Late Sleep in ADHD, Health Consequences & Treatment

Rationale

ADHD in children and adults is very often accompanied by sleep problems, that generally lead to sleepiness and impaired attentiveness during daytime. The resulting sleep debt is associated with general health problems like obesity, diabetes, cardiovascular disease and cancer.

Objective

Providing and update on adult ADHD and sleep.

Methods

During this presentation, an overview of the literature on sleep in ADHD will be discussed, the long term consequences of short sleep for health, and ongoing studies on treatment of sleep problems in ADHD.

Results

Sleep disorders most often found in ADHD are sleep apnea, restless legs syndrome and the circadian rhythm sleep disorder: the delayed sleep phase syndrome. In 75% of ADHD patients, the sleep phase is delayed, as has been shown using melatonin measurements in saliva in children and adults, actigraphy measurements of movement patterns, and by measuring 24 hr core body temperature in adults with ADHD. A late sleep pattern is often genetically driven, starts in childhood, and may have several consequences for health in general, which outcome is increasingly studied in ADHD patients.

Conclusions

As ADHD and circadian rhythm sleep disorders are intertwined in the majority of cases, the question arises whether disturbed sleep may drive ADHD symptoms, or whether ADHD induces sleep problems. The third option may be considering ADHD as a circadian rhythm disorder itself. Indications for this theory will be discussed, as will the available evidence for treatment of late sleep with sleep hygiene, melatonin at night and bright light therapy in the morning.