Feeling moody, restless or unable to concentrate is no way to go through life, so most teens who feel this way want to know what they can do about it! Sleep deprivation makes it difficult to learn and can lead to inattention or difficulty controlling impulsive, emotional reactions to situations. These are some of the same symptoms, however, that can lead to a diagnosis of attention deficit hyperactivity disorder (ADHD), so it is important to include sleep in the overall picture when evaluating any difficulties you may be having.
ADHD is a distinct disorder; however, research has shown that some people may be misdiagnosed with ADHD when the real problem is chronic sleep deprivation, due to a sleep disorder or poor sleeping habits. In addition, studies show that many people with ADHD also suffer from sleep disorders such as sleep apnea, insomnia or restless legs syndrome. In many cases, people who have both ADHD and a sleep disorder have shown marked improvement in their symptoms after the sleep problem is treated.
When teens either show symptoms of ADHD or are diagnosed with it, a sleep assessment should be included as part of the overall picture. Before meeting with your doctor, it may help to keep the Teen Sleep Diary for two weeks and bring it with you to your appointment. Be prepared to discuss:
Sleep habits and/or problems, including:
* Difficulty falling asleep or staying asleep
* Difficulty waking in the morning
* Snoring, gasping for breath, or pauses in breathing during sleep
* Restless sleep
* Any known sleep disorders, such as insomnia, sleep apnea, restless legs syndrome, or a circadian rhythm disorder
* Medical conditions that may interfere with your sleep, including obesity, upper airway obstruction, pain, neurological or psychiatric conditions
* Medications you are taking that may be disrupting your sleep
* Sleep environment and possible disruptive factors
* Lifestyle factors that may contribute to sleep deprivation, such as overextending yourself with schoolwork, sports, clubs, social activities, parttime jobs and family obligations
Daytime symptoms, including:
* Sleepiness
* Declining performance in school and other activities
* Difficulty paying attention
* Mood or personality changes
* Memory problems
* Physical complaints (e.g. headaches)
It is important that you also tell your doctor about the duration and severity of your symptoms, as well as other strategies you have used to cope with them. Ensuring that you are getting enough sleep is crucial, and a sleep study can help if a sleep disorder is suspected. Since people with ADHD often have unstable sleep-wake patterns— sleeping well some nights and poorly others—the sleep study may be more effective if it evaluates sleep over several consecutive nights to reveal the overall sleep pattern. Whether a sleep disturbance is the root cause of the problem or not, it is important to talk to your doctor about sleep, since any treatment should go hand in hand with good sleeping habits.
What are the symptoms of ADHD?
The Diagnostic and Statistical Manual (DSM-IV) divides ADHD into three types: inattentiveness, hyperactivity/impulsivity, and combined. To be diagnosed with ADHD, a person should meet A-E of the following criteria:
A. Either 1 or 2:
1. Six or more of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:
a. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
b. Often has difficulty sustaining attention in tasks or play activities
c. Often does not seem to listen when spoken to directly
d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
e. Often has difficulty organizing tasks and activities
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as homework)
g. Often loses things necessary for tasks or activities (toys, school assignments, pencils, books, or tools)
h. Is often easily distracted by extraneous stimuli
i. Is often forgetful in daily activities
2. Six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:
a. Often fidgets with hands or feet or squirms in seat
b. Often leaves seat in classroom or in other situations in which remaining seated is expected
c. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
d. Often has difficulty playing or engaging in leisure activities quietly
e. Is often “on the go” or often acts as if “driven by a motor”
f. Often talks excessively
g. Often blurts out answers before questions have been completed
h. Often has difficulty awaiting turn
i. Often interrupts or intrudes on others (such as butting into conversations or games)
B. Some hyperactive, impulsive, or inattentive symptoms that caused impairment were present before age 7 years.
C. Some impairment from the symptoms is present in two or more settings (such as in school or work and at home).
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or another psychotic disorder and are not better accounted for by another mental disorder.
