Attention deficit or sleep deficit?

Some cases of Attention Deficit Hyperactivity Disorder may be a sleep disorder in disguise, writes Vatsal G. Thakkar, a psychiatry professor, in the New York Times.

Eleven percent of schoolchildren have been diagnosed with ADHD, he writes. Adult diagnoses are up too.

For some people — especially children — sleep deprivation does not necessarily cause lethargy; instead they become hyperactive and unfocused.

Adults and children are sleeping less, Thakkar writes.

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.

Children with an A.D.H.D. diagnosis are likely to also have “sleep-disordered breathing like apnea or snoring, restless leg syndrome or non-restorative sleep, in which delta sleep is frequently interrupted,” he writes.

In a 2004 study, 34 children with A.D.H.D.  all showed a deficit of delta sleep, compared with only a few of the 32 control subjects.

Sleep disorders can be treated, writes Thakkar, who has a rare form of narcolepsy.

Early high school start times don’t fit adolescents’ sleep patterns, research shows. “Tor a teenager, a 7 a.m. alarm call is the equivalent of a 5 a.m. start for people in their 50s,” writes Russell Foster in New Scientist. It’s the hormones.

About Joanne


  1. My older kids graduated from HS in the early-mid 90s and the younger ones in the early 00s. Both video games and ADHD/ADD were much more prevalent among the latter group (although not my kids or their friends specifically, but classmates, neighbors etc.). I’ve always felt that a relationship, not necessarily causal but a correlation, between the two is likely. Almost all of the ADHD/ADD kids with whom I was sufficiently well-acquainted were avid and time-intensive gamers, and I’ve never been able to see how that could be a positive influence on the ADD. The sleep addition also makes logical sense, so it will be interesting to see where more evidence leads. It all makes me even more certain that my DH and I were right not to acquire any games. The kids were full-time athletes and did lots of outdoor play and chores and didn’t really miss them. As adults, all married (3 with kids), they still have never owned any game systems.

  2. Patti W. says:

    We found this link out when our son’s therapist suggested we have him checked for airway obstructions because he was so hyper. Turns out his adenoids were blocking most of his airway, making him snore and wake himself up at night. After looking at research that was done in the UK on ADHD, sleep deprivation, and adenoid/tonsil removals, we decided to have those adenoids removed. Voila! Much less hyper and unfocused child, no medication required. Too bad it took surgery, but it worked.

    I can also say that my middle school students get much less sleep than I did at that age. A sizable group of them have diagnoses of ADD/ADHD. While some of them really do need meds (you can tell because when they forget to take their meds it’s painfully obvious), I wonder if many of them wouldn’t benefit from more sleep. Some of my students are up later than I am at night and then get up before me in the morning. Hard to think or be able to behave with little sleep.

    • It used to be much more common for kids to have tonsils and/or adenoids removed than it has been for a long while. I never heard of any of my kids’ contemporaries having either, but in my generation it was very common. Maybe another link with the sleep issue. Of course, I think parents are more willing to let kids set their own schedule/bedtimes than I was, but I didn’t have to deal with TV in room, any cable/satellite, cell phones (or any phones in rooms), ipods etc. and our only computer was in the main part of the house. Bedtime distractions were limited to books.

  3. lightly seasoned says:

    Oh, the whole teenager sleep thing has been researched half to death. The more interesting question, I think, is why nothing has changed in response to what we know. Why do high schools begin at 6:30 am (zero hour), while elementary schools, whose population prefers to wake at dawn, start at 8:30?

    • Roger Sweeny says:

      So high school kids can have jobs, and so they can do sports and band and clubs and all the other things that will go on their college applications.

    • momof4 says:

      My swimmer daughter started early-morning practices at age 9 (at her request); getting up at 0400. Mom had to make lunches so my start time was 0330. This schedule would have continued (5 days a week, by the time she was 12) through HS, except for our family move, which brought her to a team which started an hour later. Her school, Edina HS, still pats itself on the back for its 0830 start, but ignores the fact that its zero hour is very popular, particularly with the upper end of the academic curve (swimmers and hockey players excepted; they’re at practice pretty much all year). My youngest son’s club soccer team was likely to have practice at 0600 on weekends; if that was the only indoor time available. My niece and nephew, in another state, regularly took zero hour classes. My take is that, if kids want to, they are perfectly able to get up and function, even at 0-dark-30; providing they are willing to schedule themselves an appropriate bedtime/naptime. My son also played in a soccer league that played games at midnight; some 1 1/2 hours away, so naps were required on those days. It depends on the motivation.

      • Roger Sweeny says:

        And, duh, most people don’t have the motivation.

        Also, I have known many high school students who try to go to bed early enough to get eight hours of sleep but they just lie in bed awake–and wake up the next morning tired. The hormone changes at puberty really do push most kid’s diurnal schedule ahead about two hours.

        • Mark Roulo says:

          I am aware of these studies and I find them plausible.


          But what did farming families do 100+ years ago when the boys hit puberty? Were these kids just less productive in the early morning hours? Or were they able to get to sleep at 8:00 or 9:00 PM because they were tired enough?

          • momof4 says:

            Lots of kids do farm/ranch chores before school. Animals have to be fed, cows milked, eggs collected etc.; I grew up in one of those towns and now live surrounded by them. Milking was at 0500 on the farm next to me, and the kids were out there every day. My DD had classmates and teammates who had to feed horses and muck out stalls before school – and, in a few cases, before early-morning swim practice, because the kids went straight from practice to school.

            Also, entry into boot camp, immediately after graduation, provided additional incentive.