A recent Technion-Israel Institute of Technology Sleep Laboratory study suggests that some children misdiagnosed with ADHD may actually be suffering from sleep deprivation. Researchers noted that symptoms of sleep disorders can mimic those of ADHD. Both children and adults who are sleep deprived can be hyperactive, irritable, and/or inattentive. If a child exhibits those symptoms or related symptoms, a doctor’s evaluation can determine if there is a medical condition that might be interfering with sleep.

Dr. Giora Pillar and his colleagues at the Technion studied children diagnosed with ADHD to determine if sleep deprivation leads to ADHD-type behaviors. The study, published in the Feb. 2004 issue of the journal Sleep, compared a group of 34 children diagnosed with ADHD with 32 children in a control group. Half of the ADHD group had symptoms of sleep-disordered breathing, compared to 22 percent of the control group. Fifteen percent of the ADHD group had Periodic Limb Movement Disorder, another disorder associated with sleep difficulties. None of the children in the control group had this disorder, which is usually very rare in the population.

Past studies by other research teams have shown that treatment of sleep disorders in children can help significantly improve behavior and cognitive skills. Pillar recommends that parents who are aware of ADHD-type symptoms in their children should have them evaluated for sleep disorders, and try treating them for any sleep-related issues, before considering medication for ADHD.

A study in the June 2005 issue of the medical journal Pediatrics also found that many high school students are frequently sleep-deprived. "I think sleep deprivation, sleep fragmentation, certainly causes attention deficit issues," said Richard Millman, a sleep researcher at Brown University.

"The problem is, which comes first?" asked Gayle Clachko, a social worker at Yavneh Academy. "When you don’t get enough sleep, sometimes you are more irritable and less attentive. But these kids also sometimes have trouble sleeping. Their brains are racing." She recalled one child who displayed ADHD symptoms. "He went to the Sleep Center at Hackensack Hospital [to be tested], and he doesn’t have ADD." Now that his sleep issues have been resolved, he has improved greatly, she said, and he is "much more attentive and doing much better socially and academically."

Some common sleep disorders include:

How to improve sleep habits in children:

• Provide a comfortable sleeping environment: a dark or dimly lit room, soothing atmosphere (i.e., no flashing disco balls), with familiar, comforting bedtime companions (e.g., a favorite teddy bear or blanket).

• Enforce regular, consistent bedtimes, both weekdays and weekends.

• Develop bedtime rituals and routines, allowing a child to wind down from the day’s activities: including bath or wash-up tasks, quiet play activities, soothing music, parent reading to child, and allowing older children to read for a short time in bed.

• Do not permit child to consume caffeinated foods or beverages in the evening, and do not serve large meals near bedtime.