Childhood Hyperactivity Linked to Problems With Sleep
April 17, 2000 (New York) --Many parents of children with attention deficit hyperactivity disorder (ADHD) report that their child acts up at bedtime or has problems sleeping. A new study shows that the problem may actually be related to the child's "internal clock" that determines what time the child falls asleep each night, according to a study in the April issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
Children with ADHD are typically inattentive, easily distractible, impulsive, restless, and hyperactive. In recent years, parents have reported that these children also have sleep problems, but few studies have looked into the possible connection between sleep and ADHD.
Ronald D. Chervin, MD, tells WebMD that the new study gives doctors and parents a better idea of what may be going on. "These disturbances have been widely reported for a long time," says Chervin, who is assistant professor of neurology, University of Michigan, Ann Arbor, and acting director of the Sleep Disorders Center.
Chervin describes the sleep problems of ADHD children as having trouble going to sleep or refusing to go to bed. They often have problems falling asleep and when asleep, do a lot of tossing and turning. "This study is showing that the time at which the child went to sleep varied within a two- to three-hour interval for the ADHD child, whereas it varied only about 40 minutes [for the normal] child."
The researchers used a watch-like device to measure movements during the night and record important data about sleep. The study consisted of 38 10-year-old Israeli boys who had ADHD and 64 boys of the same age who did not have ADHD. All boys in the study wore the watch-like monitoring device for five consecutive nights while they slept. Their parents were questioned about behavior problems, and the children themselves completed daily sleep logs with information about bedtimes, waking times, quality of sleep, and amount of daytime tiredness.
The sleep monitoring took place on school nights to eliminate any variations in sleep schedules that might be caused by weekends or holidays.
Study author Reut Gruber, PhD, of the National Institute of Mental Health in Bethesda, found that while the two groups of children had no real differences on many aspects of sleep, they differed significantly in terms of the times they fell asleep on each of the five nights.
For example, while a typical boy with no ADHD consistently fell asleep each night between 9:30 p.m. and 10:30 p.m., the typical ADHD boy fell asleep at 10 p.m. one night, 9 p.m. the next night, 11 p.m. the following night, midnight the next night, and 10 p.m. the following night.
Gruber and colleagues say the study suggests that sleep problems contribute to, or worsen the difficulties of, children with ADHD.
Chervin says there is ample evidence that treating sleep disorders in children can result in improvements in behavior. Studies have shown that sleep affects the parts of the brain that control thinking, decision-making, and impulsivity, which are thought to be disturbed in ADHD. Therefore, he says it is not unreasonable to think that disruption in sleep would lead to ADHD-like behavior or worsening of such behavior.
Gruber and colleagues say doctors should ask questions about sleep patterns when evaluating and treating a child for ADHD. And you should report any of your child's sleep problems to your physician.
- New research shows that children with ADHD also have problems going to bed and difficulty sleeping.
- Children with ADHD are typically inattentive, easily distracted, impulsive, reckless, and hyperactive.
- It is important to treat any sleeping problems among children with ADHD, because this can contribute to their condition.