Sleep problems in the child with attention-deficit hyperactivity disorder: defining aetiology and appropriate
Margaret D Weiss1, Jay Salpekar
1Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada. mweiss@cw.bc.ca
Insights
Children with attention-deficit hyperactivity disorder (ADHD) often face sleep issues like delayed sleep onset and daytime sleepiness. Addressing these sleep problems may help improve ADHD symptoms and overall well-being.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
Background:
- Attention-deficit hyperactivity disorder (ADHD) affects 25-50% of children and adolescents, frequently accompanied by sleep disturbances.
- Common sleep issues include delayed sleep onset, bedtime resistance, morning grogginess, and daytime sleepiness.
- Elevated rates of restless legs syndrome, periodic limb movement disorder, and sleep-disordered breathing are noted in pediatric ADHD populations.
Purpose of the Study:
- To review the prevalence and nature of sleep problems in children and adolescents with ADHD.
- To explore the relationship between ADHD, sleep disturbances, and potential contributing factors like medication.
- To discuss assessment methods and potential interventions for sleep issues in pediatric ADHD.
Main Methods:
- Literature review and synthesis of existing research on ADHD and sleep disorders in pediatric populations.
- Analysis of common sleep problems and associated conditions reported in children with ADHD.
- Examination of assessment tools and therapeutic strategies for managing sleep disturbances.
Main Results:
- Significant overlap exists between ADHD and various sleep disorders in children and adolescents.
- Medications for ADHD or comorbid conditions can contribute to sleep disturbances.
- Sleep problems may worsen ADHD symptoms, while sleep interventions might alleviate irritability.
Conclusions:
- Sleep disturbances are prevalent in pediatric ADHD and can exacerbate core symptoms.
- Assessment tools like questionnaires and sleep diaries are crucial for evaluating sleep issues.
- Targeted interventions for sleep problems, including behavioral and pharmacological approaches, show potential for improving ADHD-related symptoms.
Abstract:
An estimated 25-50% of children and adolescents with attention-deficit hyperactivity disorder (ADHD) experience problems with sleep. The most common sleep problems reported in children with ADHD include delayed sleep onset, sleep or bedtime resistance, prolonged tiredness upon waking and daytime sleepiness. Higher incidences of sleep disorders such as restless legs syndrome, periodic limb movement disorder and sleep-disordered breathing have been reported in paediatric ADHD populations compared with control populations. In some cases, medications for ADHD and/or co-morbid disorders may also contribute to sleep disturbances. Assessment tools, such as parent-child questionnaires and sleep diaries, can help clinicians evaluate sleep disturbances. Sleep problems may potentially exacerbate ADHD symptoms, and interventions targeted at ensuring adequate sleep (including behavioural, dietary, specific pharmacological agents for treatment-induced insomnia, and melatonin) could in turn potentially attenuate symptoms associated with ADHD, such as irritability. Whether metabolic or neurological pathways common to both sleep and ADHD may be disrupted, and whether targeting treatments to these pathways may simultaneously improve both ADHD and sleep symptoms, needs further elucidation.
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