According to the U.S. Centers for Disease Control, 8 percent of U.S children suffer from attention deficit/hyperactive disorder (ADHD), and half of these are being treated with drugs like Ritalin. But controversial new research asks, is it really ADHD or just a lack of quality sleep?
That's the question researchers at the Technion-Israel Institute of Technology Sleep Laboratory say doctors should ask before prescribing Ritalin and other drugs used to treat Attention Deficit/Hyperactive Disorder (ADHD).
Over-alertness and nervousness are the characteristics of ADHD, with affected children being fidgety and over-stimulated. Yet, paradoxically, the use of stimulant medications, such as Ritalin, has been shown to be the most effective method for reducing ADHD symptoms in the majority of children. Dr. Giora Pillar, of the Israel Institute of Technology Sleep Laboratory, decided to investigate this seeming contradiction further.
He now believes that some children diagnosed with ADHD may in fact simply be sleepy, and their excessive motor activity is merely a tool to stay alert. He says this could explain why stimulants - which induce alertness by increasing activity in the central nervous system - are effective for treating children with ADHD. "Sleepy children, unlike sleepy adults, may demonstrate hyperactivity and attention-deficit behavior rather than excessive daytime sleepiness," said Pillar. "This theory is supported by parental reports that children, when extremely tired, tend to be cranky, overactive, angry and aggressive."
Pillar's study, appearing in the journal SLEEP, of ADHD children with an average age of 12, found that they had significantly higher levels of sleepiness during the day. In fact, half of the test subjects with ADHD were found to suffer from some degree of sleep-disordered breathing. The most common of these disorders is sleep apnea, which is characterized by interruptions in breathing during sleep that last 10 seconds or more.
Pillar said that treatment of these sleep disorders in children often leads to substantial improvements in behavior and cognitive achievements, and a significant reduction in irritability, bad moods, anger and fear. The researchers said that parents of ADHD children diagnosed with sleep disorders should enforce good sleeping habits and avoid giving caffeinated drinks at night. The researchers acknowledge that if these steps don't work, parents should consider medication.