Medication and co-occurring conditions might be causes
Like most Americans, children and teens in the United States tend to get too little sleep. And for teenagers with ADHD, sleep problems can be especially complex.
A 2009 report from the journal Sleep found that teens with ADHD had significantly more problems with insomnia, snoring, sleep terrors and bruxism (teeth grinding). Other studies have found that daytime sleepiness, restless legs syndrome and sleep apnea are also more common among children and teens with ADHD.
It's not clear why people with ADHD often have one or more sleep disorders, but some researchers believe the reason may be related to other mental health conditions like depression, anxiety, bipolar disorder, conduct disorder, or oppositional defiant disorder that often occur with ADHD.
Sleep problems are often difficult to diagnose, and sleep deprivation often makes teenagers act more distracted, impulsive and aggressive—all symptoms of ADHD. As a result, sleep disorders can sometimes be misdiagnosed as ADHD.
Teens with ADHD are also more likely to abuse drugs or alcohol. When they do, their sleep may be affected as a result, making an accurate diagnosis even more difficult.
Medications for ADHD: Part of the Sleep Problem?
ADHD is often treated with stimulant medications like methylphenidate (Ritalin, Concerta), lisdexamfetamine dimesylate (Vyvanse) or dextroamphetamine (Dexedrine). The side effects of these stimulants can include insomnia, bruxism (teeth grinding), and other sleep problems.
But these medications are also effective at managing daytime sleepiness as well as other symptoms of ADHD, so most experts agree that treatment of ADHD with medications should not be discontinued. And the 2009 study from Sleep reported, "the contribution of psycho-stimulants to the sleep problems and disorders in adolescents with ADHD seems to be relatively slight."
Because sleep disorders can be misdiagnosed as ADHD, doctors now recommend that teens with a diagnosis of ADHD should also be screened for sleep disorders and for other conditions that often occur with ADHD, regardless of how severe a teenager's ADHD symptoms might be.
If medication appears to be contributing to sleep problems, talk to a doctor. The doctor may suggest giving medication earlier in the day or skipping the afternoon or evening dose. A lower dose of ADHD medication or a shorter-acting drug, too, might be effective.
Never stop your child's drug regimen without speaking with his/her doctor first.
Other Sleep Tips
Some of the same common-sense sleep strategies that help people with no sign of ADHD can also help those with the disorder. For example, teens with ADHD should be discouraged from using computers, cell phones, televisions and video games in the bedroom after a certain hour.
Ensuring that the teen's bedroom is a dark, quiet, comfortable place conducive to sleep is also a good idea for everyone. Plenty of exercise, a healthy diet and a consistent bedtime can also alleviate sleep problems for teens with ADHD.
National Institute of Mental Health
National Sleep Foundation
"Sleep problems and disorders among adolescents with persistent and subthreshold attention-deficit/hyperactivity disorders." Gau SS, Chiang HL. Sleep. 2009 May 1;32(5):671-9.