Melissa Arca: Sleep deprivation can appear like ADHD in children

05/16/2013 12:00 AM

05/16/2013 8:28 AM

If you're looking for the country with the most sleep-deprived children, look no further.

We've got them.

According to a new survey, U.S. students rank the worst in getting sleep. And we all know what chronic sleep deprivation can do.

Poor behavior, inattention, impulsivity, decreased cognitive performance and paradoxical hyperactivity in kids. Sound like a medical condition you've heard of?

If you guessed attention deficit-hyperactivity disorder, you're right. Chronic sleep deprivation and/or sleep disorders like obstructive sleep apnea can mimic the classic symptoms of ADHD.

According to recent Centers for Disease Control and Prevention data, we are coincidentally also seeing a rise in ADHD diagnosis among children; with approximately 11 percent of school-age children receiving this diagnosis, including one in five high school boys.

The difficult question is how many of these children actually meet the true diagnostic criteria for ADHD? The answer is infinitely complex, but one that merits being explored thoroughly before we head down the pathway toward pharmacological treatment with stimulant medication.

More and more studies reveal what we know to be intuitively true: Sleep (both quantity and quality) plays a big role in how our children function and behave on a daily basis.

Combine this poor sleep culture with our era of technology in which kids are more likely to have some sort of screen in hand rather than playing outside, and this could certainly translate into more children exhibiting inattentiveness, increased fidgetiness and hyperactivity. To parents and teachers, it looks and sounds like ADHD.

But what we must remember is that true ADHD is a diagnosis that must carefully be made by a child's doctor. Screening and evaluation includes an in-depth history to ascertain whether symptoms interfere with a child's daily school and home life. Questionnaires must be completed by a child's parents and teachers, and then evaluated by a doctor.

A mental health assessment may be necessary to evaluate for additional conditions that might exist simultaneously. And often, a child needs to be screened for a learning disability.

Diagnosis, treatment and ongoing care is a process, not simply a one-time visit that ends with a prescription in hand.

The one thing all parents struggling with a possible ADHD diagnosis in their child can do now is look at their child's sleep pattern.

Is he or she getting enough sleep, and what is its quality? Preschool children need 11 to 13 hours per night; school-age children 10 to 11 hours; and teens 8 1/2 to 9 1/2 hours per night.

If the child snores, makes choking or coughing sounds during sleep, or wakes up often at night, the child may need a sleep evaluation by a specialist to determine if he or she has something such as OSA.

By getting a handle on your child's sleep, whether your child has ADHD or is simply sleep-deprived, you will see improvement in your child's behavior and school performance.

We know that children with ADHD have inherent sleep issues and doing what we can to ensure a good night's sleep helps with improving and diminishing the symptoms.

So do it today, parents, and keep it a habit: Rein in children's bedtime so they get the amount they need, keep all screens out of their rooms (no TVs, iPhones, iPads, etc.), see your children's doctor if you think they may have a sleep issue (like loud persistent snoring), and remember that chronic sleep deprivation can certainly masquerade as ADHD.

Dr. Melissa Arca is a mother of two. Her blog,, is featured on The Bee's blog and community news network, sacramentoconnect.sacbee .com.


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