Poor sleep quality in adult ADHD

We don’t realize how important sleep is. In a recent review of a new popular science book “Why We Sleep” by Matthew Walker (and you should really check it out) [1] a commentator wrote that our attitude towards sleep reminds her of what ancient Egyptians did just before they mummified a body: they always dumped the brain because they had no idea what it is, so why bother with the mushy pudding inside the skull? (www.tinyurl.com/y85pbmck) It seems that the way we treat sleep today has similar negative consequences for our physical and mental health as if we were thrashing our brains. It certainly doesn’t help to mummify our bodies as lack of sleep can considerably shorten our lifespan [1].

Poor sleep quality disturbs all aspects of cognition and emotion [2] resulting in poor concentration and high sleepiness during the day [3]. If you suffer from ADHD you are very likely know what I’m talking about, regardless how old you are [4, 5].

Sleep problems have long been a part of daily (or rather nightly) struggles of people with ADHD [6]. In fact, it is estimated that more than 50% of adults with ADHD experience sleep concerns [7] and suffer from low sleep quality [8-11]. This makes the burden of ADHD even higher by further lowering the quality of life. Imagine being exhausted by ADHD by day and then not being able to get any rest at night… No wonder poor sleep quality in ADHD results in poor academic performance, negative relations with significant others and higher chances for obesity [12]!

Interestingly, sleep disorders would often produce symptoms mimicking ADHD, so doctors should be extra careful not to confuse ADHD with consequences of these sleep problems [13, 14].

In our recent study involving adults with ADHD (data not yet published) we found that sleep quality is closely related to symptoms of inattention, hyperactivity/ impulsivity and emotional instability and that people with poor sleep quality make a lot of errors and respond much slower in a cognitive task which required concentration.

This means that if you have ADHD and you don’t sleep well, it’s as if you’d have more severe symptoms. And if you don’t have ADHD, lack of quality sleep could essentially make you a bit ADHD.

That’s why, regardless of whether you suffer from ADHD or not, you should do all in your power to make sure you sleep well at night (for useful tips check www.sleepfoundation.org). After all, we will all spend 20-30 years of our lives journeying into slumberland, so let’s make the best of these long and frequent trips – for the sake of our bodies and minds.

 

  1. Walker, M.P., Why we sleep : unlocking the power of sleep and dreams. First Scribner hardcover edition. ed. 2017, New York: Scribner. pages cm.
  2. Krause, A.J., et al., The sleep-deprived human brain. Nat Rev Neurosci, 2017. 18(7): p. 404-418.
  3. Durmer, J.S. and D.F. Dinges, Neurocognitive consequences of sleep deprivation. Semin Neurol, 2005. 25(1): p. 117-29.
  4. Hvolby, A., Associations of sleep disturbance with ADHD: implications for treatment. Attention Deficit and Hyperactivity Disorders, 2015. 7(1): p. 1-18.
  5. Cortese, S., et al., Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J Am Acad Child Adolesc Psychiatry, 2009. 48(9): p. 894-908.
  6. Konofal, E., M. Lecendreux, and S. Cortese, Sleep and ADHD. Sleep Med, 2010. 11(7): p. 652-8.
  7. Yoon, S.Y., U. Jain, and C. Shapiro, Sleep in attention-deficit/hyperactivity disorder in children and adults: past, present, and future. Sleep Med Rev, 2012. 16(4): p. 371-88.
  8. Sobanski, E., et al., Sleep in adults with attention deficit hyperactivity disorder (ADHD) before and during treatment with methylphenidate: a controlled polysomnographic study. Sleep, 2008. 31(3): p. 375-81.
  9. Boonstra, A.M., et al., Hyperactive night and day? Actigraphy studies in adult ADHD: a baseline comparison and the effect of methylphenidate. Sleep, 2007. 30(4): p. 433-42.
  10. Schredl, M., B. Alm, and E. Sobanski, Sleep quality in adult patients with attention deficit hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci, 2007. 257(3): p. 164-8.
  11. Surman, C.B., et al., Association between attention-deficit/hyperactivity disorder and sleep impairment in adulthood: evidence from a large controlled study. J Clin Psychiatry, 2009. 70(11): p. 1523-9.
  12. Um, Y.H., S.C. Hong, and J.H. Jeong, Sleep Problems as Predictors in Attention-Deficit Hyperactivity Disorder: Causal Mechanisms, Consequences and Treatment. Clin Psychopharmacol Neurosci, 2017. 15(1): p. 9-18.
  13. Bioulac, S., J.A. Micoulaud-Franchi, and P. Philip, Excessive daytime sleepiness in patients with ADHD–diagnostic and management strategies. Curr Psychiatry Rep, 2015. 17(8): p. 608.
  14. Oosterloo, M., et al., Possible confusion between primary hypersomnia and adult attention-deficit/hyperactivity disorder. Psychiatry Res, 2006. 143(2-3): p. 293-7.

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