ADHD-The Sleep Connection

There has been an astounding increase in the number of children diagnosed with ADHD (Attention Deficit Hyperactivity Disorder). In one study, the increase approached 800% in the past decade over the last. Is there something driving this or are we making the diagnosis too often?

We know that both childhood sleep apnea and insufficient sleep can present with symptoms indistinguishable from ADHD. These symptoms consist of hyperactivity, impulsivity, and an inability to pay attention. Because of the proliferation of computers, video games, iPhones, and televisions in our children’s bedrooms they are getting less sleep. In fact, a Finnish study published several years ago found that a sleep duration of between seven and eight hours or less in children aged seven to eight was a significant factor in predicting ADHD. In my own sleep practice, I am amazed by the number of caring parents that are unaware of just how much sleep children require. Actually, a child of eight years of age requires closer to 11 hours of sleep nightly. Deprived of this they become irritable, have difficulty sitting still, and can have a very hard time concentrating. Is it any wonder that they may be thought to have ADHD?

Sleep apnea is also very common in ADHD. In one study performed a few years ago, 28% of children referred to an ENT clinic for an adenotonsillectomy for sleep apnea had a diagnosis of ADHD. Interestingly, after the procedure, 50% no longer evidenced symptoms of ADHD after one year..

Finally, children with restless legs syndrome can present with symptoms that are hard to differentiate from ADHD. Many of these children have a hard time relating what they are feeling or are misdiagnosed as having “growing pains.” Their leg pain can deprive them of much needed sleep at night or make it impossible to sit still in class during the day. Is it any wonder that they are frequently diagnosed with ADHD?

The bottom line is that not all cases of ADHD can be attributed to sleep disorders. However, many are either caused or worsened by problems with sleep. It is our job as parents to be aware of our children’s sleep needs and sleep habits. If you have a child with ADHD, take the time to notice such things as snoring, an inability to fall or stay asleep , complaints of always feeling tired and fatigued, or frequent leg movements at rest or while asleep. In many instances, dealing with the underlying sleep problem may result in the avoidance or discontinuation of medications being used in the child with ADHD.

By Robert Rosenberg