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, he is making 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.
Research on ADHD and Sleep
A study summarized on webMD (http://www.webmd.com/add-adhd/news/20110919/kids-poor-bedtime-habits-may-bring-adhd-misdiagnosis) suggests that many children are misdiagnosed and in fact, are simply overtired. The doctor quoted in this article 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 to first 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). You can find them 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 counterintuitive, 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.
Author: Debbie Sasson, PsyD
Debbie is the co-founder of Sleep Sisters (www.sleepsisters.com), a group of two “real-life” sisters who work together to help sleepless families get back on track! Not only is she a mom to daughters, Margo & Julia, but also has a doctorate in clinical psychology.