ADHD and Sleep Disorders

For those parents who have children who have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), the idea that their child may have an additional medical problem on top of their existing disorder may seem like too much to bear. But new studies have shown that children with ADHD are prone to sleepless nights spent tossing and turning, and this may be a sign that they are also suffering from a sleep disorder. Despite the challenges of dealing with yet another diagnosis, the presence of a sleep disorder may be a cause for hope for parents struggling with the challenges of ADHD, as many have found that treating and correcting sleep disorders may provide a lessening of some of ADHD’s symptoms. Several studies have shown that though not every child with ADHD has sleep problems, many do. Children who wake up feeling tired or who suffer from nightmares may be showing signs that they have restless legs syndrome or obstructive sleep apnea. Several studies have shown that children with ADHD often report difficulty awakening and excessive daytime sleepiness. One recent study showed that children who suffer from ADHD are more likely to snore, while another indicated that children who snore are nearly twice as likely to be diagnosed with ADHD. This does not mean that snoring causes the hyperactivity, but it may point to enlarged tonsils or adenoids. Numerous studies have shown that children who snore – regardless of whether they have ADHD or not – get lower scores on attention tests, language ability tests, and overall intelligence tests. Removal of tonsils and adenoids has been proven to provide better sleep and to improve behavior in many children, eliminating the need for medications. [caption id="attachment_596" align="alignleft" width="300"]Medication Can Cause Sleep Disorders ADHD Medication may be causing sleeping disorders in children.[/caption] Another concern for parents of children with ADHD is the sleep disorder called obstructive sleep apnea. Though most people associate this condition with older adults it is actually common in children as well. During sleep apnea patients stop breathing entirely while they are asleep. They are not aware of the breathing lapses, which can happen hundreds of times per night. The body responds to the lack of oxygen by gasping and awakening itself. The sleeper generally falls back to sleep so quickly that they are unaware of the episode, which causes great disturbances in their sleep quality and ability to get restorative sleep. In children, enlarged tonsils and adenoids are the leading cause of obstructive sleep apnea, but it can also be linked to chronic allergies and obesity. The condition causes the child to feel drowsy throughout the course of the day. They have a hard time concentrating and are often irritable, symptoms that may overlap with their ADHD diagnosis. Children who have sleep apnea are candidates for tonsillectomy and the removal of the adenoids if they are the cause of your child’s blockage. The best way to determine whether this is the appropriate treatment for your child is to have a sleep study done, as tonsils and adenoids are not always the reason for apnea. There are other treatments available for situations where the blockage or inability to breathe comes from another source. Finally many children who have been diagnosed with ADHD and who show symptoms of sleep disruption end up being diagnosed with a condition known as restless legs syndrome. In this situation, patients report having a strong sensation of having something creeping or crawling on their legs and sometimes on their arms as well. The feeling compels them to move constantly, and this results in tremendous losses in sleep quality and quantity, leading again to daytime drowsiness, fatigue, irritability and a reduced ability to concentrate. Because so many of the symptoms of ADHD can be exacerbated by, or mimicked by, sleep disorders, it is advised that parents of children who have ADHD take a careful look at their child’s sleeping patterns to determine whether there may be an overlap. There have been some studies that have shown that those who suffer from restless leg syndrome have a problem with the brain chemical dopamine – and this chemical has also been identified as a problem for children with ADHD. This does not mean that everybody who has ADHD has restless leg syndrome or vice versa… it is just something else for parents to consider. Parents of children who have been diagnosed with ADHD who suspect that they may also be dealing with sleep problems should consult with their child’s physician and relate their concerns. Though in some cases the sleep issues may be a function of the child’s mind being overactive and unable to shut off, there may also be physical problems which may be addressed.  For those who simply have difficulty with going to sleep because they still have more that they want to do, cognitive behavioral training may be helpful in providing them with both self-control and self-management. Parents can also be instrumental in countering the various distractions and aggravating factors that make sleeping difficult for everybody. Make sure that there is no caffeine in any food or drink that your child is ingesting after 2:00 in the afternoon, and limit the use of any kind of bright screen or electronic device that emits a blue ray light within two or three hours of going to bed. These devices trick the brain into thinking that it is daytime and time to be alert. This can lead to a difficult cycle of having a difficult time going to sleep at night as well as awakening in the morning when it is time to start the day.  Children sleep better if they get plenty of exercise during the day, and bedtimes can be made much easier if they include nightly routines such as taking a bath, reading or being read to. Some children with ADHD respond very well to listening to relaxing music before they go to sleep. Finally, check with your physician to see whether your child’s ADHD medication may be interfering with their sleep. It may be possibly to simply change your drug schedule in order to provide a good night’s rest.