Lack of Sleep Possible (ADHD Misdiagnosis 3)
Over the past few weeks we had a look at the very real problem of ADD/ADHD
misdiagnosis. The bottom line of much of that was said is that it is very important to
research alternative explanations for ‘ADD like symptoms’ before meekly accepting a
diagnosis. This is because it is, sadly, often the case that those making a positive
results have something to get from it.There are a few instances in which ADD/ADHD has been misapplied to a child because of an extreme cause such as a bacterial infection that causes similar behavior which we will discuss in more depth next week. In other cases the explanations are rather more mundane. This is perhaps nowhere more true than in the case of the role of sleep (or rather the lack thereof) on general health and behavior. Millions of mothers throughout the ages have sworn by the fact that their kid’s behavior gets worse for every extra hour of sleep that they did not get. It turns out that modern science is confirming this bit ‘folk wisdom’.
One of the most interesting pieces of research on the effects of a lack of proper sleep is particularly relevant for our discussion of ADD/ADHD misdiagnosis. The research was conducted by the University of Helsinki (Finland) and the Finnish National Institute of Health and Welfare. The study took 280 healthy children that were seven to eight years old and intensely watched their sleeping behavior. The simple question was the following: Are healthy children who get too little sleep more likely to display the symptoms generally associated with ADD/ADHD? The simple answer: Absolutely!
Researchers measured the sleeping patterns of the children who participated in the study in two ways, one subjective and the other objective. In an effort to be subjective the parents completed a list of questions concerning their child’s sleep patterns on a normal day; for a week the child’s sleep patterns were watched and noted to complete the testing. This was done by asking them to wear actigraphs (movement measurers) to determine how long they actually rested for.
In addition to the tracking of sleeping patterns the parents were also asked to rate aspects of their children’s behavior using a measure that is commonly used in the diagnosis of ADD/ADHD. The results of this research strike a powerful blow for common sense. It can be summarized as follows:
• Most parents seriously overestimate the time that their children actually rest. This is because they do not ‘factor in’ the time that they spend falling asleep or when they lie awake for prolonged periods.
• Children with average sleep durations of less than 7.7 hours that were measured by the monitors showed higher test results when looking at impulsive and hyper behavior. This means that they would be much more likely to be diagnosed with ADD/ADHD.
This study is one of the first that actually confirms something all parents know almost instinctively: Lack of sleep leads to little Johnny ‘acting out’ the next morning! If this continues over a few weeks a trend gets established and Johnny is at serious risk of being labeled as ADD/ADHD!
Dr. Juulia Paavonen who was in charge of the study lays her finger securely on both this problem and its solution: “We were able to show that short sleep duration and sleeping difficulties are related to behavioral symptoms of ADHD. It turns out that some of the symptoms displayed through behavior could be avoided if the child was sleeping appropriate lengths of time on a consistent basis. An increase in concentration and the ability to react calmly in situations has been seen in just getting a half hour more of sleep each night.”
All of the above should make it clear that one of the first things any concerned parent should do before submitting a child for a possible ADD/ADHD diagnosis is to make sure that the child gets enough sleep. It is difficult to pin an exact figure on ‘enough’ as the amount of sleep needed for optimum performance will differ from person to person. Eight hours and more should nonetheless be seen as a very good benchmark to work from. It is highly unlikely that your child will need less sleep but an increase in their sleep hours is almost gauranteed.
Helping children to ‘make the numbers’ when it comes to sleep can be very difficult but it is a discipline that you will have to learn. A bit of planning and the establishment of a firm bedtime routine could help you in this regard. Having behavior become more manageable is a huge result. By paying more attention to a child’s sleeping behavior could be the one simple act that prevents the life changing ADD/ADHD results in your life. So next time you deal with problems of hyperactivity and impulsiveness your first response should perhaps be to ‘sleep on it’ before doing anything else!
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