Monday, April 29, 2013

Good Night ADHD

Are kids getting labeled with Attention Deficit Disorder maybe just not sleeping well?

For as long as there's been ADHD there's been talk about ADHD and sleeping or rather not sleeping.  We all know kids with ADHD who have trouble getting a good night's rest. Some parents blame the drugs. Some blame the ADHD. Now some wonder whether ADHD could be a sleep disorder in disguise. That's right, bad sleep masquerading as ADHD.  That last theory kept a few parents awake this weekend. The Bad Sleep Hypothesis popped up on The New York Time's Most Emailed.  Article kept me up past bedtime too.

The evidence between bad sleep and ADHD?

Typically the bad sleep studies show kids who have trouble paying attention and staying focused also have trouble sleeping, whether it be breathing related (e.g., snoring, mouth breathing) or other sleep disturbances (e.g., sleep apnea, restless leg syndrome). Last year at Psychology Today I reported on a study of over 11,000 children in the UK that showed a link between sleep-disordered breathing in infancy and later behavioral problems like hyperactivity and aggression in addition to anxiety and depression. A pretty good study with a few caveats.  This study has been taken to show the effects of bad sleep on attention.  According to this theory bad sleep actually impedes proper brain development thus leading to the real deal, ADHD.

The evidence sleep troubles might get misdiagnosed as ADHD?

Exhibit A: The Tonsils Study. The author of the New York Time's article, Vatsal G. Thakkar, a shrink at the N.Y.U. School of Medicine, mentioned it. So kids were in the hospital for tonsillectomies, procedures often done to correct breathing issues.  Of the 78 children going under the knife, 28 percent were found to have A.D.H.D., compared with only 7 percent of the control group (undergoing different operations).  At that the time 7% would have reflected the national average.  Here's the pretty remarkable part. A year later half of the children with ADHD at the time of the surgery no longer showed enough symptoms to meet the diagnostic criteria.  That's tantalizing evidence there's something up with at least some cases of diagnosed ADHD.

Good luck to the sleep researchers.  Good luck to the parents and kids in future sleep studies.  It's challenging enough getting kids settled into their own beds or the ocassional hotel bed but can you imagine hooking your hyperactive 8-year old to the appropriate electrodes and such before bedtime in a strange sleep lab?  Gee, we think Jaden is not sleeping well, let's take him to this scary room so we can test whether he has a sleep disorder. I'd rather spend another night with a family of five in two beds in a single room in an airport Holiday Inn after two cancelled flights with a rotting tooth, no luggage and no Vicodin (i.e. my last vacation).

Seriously, ADHD diagnoses have sky-rocketed over 40% in less than a decade.  Forteeee-percent. Less than a decade, people. About 11% of kids here in the United States have been diagnosed or will be diagnosed with ADHD at some point.

Unless you've been living and sleeping under a rock you know all the hype about kids not sleeping enough...beause of the homework, the Mandarin lessons, the sports schedules, the school musical, the texting, the smart phones, the texting, the iPods, the texting, the laptops, the texting, tv, the texting, video games...

So as ADHD goes up, sleep goes down. Or as sleep goes down, ADHD up. Coincidence?

Could sleep play a role in ADHD? Or at least bogus ADHD diagnoses? If only I could stay focused to give it more attention. No, I don't have ADHD but like everybody else, there's simply too much to do, too little time, too many social media distractions and often too little sleep. 

How about you?









2 comments:

Awesome Mom said...

I know that a lot of the kids in my son's special ed class have parents that see no problem with letting them stay up all hours and not helping them get enough sleep. It drives his teacher nuts. Sadly I can't blame sleep for my son's attention issues because I am very firm about making sure all my kids get enough sleep at night. It would be nice if drugs or more sleep could help him.

Polly Palumbo, Ph.D. said...

Hi Awesome, I am no longer surprised at the variations in bedtimes. Personally I'm pretty strict on bedtime - maybe because my parents were both teachers and always talking about kids not getting enough sleep. And yes as you point out, it's not a cure-all but still, worth paying attention to. Some interesting comments for the NY Times article if you're interested.