Is There A Connection Between ADHD And Narcolepsy?

Attention-deficit hyperactivity disorder (ADHD) is often associated with comorbidities with other mental illnesses or disorders, including sleep disorders. For this reason, some individuals may wonder whether ADHD has any connection to narcolepsy and how the two are related. Understanding this connection could be the start to understanding your own unique symptoms and seeking support. 

Is there a link between ADHD and narcolepsy? 

Studies suggest a link between attention-deficit hyperactivity disorder and narcolepsy, as "both narcolepsy and ADHD share the symptoms of sleep disturbance and excessive daytime sleepiness" among others. 

Child and adult ADHD is a neurodevelopmental condition with a pattern of hyperactivity, inattention, and impulsivity. ADHD is also a form of neurodiversity associated with unique brain differences. Narcolepsy is a neurological condition characterized by excessive daytime sleepiness and cataplexy, depending on its type. Cataplexy refers to the sudden loss of muscle control that may be incited by strong emotions. 

Some people with narcolepsy also experience ADHD symptoms. Moreover, both ADHD and narcolepsy are associated with a higher prevalence of sleep disorders when compared to the general population. Understanding this connection may help individuals with both conditions understand what condition could be causing symptoms. However, if you’re experiencing new or worsening physical symptoms, talk to a medical doctor for guidance. 

Attention-deficit hyperactivity disorder (ADHD) and narcolepsy studies 

Another study of pediatric patients with narcolepsy suggests that more severe ADHD symptoms may produce higher levels of "sleepiness, fatigue, and insomnia." Stimulant medication is often used to treat ADHD and narcolepsy symptoms. The study's findings, however, indicated that stimulant medications did not alleviate these individuals’ ADHD symptoms. Another study of children with ADHD showed that one-fifth of research participants had a "narcolepsy-like sleep phenotype." 

ADHD and narcolepsy: What's the connection between Attention-deficit hyperactivity disorder (ADHD) and narcolepsy? 

Narcolepsy and ADHD may be characterized as distinct disorders, but they share some symptoms, especially in relation to sleep disturbances and their effects. 

Researchers are studying the mechanisms connecting these two conditions, suggesting there might be "shared genetic, neurochemical, or environmental factors that contribute to both." Some research also indicates a "shared brain pathophysiology" as well as dysregulation of noradrenaline, a neurotransmitter that may contribute to changes in REM sleep.

ADHD, narcolepsy, and sleep disturbances

One aspect connecting ADHD and narcolepsy is the prevalence of sleep-related disturbances in both conditions. Between 25% and 50% of people with ADHD report a sleep disturbance. 

Some people with ADHD may also experience sleep disorders, such as delayed sleep phase syndrome (DSPS), circadian rhythm sleep disorder, sleep-disordered breathing (SDB), obstructive sleep apnea (OSA), and restless legs syndrome (RLS). Circadian rhythm sleep disorders cause an alteration in the timing of the sleep-wake cycle, which may be attributed to behavioral and biological factors, such as delay in melatonin increase release. 

RLS causes an uncontrollable urge to move the legs and possible discomfort. According to researchers in the above study, up to 44% of people with ADHD have RLS symptoms, which have been linked with dopamine deficits in both disorders. 

Narcolepsy itself is sometimes referred to as a sleep disorder, as it relates to the brain's ability to regulate the sleep-wake processes. People with narcolepsy may also have RLS, sleep apnea, insomnia, and excessive daytime sleepiness (EDS). ADHD patients often also experience EDS, sometimes called hypersomnia. Studies suggest a connection between ADHD and narcolepsy in relation to hypersomnia. 

Presence of ADHD symptoms in sleep disorders

Factors like daytime sleepiness, fatigue, severity of insomnia, and quality of life are associated with the presence of ADHD symptoms in people with narcolepsy. Those with narcolepsy type two (narcolepsy without cataplexy) are more likely to experience ADHD symptoms, according to findings. Some researchers speculate the possibility of ADHD with hypersomnia being a subtype of narcolepsy type two. 

Sleep disturbances are associated with:

• Impairments in the processing of emotional facial expressions
• Increased likelihood of depression, anxiety, and other mental disorders
• Increases in hyperactivity
• Increases in inattention
• Increased vulnerability to physical illness
• Fatigue
• Restlessness

Ways to address sleep patterns in narcolepsy and ADHD

Sleep routine for attention deficit hyperactivity disorder and narcolepsy

Developing a sleep routine that can promote quality sleep may help individuals alleviate ADHD and narcolepsy symptoms. According to the Division of Sleep Medicine at Harvard Medical School, the following habits may reduce narcolepsy symptoms: 

• Taking a 15 to 20 minute nap in the afternoon to improve alertness (for those with extreme tiredness, an additional nap in the late morning might be recommended) 
• Staying active by taking walks or partaking in physical exercise
• Fostering positive sleep habits, such as going to bed at the same time each night, ensuring the room is comfortable, listening to relaxing music, and unplugging from technology and TV before bedtime
• Avoiding coffee in the late afternoon, evening, and night
• Eating light meals, as some people with narcolepsy may experience more drowsiness after eating a large meal

Managing ADHD symptoms at night

The following techniques might be beneficial for managing symptoms of ADHD at night: 

• Taking melatonin supplements 
• Taking a bath shortly before bed
• Reading a book 
• Avoiding engaging in projects that require intense focus at night
• Exercising during the day and avoiding extraneous exercise right before bed 
• Wearing a weighted blanket
• Keeping your bedroom comfortable, quiet, and dark
• Considering light therapy to regulate the sleep-wake cycle
• Avoiding taking naps during the day
• Avoiding caffeine and substance use later in the day
• Discussing the side effects of your medication with your doctor

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

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Support options for ADHD and narcolepsy

Living with challenging symptoms can take a toll on one’s well-being. Seeing a therapist may be a way to receive personalized advice. However, some individuals face barriers to in-person sessions, such as distance or time. In these cases, online therapy platforms like BetterHelp allow clients to have sessions with a licensed therapist via phone, video, or live chat. In addition, online platforms often offer resources like journaling prompts and group sessions. 

One of the therapeutic approaches used by therapists is cognitive-behavioral therapy (CBT), as it may reduce core and emotional symptoms of ADHD. CBT may also be helpful in addressing narcolepsy symptoms, particularly hypersomnia and depression.  

A meta-analysis and systematic review that looked at online interventions for ADHD suggests that virtual therapy could be effective for addressing attention deficit and social functioning in adults with ADHD. The meta-analysis evaluated six randomized controlled trials involving 261 people with the condition. Another CBT-based online therapy for insomnia, a condition that often affects people with narcolepsy or ADHD, has also been found to be an "effective approach for lessening insomnia" and anxiety symptoms.