Does Your Child Have ADHD or Is He Just Sleep Deprived?


adhd-teens-sleepA number of mental health professionals are concerned about the growing percentage of high school students who are diagnosed with ADHD (Attention Deficit Hyperactivity Disorder). Earlier this year, the Center for Disease control released the results of a large survey, and found that one in five teenage boys were diagnosed with ADHD! Historically, ADHD was estimated to effect 3-7% of the population. So what gives? How can there be such a huge increase in the number of children with this diagnosis?

An article in the The New York Times (April 27,2013), titled “Diagnosing the wrong deficit” by V. Thakkar, suggests that chronic sleep deprivation in children may be the culprit. There is no shortage of studies that demonstrate that children and adults are getting less sleep than they need. Frequently teens complain that they stay up late doing homework—and don’t forget that crafting 3000 texts a month takes some time too! (Don’t get me started! According to one source, teens average 3339 texts per month!). Moms and Dads complain about endless laundry, housework, and, yes, hours helping kids with their homework! The net result—everyone is pooped.

Interestingly, while adults respond to sleep deprivation with lethargy and fatigue, children can become hyperactive and unfocussed. All parents have observed “overtired” children becoming “hyper”. It can be hard to settle them down.

A 2006 study in the Journal Pediatrics reported some intriguing findings. They looked at 78 children who were having tonsillectomies due to difficulty breathing while asleep. Of those children, almost 30% were found to have ADHD compared to 7% in the control group. What was even more striking, was that one year after the surgery, nearly half of the children who were diagnosed with ADHD no longer had the ADHD symptoms. These symptoms were caused by sleep deprivation!

In first period high school classes, teachers observe that many teens look dead to the world. When their heads drop on their desk and they start drooling, youngsters argue that they worked until 2 a.m. doing homework. Maybe. But maybe they were up until 3 a.m. playing the latest Xbox game, unbeknownst to their parents.

High School starts around 7 a.m., which makes it even more difficult for teens to get sufficient sleep. According to the National Sleep Foundation, adolescents need 9 ¼ hours of sleep a night on average. Forget about it—maybe on weekends, where kids can sleep 10-12 hours!

In addition to voluntary sleep deprivation, a small percentage of children suffer from sleep disorders, like Obstructive Sleep Apnea (OSA). Some studies suggest that up to 4% of children may struggle with a sleep disorder like sleep apnea or restless leg, which can result in similar symptoms to ADHD. While OSA is most closely associated with obesity in both adults and children, it is possible to be slender and to OSA. I have several slender adolescents in my practice whose problems stem from Obstructive Sleep Apnea.

So what can parents do?

  • Pay attention to how much sleep your teenager is getting. What time is he going to sleep? What time does she get up? How does he look and act in the morning? Is she coming home in the afternoon and napping?
  • Be firm and hang tough when it comes to electronic devices after 9 p.m. Nobody said raising a teenager was easy! Lock up their cell phones and video games if necessary! (My father used to complain how obnoxious I was when I was 15—He loved to say, “Wait until you have a teenager and then you will know what I am going through.” Of course, he was right!)
  • Look in on them when they are sleeping. Are they thrashing about? Are they snoring loudly, and then stop breathing? Is there a family history of sleep disorders? If in doubt, talk to your pediatrician.

How do you make sure your teenager is getting enough sleep?


  1. Anonymous

    What about other sleep issues? My 7 year old talks in her sleep, grinds her teeth and constantly moves her legs and arms. Should I be concerned about this?

  2. Dr. Paul

    This would be a good reason to talk to her primary care provider and see if a referral to a sleep doctor would be in order.

  3. Anonymous

    My son was DX with ADHD when he about 5 yrs old and was placed on medication. He is now 11 yrs. old.. Do you think he should be reevaluated for ADHD or dose he have ADHD and that is just that?