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A Lack of Sleep or ADHD?

At a busy pediatric clinic in Rhode Island, Dr. Judith Owens sees a fair share of hyperactive children. They come in bouncing off the walls. Some may have trouble focusing in school or lash out at others for no apparent reason.

Could this type of behavior, the parents wonder, mean that their child has something as serious as attention deficit hyperactivity disorder (ADHD)? Before she answers, Owens is quick to ask them a question she fears too few are posing: "How well is your child sleeping?"

In fact, the same symptoms that characterize ADHD often overlap with the type of problems that result from a lack of sleep, according to various studies. Although doctors can usually separate the two, Owens warns that mood and behavioral changes caused by sleepless nights might sometimes be mistaken for ADHD.

"In the back of everyone’s mind should be whether these symptoms are related to sleep problems." says Owens, a pediatrician at Rhode Island Hospital in Providence.

How to Spot a Sleep Disorder
A thorough look at your child’s sleep behavior can help determine whether the problem is simply a lack of rest. Excessive daytime sleepiness is often the clearest indication.

Snoring is another key warning sign. In a recent study, researchers at the University of Michigan found that loud snoring helped predict which children would end up hyperactive several years later.

"Snoring is a major symptom of a sleep apnea." says Owens, referring to one of the main sleep disorders that children face. After several restless nights, children may demonstrate the same hyperactivity that kids with ADHD show.

Still, trying to distinguish sleep disorders from attention deficit ones can prove complicated. Not only are the symptoms very close, there is the chance that ADHD may interfere with sleep as well.

Studies suggest that children with attention deficit disorders are naturally sleepier than healthy kids, possibly due to overactive minds that keep them stirring at night. This could partly explain why some become hyperactive—such behavior is the body’s way of adapting to a lack of sleep, Owen explains.

Catching Some Zzz’s
Regardless of the ultimate cause, sleep problems can lead to irritability, a lack of focus and trouble in school. And if it turns out that your child does have ADHD, the wide use of stimulant medications may create its own sleep problems.

Owens says that newer drugs, such as Strattera, are less likely to interfere with sleep than Ritalin and the rest. But some children still complain of tiredness and irritability after taking Strattera, according to the Food and Drug Administration.

Whether a child’s lack of sleep is from ADHD, medications or sleep apnea, getting a good night’s rest is crucial. A lack of sleep can either exacerbate ADHD symptoms or cause problems that seem just as bad.

The first step, Owen says, is for parents and doctors to discuss a child’s sleep behavior. If your child is waking often in the night or having trouble going to sleep, there are simple steps you can take.

Owens recommends the basics:

• A regular bed time
• No caffeine or running around shortly before bed
• A relaxing bedtime environment, meaning no television

"Insomnia in children frequently affects parents’ sleep and stress." says Owens.