It appears that there’s an association between increased sleep disorders in children with ADHD although, as with so many questions, there are very few well-designed studies with solid evidence. One trial reports between one quarter and one half of parents with ADHD children complain that their kids have sleep disturbance. Restless legs syndrome as well as periodic limb movements disorder are reported fairly consistently in children with ADHD. In addition, there are reports of excessive nocturnal motricity (i.e. higher levels of activity while asleep) along with sleep difficulties associated with sleep-disordered breathing. Untreated youngsters with ADHD have a higher incidence of sleep-onset insomnia. Some sleep disorders in children with ADHD are caused by the treatment itself. Stimulants often lead to improved sleep in kids with ADHD but they can also cause sleep disturbance. For example, ADHD children can have rebound hyperactivity when the medication wears off, which affects sleep onset.

Many of the same sleep difficulties are reported in adults — even in those for which depression-related sleep disorders have been controlled. Interestingly, many more ADHD patients report very poor sleep quality despite the relatively normal biological parameters of sleep as measured by polysomnography. They also have a higher incidence of restless legs syndrome and periodic limb movements disorder. The evidence for a higher incidence of sleep-disordered breathing symptoms in an adult population is not borne out (the evidence in kids may not be very robust).

For a good review of therapeutic options in children, I’d recommend: Lecendreux and Cortese; Sleep problems associated with ADHD: a review of current therapeutic options and recommendations for the future; Expert Rev. Neurotherapeutics 2007;7(12),1799-1806.

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