Abstract
Background: Sleep disorders and sleep problems commonly occur in adults with ADHD and add to functional impairment. Evidence-based treatments for sleep could improve function in the adult ADHD population. Methods: A literature review was conducted to present the clinical science informing treatment of sleep in adults with ADHD. Results: Six systematic prospective studies of sleep intervention in adults with ADHD were identified. Three of these, all including well-characterized ADHD patients, offered evidence for a significant effect of morning light therapy. Across the studies, preliminary evidence for melatonin, behavioral therapy, and weighted blankets were also found. Implication: Low-risk interventions such as light therapy may improve sleep in adults with ADHD, but many sleep interventions currently in use remain unstudied in the ADHD population. Considerations for evidence-informed practice and future research directions are discussed.
Highlights
Attention-deficit hyperactivity disorder (ADHD) is a neurobiological disorder associated with high levels of impairment in adulthood [1,2,3] and is estimated to affect up to 5% of adults worldwide [4,5,6]
There is strong evidence that adults with ADHD have an elevated risk for sleep-related problems, from surveys relying on screeners to identify ADHD [4,7,8], and clinical research studies that more completely characterized presence of ADHD [9,10,11,12,13,14]
In addition to the findings emphasized above, we found that ADHD subjects, compared to controls, reported significantly more kinds of sleep problems, had a wider range of bedtimes, and were more likely to have difficulty going to bed, sleeping restfully, or waking in the morning
Summary
Attention-deficit hyperactivity disorder (ADHD) is a neurobiological disorder associated with high levels of impairment in adulthood [1,2,3] and is estimated to affect up to 5% of adults worldwide [4,5,6]. There is strong evidence that adults with ADHD have an elevated risk for sleep-related problems, from surveys relying on screeners to identify ADHD [4,7,8], and clinical research studies that more completely characterized presence of ADHD [9,10,11,12,13,14]. Current diagnostic criteria for ADHD require the presence of inattentive or impulsive-hyperactive traits. These traits must start in childhood, often persist into adulthood, and must impair function in two or more life settings [16]. Evidence-based treatments for sleep could improve function in the adult ADHD population. Considerations for evidence-informed practice and future research directions are discussed
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