Amid ADHD spike, doctors urge closer look at sleep issues

At a recent Paris scientific conference, scientists in psychiatry discussed evidence supporting the theory that sleep and attention deficit hyperactivity disorder (ADHD) are intertwined. However, some experts caution that more proof is needed to make the association and that many new cases involve children whose sleep disorders cause behaviors that mimic ADHD.

"If adults don't get enough sleep, they'll appear sleepy," says Dr. Syed Naqvi, a pediatric sleep expert at UT Southwestern's Peter O'Donnell Jr. Brain Institute. "Children don't do that. They show ADHD-like behavior instead -- hyperactive or inattentive."

Dr. Naqvi says he sees plenty of ADHD-diagnosed children whose behavior only improves after better sleep quality and duration. Occasionally, he has found that ADHD medications are the root of the sleep issues.

Dr. Preston Wiles, an ADHD expert with the O'Donnell Brain Institute, acknowledges that the increasing number of children taking these medications is "concerning." He says the trend is fueled in large part by a lack of qualified clinicians who can accurately diagnose ADHD and understand child behavior.

"Pills can be a poor substitute for taking the time to truly understand what is going on with behavior," Dr. Wiles says.

Dr. Naqvi offers a few tips to help parents determine whether sleep disturbances are affecting their child's behavior:

• Watch for signs of breathing issues, such as snoring or short intervals of halted breathing, and get an evaluation by a sleep expert.
• Measure the duration of nighttime sleep the child is getting and monitor any sleepiness during the daytime.
• Monitor school performance and seek help if it doesn't improve after starting ADHD medications.