Lack of Sleep Possible (ADHD Misdiagnosis 3)

child-sleepingOver the past few weeks we had a look at the very real problem of ADD/ADHD misdiagnosis. The bottom line of much of that was said is that it is very important to research alternative explanations for ‘ADD like symptoms’ before meekly accepting a diagnosis. This is because it is, sadly, often the case that those making a positive diagnosis have a vested interest in doing so. In some cases an ADD/ADHD misdiagnosis could be due to some rather unusual explanations (For example: Some kinds of bacteria mimic the effects of ADD/ADHD, more on this next week). In other cases the explanations are rather more mundane. This is perhaps nowhere more true than in the case of the role of sleep (or rather the lack thereof) on general health and behavior. Millions of mothers throughout the ages have sworn by the fact that their kid’s behavior gets worse for every extra hour of sleep that they did not get. It turns out that modern science is confirming this bit ‘folk wisdom’.

One of the most interesting pieces of research on the effects of a lack of proper sleep is particularly relevant for our discussion of ADD/ADHD misdiagnosis. The research was conducted by the University of Helsinki (Finland) and the Finnish National Institute of Health and Welfare. Under the microscope were the sleeping patterns and the behavior of 280 healthy seven and eight year olds. The simple question was the following: Are healthy children who get too little sleep more likely to display the symptoms generally associated with ADD/ADHD? The simple answer: Absolutely!

Researchers measured the sleeping patterns of the children who participated in the study in two ways, one subjective and the other objective. For the ‘subjective’ test they asked parents to fill in a questionnaire about their kid’s normal sleeping habits, they then also did their best to measure the accuracy of these estimates by actually noting down how much the children slept each evening for a week. This was done by asking them to wear actigraphs (movement measurers) to determine how long they actually rested for.

In addition to the tracking of sleeping patterns the parents were also asked to rate aspects of their children’s behavior using a measure that is commonly used in the diagnosis of ADD/ADHD. The results of this research strike a powerful blow for common sense. It can be summarized as follows:
• Most parents seriously overestimate the time that their children actually rest. This is because they do not ‘factor in’ the time that they spend falling asleep or when they lie awake for prolonged periods.
• Children with average sleep durations of less than 7.7 hours (as measured by the actigraphs) scored significantly higher in tests measuring hyperactivity and impulsivity. This means that they would be much more likely to be diagnosed with ADD/ADHD.

This study is one of the first that actually confirms something all parents know almost instinctively: Lack of sleep leads to little Johnny ‘acting out’ the next morning! If this continues over a few weeks a trend gets established and Johnny is at serious risk of being labeled as ADD/ADHD!

Dr. Juulia Paavonen who was in charge of the study lays her finger securely on both this problem and its solution: “We were able to show that short sleep duration and sleeping difficulties are related to behavioral symptoms of ADHD. The findings suggest that maintaining adequate sleep schedules among children is likely to be important in preventing behavioral symptoms. Even [an extra] 30 minutes per night has been shown to give a major improvement in objective cognitive tests, improving reaction times, impulsivity and attention spans.