People say things like this to us all the time, “My child is so hyper in the late afternoon – I’m sure he has ADHD.” This may be true. Another possibility is that a hyperactive child is over-tired. When a child is not getting enough sleep, his body makes more cortisol and adrenaline so that he can stay awake. Those hormones are his body’s way of fixing a problem, only, it’s a poor fix. When children are too tired, they can’t fall asleep when they need to and are missing out on important sleep time – time when their brains should be processing the day’s events, the learning that occurred and the emotions that were felt. Being overtired looks a lot like ADHD (attention deficit hyperactivity disorder).
A study summarized here on WebMD suggests that many children are misdiagnosed and in fact, are overtired. This doctor found that children who are getting the ADHD diagnosis mistakenly are children who sleep in a bed with their parents and who do not have a consistent bedtime. He emphasizes that sleep and ADHD are very complicated in their correlation. That is, many children with ADHD have a hard time with sleep and because they are missing sleep, their behaviors are more hyperactive. Of course, we don’t mean to say that all children who are getting an ADHD diagnosis are actually simply overtired, but we are saying that before you seek out this diagnosis for your child, it might be helpful first to examine how much sleep he’s getting and how firm your parenting is around sleep routines.
As with all children, it is important for children who have ADD/ADHD to have a very predictable and consistent pre-bed/nap routine and bedtime. For children who seem more active and who have more challenging behaviors, you might try some or all of the following:
Although your child may not want to nap anymore, we highly recommend that children (through kindergarten) take an hour every day for “quiet time.” Alone in her room playing quietly.
A weighted blanket may also be helpful. We use these blankets with kids who really find comfort in physical pressure (like hugs). Here’s just one weighted blanket – you can find more on Amazon.com.
Dim lights are really important 30 minutes before you would like your child to fall asleep – it helps your body produce more melatonin (the sleep hormone).
Limit screen time and no screens after 5pm. If you have a child who seems hyperactive, you might consider limiting screen time to an hour a day and should certainly not allow her to look at a screen within a few hours of bedtime.
Try an earlier bedtime – although it is counter-intuitive, your child may be overtired. Try moving bedtime a half hour earlier for 5 days and see what happens. If it’s been working, you can even try another half hour the following week.
Be patient! This is so hard – we know! When you’re dealing with a challenging child, it is easy to let your emotions rise to the surface. However, your child can tell how you feel and often, our emotions only escalate our children’s behavior.
If you have tried all of the above and are still finding that your child’s behavior is impulsive and hard to manage and if others who are with your child outside your home (teachers, care-givers) agree, it would be beneficial for you to speak to your child’s doctor and/or a developmental pediatrician.
2 Responses to “ADHD and Sleep”
Thank you so much for this. I am an early childhood educator. One of my best friends (she is also in early childhood) and I have been preaching this to parents for years. Sleep schedules are so vital for development and behavior management. It is just as important as food and exercise. I have so many preschoolers that are just completely overtired. I feel so bad for my 4 year olds because they are going to go to Kindergarten and then miss out on naptime, making them even more sleep deprived. I also feel like you, in that sleep deprivation leads to a lot of misdiagnosed ADHD. All we can do is continue to educate parents on the importance of sleep. And educate early learning teachers on making sleep as much of a priority in their classrooms as the social/emotional and cognitive leaning domains are.
OMG I totally agree. For 4.5 months in school, my son has been acting up and misbehaving. I couldn’t figure out what was wrong? I’ve tried everything under the sun with trying to correct my 4 yr old son behavior in pre-K. All his teachers was saying, get him evaluated but I knew nothing was wrong with him because he didn’t act that way around me or his father.
So one day I was at my wits end. I was on the Internet and saw something about sleep deprivation in children. I read that when children are sleep deprived they are HYPER! I read further and saw the symptoms of sleep deprivation in children and the symptoms matched perfectly to his naughty behaviors in school. I came up with the conclusion that he was NOT getting enough sleep! My son sleeps with me and he was getting that same amount of sleep I was getting, which was 7-8 hours of sleep. But for his age he needed 11-12 hours of sleep! I didn’t know he needed that amount of sleep! So I changed his bedtime to 8pm. The very next day, it was like an angel appeared! My son’s behavior was suddenly EXCELLENT!!!!! I was shocked!!!! His teachers was shocked!!!!
It’s amazing how lack of sleep can ruin a child! My son was real close to being diagnosed as ADHD! I’m glad I read up on that! I saved my son from medication that could have ruined him and make him appear slow!