Attention-Deficit Disorder or Lack of Sleep?
CDH Sleep Medicine Director Says Sleep Disorders at Root of Many Childhood and Adolescent Behaviors
WINFIELD, Ill., March 9, 2007 — The impact of sleep deprivation in children and teenagers is an eye-opener, mimicking conditions ranging from attention-deficit disorder to adolescent depression to drunk driving.
Children who have trouble staying on task—distractible, fidgety, constantly moving—are often diagnosed with attention-deficit/hyperactivity disorder (ADHD), but may have actually have a sleep disorder, says Anna Ivanenko, MD, pediatric sleep medicine director at Central DuPage Hospital in Winfield.
“Studies have shown a clear link between sleep dysfunction, which causes excessive daytime sleepiness, and behavioral, mood and performance deficits,” says Dr. Ivanenko, who reported her findings recently at the second annual “Sleep and Learning” Seminar for DuPage County educators, sponsored by Central DuPage Hospital.
Children with sleep apnea, for instance, have a restless sleep, characterized by loud snoring, respiratory pauses and troubled breathing, sweating. Not surprisingly, they have trouble waking up in the morning, are sleepy during the day, and exhibit a wide range of behaviors usually associated with ADHD: hyperactivity, poor impulse control, aggressiveness, attention span problems, social withdrawal and learning problems, according to Dr. Ivanenko.
“Treating a child who has a sleep disorder and allowing him to get a good night’s sleep will frequently eliminate ADHD symptoms and the need for ADHD medication,” says Dr. Ivanenko. “We urge parents to consider screening for sleep dysfunction in children diagnosed with ADHD who exhibit some of these issues as well: stalling behaviors or refusal to go to bed, excessive daytime sleepiness, awakening during the night, irregularity of sleep and snoring.”
According to the Centers for Disease Control and Prevention, 4.4 million children ages 4 to 17 have been diagnosed with ADHD, and as of 2003, more than half are currently receiving medication treatment for the disorder. Parents of almost 8 percent of school-aged children reported an ADHD diagnosis (2003, CDC website).
Moody, Broody Teenagers or Just Sleepy?
Lack of sleep is equally problematic for teenagers, who are at odds with a school system that wakes them up earlier each year, a full day of activities and sleep patterns that change dramatically from their childhood. “Circadian rhythms change in adolescents—brains and bodies are geared to feel wide awake until late at night and to sleep later in the morning,” says Ivanenko. “High school students’ natural time to fall asleep is around 11 p.m., but many have to wake up quite early on schooldays. They still need 9 to 9¼ hours of sleep each night, but it’s not surprising that the average teenager gets just 7¼ hours.”
The lack of sleep translates into moodiness that is often dismissed as typical of adolescents, but might well be remedied by a good night’s sleep. During the day, sleep-deprived teenagers are irritable, have difficulty paying attention in classes, and are more likely to succumb to feelings of anxiety, depression and hopelessness, according to the National Sleep Foundation (NSF).
Equally alarming is the effect it has on drivers, particularly teenagers who are just mastering behind-the-wheel skills. The NSF reports that drowsy driving causes more than 100,000 crashes annually and is as dangerous as drunk driving. Sleep deprivation is equivalent to driving with a blood alcohol content of .08%, which is illegal for drivers in many states.
But there are strategies for parents to help get their teens on the road to good nights, better mornings and more productive days.
Set a consistent bedtime and wake time for your teen, even on weekends, that allows for at least 8½ to 9¼ hours of sleep each night
Encourage your teen to establish a relaxing bedtime routine that includes pleasure reading, taking a bath or listening to music
Set up a bedroom for your teen that is cool, dark and quiet
Keep the television, computer and cell phone in the living room or den instead of your teen’s bedroom
Help your teen to cut out caffeine after lunchtime
Create an environment that allows your teen to get into bright light in the morning and avoid it in the evening
Be a good role model—talk to your teen about the importance of sleep and set the tone by making sleep a priority in your life
(from National Sleep Foundation/Central DuPage Hospital Sleep Center)
Dr. Ivanenko is an independent practitioner on the medical staff of Central DuPage Hospital. She is not an employee of CDH.
About Central DuPage Hospital
Central DuPage Hospital is a nationally recognized 361-bed facility located in Winfield, Ill., a suburb of Chicago. The Central DuPage Hospital Center for Sleep Health is accredited by the American Academy of Sleep Medicine (AASM) for meeting high standards for excellence and service. The Center features six private, hotel-like rooms for testing, with some rooms designed especially for children.
For more information about Dr. Ivanenko or the Central DuPage Hospital Center for Sleep Health contact (630) 933-4CDH or visit www.cdh.org.
Central DuPage Hospital
Amy Jo Steinbruecker