You may have seen recent news articles about the link between ADHD and sleep. Researchers are putting forth theories about how the two are connected. But sometimes, a researcher will introduce a new, unproven theory and the media will report it as fact. This can be really confusing for parents.

As a pediatric neuropsychologist for 20 years, I’ve worked with many children with ADHD, as well as kids with sleep issues. I talk with parents all the time about the role of sleep in a child’s well-being, and how ADHD symptoms manifest.

There are interactions between sleep, attention and learning. But it’s important not to confuse the issues. Here’s a breakdown of a few key points I think are important to understand:

  1. ADHD is not a sleep disorder.

Research tells us that kids with ADHD can have trouble settling down at night. We know they get less sleep than other kids by 45 minutes on average. We also know that a small percentage of kids with ADHD have significant trouble falling asleep and suffer from insomnia.

When a child has ADHD, it can affect her sleep. And lack of sleep can affect her attention. This means your child could have trouble paying attention in school. She could also be cranky and have behavioral issues. However, most experts, including myself, agree that ADHD is not a sleep-related disorder.

  1. Be skeptical of single studies and theories on ADHD and sleep.

Studies show that adults with ADHD go to sleep later than adults without it. One study even shows this is true for kids. Because of this, a few researchers have claimed that attention issues in kids with ADHD may be caused by a lack of sleep.

However, kids aren’t little adults. And good science on child development is not based on one study or on studies of adults. Also, keep in mind that the 45-minute sleep difference for kids with ADHD isn’t big enough to cause the attention symptoms we see.

So when you hear about a single study or theory about ADHD and sleep, be skeptical.

  1. Brain networks that control sleep function the same in kids with and without ADHD.

Researchers are learning more every day about ADHD and the brain, and sleep and the brain.

We know that sleep is controlled by a network of neurons in the brain. This network is called the reticular activating system.

And this system is central in being “awake” and “alert,” and does have a role in attention.

However, studies haven’t found this system to be different in structure or function between kids with and without ADHD.

  1. But some kids with ADHD do have sleep issues.

Of course, there are some kids with ADHD who do have sleep issues. For example, if a child doesn’t get to sleep until midnight and wakes up at 7am for school, it can affect her attention.

But when professionals like me diagnose a child with ADHD, we also look at how she’s sleeping. With a careful evaluation, it’s unlikely that a child will be misdiagnosed with ADHD when it’s really a sleep problem.

Studies also show that around 10 percent of kids taking ADHD stimulant medication go to sleep later. If bedtime is really late, and your child isn’t sleeping enough to feel rested the next day, talk to your prescriber immediately.

  1. Don’t let modern family life get in the way of your child’s sleep.

There are a few other common sleep situations I see in my practice that parents should also be aware of.

When some kids hit high school, they begin to sleep very little and may start struggling in class. When this happens, sometimes parents bring them to me for an ADHD evaluation.

I find in these cases that these teens are just overscheduled and stressed. They may be staying up until 1am doing homework, then waking up at 6am for school, while playing sports and doing other activities during the day.

The solution here is clear: These kids aren’t getting enough sleep. It’s the parents’ and my job to get those kids sleeping near nine hours per night and learning to manage their time better.

Working parents face an additional challenge. They work long days and understandably want to spend time with their kids when they get home at night. Still, that keeps children up later. Then the parents may have to drop them off early in the morning before work. That cuts into kids’ total sleep time. I try to help parents come up with creative solutions for individual families to work around these challenges.

Finally, smartphones are a blessing, but they’re a sleeping curse according to several studies. Playing video games and texting on a bright screen doesn’t let the mind quiet down to fall asleep. I advise parents of teens and middle-schoolers to keep cell phones in the kitchen, not in the bedroom.

The Bottom Line

All children need a certain amount of sleep to pay attention and learn well. However, very few kids with sleep issues get misdiagnosed with ADHD.

It’s important that we don’t confuse these two related, but different issues.

你有可能也看過近期一份關於ADHD和睡眠之間的關係的報道,研究人員列出了一些有關兩者之間的關係的推論。然而,當媒體報道一些研究人員介紹的未經證實的新理論時,有時會把它當成事實來報道,這有可能會使得家長們感到混淆。

作者作爲一個有二十年經驗的兒童精神心理學家,接觸過無數有專注力不足及過度活躍症(ADHD)的兒童,也處理過不少有睡眠問題的兒童。我經常會跟家長們分享睡眠對兒童健康的重要性,也會向他們介紹ADHD症狀的不同表現形式。

雖然睡眠、專注力和學習三者之間確實是互相影響,但切忌把它們混為一談。以下是一些我們需要認清的要點:

1 ADHD不是一種睡眠障礙

研究人員指出,患ADHD的兒童會有睡眠問題,相比其他兒童,他們平均少睡四十五分鐘,更有一小部分出現嚴重睡眠問題,以致長期失眠。

當小孩有ADHD,他的睡眠就會受到影響,而睡眠不足就會影響他的專注力,以致他上課時不能集中精神聼講。他更有可能容易發脾氣,及出現其它行爲問題。然而,大部分專家,包括作者本人,都認爲ADHD不是一種睡眠障礙。

2ADHD與睡眠的單一研究及理論應抱審慎的態度

有些研究發現,患ADHD的成人比其他人睡得晚,更有一項研究指出,兒童患者也有相同表現。因此,有幾位研究人員就得出結論,認爲兒童出現ADHD的原因可能是因爲睡眠不足。

不過,小孩子不是小大人,根據一個單一研究,或根據其他對成人的研究,對兒童發展作出的推論,看來不夠科學。而且,患ADHD的孩子與其他兒童的四十五分鐘睡眠差異,不足以造成我們所見的專注力不足症狀。

所以,當你聽到一個單一的研究報告,或類似形式得出來的ADHD與睡眠的推論,請抱審慎態度。

3 不論有沒有ADHD,兒童控制睡眠功能的大腦部位是相同的

科學家對大腦與ADHD的研究,以及大腦與睡眠的研究成果日新月異。

原來睡眠機制是由大腦的一個神經元網絡所控制,這個網絡叫網狀激活系統。系統主宰“清醒”及“警戒”狀態,故此會影響專注力。

然而,研究結果顯示,不論兒童有沒有ADHD,他們的網狀激活系統的結構和功能都沒有分別。

4 部分患ADHD的兒童確實會出現睡眠問題

當然,有部分患ADHD的兒童會有睡眠問題,例如,一個小孩到午夜時分才上牀睡覺,而早上七時便要起牀上學,他的專注便會受到影響。

不過,作爲專業人員,當我們診斷一個ADHD兒童時,會了解他的睡眠狀況。經過小心衡量後,很少會把真正的睡眠障礙誤診為ADHD。

研究亦顯示,約有一成服用ADHD藥物的兒童會睡得比人晚。如果上牀時間的確太夜,你的孩子第二天沒有足夠休息,請盡快徵詢他的主診醫生。

5 、不要因爲現代的家庭生活方式影響孩子的睡眠

在本人的診症經驗中,發現有幾種其它常見的睡眠狀況,希望可以提醒一下家長。

當有些孩子讀到高中的時候,他們開始睡得很少,並在課堂上出現種種問題。父母看見這種情況,便會把他們帶來,做個ADHD評估。

在這種情況下,我們會發現,這些年輕人只是過度疲勞和壓力太大。因爲他們晚上做功課到淩晨一點,然後早上六點又要起牀上學,再加上日間還會進行種種體育運動和其它活動。

很明顯,這些孩子只是睡眠不足,解決辦法是由我和他們的家長聯手,設法讓孩子每晚睡足九個小時,並學會更好地安排自己的時間。

雙職父母更有另一個難題,他們工作時間長,很自然想在晚上與孩子多相處一回,這樣孩子就要睡晚一點。第二天,父母又要在上班前把他們提早送上學,這樣孩子的整體睡眠時間又再減少。面對各個家庭個案時,我會嘗試協助家長想出一些別具創意的方法,去解決他們各自面對的難題。

最後要提到的是,智能電話雖然是一項偉大的發明,但正如多份研究顯示,它也是令人失眠的元兇。不論是玩遊戲,還是以文字訊息聊天,手機屏幕發出的藍光都會刺激大腦,令人難以靜下來入睡。因此,我建議有青少年及中學生子女的家長,他們應該把所有手機放進廚房,而不是放在睡房。

總結︰

所有孩子都需要一定量的睡眠時間,才能集中和有效地學習。不過,可以放心的是,很少孩子會因睡眠不足而被誤診為患有ADHD。

ADHD 與睡眠障礙,兩者互有關聯,但卻是不同的問題,千萬不可以把兩者混為一談。