Sleep and ADHD: Does Your Child Have a Sleep Disorder?
Barbara Luther was my first ADHD coach, and she continues to be one of my favorite resources for all things ADHD. She has an amazing ability to stay on top of the research, and to remember what she's read! So when she agreed to do an article for you all on sleep, I was thrilled. But it's so much information, we've decided to divide it into two articles. “Sleep and ADHD: Does Your Child Have a Sleep Disorder?” is part one, offering a fresh perspective on the relationship between research and real life. Stay tuned for part two, “Sleep and ADHD: Tools and Strategies to Manage ADHD Sleep Challenges.”
We can read sleep research results in two very different ways: as a sleep disorder that needs treatment, or as what is normal for this child. Which is it for YOUR child?
What is Your Child's Sleep Pattern?
Long before all the electronic devices we have today, back when I was a child, I would grab my flashlight and read under the covers for an hour or two after mom put me to bed. I think she knew what I was doing, but didn't say anything about it.
I would read until I got tired, then I would turn my flashlight off and make up stories in my mind until I drifted off to sleep. Even then, it was not unusual for me to wake up during the night and create imaginary scenarios for a while. They were fun, and I just assumed it was what kids did.
I was probably getting six hours of sleep on weeknights.
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Sleep Issues and Sleep Disorders
Now, current science says that school age kids need somewhere between 9 to 11 hours of sleep per night (National Sleep Foundation), but I didn't seem to need that much. There are many studies out today calling attention to serious sleep issues in children with ADHD, some claiming sleep issues to be as high as 70 to 80%. Based on current thinking, I would have been diagnosed with a co-existing sleep disorder.
However, my sleep pattern really hasn't changed much through my life. I still take quite a while to get to sleep, and I wake up during the night – often more than once – because of restless legs and thoughts swirling in my head. In other words, my childhood sleep pattern was my norm. (These sleep characteristics are being identified today as common to the Inattentive type, and there is some thought that a subset of those with ADHD truly don't need as much sleep as others.)
Not All Sleep Patterns Are Alike
There is no doubt that sleep issues can be very serious in children with ADHD, but it seems to me that we have never paused to learn what is normal for a child with ADHD.
We have learned over the years that those with ADHD are wired differently, organize differently, focus and learn differently, and feel things quite differently than the general population. So, why, then, would we think that our sleep patterns would be like everyone else's?
Before we rush into diagnosing a sleep condition, perhaps we would be wise to study our ADHD children's patterns. Maybe they naturally take a while to get to sleep, or maybe they do have fragmented sleep yet it doesn't actually bother them that much. It was reported in 2013 that a study found two separate nocturnal melatonin peaks in ADHD children but not in non-ADHD children. Two separate peaks would cause a different sleep pattern, it seems to me.
Researchers have also discovered that all human beings, before the light bulb was developed, had segmented sleep. They actually had names for the two segments: First Sleep, a period of wakefulness, and Second Sleep. Some folks have proposed that while many people adapted to one continuous block for sleep, many others continue to follow the natural rhythm of sleeping in segments.
“Some who are prone to nocturnal awakenings may possess circadian rhythms capable of withstanding the impact of artificial lighting,” according to Roger Ekirch, author of A Day's Close: Night in Times Past. “Their circadian rhythms may vibrate to an older, more natural tuning fork.”
A New Perspective on Sleep
Even though your children's sleep might not look how we expect it to, their sleep patterns may be working for them just fine.
“Our expectations about our bodies go a long way toward shaping what symptoms we find distressing and what we ignore,” according to Albert Fuchs.
In addition, the stories we tell ourselves also shape our perceptions and concerns. If we see an unusual pattern that's actually working, then the message we tell ourselves -- that unique is just fine -- can alleviate unnecessary anxiety.
Sleep and Your Child
So, does your child have a sleep disorder that needs treatment? Or is your child's sleep pattern working for her, even though it's not what you might expect?
You won't really know which is true until you check in with your child's experience. If you knew that your child's sleep pattern was normal for him/her, would you be less anxious about sleep? If so, maybe your children can embrace their patterns of segmented sleep to be creative, play, learn, reflect, and be mindful.
I certainly did not worry about my sleep pattern as a child – I used the time to read and to imagine. It felt like my own special time. It was only as an adult that the focus on sleep disorders caused me to focus negatively on my natural sleep pattern. Now, I'm taking back “my normal,” and enjoying my own quiet, special time at night again.