![]() ![]() Problems with sleep can, however, also lead to the development of ADHD or ADHD-like symptoms, potentially resulting in misdiagnosis (Cortese et al. Problems with sleep may be an intrinsic feature of ADHD, or may both exacerbate and be exacerbated by the symptoms of the disorder. The association of sleep with ADHD is multifaceted and complex. Indeed, high nocturnal activity and disordered sleep were defining characteristics of ‘hyperkinetic reaction in childhood’ or ‘attention deficit disorder’ in earlier versions of the DSM (American Psychiatric Association 1980 Barkley 1990 Sadeh et al. In a recent Australian study, 62 % of children with ADHD had moderate or severe sleep problems and 22 % took sleep medications during the 1-week observation period (Efron et al. Although diagnosis relies on observations made while patients are awake, the prevalence of sleep disturbances in individuals with ADHD is reported to be in the range 25–55 % (Corkum et al. ![]() Inattention, hyperactivity and impulsiveness are recognized as the symptoms of ADHD according to the current diagnostic criteria and are associated with characteristic behavioral difficulties and impairments of day-to-day functioning. 2007) and to persist into adulthood in approximately two-thirds of patients (Spencer et al. This review aims to provide a comprehensive overview of the relationships between ADHD and sleep, and presents a conceptual model of the modes of interaction: ADHD may cause sleep problems as an intrinsic feature of the disorder sleep problems may cause or mimic ADHD ADHD and sleep problems may interact, with reciprocal causation and possible involvement of comorbidity and ADHD and sleep problems may share a common underlying neurological etiology.Īttention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that has been estimated to affect approximately 5.3 % of children and adolescents worldwide (Polanczyk et al. Current guidelines recommend assessment of sleep disturbance during evaluation of ADHD, and before initiation of pharmacotherapy, with healthy sleep practices the first-line option for addressing sleep problems. Long-acting formulations may have insufficient duration of action, leading to symptom rebound at bedtime. Psychostimulant medications are associated with disrupted or disturbed sleep, but also ‘paradoxically’ calm some patients with ADHD for sleep by alleviating their symptoms. ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian-rhythm sleep disorders). Evidence from published studies comparing sleep in individuals with ADHD with typically developing controls is most concordant for associations of ADHD with: hypopnea/apnea and peripheral limb movements in sleep or nocturnal motricity in polysomnographic studies increased sleep onset latency and shorter sleep time in actigraphic studies and bedtime resistance, difficulty with morning awakenings, sleep onset difficulties, sleep-disordered breathing, night awakenings and daytime sleepiness in subjective studies. The relationships of ADHD with sleep problems, psychiatric comorbidities and medications are complex and multidirectional. ICD-10-CM F51.04 is grouped within Diagnostic Related Group(s) (MS-DRG v40.Attention-deficit/hyperactivity disorder (ADHD) is commonly associated with disordered or disturbed sleep. Insomnia not due to a substance or known physiological condition insomnia due to known physiological condition ( G47.0-). ![]()
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