I’ve heard that sleep disorders are sometimes misdiagnosed as ADHD. How can doctors tell if someone has ADHD or a sleep disorder — or both?
Great question. Some signs of ADHD, like trouble with focus or self-control, can look a lot like some signs of sleep disorders. That’s because trouble with attention can affect sleep — and trouble with sleep can affect attention.
Doctors can tease the problems apart, though, and make an accurate diagnosis. The symptoms can look alike, but they have different root causes.
Here are some of the ways ADHD can affect sleep:
People with ADHD can have trouble winding down at night. It may take a long time to “shut off” their brain so they can sleep.
Not getting enough sleep makes it harder for people with ADHD to concentrate the next day.
ADHD medication can play a role. If it keeps working too late in the day, it can delay the relaxing needed to get to sleep. If this happens a lot, ask your doctor about fine-tuning the medication.
Sleep disorders can affect the amount or quality of sleep a person gets. And this can interfere with things like attention and stamina during the day. Here are some different types of sleep disorders:
Sleep apnea: This involves snoring and frequent, long pauses in breathing.
Nightmares and night terrors: These can rise to the level of a disorder if they happen a lot and cause problems with getting stuff done during the day.
Restless legs syndrome: This involves unpleasant sensations in the legs and can wake people up many times during the night.
Insomnia: This makes it hard to fall asleep or stay asleep — or both.
If you’re wondering if you’re seeing signs of ADHD or a sleep disorder, you can help the doctor look for patterns in the following areas:
Sleep schedule: Write down details about sleep habits like bedtime and wake-up time. Take notes on sleep quality, too. For example, is weekend sleep more restful compared to weeknights?
Snoring: Does loud snoring happen a lot? Does it sometimes sound like there’s no breathing for a second or two? Removing tonsils and/or adenoids can relieve sleep apnea in some people and, with it, some attention problems.
Exercise: Is it easier to stay focused on days that include a lot of exercise? Does more physical activity seem to help with falling asleep or staying asleep?
Nutrition: Take notes on how much caffeine is consumed each day. This includes soda and coffee. Take notes on junk food, too. See if eating healthy, balanced meals helps with paying attention during the day and sleeping better at night.
Screen time and downtime: Watching TV or playing video games can make it hard to settle down at night. See if reading or another calming activity can help with falling asleep.
Keeping a close eye on these areas can be a big help to your doctor. The details you share can help with making an accurate diagnosis.
Keep in mind that not everyone who has trouble sleeping has ADHD. But trouble sleeping may have an even bigger effect on people who do have ADHD. That’s why talking about sleep is such an important part of any ADHD testing and treatment plan.
Tell us what interests you
About the author
About the author
Laura Tagliareni, PhD is a pediatric neuropsychologist in New York City and a clinical instructor at NYU Langone Medical Center.