Excessive Daytime Sleepiness in Patients With ADHD—Diagnostic and Management Strategies

Stéphanie Bioulac, Jean-Arthur Micoulaud-Franchi, Pierre Philip
Curr Psychiatry Rep. 2015-07-01; 17(8):
DOI: 10.1007/s11920-015-0608-7

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1. Curr Psychiatry Rep. 2015 Aug;17(8):608. doi: 10.1007/s11920-015-0608-7.

Excessive daytime sleepiness in patients with ADHD–diagnostic and management

Bioulac S(1), Micoulaud-Franchi JA, Philip P.

Author information:
(1)Centre Hospitalier Charles Perrens, Pôle de Pédopsychiatrie Universitaire,
121, rue de la Béchade, 33076, Bordeaux, Cedex, France,

The links between attention-deficit hyperactivity disorder (ADHD) and sleep
disorders remain unclear. Specific sleep disorders are a frequent comorbid
condition associated with ADHD according to a categorical approach. However,
sleep disorders can also induce ADHD-like symptoms according to a dimensional
approach and are thought to be the consequence of excessive daytime sleepiness.
It may thus be difficult for clinicians to differentiate the diagnosis of ADHD
comorbid with a sleep disorder from sleep disorders with ADHD-like symptoms. This
distinction could be important for the appropriate management of patients with
dual complaints of trouble maintaining attention and daytime sleepiness. This
paper summarizes the main sleep disorders associated with ADHD: sleep-related
breathing disorders, sleep-related movement disorders, circadian rhythm
sleep-wake disorders, and central disorders of hypersomnolence (aka
hypersomnias). The history of presenting symptoms should be taken into account
since ADHD is a neurodevelopmental disorder whereas ADHD symptoms comorbid with
sleep disorder are not. Finally, we propose a model to clarify the links between
ADHD, ADHD symptoms, and excessive daytime sleepiness induced by sleep disorders.
Clinicians should therefore routinely assess, monitor, and manage the sleep
problems of patients with ADHD who have both comorbidities and should search for
the presence of ADHD symptoms in subjects with sleep disorders.

DOI: 10.1007/s11920-015-0608-7
PMID: 26122671 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus