Potential Misdiagnosis of Childhood ADHD
The symptoms of sleep deprivation in children resemble those of Attention Deficit Hyperactivity Disorder (ADHD). These include being wired, moody and uncooperative, unable to pay attention or sit still, and to have poor social skills.
The truth is that many children are given a diagnosis of ADHD when in fact the real problem may lie in a sleep disorder such as sleep apnea. This misdiagnosis may account for a significant 22% increase from 2003-2007 in the number of children adjudged to have ADHD.
The latest study to propose a link between inadequate sleep and ADHD symptoms appeared last month in the journal Pediatrics. Researchers followed 11,000 British children for six years, starting when they were 6 months old. The findings were eye-opening: children whose sleep was affected by breathing problems were 40 percent to 100 percent more likely to develop behavioral problems resembling A.D.H.D. than normal breathers.
Karen Bonuck, the study’s lead author and a professor of family and social medicine at Albert Einstein College of Medicine in New York says, “Lack of sleep is an insult to a child’s developing body and mind that can have a huge impact.”
Other studies now under way indicate that removal of a child’s adenoids (tonsils) improves behavioral issues and resulted in less likelihood of an ADHD diagnosis. But perhaps most significant is the finding that most children already found to have ADHD before tonsillectomy surgery subsequently behaved so much better that they no longer fit the ADHD profile.
Dr. Ronald Chervin, a neurologist and director of University of Michigan Sleep Disorders Center in Ann Arbor feels that behavioral problems linked to nighttime breathing difficulties are more attributable to inadequate sleep than oxygen deprivation. Other sleep experts point out that children who lose as little as half an hour of needed sleep per night can exhibit behaviors typical of ADHD. To compound this misdiagnosis, drugs like Ritalin prescribed to treat ADHD in children may only exacerbate the problem because they can cause insomnia.
Sleep deprivation is difficult to spot in children. Of the 10,000 members of the American Academy of Sleep Medicine, only 500 have specialty training in pediatric sleep issues. Professor Bonuck says, “It’s incredible that we don’t screen for sleep problems the way we screen for vision and hearing problems.”