Counting Sheep
Living in a 24×7 society is not only stressful for adults, it is affecting our children as well. While the media is finally recognizing that the public needs to be educated about getting an adequate amount of sleep, it is also crucial to address the issue of sleep for school-aged children. Attention deficit hyperactivity disorder (ADHD) among children is on the rise and it is important for parents, teachers, and physicans to become involved in recognizing and treating its signs and symptoms.
Ronald D. Chervin, MD, assistant professor of neurology at the University of Michigan, Ann Arbor, and acting director of the Sleep Disorders Center, says children who have trouble going to sleep often have ADHD. He says that a recent study conducted by Reut Gruber, PhD, and colleagues may help give parents and doctors a better idea about what is really going on. The Gruber study found that children with ADHD often have sleep problems that contribute to or worsen their disorder. The researchers used an actigraph to measure and record the sleep activities of 38 10-year-old boys who had ADHD and 64 boys of the same age who did not have the disorder. All the boys wore a wrist actigraph while they slept for 5 consecutive school nights. They were also to complete daily sleep logs about when they went to bed and woke up, their quality of sleep, and the amount of daytime sleepiness they experienced. The boys’ parents were also questioned about behavior problems. The study found that their children often acted up at bedtime or had problems sleeping and that the children had no real differences once they got to sleep; however, there was a significant difference in the time they fell asleep on each of the 5 nights. Chervin says, “This study shows that the time at which the child went to sleep varied within a 2- to 3-hour interval for the ADHD, whereas it varied by only about 40 minutes [for the normal] child.” One example from the study explains that where a boy without ADHD would fall asleep at 9:30 pm or 10:30 pm each night, the typical ADHD boy would fall asleep at 10:00 pm one night, 9:00 pm the next, 11:00 pm another night, and perhaps 12:00 am the following night. Gruber and colleagues say the study suggests that sleep problems contribute to, or worsen the difficulties of, children with ADHD. Chervin agrees and adds that there is enough evidence that treating sleep disorders in children can result in improvements in their behavior.
On page 23 in this issue, Patricia Carroll, RRT, RN, BC, CEN, MS, writes an article on ADHD and school productivity and discusses the similarities between children with ADHD and those with sleep disorders, such as sleep-disordered breathing and restless legs syndrome. These disorders can interrupt sleep and result in sleep deprivation, which ultimately affects overall school productivity during the day.
Recognizing and diagnosing ADHD in children is crucial and requires the involvement of parents, teachers, and physicians. Before this problem gets out of control and children are grown, we, as a society, need to recognize the signs and symptoms of ADHD and get these children the proper treatment.
Paige Smith
Editor
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