Is A.D.H.D. actually sleep deprivation?

The New York Times has an interesting editorial from a professor of psychiatry at N.Y.U. School of Medicine who sees a lot of adults who think they have A.D.H.D. but they actually have sleep deprivation.

Vatsal G. Thakkar points out that there is a number of studies that show a huge proportion of children with A.D.H.D diagnoses often also have a sleep disorder such as apnea, snoring, restless leg syndrome or non-restorative sleep.

And for some people, especially children, sleep deprivation can cause them to become hyperactive and unfocussed instead of lethargic.

From The New York Times:

“We all get less sleep than we used to. The number of adults who reported sleeping fewer than seven hours each night went from some 2 percent in 1960 to more than 35 percent in 2011. Sleep is even more crucial for children, who need delta sleep — the deep, rejuvenating, slow-wave kind — for proper growth and development. Yet today’s youngsters sleep more than an hour less than they did a hundred years ago. And for all ages, contemporary daytime activities — marked by nonstop 14-hour schedules and inescapable melatonin-inhibiting iDevices — often impair sleep. It might just be a coincidence, but this sleep-restricting lifestyle began getting more extreme in the 1990s, the decade with the explosion in A.D.H.D. diagnoses. …

“One study, published in 2004 in the journal Sleep, looked at 34 children with A.D.H.D. Every one of them showed a deficit of delta sleep, compared with only a handful of the 32 control subjects.

“A 2006 study in the journal Pediatrics showed something similar, from the perspective of a surgery clinic. This study included 105 children between ages 5 and 12. Seventy-eight of them were scheduled to have their tonsils removed because they had problems breathing in their sleep, while 27 children scheduled for other operations served as a control group. Researchers measured the participants’ sleep patterns and tested for hyperactivity and inattentiveness, consistent with standard protocols for validating an A.D.H.D. diagnosis.

“Of the 78 children getting the tonsillectomies, 28 percent were found to have A.D.H.D., compared with only 7 percent of the control group.”

The author points out that in a follow-up to that study, a full half — 11 of the 22 — no longer met the criteria for A.D.H.D.

I find this article very interesting because when Rose had her tonsils out last summer our local E.N.T. mentioned in passing a possible connection between tonsil removal and helping A.D.H.D. He was going over the American Academy of Pediatrics list of reasons to remove tonsils and he said they had not added A.D.H.D yet but he said it often helped kids who had A.D.H.D. I’m surprised he was aware of these studies.

So have you ever heard of this connection between sleep deprivation and A.D.H.D. symptoms? Have you noticed any of these connections in your own kids? Did your E.N.T. explain any connection when talking about a possible tonsillectomy? Did you notice any improvement with a tonsillectomy?

50 comments Add your comment

[...] Is ADHD actually sleep deprivation?Atlanta Journal Constitution (blog)Vatsal G. Thakkar points out that there is a number of studies that show a huge proportion of children with A.D.H.D diagnoses often also have a sleep disorder such as apnea, snoring, restless leg syndrome or non-restorative sleep. And for some people, …Diagnosing the Wrong DeficitNew York Timesall 3 news articles » [...]

[...] Is ADHD actually sleep deprivation?Atlanta Journal Constitution (blog)The New York Times has an interesting editorial from a professor of psychiatry at N.Y.U. School of Medicine who sees a lot of adults who think they have A.D.H.D. but they actually have sleep deprivation. Vatsal G. Thakkar points out that there is a …Diagnosing the Wrong DeficitNew York Timesall 3 news articles » [...]

[...] Is ADHD actually sleep deprivation?Atlanta Journal Constitution (blog)The New York Times has an interesting editorial from a professor of psychiatry at N.Y.U. School of Medicine who sees a lot of adults who think they have A.D.H.D. but they actually have sleep deprivation. Vatsal G. Thakkar points out that there is a …Diagnosing the Wrong DeficitNew York Timesall 3 news articles » [...]

Techmom

April 29th, 2013
7:56 am

My son has always been more attentive when he gets plenty of sleep but I hadn’t considered sleep being the cause of ADHD. Perhaps it’s more along the lines of a driver of the symptons/behaviors of ADHD (like too much sugar is also a driver) rather than the cause. In other words, decreasing sugar and increasing sleep may result in milder symptoms but I don’t think it will make ADHD go away (unless it was improperly diagnosed to begin with). I do think it’s an interesting study that may allow teachers & doctors to more often suggest routine changes to help curb certain behaviors before jumping straight to meds though.

Techmom

April 29th, 2013
8:08 am

Just read the whole article. The author isn’t suggesting that ADHD is caused by a lack of sleep but that it is sometimes misdiagnosed and the actual issue is sleep deprivation. Very interesting indeed.

Uh, Oh...

April 29th, 2013
8:10 am

…don’t get the legion of ADHD fans started on their high horse that this (ADHD) is REAL, even though it is something that was invented by “researchers” in the last 60 years…and, now, an article that gives a rational reason for kids hyperactivity, saying that it is NOT necessarily a latent condition…too late, you already printed the article…

FCM

April 29th, 2013
8:13 am

I have heard that Tonsillectomies help with some of the ADHD symptoms but that it does not fully go away. Younger child with ADHD does need to have hers removed for other reasons though.

We also tried one of the meds that facillitates sleep and saw no effect on her ADHD. Certainly there are times when I put her to bed earlier or even go up with her to settle her in, b/c she is woundup so much she doesn’t even realize that is the issue.

No i don’t think lack of sleep is the cause of ADHD.

Young Lady

April 29th, 2013
8:28 am

Techmom- If you read the article, which isn’t the best written one, it looks more like they’re dealing with a misdiagnosis issue. Basically they were diagnosing the kids before they found the sleep disorders and then the symptoms disappeared in most of them after treatment. Which is just a case of needing to refine the diagnostic tool to include sleep study.

But I’m seriously questioning the methodolgy behind at least one of the studies in this because if you have a breathing problem in an infant then that can lead to a lifetime of health issues not only ‘behavioral difficulties.’ That is incredibly vague because that can mean a lot of different things and not well explained how they controlled for the fact these children likely have severe health issues and are probably special needs.

DB

April 29th, 2013
8:33 am

I think lack of sleep is a HUGE factor in so many health issues. While it may contribute to ADHD-like symptoms in children, I suspect that a great number of people who suffer from depression would find that many of their symptoms would be alleviated if they got more sleep on a consistent basis, not just sleeping late one day a week or so to “catch up”. There’s already interesting studies on weight gain and lack of sleep, and there’s a reason why sleep deprivation was used as a torture method. People need more sleep than they think they do.

Really?

April 29th, 2013
8:54 am

ADHD is made up. It’s an excuse to not focus on the task at hand. more and more kids are catching on to this and using it as an excuse not to do their work.

And more and more adults are falling for it.

Get the kids off the video games, feed them healthy meals, and get fresh air, exercise, and plenty of sleep. Why is this so hard to comprenend?

Becuase a parent would rather rush their kids off to the doctor, to issue some sort of pill so their kids can get hooked on pills, other than actually being an involved parent.

Why did you have kids, if you can’t take care of them?????

motherjanegoose

April 29th, 2013
8:55 am

FCM…I concur: ” No i don’t think lack of sleep is the cause of ADHD.”

I also believe that most people do not get enough sleep. I am very picky about sleep, as I typically attract illness when I am not well rested and I am not able to focus in meetings or with the children.

There is so much out there that keeps people from sleep and electronics is certainly a distraction. We heard a sermon on self control yesterday, at church. It was mentioned that some people are the boss of many others ( at their jobs) but cannot control even themselves personally. I found it interesting. Making sure you get enought sleep and turning off your world, takes self control.

As an educator, I see lots of children out of control. I am now wondering about the trickle down effect of living in a family that has no self control. This ( to me) is kind of like living in a family that:
* eats poorly
*does not exercise
*has no manners
* does not bathe
* uses surly vocabulary

a child will then come to school as a product of his/her environment ( catlady can share some more on this). Thus, we have children who come to school tired and cranky because there is no self control about bed time for adults or children. Just thinking out loud here.

Mayhem

April 29th, 2013
10:23 am

Again, haven’t we covered ADHD NUMEROUS times already?

This topic has been up since 11:00 last night, and you’ve gotten 11 responses, 2 of which were your own.

Boring…….

motherjanegoose

April 29th, 2013
10:30 am

Mayhem, here’s your chance…suggest an exciting topic and we can move on today! What ideas do you have up your sleeve for us? Sometimes I have forged a new path and it has been interesting. Why not give it a shot, if you are ready?

K's Mom

April 29th, 2013
10:38 am

I notice my 3yo is much less focused and much less able to follow directions under two conditions. One is being sleep deprived and the other is when he takes allergy medication (which unfortunately ’tis the season). I do not think ADHD is made up, but I do think a lot of children are diagnosed due to poor parenting and lazy teachers. I would love to see some sort of evidence based research over the long term on children and their school successes/failures where sleep and diet are considered.

tina

April 29th, 2013
10:41 am

Mayhem, I almost said this would be our next topic when we talked about it Thurs.

DB

April 29th, 2013
10:47 am

@Mayhem: Since you’ve appointed yourself the blog police, perhaps you could set down in cement just how many times a topic may be discussed.

As many on this blog have suggested in the past — if you don’t have anything to contribute meaningfully to a topic, you’re free to pass on it for the day and get on with your life. I truly don’t understand why you feel the need to bitch incessantly about something you have NO control over. It’s T’s column. You don’t like it, don’t read it. And for heaven’s sake, stop subjecting us to your whining. It’s BORING.

ADHD Mom

April 29th, 2013
10:50 am

I’m not a doctor, but I have ADHD and so do both of my kids. None of us have problems with our sleep. And in response to “Really?” I knew a comment like yours was coming. You have absolutely no idea. I had ADHD even in the 70s and 80s (and I’ve been athletic, active, and hated video games all my life). As far as just making excuses, no…despite challenges and having teachers accuse me of “being careless” and “refusing to sit still,” I’m now working on a PhD!!!! And this comes after years of successful, stable employment. You can’t judge the entire diagnosis by those who milk it!

bgb

April 29th, 2013
10:55 am

If it weren’t for complaints, T wouldn’t get many clicks on her blog.

Is it just me,
or do the often poorly punctuated and phrased sentences (?) that T writes (not the ones she copy/pastes),
make them nearly unreadable?

jarvis

April 29th, 2013
11:19 am

Not totally on topic, but sleep needs are very dependent on the person.

Edison only slept 3 hours a night, and Ben Franklyn 5 hours.

I’ve never needed much sleep. It’s not for everyone. Apparently about 3% of the population doesn’t need nearly the 7 hours the study is talking about. Last night I went to bed at around midnight and woke up at 5 AM. Not like and insomniac that struggles to get back to sleep. I was wide awake and refreshed. I fall asleep easily and sleep hard while I’m out.

Let’s say I sleep 5.5 hours a night on average. In a year, I’ve slept 900 less hours (give or take) than my 8 hour a night friends. I figure that in 60 years of my life, I’ll have been awake nearly 2,300 days longer. That’s over 6 years of me doing things while they were asleep…..cool things…..like calulating how many hours I’ve been awake.

motherjanegoose

April 29th, 2013
11:23 am

HAHA Jarvis. Thanks for the laugh! I wonder if there is a way to determine how much sleep you actually need, per person. Anyone know?

jarvis

April 29th, 2013
11:27 am

@bgb, I don’t complain on her much. If the topics don’t interest me, I simply don’t comment. She can’t hit on 100% of the time.

She has all together quit writing on all topics regarding sex (which were actually in the old blog description), and those used to be a nice fun change up. I assume that is because her two oldest children probably read the blog now.

Busy Mom

April 29th, 2013
11:32 am

This is interesting to me since my 1st grade son is going in for evaluation next week. He has trouble focusing and is easily distracted, but doesn’t have any behavior problems at school. I haven’t really paid too much attention to this topic before on the blog, but these comments are timely. I don’t want a quick ADD diagnosis, but something is going on with him.

He’s also young (Summer birthday) but so are other kids. Any advice would be appreciated.

Realist

April 29th, 2013
11:50 am

Much more money to be made drugging these kids than getting them real solutions. You do the math. Get your kids out of the government prison system immediately. Please don’t let the system destroy their future. Homeschool them, get them into a private school, do whatever you need to do to make it happen. Don’t let them become another victim of this dysfunctional system.

motherjanegoose

April 29th, 2013
12:13 pm

@Realist…what credentials do you have for giving advice about ADHD? Please share. I have none but I have seen LOTS of children in my 30 years in education and also have seen how medication, among other things, can make life easier for everyone. I have also seen parents who decided that the public school ( diagnosis) was wrong and yanked their kids out to homeschool. Then, that was a disappointing disaster. There is not a black and white answer for this, as far as I can see.

@Busy Mom…I hope catlady will hop on with some suggestions for you. Being the youngest in the class can present it’s own set of problems. My own two were summer birthdays and we did not have a problem but I observed younger students with problems most every year.

jarvis

April 29th, 2013
12:27 pm

Realist was publically educated and look where it got him….parnoid and unemployed. Take heed.

Uh, Oh...

April 29th, 2013
12:37 pm

Enter your comments here

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Uh, Busy Mom...

April 29th, 2013
12:48 pm

…oops

Then, please do NOT let them label your child; you have already noticed that he may have an attention span deficit, yet that does NOT mean he is any different from the other, older kids. My son, too, has a June birthday and was generally almost a year younger than most of his peers all during school. He, too, had an attention span deficit (still does), and, unlike your son, he had some “activity” problems while in elementary school. We worked and worked with him, yet he was still somewhat “hyperactive” – but, we chose to acknowledge that he was just being himself, as well as just being a “boy”, and the teachers understood, fortunately.

He graduated from high school, on time, and played sports, which helped channel some of that “extra” energy; he qualified for the Hope Scholarship, maintaining the necessary 3.0 GPA all four years of college (unfortunately, for us, he went to college out of state, but you get my drift regarding the GPA). He has been out of college for 3 years now and is employed with an international company and is seemingly doing well financially while basically being completely on his own since graduating from HS.

Again, do NOT let them pigeon-hole your son with some made up diagnosis, or let them “medicate” him when, in all probability, he is just being a boy…

[...] apnoea or snoring, restless leg syndrome or non-restorative sleep, in which deep sleep is …Is ADHD actually sleep deprivation?Atlanta Journal Constitution (blog)Diagnosing the Wrong DeficitNew York Timesall 6 news [...]

Techmom

April 29th, 2013
1:03 pm

I know we’ve talked about ADHD several times but I do think this was a good reason to bring it back up considering how much people do think ADHD is over-diagnosed. The opinion of the author is that it also applies to adults and not just kids. We lead increasingly stressed and over-scheduled lives to the detriment of our health.

Busy Mom

April 29th, 2013
1:11 pm

I do think part of it is that it’s just the way he is, but it’s to the point of causing a problem. He doesn’t finish some of his assignments at school, and at home sometimes I can give instructions and it’s like he didn’t even hear me. He makes good grades so that’s not the issue and he is quiet and reserved in the classroom, not bouncing off the walls. The pediatrician doesn’t want to jump on a diagnosis (thinking it could be something else), but I’m interested to see what the evaluation brings out.

Uh, Busy Mom...

April 29th, 2013
1:40 pm

…again, he is probably just being himself, and if he is not doing anything other than being less than completely focused, then he is completely normal, thoyugh he may need to be “sat on” regarding completing assignments…my son still tunes us out!

motherjanegoose

April 29th, 2013
1:51 pm

What does “being a boy” look like? I have seen hundreds of boys being boys. I have a son myself.
There are lots of different ways to be a boy. Is it that we simply expect boys to be rowdy? Not all are. I remember one student, whose Dad was a surgeon. He did not want any part of anything messy or gooey such as fingerpaint. The girls ( in my class) were having a big time and he was beyond apprehensive. Would not go near the stuff. Yet, he was a boy!

Uh, motherjane...

April 29th, 2013
1:58 pm

…if we have to explain it (as in the saying “boys will be boys”) you wouldn’t understand anyway, so please try not to be combative as that is really not your style, at least that is what I have observed over the years from you, though I will admit that things, and people, do change…

motherjanegoose

April 29th, 2013
2:34 pm

Many parents explain their child’s behavior that way. This I know. Not wearing combat boots :).

Dekalb mom

April 29th, 2013
2:35 pm

Busy mom – you should not let others tell you what is best for your son – they have never met him, much less diagnosed him. You and your doctor, along with his teacher(s), should figure it out. My son was struggling in school – very athletic and plays outside a lot, limited tv/video time, relatively healthy eater, not a behavioral problem except for maintaining focus. . But his performance in school was poor and his confidence was plummeting. He is now on a combination of a non-stimulant adhd med and a mild short acting stimulant (no noticeable side effects) and the difference has been monumental. His ability to learn and retain have increased dramatically, as has his confidence. The medication was a lifesaver in our household. Wish we had been willing to go on it sooner but we fought the diagnosis. However, I am glad we made sure it was nothing else before we did go this route. Good luck – it is a difficult journey but we are luckily seeing a huge payoff now.

K's Mom

April 29th, 2013
3:29 pm

@MJG, as you know I am not a teacher, but my 3yo falls into the boys are just a little different in the way he learns and functions category. He had a teacher for 2 months where it caused huge issues, but his current teacher embraces it. Here are the things that I see as different between my son and the boy in his class and the girls. First, K is more physical and will rough house with his classmates is given the opportunity and not managed. His favorite way to greet my nephew is to tackle him. Now we have taught him that is not appropriate, but his first teacher thought he was being mean and his current teacher saw it as a normal way boys interact and that he needed to be taught that there is a time and a place. K also learns better when he gets to move, touch, feel, dance and sing. The girls in his class can already sit still for far longer than the boys. K’s current teacher understands child development and really works hard to keep her classroom moving and to differentiate well for the boys and girls. I think the biggest reason boys are overdiagnosed with ADHD is that they are made to be in constant motion and there are some teachers who are too lazy to use that energy in a constructive way and would prefer to put them on medication. I have no idea if either of mine have ADHD and will not for years, but a pediatrician and a psychologist would be part of the diagnosis, I would not rely only on what a teacher says.

K's Mom

April 29th, 2013
3:33 pm

And the phrase boys will be boys drives me nuts. That is allowing boys to act like jerks only because they are boys. I do not allow that. BUT, there are huge learning style differences between boys and girls and very few schools account for these true differences.

motherjanegoose

April 29th, 2013
3:50 pm

@ K’s Mom…I completely agree with your second comment at 3:33. As an educator, I am fully aware of learning styles. I am also aware that some parents use the “boys will be boys” comment to toss off poor behavior and rid themselves of directing their boys to be considerate and polite, when it is necessary. My son was a typical boy. He also knew what was expected of him and when.

Uh, K's Mom...

April 29th, 2013
3:52 pm

…thanks for putting into excellent verbiage the difference about boys – you said what I meant to say, and I did not at all mean to imply that boys should be allowed to act like jerks…

And, Dekalb Mom, your description of your son compared with Busy Mom’s son are totally different – good luck to both of you moms…

K's Mom

April 29th, 2013
4:24 pm

@Uh, K’s mom, I am glad what I said made sense. It is a nuance that I did not at all understand until I had a child in preschool whose teacher was a constant complainer about his snatching toys and jumping up and down (he was 2 at the time, he had a 3month old sibling and we had just moved to a new state). My best friend is a preschool teacher with a master’s in child development and she helped me assess that the real problem was classroom management. Once K moved to the 2.5 yo class with his fabulous teacher all of his “behavior” problems ceased to exist. He at time misbehaves, as any child does, but he is having great success in the classroom with a great teacher.

catlady

April 29th, 2013
5:05 pm

Well, I think this is intriguing. I have noticed that extremely active, inattentive kids are quick to discuss staying up late and playing video games ( unbelievably often with ‘mama’s new boyfriend’). But is it cause/effect or co existing? Many of the kids I teach have no set bedtime, and other indicators of disorganized home life.

Those of you with ADHD children, remember I am not talking about your child. These are observations made over 4 decades, working with over 1000 kids.

John Redmond tells parents that when their child misbehaves, they should be put to bed an hour earlier because it means they are overtired. Not to bed early for one day, but for a week or more. I find that interesting as well, as it may have support from this study. Redmond has been giving this advice for many years, BTW.

My son had ” selective” ADD. He could pay attention to certain things for hours, but other, less preferred activities, not so much. I attributed it to the TBI he suffered at age 3. Not so much the brain injury itself, you understand, but the way he was doted on afterward by everyone. LOL

Busy Mom

April 29th, 2013
6:34 pm

@catlady…I think that is all interesting too. My son has a set bedtime that has always been in line with his age (later as he gets older) so I don’t think it’s a sleep issue. I think his is “selective” too since he can watch a tv show or even read a book for long periods of time. It’s more an issue of completing “tasks” such as schoolwork, getting dressed, etc.

MK

April 29th, 2013
10:20 pm

For those of you who believe your child has ADHD, please, please look up dyspraxia. My family has it and it could explain a lot. It can be treated without medication as well. It’s not a made up “disease” or anything like that. I’ve always had it but never realized it until I reached adulthood and several children in my family has been diagnosed with it.

Nursemom

April 30th, 2013
8:45 am

Funny, my son’s pediatrician feels like so many teachers are used to their students being medicated for ADHD and if one student is “busy” (typical 8 yr old boy) he will stand out more becuase he’s not medicated. I am choosing not to medicate my “busy” 8 yr old son!

K's Mom

April 30th, 2013
9:54 am

@catlady, I read a lot of John Rosemond and when K acts like a terror we institute the go to bed early rule. It works. He generally has missed a nap or has been up late the night before.

@nursemom, my brother was a busy child, I am so thankful I got to see him grow up. It has prepared me to have 2 sons. He was labeled as immature and hyper by several teachers, but our pediatrician told my mom that he was completely normal for his age and for being a boy. My mom refused to medicate and my brother made it through HS and through college with good grades. He now has a good job, a great wife, owns a home….etc. If you firmly believe that he does not need to be medicated, stick to your guns.

We plan to hold our two back in school because of their late May birthdays. I think that extra year of maturity will help tremendously with all of this too!

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[...] sleepingKVUEAre we confusing ADHD with sleep deprivation? Leading expert says …Daily MailIs ADHD actually sleep deprivation?Atlanta Journal Constitution (blog)The Takeaway -Huffington Postall 18 news [...]

catlady

April 30th, 2013
1:42 pm

Nursemom, that may be true in some areas, but not around here.

motherjanegoose

April 30th, 2013
2:15 pm

@nursemom…I am with catlady…I have never seen that to be true. But then I have not been in your son’s class. I have had many teachers comment ( to me) that seeing a child in a Doctor’s Office for 15-20 minutes a few times each year is not the same as seeing a child with a room full of peers 5 days a weeks. Different for sure. catlady?