5 things I tell parents about ADHD and sleep

You may have seen recent news articles about the link between ADHD and sleep. Researchers are putting forth theories about how the two are connected. But sometimes, a researcher will introduce a new, unproven theory and the media will report it as fact. This can be really confusing for parents.

As a pediatric neuropsychologist for 20 years, I’ve worked with many children with ADHD, as well as kids with sleep issues. I talk with parents all the time about the role of sleep in a child’s well-being, and how ADHD symptoms manifest.

There are interactions between sleep, attention and learning. But it’s important not to confuse the issues. Here’s a breakdown of a few key points I think are important to understand.

1. ADHD is not a sleep disorder.

Research tells us that kids with ADHD can have trouble settling down at night. We know they get less sleep than other kids by 45 minutes on average. We also know that a small percentage of kids with ADHD have significant trouble falling asleep and suffer from insomnia.

When children have ADHD, it can affect their sleep. And lack of sleep can affect their attention. This means your child could have trouble paying attention in school. Your child could also be cranky and have behavioral issues. However, most experts, including myself, agree that ADHD is not a sleep-related disorder.

2. Be skeptical of single studies and theories on ADHD and sleep.

Studies show that adults with ADHD go to sleep later than adults without it. One study even shows this is true for kids. Because of this, a few researchers have claimed that attention issues in kids with ADHD may be caused by a lack of sleep.

However, kids aren’t little adults. And good science on child development is not based on one study or on studies of adults. Also, keep in mind that the 45-minute sleep difference for kids with ADHD isn’t big enough to cause the attention symptoms we see.

So when you hear about a single study or theory about ADHD and sleep, be skeptical.

3. Brain networks that control sleep function the same in kids with and without ADHD.

Researchers are learning more every day about ADHD and the brain, and sleep and the brain.

We know that sleep is controlled by a network of neurons in the brain. This network is called the reticular activating system. And this system is central in being “awake” and “alert,” and does have a role in attention.

However, studies haven’t found this system to be different in structure or function between kids with and without ADHD.

4. But some kids with ADHD do have sleep issues.

Of course, there are some kids with ADHD who do have sleep issues. For example, if a child doesn’t get to sleep until midnight and wakes up at 7 a.m. for school, it can affect the child’s attention.

But when professionals like me diagnose a child with ADHD, we also look at how the child is sleeping. With a careful evaluation, it’s unlikely that kids will be misdiagnosed with ADHD when it’s really a sleep problem.

Studies also show that around 10 percent of kids taking ADHD stimulant medication go to sleep later. If bedtime is really late, and your child isn’t sleeping enough to feel rested the next day, talk to your prescriber immediately.

5. Don’t let modern family life get in the way of your child’s sleep.

There are a few other common sleep situations I see in my practice that parents should also be aware of.

When some kids hit high school, they begin to sleep very little and may start struggling in class. When this happens, sometimes parents bring them to me for an ADHD evaluation.

I find in these cases that these teens are just overscheduled and stressed. They may be staying up until 1 a.m. doing homework, then waking up at 6 a.m. for school, while playing sports and doing other activities during the day.

The solution here is clear: These kids aren’t getting enough sleep. It’s the parents’ and my job to get those kids sleeping near nine hours per night and learning to manage their time better.

Working parents face an additional challenge. They work long days and understandably want to spend time with their kids when they get home at night. Still, that keeps children up later. Then the parents may have to drop them off early in the morning before work. That cuts into kids’ total sleep time. I try to help parents come up with creative solutions for their families to work around these challenges.

Finally, smartphones are a blessing, but they’re a sleeping curse according to several studies. Playing video games and texting on a bright screen doesn’t let the mind quiet down to fall asleep. I advise parents of teens and middle-schoolers to keep cell phones in the kitchen, not in the bedroom.

The bottom line

All children need a certain amount of sleep to pay attention and learn well. However, very few kids with sleep issues get misdiagnosed with ADHD.

It’s important that we don’t confuse these two related, but different, issues.


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