Sleep Problem Connection with Adult ADHD

Recent research presented at the 2017 European College of Neuropsychopharmacology Conference (ECNP) in Paris, France, has presented the theory that many of ADHD cases may be in fact an issue associated with a lack of regular circadian sleep. Past data does show that approximately 75% of adults with ADHD also have sleep problem but the medical field has thought that to be a separate problem.

Sleep Problem and Adult ADHD

There is extensive evidence that indicates adults with ADHD also tend to display sleep problems. In a theory presented at this year’s ECNP data was presented that suggests that ADHD and circadian problems (sleep issues) are intertwined in a majority of patients. While all ADHD problems may not be associated with circadian patterns, it does appear to be an important element.

ADHD and Physiological Sleep Phase

Symptoms and behaviors indicating a connection between adult ADHD and circadian or sleep problem rhythm include:

  • Changes in level of sleep hormone melatonin delayed by 1.5 hours from those without diagnosis of ADHD
  • Changes in sleep-related movement patterns are delayed
  • Core body temperatures associated with sleep are delayed which corresponds to the delay of melatonin changes
  • Those with ADHD often have great alertness in the evening (opposite of the general population)
  • Sleep related disorders associated with adult ADHD include restless leg syndrome, sleep apnea, and delayed sleep phase syndrome
  • Approximately 70% of those diagnosed with adult ADHD show over-sensitivity to light, with many needing to wear sunglasses during the day; this light sensitivity may be associated with a circadian shift.

While a disturbance of the natural sleep or circadian system may be physiologically connected to ADHD, it may also have links to other mental illnesses like depression or bipolar disorder. Further research will help in the development of alternative or adjunct therapies, such as bright light therapy or use of melatonin in the evening, to be used as part of a comprehensive ADHD treatment plan for those with a sleep problem.

Adult ADHD Treatment Options

Call Dr. Hege for a comprehensive mental health evaluation to determine all adult ADHD treatment options, including medication and adjunct therapies, available for your individual needs.

Sleep Problems and Psych Disorders: The Relationship

Research has found that sleep problems which used to be viewed as a symptom of mental health disruption may actually be a contributing factor for psychiatric disorders. Studies at Harvard Medical School confirm that sleep problems affect between 10% to 18% of adults in the general U.S. population; the percentage of adult patients seen in psychiatric practices with chronic sleep issues jumps to 80%.

Sleep Problems Point to Increased Risk for Psychiatric Disorders

Patients with a diagnosis of anxiety, depression, bipolar disorder and ADHD commonly report being plagued with sleep problems. While sleep dysfunction was once viewed as a symptom, clinical data supports the hypothesis that adult sleep problems raise the risk for developing a psychiatric disorder. In long term studies it was found that adults who reported a history of insomnia were four times as likely to develop major depression on re-evaluation three years later, indicating the sleep disruptions developed before the mental health disorder.

Sleep Problems versus use of Antipsychotics

Sleep issues and insomnia began to be more closely looked at in the 1970’s. The sleep problems were thought to be directly tied to use of antipsychotics at the time; however, data indicates a long history of sleep disturbance complaints long before use of antipsychotics began. Today it is more widely believed that chronic sleep problems puts one more at risk for the development of psychiatric issues and that treating the sleep disorder can actually assist in alleviating symptoms of a co-occurring mental health problem.

Sleep Disorders in Psychiatric Patients

Of the more than 70 types of sleep disorders the most common problems are insomnia, obstructive sleep apnea, unpleasant sleep movement syndromes and narcolepsy. The University of Brazil Medical School reports the type and impact of the sleep problems vary by the psychiatric diagnosis with examples noted below:

  • Up to 90% of adults with major depression experience a sleep problem
  • One-in-five adults with depression suffer from obstructive sleep apnea
  • Depressed adults with insomnia less likely to respond to treatment, at a higher risk for relapse and are more likely to die by suicide
  • Up to 99% of adults with bipolar disorder experience insomnia or restless sleep
  • In adults with bipolar depression up to 78% sleep in excessive amounts
  • More than 50% of adults with anxiety disorders have dysfunctional sleep patterns
  • Sleep problems precede anxiety disorders 27% of the time
  • Sleep dysfunction precedes depression 69% of the time
  • 68% of adults with PTSD report sleeping problems
  • Long term studies indicate that insomnia or other sleep disruptions worsen before a manic episode or bipolar depression

Sleep and mental health are interconnected though not yet completely understood. Neurochemistry studies do indicate that having a good night’s sleep promotes a healthier outlook, while chronic sleep problems can set up an arena for negative thought processes and emotional vulnerability. Call the office for a comprehensive evaluation with Dr. Hege who will work with you to get your sleep patterns and mental health issues back into functional ranges.