ADHD and Sleep Problems in Children

Abstract

In the evaluation of Attention Deficit Hyperactivity Disorder (ADHD), medical and behavioral problems related to sleep are important to consider. A relationship between ADHD and sleep has been acknowledged for some time. Sleep disturbances were among criteria for ADHD diagnosis in the past and rating scales for ADHD included items related to sleep disturbance (American Psychiatric Association [APA], 1987; Conners, et al. 1998, 1998). While our knowledge about the relationship between ADHD and sleep problems has improved in recent years, it remains challenging to tease apart the effect of insufficient or poor quality sleep on attention, alertness, learning and behavior and what might be due to a primary ADHD, mood or behavior problem (Simonds, 1984). This interface of mental health disorder and sleep disorder is a challenge many clinicians face in practice. Medical, mental health, behavioral and psychosocial factors can directly affect the quality and duration of sleep. Poor sleep, in turn, can have effects on daytime functioning and health. In addition, such medical and mental health problems can have direct effects on attention, learning and behavior. Sorting out the important contributing factors during a comprehensive evaluation can be challenging due to sleep and ADHD problems commonly co-occurring. The primary purpose of this chapter is to highlight the importance of including the evaluation of sleep as a part of the assessment of disorders such as ADHD because the best management for the individual patient depends on the accuracy of the diagnostic evaluation.