Can a New Sleep Treatment Help Teens with ADHD Improve Their Sleep and ADHD Symptoms?

What you need to know

• Many teenagers with ADHD have sleep problems, which can make their ADHD symptoms worse
• Researchers developed a new sleep treatment called SIESTA specifically for teens with ADHD
• This study will test if SIESTA helps improve sleep and ADHD symptoms better than usual ADHD treatment alone

Background on ADHD and sleep problems in teens

Attention-deficit/hyperactivity disorder (ADHD) is a common condition that affects many teenagers. It can cause difficulties with attention, hyperactivity, and impulsivity. Up to 72% of teens with ADHD also experience sleep problems, which is much higher than teens without ADHD. These sleep issues can include:

• Taking a long time to fall asleep
• Waking up frequently during the night
• Not getting enough total sleep

Having poor sleep can actually make ADHD symptoms worse. It can lead to more trouble paying attention, more hyperactivity, and more emotional difficulties during the day. Sleep problems in teens with ADHD have also been linked to:

• More oppositional behavior
• Increased depression symptoms
• Poorer functioning at school and at home

Because sleep and ADHD symptoms seem to affect each other, experts recommend treating both issues together rather than separately. However, there aren’t many sleep treatments designed specifically for teenagers with ADHD.

The SIESTA sleep treatment for teens with ADHD

To address this need, researchers developed a new sleep treatment called SIESTA (Sleep IntervEntion as Symptom Treatment for ADHD). SIESTA combines several approaches:

• Cognitive behavioral therapy (CBT) techniques for improving sleep
• Motivational interviewing to increase teens’ motivation to change sleep habits
• Training on planning and organizational skills

The treatment consists of 7 individual sessions with the teenager and 2 sessions with parents. It covers topics like:

• Education about sleep and how it relates to ADHD
• Improving sleep hygiene (habits and environment that promote good sleep)
• Setting realistic sleep goals
• Creating personalized sleep plans
• Addressing issues like racing thoughts at bedtime
• Balancing parents’ involvement in teens’ sleep habits

SIESTA was designed to address some of the specific challenges that teens with ADHD face when it comes to changing sleep habits. For example, many struggle with motivation, planning, and resisting temptations like late-night phone use.

About the research study

This paper describes the protocol for a research study testing whether SIESTA is effective. Here are the key details:

Study design: This is a randomized controlled trial. About 92 teenagers with ADHD and sleep problems will be randomly assigned to one of two groups:

1. SIESTA treatment + usual ADHD care
2. Usual ADHD care only (control group)

Participants: The study will include teens ages 13-17 who:

• Have been diagnosed with ADHD
• Are experiencing sleep problems like taking >20 minutes to fall asleep or getting <7 hours of sleep
• Have an IQ of 80 or above

Assessments: Participants will complete assessments at 3 time points:

• Before treatment (baseline)
• About 7 weeks after baseline (post-treatment)
• About 3 months after post-treatment (follow-up)

What’s being measured: The study will look at many outcomes, including:

• Sleep patterns (e.g. total sleep time, how long it takes to fall asleep)
• Sleep problems and habits
• ADHD symptoms
• Other mental health symptoms like anxiety and depression
• School performance
• Conflicts between teens and parents

Sleep will be measured both objectively (using a wrist device called an actigraph) and subjectively (using sleep diaries and questionnaires).

Potential impact

If SIESTA is shown to be effective, it could become an important new treatment option for teenagers with ADHD who are struggling with sleep. Improving sleep could potentially lead to improvements in ADHD symptoms, mental health, and overall functioning.

The researchers have formed an advisory board of healthcare professionals, patient organizations, and policy makers to help implement SIESTA throughout the Flanders region of Belgium if the results are positive. They hope this collaborative approach will help the treatment reach teens who could benefit from it.

Conclusions

• This study will provide important evidence on whether a specialized sleep treatment can help address both sleep problems and ADHD symptoms in teenagers
• The results could inform treatment guidelines and lead to new options for teens with ADHD and sleep issues
• If effective, efforts are already in place to implement the treatment more widely

While we await the results, this study highlights the important connection between sleep and ADHD symptoms. Teens with ADHD who are having sleep difficulties may want to discuss this with their healthcare providers, as addressing sleep could potentially improve overall functioning.