Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurobehavioral disorders in children -- and it's on the rise with 9.5 percent of children diagnosed at some point during their childhood. While the reasons are most certainly multifactorial, with genetics, environment, and lifestyle all playing a hefty role, now there's reason to believe that sleep (or lack of it) is a significant factor leading to the misdiagnosis of ADHD.
Recently, a study published in the April 2012 issue of The Journal of Pediatrics, added to the mounting body of evidence that sleep disorders such as obstructive sleep apnea can lead to daytime symptoms of hyperactivity and inattention among children. The link is certainly complex considering children with ADHD exhibit inherently different sleep patterns. Nonetheless, this interconnectedness is an important one when evaluating and considering the diagnosis of ADHD in any child.
What is obstructive sleep apnea (OSA)?
OSA is a sleep disorder characterized by snoring, gasping, and/or choking during nighttime sleep which dramatically interferes with a child's quality of sleep. About 3-5 percent of children have this and it's much more common in obese children. Once diagnosed, children may need to undergo removal of their tonsils and adenoids.
We know that children who are recognized early and treated promptly have a better quality of sleep and are thus, less prone to the symptoms of ADHD.
How does sleep deprivation cause hyperactivity and inattention?
Unlike adults, children who are deprived of sleep, whether it's from a sleep disorder such as OSA or simply too little sleep, react by becoming wired. They have difficulty paying attention, they are hyperactive, and are more prone to acting out.
What does this mean for my child?
If your child is currently diagnosed with ADHD, this doesn't mean he doesn't have it. What it does mean is that parents and pediatricians alike need to be sure to assess your child's sleep status. Consider these questions: How many hours of sleep is he getting per night? Does he snore/gasp/choke while sleeping? Does he stay up late playing video games or watching TV?
Ideally, your school-age child should clock about 10-11 hours per night and 8.5-9.5 for teens. If you suspect a sleep disturbance such as OSA, notify your child's doctor and have him evaluated. Make sure bedtime is at a reasonable hour and have a no screens in the bedroom rule.
If we can eliminate sleep deprivation as one factor contributing to a child's ADHD, we are better able to treat and manage this condition and potentially without the need for medication.
Dr. Mom's bottom line^Both quantity and quality of sleep is essential in the overall health of your child. Making sure your child is getting the best sleep possible will help eliminate symptoms of ADHD in some children.