The Informed Parent

Sleep Problems And ADD

by Peter W. Welty, M.D., F.A.A.P.

Lately there has been interest in whether sleep problems are linked to attention and hyperactivity problems in young children. A new survey has found that children who snore, appear sleepy, or show other problems of sleep-disordered breathing at night are more likely to be reported by their parents as having problems with inattention and hyperactivity during the day.

In a recent article from the journal PEDIATRICS, Ronald D. Chervin, M.D., M.S., of the University of Michigan, Ann Arbor, looked at the sleep behaviors of 866 children. These children ranged in age from 2 - 13 years, and were recruited from two general pediatric clinics. The study found that 16 percent of the children were habitual snorers...snoring during half of their sleep time. Dr. Chervin found a significant association between habitual snoring and hyperactive behavior. Habitual snoring was found to be associated with a 12 - 22% increased likelihood of hyperactivity and impulsivity. There was also a strong association between snoring and hyperactive behavior in boys younger than eight years of age. In these younger boys, the likelihood of hyperactivity jumped from 9% in the non-snorers, to 30% in the habitual snorers.

Dr. Chervin concluded that there was a strong association between sleep problems and daytime behavioral problems, especially in boys younger than eight years of age.

Sleep-disordered breathing problems can influence behavior during the daytime. Sleep-disordered breathing problems can often lead to partial or full awakenings during sleep, leading to poor quality of sleep, and daytime sleepiness. Many researchers have associated daytime sleepiness with a child’s mood, thinking and learning abilities, and behaviors. Chronic sleep deprivation can lead to mood changes, inattention, delayed reaction time, decreased motivation, aggressive behavior and hyperactivity. These are symptoms that are commonly associated with ADHD. Thus, children with sleep disorders may appear as if they have ADHD during the daytime.

If you are wondering if your child has a sleep disorder, consider the following questions often asked by doctors to screen for sleeping problems:

1. Does your child have any long-standing problems at bedtime?
    
2. Does your child have difficulty waking in the morning, seem sleepy during the day, or take naps?
    
3. Does your child have loud or nightly snoring, or any breathing difficulties at night?
    
4. Does your child wake up a lot during the night?
    
5. Does he sleepwalk or have nightmares?
    
6. Does you child get enough sleep?

If there seems to be a problem with your child‘s nighttime breathing, discuss it with his doctor. Long-standing nighttime breathing problems may result in behavior and attention problems during the day, which can look like ADHD symptoms.