Sleep Disorders Can Mimic ADHD

The free dictionary defines conundrum as “A paradoxical, insoluble, or difficult problem; a dilemma.” Well, teasing out the symptoms of ADHD in order to be certain of a diagnosis is a conundrum. So many other disorders have ADHD like symptoms that it is very difficult to determine the specific problem. Autism, PDD, CAPD, NLD and other disorders all have characteristics which are identifiable with the hallmarks of ADHD: difficulties with behavior, problems in school and trouble with social interactions. It is no wonder that parents get alarmed and fear the worst when they recognize these symptoms in their child. What is important to note, however, is that often the cause of these behaviors has no relationship to one of these disorders. It may be the result of a sleep disorder.
Poor sleep patterns, inconsistent bedtimes and the inability of the baby or child to get to sleep on their own can result in behaviors that mimic ADHD or other disorders. Additionally, sleep problems create stress for the household. A crying, sleepless baby can keep other family members from getting a good night’s rest. They can strain a mother and father’s relationship and affect interactions among family members. Lack of sleep at night creates a kind of chain-reaction of daytime behaviors. When children don’t get enough sleep, it can manifest in hyperactivity, crankiness, combativeness, inattention and poor compliance. These symptoms are also characteristic of ADHD. If the child is school age, and exhibits these behaviors, they are very often misdiagnosed. What’s more is that children with ADHD often have a hard time falling asleep and/or tend to sleep less than their peers in general. This often leads parents and teachers to suspect that ADHD is the culprit.

The situation also becomes complicated because of a parent’s efforts to help the child to sleep. It is natural to attend to a child who won’t sleep. The parent will soothe the sleepless child by rocking them, giving them a bottle or something to drink, keeping them company until they fall asleep or taking them into their own bed, or other seemingly helpful strategy. This, of course, ends up promoting the sleeplessness because the baby or child becomes dependent on the interaction, and gets distressed when it is stopped. Alternatively, the parent continues the pattern and ends up sleep deprived and irritable. Many times sleeplessness or interrupted sleep patterns reflect emotional issues of a parent or parents, or can be attributed to psychological problems related to separation anxiety or temperament.

This problem can seem a little like “the chicken and the egg controversy”. Your child may very well be ADHD (or other disorder) and have sleep related problems. Or she could have ADHD alone. Or she might only suffer from a sleep disorder which is perpetuated by well intentioned but ill-advised bedtime routines. It certainly is a conundrum.

One thing is certain. Every child needs a good, uninterrupted night’s sleep. If you see that your child does not have good sleeping habits and is exhibiting any of the behavior symptoms characteristic of ADHD and other disorders, it is definitely worthwhile to work on developing an appropriate sleep routine. You may find that your well rested child has suddenly developed better behaviors.

1. Set a specific time for bedtime. If the issue is not sleeping long enough, start working toward a good bedtime by backing up the time gradually. You can start by getting the child to bed fifteen minutes earlier, then thirty minutes earlier, and so on until you reach your goal.
2. Prepare your child verbally by giving them advance notice of bedtime.
3. Do not allow a toddler or child to be involved in a stimulating activity immediately prior to bedtime. TV, high energy play and video games are arousing and can delay a child’s “sleepiness”
4. Spend the time right before bedtime in a calming routine. You can give a young child a warm bath and then read to them after they get in bed. Focus on activities that are calming and comforting to the child.
5. Be firm when you say goodnight. You can leave a nightlight on, or keep the door ajar if it reassures the child.
6. If the child starts crying, avoid going in to check on them. Giving them attention can actually cause them to cry more when you leave. If an older child gets out of bed try to direct them back to bed without discussion. They are seeking interaction, so you need to make it as minimal as possible. Keep in mind that if they are fed, toileted, bathed and not thirsty, then they are probably testing you.

Sleep problems are a common problem with everyone, regardless of age. However, children especially need sleep to help regulate their daytime behavior. Once an irregular sleep pattern has emerged, it is not easy to overcome. It will take time and patience to get your child to fall asleep at bedtime and to stay asleep throughout the night. Most children will respond to the above strategies. Please be aware that there are some children who have what is considered a complex sleep disorder. These children cannot self soothe and self-regulate. Developmental issues, emotional problems and/or medical problems may contribute to the sleep disorder and indicate the need to consult with a psychologist or child development specialist.

Nancy Konigsberg

Nancy Konigsberg is a pediatric occupational therapist and child development specialist with more than 16 years experience. She has a six year old son recently diagnosed with ADHD. Nancy has a blog called Milestone Mom which discusses ADHD and a variety of other developmental disorders. In it you can find disorder specific information and symptoms along with exercise treatment and therapy techniques. Readers from all over the world can write to Nancy and get suggestions tailored to their individual situations.

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About the author

Nancy Konigsberg is a pediatric occupational therapist and child development specialist with more than 16 years experience. She has a six year old son recently diagnosed with ADHD. Nancy has a blog called Milestone Mom which discusses ADHD and a variety of other developmental disorders. In it you can find disorder specific information and symptoms along with exercise treatment and therapy techniques. Readers from all over the world can write to Nancy and get suggestions tailored to their individual situations.

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The "ADHD Mommas" are not medical or mental health professionals, nor an ADHD coach. Any opinions shared here are just that, opinions. I, and the other "ADHD Mommas," are sharing our experiences with our own ADHD children. Please do not re-post or publish any content or photos without a link back to {a mom's view of ADHD}. Have the courtesy to give credit where credit is due. Copyright protected. All rights reserved.

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