Sleep disorders in adult ADHD: a key feature

L. Salerno (1), N. Makris (2), S. Pallanti (3,4,5)

1 Institute of Neurosciences, Florence, Italy; 2 Center for Morphometric Analysis, Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 3 Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino (NEUROFARBA), University of Florence, Florence, Italy; 4 Department of Psychiatry and Behavioral Sciences, UC Davis Health System, Sacramento, CA, USA; 5 Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, USA


Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder affecting individuals across the life span, and the relationship between ADHD and sleep poses several challenges in clinical practice. As ADHD symptoms overlap with those of sleep disorders, the aim of this paper is to summarise the state of art regarding the relationship between these conditions, in order to provide suggestions for future research and key elements to take into account during the diagnostic assessment of ADHD as well its clinical management. 


We performed a PubMed search for articles published from 2005 to 2016, using the following key words: attention deficit disorder, ADHD, sleep disorders. The literature search was conducted in March 2016. Only articles written in English and providing data on adult population were considered. 


We found 773 articles matching keywords. Applying the above-mentioned exclusion criteria, only 30 resulted pertinent to our aim. Other articles from other databases were selected according to their importance, and then further filtered according to their capability in answering our research objectives. A total of 35 articles allowed us to identify the most frequently reported sleep disorders in adult ADHD, the potential neurobiological substrates at the basis of the similarities in symptomatology and the most important implications for clinical and research settings. 


A poor sleep can worsen ADHD symptomatology, resulting in an increasing risk for accidents and health problems. An increased risk for depression has also been documented. Because of the overlapping symptomatology, the presence of a sleep disorder should be adequately screened during ADHD assessment and during the clinical management of the disorder. The similarities between symptoms of ADHD and those of a sleep disorder suggest certain basic disturbances in a potential common circuitry that require further exploration. The understanding of the causes accounting for the frequent co-occurrence of sleep disorders in people affected by ADHD may help to implement an effective treatment for improving quality of life of these patients.

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