Evaluating sleep in children with ADHD: Why it is important

jay tarnow

Children with ADHD commonly experience sleep problems. Past studies indicate 70-85% of children with ADHD have sleep problems. In some of these cases, the significant sleep difficulties the children are experiencing are contributing to the symptoms and could even lead to the child being misdiagnosed. In other cases, sleep problems co-exist with ADHD and contribute to functional impairment.

 

Although the association between sleep difficulties and the ADHD diagnoses is well known, sleep difficulties are not regularly evaluated during an ADHD assessment. Going along with the American Academy of Pediatrics assessment recommendation, assessing a child’s sleep difficulties should be a part of the treatment plan.

 

Following this idea, a new study on the relationship between ADHD and sleep difficulties in children found that sleep difficulties often impair a child’s daily functioning in ways independent of ADHD symptoms themselves.

 

The study consisted of 192 children with a mean age of 10 who had been carefully diagnosed with ADHD. The participants were measured on scales regarding their sleep behaviors, ADHD symptoms, and their daily functioning. The results found that the most prevalent sleep problem, excessive daytime sleepiness, was reported in 42% of the children.

 

In addition, 30% had insomnia, 26% had periodic limb movements (PLMS), and 25% had a sleep-related breathing disorder (SRBD).

 

Analysis of the data indicated that sleep problems – especially excessive daytime sleepiness – significantly contributed to lower daily functioning skills even after ADHD symptoms were controlled. Higher levels of insomnia predicted increased social impairment – beyond the impairment explainable by ADHD symptoms.

 

This research highlights the need to assess children with ADHD for sleep difficulties, and to treat these difficulties if and when they are identified. Although ADHD symptoms can impair a child’s functioning in many ways, parents, educators and clinicians should not attribute all the child’s difficulties to ADHD before potential sleep difficulties are examined.

 

The following post is based on the research article “The Functional Impact of Sleep Disorders in Children with ADHD” published in the Journal of Attention Disorders. For more information the article abstract can be found on PubMed.

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