Sleep Deprivation and ADHD Revisited

In a previous article I pointed out that lack of sleep is one of the most common reasons for ADD/ADHD misdiagnosis. (The article can be found here). It seems that I am not alone in making this observation. More and more medical professionals are pointing out the possibility of cross-confusion between ADD/ADHD and sleep deprivation. The main reason behind this is the fact that the two ‘conditions’ share remarkably similar symptoms.
One of the latest physicians to flag up the issue is Dr. Gregory Olmor, director of Pulmonary Medicine and the Sleep Lab at Akron Children’s Hospital (Click here for a video where he discusses his findings). He reminds parents that children need, on average (there will of course be individual variations), the following amounts of sleep:
Teenagers: 9 hours
6 – 12 year olds: 10 hours
Preschoolers: 11 hours
If they don’t get this amount of sleep (as is the case with many kids in our society!) children are likely to become distracted, irritable and impulsive. Sound familiar?
Any parent should, in light of the above, first eliminate sleep deprivation as a possible explanation for ‘ADHD like’ behaviour before going down the path to a full blown diagnosis (with the accompanying pressure to medicate). But how can you ensure that your child gets more, and better, sleep? Here are some practical suggestions:
Establish a strong bedtime routine: This may be difficult to work into your busy schedule but I highly recommend that you make the effort, especially in the case of smaller children. The regular repetition of a bath, followed by a drink, followed by a story (or whatever else you decide on) can be very reassuring and will help the child to make the transition from wakefulness to being ready for sleep.
Keep night time interaction to a minimum: If your child wakes up at night (perhaps due to a nightmare of a bit of anxiety about the dark) you should, of course, move in and reassure and comfort him/her. This is, however, not the time to have a deep discussion about the reasons for the nightmare or the anxiety (Save this for the morning). Settle the child as quickly, and compassionately, as possible and then withdraw to allow him/her to drift back to sleep.
Use a reward chart: If you place something on a reward chart for every night during which there were no call-outs or ‘escapes’ your children will be able to see a visual presentation of their progress. This should reinforce the importance of undisturbed sleep in their minds.
Keep distractions to a minimum: For older kids it may be necessary to have strict rules for the prevention of middle of the night ‘electronic activities’ (e.g. listening to music, watching TV, surfing the web, instant messaging etc.). This will almost certainly be resented at first but could, in time, lead to the establishment of much healthier sleeping patterns.
Encourage physical activity: It does not take a rocket scientist to work out that the more active a person was during the day, the more likely he/she will be to ‘crash’ and sleep through the night. Encouraging your kids to participate in sport will therefore not only aid their physical fitness and motor development, it could also turn them into much better sleepers.
Avoid caffeine close to bedtime: As a stimulant caffeine is famous for its powers to keep people awake. Yet many people think nothing of allowing their children to drink near industrial qualities of the stuff close to bedtime. I am not, in the first instance, referring to the caffeine in coffee (which many parents would take care to avoid) but rather to the huge amounts found in many soft drinks. Drink such as this will hit a child with a double whammy: They will put the child on the ‘blood sugar rollercoaster’ and then make sure that he/she ‘hangs on for the ride’ through being wide awake! It is my opinion that drinks like these should be avoided at any time, but especially close to bedtime.
If none of the above is effective in helping your child to get a better night’s sleep it may be necessary to seek a bit of professional help (with the focus firmly on sleeplessness and not on a possible ADD/ADHD diagnosis). A medical professional focussing on sleep related issues should be able to suggest several techniques, beyond those mentioned above, with which to send your child to dreamland quicker and for longer.
There are obviously several different products on the market that claim to ‘cure’ sleeplessness. I would personally caution against using any of them on your children until you get an independent and knowledgeable medical opinion.
Many people needlessly go down the road to an ADD/ADHD misdiagnosis when all their kids need is a few nights of proper sleep. Make sure that you are not one of them: Look into possible sleep deprivation first. Sweet dreams!