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At a glance, confusing sleep issues with ADHD seems impossible. After all, they are opposites.

Sleep deprivation causes tiredness, while ADHD leads to hyperactivity. On closer inspection, though, the commonalities between the two are striking. ADHD and sleep disorders share several common symptoms, including problems paying attention, forgetfulness, and poor impulse control. Because of this, many parents are asking whether their child might not have ADHD after all. Could it be a classic case of misdiagnosis?

There are two reasons physicians may not get your child’s ADHD diagnosis correctly. The first is that doctors do not have a definitive test for ADHD (even though several genes are associated with the condition). They conduct various psychological and behavioral tests to determine whether a child has it, which is prone to error.

Second, sleep disorders are rare in children. Once they get to school age, most have regular circadian rhythms, helping them sleep well at night. Therefore, physicians won’t usually check for them. Because of these factors, doctors can mistake ADHD for problems with getting enough rest at night. Children with ADHD-like symptoms might be tired.

To complicate matters further, sleep disorders can worsen ADHD symptoms. Therefore, your child’s diagnosis might be correct, just incomplete. Eliminating insomnia or restless sleep could reduce ADHD or get rid of it entirely without the use of medication.

Ideally, clinicians should consider all alternatives before making an ADHD diagnosis. Other conditions producing similar symptoms are usually easier to treat. Moreover, the proper diagnosis means children receive the correct interventions for their disorder.

A thorough ADHD assessment takes time. Medical professionals should take multiple lines of evidence into account when giving a diagnosis. A casual evaluation isn’t sufficient.

Then there is the fact that ADHD-like symptoms can result from multiple conditions besides a lack of sleep. Trauma, depression, and anxiety may all play a role in attention-deficit hyperactivity disorder and sleeplessness. Therefore, parents and medical practitioners need to be careful. They should explore all avenues before coming to any diagnostic conclusions.

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What are the signs your child has a sleep disturbance but not ADHD?

Parents should look out for unique signs their child has a sleep disturbance, not ADHD. The wrong diagnosis could result in incorrect treatment.

As mentioned above, only a tiny fraction of children develop sleep disorders. However, physicians should rule them out first, as well as other more severe conditions,

Signs of a sleep disturbance issue include:

  • Falling asleep regularly in school (as opposed to daydreaming or merely becoming distracted)
  • High levels of irritability
  • Difficulty falling or staying asleep
  • Coughing in the night
  • Screaming or signs the child is panicking in the middle of the night
  • Pauses in the breath at night
  • Trouble paying attention to what people say

As you can see from this list, there is some overlap between the conditions. However, others are less common in ADHD than sleeplessness.

Check the guidelines for how much sleep your child should get for their lifecycle stage. Then compare these to the actual amount they get every night. Less-than-normal duration is okay for a night or two, but the total length should average over a week or fortnight.

Investigate further if your child is getting fewer hours than the average child. It could impact their behavior and cause unwanted health issues. Dealing with sleep disorders early on may prevent symptoms from developing further.

What are the signs your child has ADHD but not a sleep disorder?

On the flip side, there are signs your child has ADHD but not a sleep disturbance. Around 6 to 10 percent of the population has attention-deficit hyperactivity disorder, making it more common than you might think.

Tell-tale signs of ADHD include:

  • Difficulty sitting still or an uncontrollable desire to fidget
  • Trouble organizing possessions and items
  • Trouble listening to and understanding instructions or directions
  • A tendency to interrupt
  • Excessive amounts of energy beyond that of other children
  • A habit of blurting things out, even at inappropriate times
  • Difficulty remaining seated for long
  • Trouble focusing on tedious or unrewarding activities, such as schoolwork

It’s essential to note that most kids display these signs to some degree. However, it is more pronounced in ADHD children. Their symptoms are more intense and long-lasting throughout the day, affecting their functioning across numerous domains.

Can children have sleep disorders and ADHD simultaneously?

Sleep disorders and ADHD may feed into each other, worsening the symptoms of each. Kids with attention-deficit hyperactivity disorder tend to have more energy than regular children, making it harder for them to switch off at bedtime.

ADHD medications may also make insomnia worse for some children. Sleeplessness is a common side effect if children are active until their heads hit the pillow.

A minority of children experience genuine sleep disturbances without ADHD, but these are rare. Your doctor could misdiagnose the latter condition, but it is unlikely. More probable, a lack of sleep worsens your child’s behavior.

How can parents deal with ADHD-related sleep issues?

Parents can do several things to deal with ADHD-related sleep issues. Here’s a rundown of your options.

Check for signs of other medical conditions

Before concluding your child has sleep issues, check they don’t have any other underlying condition that might be causing symptoms. As discussed earlier, mental health issues can be the driving force behind trouble getting enough sleep.

Write down a behavioral plan

If you can’t find any sleep disorder issues, the next step is to write down a behavioral plan to help the child get more sleep. Options include:

  • Setting a regular bedtime. (For instance, you could put your child to bed at 7 pm every night).
  • Eliminating screen time or other distractions that might inhibit sleep at night time
  • Ensuring your child feels safe at night. (Some children can struggle to get sleep if they fear the dark or monsters).
  • Remove the clock from the bedroom. (The constant clock ticking can be a distraction for some children and a source of anxiety).
  • Make sure the child’s room has low noise and light levels. (Streetlights and sounds can keep children up at night. Black-out, sound-proof curtains can eliminate these).
  • Eat several hours before going to bed. (Eating right before bedtime can disrupt the circadian rhythm and make sleep more challenging).
  • Set regular wake times. (Children who sleep excessively in the morning may struggle to go to sleep at regular times).
  • Don’t allow older children to take too many naps during the day. (Daytime napping can make it more challenging for them to get enough sleep at night).

Take them to a sleep specialist

Kids’ sleep disturbances and issues are rarely critical. However, sometimes they develop severe problems that affect their ability to function. Taking them to a child psychologist or pediatrician at this stage can be a good idea.

Sleep specialists are the best medical professionals for evaluative purposes. They can tell you definitively if your child has a sleep problem. Sleep issues rarely cause symptoms severe enough for doctors to misdiagnose your child’s condition as ADHD.

Depending on their physiology, your child may have sleep apnea, where their airways get blocked. This disease causes breathing to stop repeatedly through the night, forcing the child to wake up and gasp for air. It is not as distressing as asthma because your child is asleep when it happens, but it does reduce sleep quality, potentially causing ADHD-like symptoms in the daytime. Sleep apnea is a serious sleep issue. Therefore, parents should take the child to a physician if they suspect it. Left untreated, it can lead to severe health issues in the future, such as high blood pressure.

Children with sleep apnea can also receive a false ADHD diagnosis. Therefore, you should return to a pediatrician after you get symptoms under control for a second assessment. You may find your child’s ADHD symptoms subside.

Conclusion

In summary, doctors rarely mistake ADHD for sleep disorders. However, it can happen. A small minority of kids can’t sleep at night, making them distracted and forgetful.

More likely, a sleep disorder is making your child’s ADHD worse. Resolving it can lead to an improvement in symptoms.

Generally, ADHD and sleep issues go hand-in-hand. Children with ADHD are more likely to be hyperactive at night, leading to shorter, poorer quality sleep which then feeds into worsening symptoms the following day.

Knowing this, parents should stop the cycle by improving bedtime hygiene. Children should relax in the evening and minimize stimulation to keep them calm. Parents should also prepare their bedrooms to be more conducive to sleep. Buying blackout curtains and removing ticking or bright clocks are excellent strategies.