![]() ADHD and Sleep Problems: The Impact of SymptomsĪDHD alone is strongly associated with sleep-related problems like hypersomnia (tiredness during the day), night-time waking, and more that can complicate treatment.ĪDHD symptoms during the day, like difficulty with time management and organization, can contribute to stress and restlessness, which may delay readiness to sleep as well. In all, up to 75 percent of children in the study saw a significant reduction in ADHD symptoms as their dosages increased. 4 At the same time, clinically significant improvements in ADHD symptoms were also observed at the higher dosages. Reports of “severe” sleeping troubles increased as children with ADHD were given higher dosages of long-acting methylphenidate in one study (8.5 percent reported trouble sleeping at 18 mg. Research also suggests a strong correlation between stimulant medication dosage, ADHD symptom reduction, and the increased frequency of sleep problems. Indeed, stimulants and non-stimulants in combination can also effectively treat ADHD. Clonidine and guanfacine, alpha 2 agonists, are approved for ADHD treatment alone or in combination with stimulants, were previously used off-label to treat sleep disturbances linked to stimulant use. Still, other non-stimulant formulations may be helpful in addressing sleep problems. The non-stimulant had a beneficial effect on sleep onset of about 12 minutes. One study 3 that analyzed the effects of methylphenidate (stimulant) and atomoxetine (non-stimulant) on sleep in children with ADHD found that the stimulant increased sleep-onset latency by a staggering 40 minutes. When comparing patients with ADHD who use stimulants to those who use non-stimulants, it is clear that sleep is impacted in different ways. taking more than 30 minutes to fall asleep), compared to 10 percent of children with ADHD who do not take medication. 1 About 30 percent of children with ADHD who take stimulants of any kind experience nightly insomnia (i.e. Individuals with ADHD are at an elevated risk for sleep problems and stimulant medications, no matter the formulation, further increase the risk for problems like difficulty falling and staying asleep, and shorter duration of sleep. ADHD and Sleep Problems: A Review of Medication Research In their work to achieve ADHD symptom reduction with minimal side effects, clinicians should titrate while evaluating a patient’s environmental and familial conditions, screen for primary sleep disorders, and, throughout treatment initiation and maintenance, encourage good sleep hygiene. In other words, ADHD symptoms and the first-line interventions to treat those symptoms both elevate an individual’s risk for poor sleep. Sleep problems, such as insomnia, are a common side effect associated with ADHD medications, especially stimulants. And clinical experience shows us that ADHD symptoms and characteristics – difficulty “shutting down” the mind, for instance – plus comorbid psychiatric disorders like anxiety and oppositional defiant disorder (ODD) can cause or aggravate sleep problems as well. Research confirms the increased prevalence of sleep problems among children with attention deficit hyperactivity disorder (ADHD or ADD). Sleep problems and ADHD are tightly interwoven.
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