Transcript
Announcer:
Welcome to NeuroFrontiers on ReachMD. On this episode, we’ll learn about the importance of addressing sleep problems in patients with ADHD from Dr. Roberto Olivardia. Not only is he a Clinical Associate in Psychology at the Mass General Brigham McLean Hospital, but he also serves on the Professional Advisory Boards for Children and Adults with ADHD and the Attention Deficit Disorder Association. Let’s hear from Dr. Olivardia now.
Dr. Olivardia:
I don't know anyone with ADHD that doesn't have an issue with sleep. It is currently not part of the diagnostic criteria for the DSM-5, but I guarantee that at some point in the future it will be, and I think it should be.
I would say there are a multitude of issues that people with ADHD have with sleep. The most common is getting to sleep and falling asleep. That could be a combination of individuals that didn't manage their time very well throughout the day to get the things that they needed to get done, so they might end up going to bed a lot later than they expect. People with ADHD are significantly more likely to actually get a rush of energy at 10 or 11 o'clock at night and have that almost extend till 1:00 or 2:00 in the morning. It's something called the delayed sleep phase syndrome.
Even when people with ADHD go to bed at a “normal time,” their ability to shut their minds off is very difficult. That latency period—which is the time between when people go to bed and shut the lights off to the time they go to sleep—could typically range anywhere from 10 to 25 minutes. For someone with ADHD, that window is an opportunity to start thinking about things you're anxious about, excited about, wondering about, or philosophizing about, which then activates and arouses your mind, which makes it hard to go to sleep. In addition, people with ADHD are more likely to have problems staying asleep, having multiple awakenings throughout the night, and having trouble waking up in the morning, even with ample sleep.
People with ADHD are also significantly more likely to have a sleep disorder, such as sleep apnea, restless legs syndrome—which affects about a quarter of people with ADHD—sleepwalking, sleep talking, and bedwetting, particularly pre-puberty. All of these things are dysregulation of arousal centers in the brain.
So just like we know that having ADHD can predispose people to sleep problems, sleep problems also impact ADHD. So when we're not sleeping, all it will do is exacerbate those ADHD symptoms. And then what happens is this very vicious cycle: people with ADHD might nap during the afternoon because they didn't get a good night's sleep. But then if you take a three- to four-hour nap in the middle of the day, you're not going to be tired at 10 o'clock at night, and then you're going to be up until 3:00 in the morning, and then it becomes a cycle.
So it's so important to work on sleep hygiene and sleep medicine because it's for all the benefits that sleep brings but also because sleep treatment is part of ADHD treatment.
Announcer:
That was Dr. Roberto Olivardia sharing his insights on the link between sleep problems and ADHD. To access this and other episodes in our series, visit NeuroFrontiers on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
