Do Children With ADHD And Sleep Disorders Get Misdiagnosed?

Difficulties with attention. Forgetfulness. Lack of self-control. These are the behaviors that are frequently linked to Attention Deficit Hyperactivity Disorder (ADHD), but they can simply be symptoms of sleep deprivation. It can be challenging to distinguish between the two problems at times because many children with ADHD also struggle with sleep.

When a child’s symptoms could actually be caused by a lack of sleep, parents occasionally wonder if their child has been wrongly labeled with ADHD. Additionally, we hear accounts from parents whose children’s ADHD symptoms subsided or vanished as soon as their sleep issues were resolved. Does that imply that they didn’t always have ADHD?

According to David Anderson, PhD, a clinical psychologist at the Child Mind Institute, sleep problems are uncommon in children, hence it is unlikely that many children have either an ADHD-related sleep disorder or both an ADHD and a sleep disorder. However, it is true that insufficient sleep can increase or develop ADHD symptoms (even if your child does not have a sleep condition). Therefore, resolving sleep disorders can aid in symptom reduction.

Before diagnosing ADHD, a clinician should always examine other reasons for the symptoms, according to Dr. Anderson. He explains that “we want to rule out a number of other issues that could pose as ADHD symptoms as part of a good assessment for ADHD.”

In addition to sleep problems, other causes could be melancholy, trauma, or worry. All of these conditions can appear with identical symptoms and, coincidentally, make it difficult for a child to go to sleep. The key to finding the cause is to consider symptoms like hyperactivity, distractibility, and inattention in the context of all of a child’s symptoms.

Indications Of A Sleep Disorder

Lack of sleep can be brought on by worry, including night terrors, or by a medical condition that affects breathing and makes it difficult to get a good night’s sleep, such as sleep apnea or asthma.

Dr. Anderson points out that although sleep disturbances are only detected in a tiny percentage of children, it is crucial to rule out other, more severe medical conditions during a preliminary mental assessment. What to watch out for includes:


  •         Difficulty falling asleep
  •         Difficulty remaining asleep
  •         Having trouble getting out of bed in the morning
  •         Waking up in a panic or yelling
  •         Coughing as you awaken
  •         Breathing pauses or labored breathing while you’re sleeping
  •         Unusual noises when sleeping
  •         Irritability
  •         Falling asleep in class
  •         Being easily distracted and having trouble focusing

Although there are recommendations for how much sleep children should get at each age, each child has a different demand, so sleeping less than usual is not necessarily a sign that something is wrong. 

However, the fact that they slept fewer hours than the typical child their age warrants additional examination. Furthermore, sleep deprivation can affect a child’s behavior even if it does not get to the point of a problem.

Indications of ADHD

Approximately 6–10% of people have ADHD, and it usually becomes apparent by the time a child is young. Observe the following warning signs:

  •         Difficulty maintaining concentration on tasks they may find tedious or unfulfilling
  •         Issues with direction-following and listening
  •         Difficulty remaining seated, fidgeting
  •         Unreasonably high levels of energy
  •         Tendency to speak out loud and disrupt
  •         Being easily distracted
  •         Arranging challenges
  •         Losing items and forgetfulness
  •         Impatience

Even though all children display some of these behaviors, according to Dr. Anderson, when determining whether a child has ADHD, “we’re trying to establish whether there is an intensity that is higher than for other kids in that age group and whether it is impairing the child’s functioning across multiple settings. These requirements suggest that there may be a presence.

What If A Kid Possesses Both?

It can be somewhat of a chicken-and-egg problem to link sleep and ADHD. Children with ADHD frequently have a lot more energy than typical children, according to Dr. Anderson. That could result in difficulties falling asleep, which might result in fewer hours of sleep each night.

Additionally, if an ADHD drug is still in effect while a child is attempting to go to sleep, it is possible that the child will experience insomnia.

Therefore, it’s also conceivable that a child’s ADHD symptoms could be becoming worse from sleep deprivation, excluding a diagnosable sleep problem.

Additionally, a small percentage of kids—childhood sleep disorders are quite uncommon—might have both ADHD and an unidentified sleep condition. Although they may not actually have ADHD, medication for sleep issues may help to lessen their symptoms.

Do Children With ADHD And Sleep Disorders Get Misdiagnosed?

Things To Do

Consult your doctor if a child receiving a stimulant medicine is having difficulties falling asleep. Your doctor may decide to lower the dosage or change the schedule of the drug so that it doesn’t take effect at night.

A trip to a sleep specialist, psychologist, or the child’s pediatrician may be necessary if a child’s lack of sleep appears to be causing issues without any obvious medical condition. According to Dr. Anderson, they may “create a behavioral plan with the parent that’s going to help the child get what we think is the more appropriate amount of sleep.” This can entail establishing a bedtime routine that is more dependable, reducing screen time before bed, or using other behavioral techniques to help with sleep hygiene.

The next sensible step is to contact a doctor about a sleep study or other tests to see whether a medical intervention is required if sleep apnea or another medical condition is detected.

Dr. Anderson adds that a cautious practitioner would be cautious in diagnosing ADHD if there is a chance of major sleep disorders. It may be necessary to reevaluate the ADHD diagnosis if an effective sleep disorder treatment reduces the symptoms of ADHD.

Dr. Anderson emphasizes that only a small percentage of kids experience sleep issues severe enough to be mistaken for ADHD. Nevertheless, he claims that “they’re definitely something to take into account when evaluating ADHD symptoms.”