Question:
Is anyone familiar with sleep disorders associated with ADD, and
treatmentof them? I have a 14 year old son with ADD and an sleep disorder
that has not been pinned down despite a sleep study (he is being set up
for another sleep study soon).
Answer:
Other than that a sleep disorder WILL manifest symptoms of ADD. I
personally believe that looking for ADD in someone who has sleep apnea
or another sleep disorder is like looking for emphysema in a drowning
person.
Here is a post made by a frequent poster, Sally Soest, a writer, who
gathered together information for someone with a similar question.
Sally writes:
"I'm not a sleep specialist or a pediatrician, but recently as a
medical writer I worked with a sleep disorders specialist on
researching and editing some articles on pediatric sleep problems.
"One of the articles was on the misdiagnosis of pediatric sleep
disorders as ADHD. A lot of ADHD symptoms are similar to what you see
in sleep-deprived or sleep-disturbed children: inattention,
distractability, hyperactivity, aggression, impulsiveness, emotional
displays, etc. The medical literature reports numerous examples:
*Restless legs syndrome/periodic limb movement disorder - 13 children
in one report, all misdiagnosed with ADHD. Picchietti, Child Adolesc
Psych Clin N Amer 5(3), 1996.
*Upper airway resistance syndrome - 25 children misdiagnosed as ADHD,
symptoms resolved by T and A. Guilleminault, Eur J Pediatr 139, 1982.
-Obstructive sleep apnea - study of 31 children, much higher incidence
of snoring than in normal group. Weissbluth, J Dev Behav Pediat 4,
1983.
*Narcolepsy - of 88 children with confirmed narcolepsy, 13% had an
initial misdiagnosis of ADHD. Dahl, J Am Acad Adolesc Psych 33(6),
1994.
*Delayed sleep phase syndrome - case study of one child whose behavior
improved after treatment. Dahl, J Ped Psychol 16(2), 1991.
*Excessive daytime sleepiness - 3 of 10 children diagnosed with ADHD.
Palm Acta Pediatr 81, 1992.
"A lot of people assume, for example, that if a child behaves better
on Ritalin, that proves he has ADHD -- but Ritalin will make anybody
more alert and responsive.
"The point is, something besides, or in addition to, ADHD may be going
on. Sleep talking is a common disorder of arousal which by itself is
unimportant but might indicate that something else is disturbing their
sleep. Depending on the particular type of disturbance, a sleep
specialist should be able to suggest an effective treatment.
"An experienced sleep specialist is more likely than anyone else to be
able to help with whatever sleep problems they may have. Most
non-sleep specialists are pretty unsophisticated about sleep.
"I would suggest you locate a board certified sleep specialist,
preferably a pediatric one (although those are hard to find) at an
accredited sleep disorders center, preferably one that has experience
with pediatric sleep problems. Call the sleep centers in your area,
and ask about accreditation and experience with pediatric sleep. "
Studies have shown that ADD can be mistaken for Restless Leg
Syndrome/Periodic Limb Movements in Sleep. I suggest that you ask your
sleep specialist about this.
I just had a sleep study done. I have ADD....but I also have Fibromyalgia and depression. Level 3 and 4 were greatly reduced and I only spent 14% of my total sleep time in REM. The doctor suggested I stop taking Ativan and Soma as it interfers in Level 3/4 and REM sleep.
