disordered breathing in
hour-disorder
affecting 11 percent of school-age childrenpediatric populations: A mAedtau-latns awlyitshis.ASDleHeDp MofetdeincincoepReevwieiwths
Becker
SP
&
Lienesch (aJVdAiu.s(lstNehoro,voeedtmaibnl.e, mr220o01r1e48.t))h.SNaynimgthhpttrtioemmee-sqmuceoadrnittaeinrsuoefi1n8t(o4):349-356.
personal and family lives related
to
use in adolescents witchasAeDsH(BDr: oliwnkns,t2o0s1le3e.p) AprDoHblDemisscahnadracterizeTsdabi My H et al. (August 201A6D)H. SDleseypmPprtoobmlesm. s in Children with
internalizing symptomdse.vSeleloeppmMeednitcainlely5i1n:1a7p1-p1r7o8p. rhitatptes:l/e/dvoeil.s of Attention Deficit/Hyperactivity Disorder: Current Status of
org/10.1016/j.sleep.20in1a8t.0te6n.0ti2o1n, impulsivity and hyperactivity.Knowledge and Appropriate Management. Current Psychiatry
Hvolby
A.
(2015).
AssIoncdiaivtiiodnusaolsf
swleitehp
AdiDstHuDrbacanncebweitvhery
Reports successful
18(8):76.
hAtDtpHsD://.dTohi.eorcgu/r1r0e.1n0t0n7a/ms11e9r2e0fl-e0c1t6s-0th7e11i-m4 portance of the inattention aspect of the disorder as well
ADHD: implications foinr tlriefea.tHmoewnte. vAettre, nwtiiotnhoDuefticiditeanntdification andNational Instituteaosf tNheeuorothloegriccahl aDriasoctredreirsstaicnsdoSfttrohkeed. (is2o0r1d8e).r such
Hyperactivity Disordersp7r(o1p):e1r?1t8re. ahttmtpse:n//tw, AwDwH.nDcbmi.nalymh.naivhe.gsoev/riousRestless Leggs SyansdrhoympeerFactiSvhiteyeta.nhdttpims:p//uwlswivwi.tnyi.nds.nih.
pmc/articles/PMC43c4o0n9s7e4q/uences, including school failure, famgoilvy/Disorders/Patient-Caregiver-Education/Fact-Sheets/ stress and disruption, depression, problemRseswtlietshs-Legs-SynSdyrmompet-oFmacst-Sheet
relationships, substance abuse, delinquency, accidental injuries and job failure. Early identification and treatment are extremely important.
Typically, ADHD symptoms arise in early childhood. According to the DSM-5, several symptoms are required to be present before the age of 12. Many parents report excessive
Medical science first documented children exhibiting inattentiveness, impulsivity and hyperactivity in 1902. Since that time, the disorder has beenFogrivfeunrtnhuemr einrofoursmnatmioens, please
motor activity during the toddler years, but ADHD symptoms can be hard to distinguish from the impulsivity, inattentiveness and active behavior that is typical for kids under the age of
including minicmonaltabcratiNnadtyisofnuanlcRtieosno, urce Center on hyperkinetic reactAioDnHoDf c:hAildPhroogorda,manodf CHADD attention-deficit disorder with or without
hyperactivity. W4it6h0th1 ePDreisaigdneonsttsicDanridveS,taStuisitteic3al00 Msyasnteumal,,tFhieftdhiEsodridtieorLnah(naDhsSabMme-e5,nM) rceDlansa2sm0if7iecd0a6ti-o4n832 attention-deficit/hypera1c-t8iv0it0y -d2i3so3r-d4e0r5o0r
nrc
National Resource Center on ADHD
A Program of CHADD
This fact sheet is supported by Cooperative Agreement Number NU38DD005376 from the Centers for Disease Control and Prevention (CDC). The contents are solely
the responsibility of the authhoerlspa4ndaddohndo.tonregcessarily represent the official views of CDC. Permission is granted to photocopy and freely distribute this factsheet for non-
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commercial, educational purposes only, provided that it is reproduced in its entirety, including the CHADD and NRC names, logos and contact information.
? 2019 Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). All Rights Reserved.
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