Attention Deficit Hyperactivity and Sleep

Sleep Disorders and Attention-Deficit Hyperactivity Disorder in Children: A Missing Differential Diagnosis

from Journal of the American Psychiatric Nurses Association, Vol. 12, No. 4, 216-224 (2006)

Kristen Hedger Archbold

Department of Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, archbold@u.washington.edu

Attention-deficit hyperactivity disorder is a common diagnosis among children. Symptoms of attention-deficit hyperactivity disorder include inattention, motor restlessness, and impulsivity. Associated cognitive difficulties are also common. These symptoms are not specific to attention-deficit hyperactivity disorder and may also manifest in the behavior of children with sleep disorders such as restless leg syndrome, periodic limb movement disorder, and obstructive sleep apnea.

Unfortunately, sleep disorders are not routinely considered as a differential diagnosis for attention-deficit hyperactivity disorder in children. Symptoms, causes, and treatments for attention-deficit hyperactivity disorder, restless leg syndrome, periodic limb movement disorder, and obstructive sleep apnea are described and compared to illustrate similarities among the disorders. Practitioners are encouraged to assess their pediatric clients for symptoms of a sleep disorder when considering a diagnosis of attention-deficit hyperactivity disorder. Guidelines for sleep pattern assessment are included and discussed as appropriate for use by the psychiatric nurse clinician in the clinical setting.