Prevalence of confirmed Attention Deficit Hyperactivity Disorder (ADHD) is increasing:
The association of sleep with ADHD is multifaceted and complex. A recent systematic review indicated that the prevalence of OSA in patients with ADHD (25–30 %) is higher than in the general population (about 3 %) (Youssef et al. 2011).
While 2 % of typically developing children and adolescents (aged 8–17 years) are reported to meet the diagnostic criteria for Restless Legs Syndrome (RLS) (Picchietti et al. 2007), up to 44 % of children with ADHD have symptoms of RLS, and 26 % of children with RLS have symptoms of ADHD (Cortese et al. 2005; Owens 2008).
The effects of stimulants on sleep in patients with ADHD differ from patient to patient and reflect the underlying complexity of the links between ADHD and sleep disturbance (Graham et al. 2011).
Current guidelines recommend assessment of sleep disturbance during evaluation of ADHD.
Both European and US guidelines recommend assessment of sleep disturbance during evaluation of an individual for suspected ADHD, and before initiation of pharmacotherapy (Graham et al. 2011; Wolraich et al. 2011).
Excessive daytime sleepiness was reported in 47% of patients with ADHD, among whom 22% had a hypersomnolence disorder. Patients with sleep disorders may present with features of ADHD. 61% of patients with hypersomnolence have clinically significant ADHD symptoms.
Hypersomnolence is diagnosed by a sleep specialist with:
A Multiple Sleep Latency Test (MSLT)
Author: Phil Teuwen (BSc, MBA, ACP-Sleep), Sleep Scientist
References
- Youssef NA, Ege M, Angly SS, Strauss JL, Marx CE. Is obstructive sleep apnea associated with ADHD? Ann Clin Psychiatry. 2011;23:213–224.
- Picchietti D, Allen RP, Walters AS, Davidson JE, Myers A, Ferini-Strambi L. Restless legs syndrome: prevalence and impact in children and adolescents—the Peds REST study. Pediatrics. 2007;120:253–266. doi: 10.1542/peds.2006-2767.
- Cortese S, Konofal E, Lecendreux M, Arnulf I, Mouren MC, Darra F, Dalla Bernardina B. Restless legs syndrome and attention-deficit/hyperactivity disorder: a review of the literature. Sleep. 2005;28:1007–1013.
- Owens JA. Sleep disorders and attention-deficit/hyperactivity disorder. Curr Psychiatry Rep. 2008;10:439–444. doi: 10.1007/s11920-008-0070-x.
- Graham J, et al. European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry. 2011;20:17–37. doi: 10.1007/s00787-010-0140-6.
- Wolraich M, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128:1007–1022. doi: 10.1542/peds.2011-2654.
