ADHD and Sleep Disorders in Children: Better Sleep Can Lead to Better Behavior

The term “sleep deprived” might bring to mind an image of an adult zombie-walking with an empty, outstretched coffee cup. Most adults know from experience that not getting enough sleep the night before makes for a rough day, but at least it’s just an occasional thing for them. Some people experience sleep deprivation on a regular basis due to a sleep disorder, and many of those are children with ADHD.

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According to Marsha Luginbuel, Ph. D., NCSP, sleep disorders deprive up to 10.5 million children of the rest they need; sleep disorders are often overlooked in children. Sleep disorders often affect children who have ADHD. Many children with sleep disorders don’t appear to be sleepy because sleep deprived children often overcompensate with hyperactive behavior and other ADHD symptoms, instead of behaving as a sleep-deprived adult would. Children may not realize that there is something wrong with their sleep, so they can’t tell their parents or doctors. Diagnosis must occur before treatment can begin, and a sleep study is often conducted to help with a diagnosis.

Treatment Options for Sleep Disorders in Children

It is common practice to try mild treatments first, before moving on to stronger options. Doctors may suggest behavioral therapy before prescribing any medications. They may recommend trying a soothing bedtime routine for the child, such as a bath and cup of warm milk. If that doesn’t work, then they may suggest a mild medication that has drowsiness as a side effect, such as Diphenhydramine hydrochloride (brand name Benadryl) an antihistamine, or a low dose of Clonidine, a blood-pressure lowering medication.

Some pediatricians and psychiatrists refuse to prescribe benzodiazepenes or “sleeping pills” to children, citing the possibility of side effects such as slowed heart or respiratory rates. Benzodiazepenes are the family of medications that include diazepam or “Valium.” Other professionals are cautious in prescribing these kinds of medications but do use them when the situation indicates they are needed. Psychiatrist Dr. Naeem Qureshi says that the benzodiazepene commonly used first is clonazepam, in very small doses, gradually increasing the dose until it helps or until undesirable side effects occur. If clonazepam doesn’t work, they move on to other medications such as lorazepam. Parents are cautioned to watch their children carefully when they first begin these types of medications for negative side effects, such as breathing difficulties or becoming overtired during the day.

Results of Proper Treatment for Sleep Disorders

Children who have ADHD and sleep disorders are difficult to treat, but when the proper treatment is found, the results can be impressive. Children’s behavior may improve and their irritability will usually decrease. This can make life run more smoothly, and improve relationships, especially within the family. The children who are treated successfully may be more alert and attentive during the day, and be happier overall. Treating a sleep disorder may reduce or eliminate ADHD symptoms. It may be difficult to find the right treatment, but it’s important that parents try. If a child who has the comorbidity of ADHD and a sleep disorder starts to get better sleep, life can improve dramatically for the child, as well as for the entire family.