Problems sleeping cause ADHD Behavior in Children and Adults
Any “thing” that causes a problem sleeping can also cause a child or an adult to have signs and symptoms of ADHD.
If you take a moment to think about it, it only makes sense that sleep disorders-regardless of the cause-can cause behavior often misdiagnosed as attention deficit hyperactivity disorder.
Ten year-old Leslie was a perfect example of a child misdiagnosed with ADHD-who in fact was suffering disordered sleep.
Leslie just seemed to be a tired, sleepy little girl when she first showed up in my office with her mom. Her teacher had urged her parents to have Leslie evaluated for ADHD, because “She had so many symptoms of ADHD behavior.”
Ironically, her symptoms were poor concentration, poor attention span, and failure to complete assignments, falling asleep in class, failing grades, and acting as if she was in a daze. She was definitely not hyperactive and reportedly rarely impulsive. Several of these are indeed symptoms of ADHD, but not enough to make a true diagnosis. That’s what made Leslie’s behavior so confusing to her parents. She was tired….all the time, not just at school.
Her parents had resisted the “idea that Leslie had ADHD” for as long as they could…at least until her teacher told them she was going to fail her grade if something wasn’t done and soon.
Leslie’s story was like so many other children misdiagnosed with ADHD-She never received a thorough evaluation for her “ADHD behavior”. Her previous doctor had started Leslie on Adderall without even seeing her in his office.
That’s just plain wrong! How could he possibly know that Leslie didn’t have one of the now more than 80 things that mimic ADHD causing misdiagnosis of ADHD? How did he know that Leslie didn’t have a heart condition that would have made use of certain ADHD drugs dangerous?
While he did tell Leslie’s mother he wanted to see her a month after starting the Adderall, he didn’t follow-up on the need for an appointment-so none was made. Leslie never had a single drop of blood drawn, never had an ADHD parent-teacher survey done-never had any type of physical examination.
As a consequence, her condition worsened to the point Leslie did fail the fourth grade.
Even though she was on a stimulant medication that helped her stay awake at school, Leslie crashed every afternoon when the drug "wore off". And when she crashed, she really crashed-often in bed by supper-time.
We suspected Leslie was suffering a sleep disorder based on questions her mother and father and teacher answered on my routine ADHD surveys.
What signs and symptoms of disordered sleep did Leslie show?
- Being just as tired when she awoke as when she went to bed
- Going to bed earlier than expected-without being asked
- Kicking the covers off in the middle of the night
- Falling out of bed while asleep
- Complaining of being restless when in bed or laying on the couch
- Not participating in play or social events expected for her age
- Sleeping on weekends or when out of school when most kids would be playing with friends
- Falling asleep while watching TV or reading a book or riding in a car
- Snoring or awakening gasping for air in the night or when laying on the couch
- Being irritable on family outings that took her away from home for many hours.
It’s easy to see how these symptoms could be so confusing, yet…I just couldn’t get a diagnosis of ADHD from them. So, how did we finally prove Leslie was suffering from a sleep disorder instead of ADHD? And.. which sleep disorder was causing her behavior?
These will be the topic of our next article….How to Diagnose and Treat Sleep Problems that cause ADHD Behavior.
Many things can cause a child to show symptoms of ADHD behavior including disorders of sleep and most are curable or at least treatable.
Frank Barnhill, MD
Here’s an article that brings attention to disorder sleep causing learning and behavior problems. Enjoy!
Is Excessive Daytime Sleepiness the Cause of Learning and Behavior Problems in Children?