Mis-diagnosed ADHD or Sleep Disorder? March 12, 2012
Did you know that the symptoms of sleeplessness are so alike those of Attention-Deficit-Hyperactivity Disorder (ADHD), that many children have lost their diagnosis of ADHD simply by having their sleep treated? For example, tantrums, hyperactivity, inattention, and other daytime problem behaviours are common symptoms of sleep loss in children (well, adults too for that matter – we just know how to control ourselves better), and also symptoms of ADHD. In fact, sleep researchers put out a call to Pediatricians in a well known journal in 2011 to encourage them to question parents about their child’s sleep habits before giving a potential mis-diagnosis of ADHD. If your child, or anyone you know has a child who has been labeled with ADHD – take a look at their sleep habits before resorting to other treatment. Are their sleep needs being met? Do they seem tired or groggy when they get up in the morning? Are they showing signs of being tired long before their regular bedtime?
Could you imagine your child being labeled with ADHD and medicated, on an IEP at school, having many behavioural problems, when all along it was due to a sleeping problem? This is not to say that all cases of ADHD are not real cases of ADHD, but it’s significant enough that it’s worth a second investigation.
My son is a little more flexible with his sleep now that he’s getting a little older, but still has his moments. If he got to stay up really late because of a holiday or a family get together, my husband and I always know we are going to pay for it later. Last summer his cousins came out to the lake to visit us one day, and they were having so much fun together we let him stay up until 9:30 (bedtime was usually 7). The next few days were filled with CRAZY tantrums every time he didn’t get something he wanted, or didn’t want to do something. Needless to say, he went to bed early several nights in a row, and all was fixed within a week. But imagine what his behaviour could have been like had we let him stay up past his bedtime night after night? If I didn’t know what his sleep needs were, that could very well have been our life. And I wouldn’t have known what to do with him or how to cope, and it’s very easy to see how that would spiral into a case of ADHD when I took that complaint to the Pediatrician. Because I have been so diligent with my son’s sleep needs, when he starts to behave that way I know he either needs to go to bed early at night, or he has a possible ear infection (that’s another story).
Getting them to stay in bed once they’re in there! February 28, 2012
When my son was 18 months he started to absolutely hate his crib. My husband and I decided to get him a bed so bedtime and sleep didn’t become this awful place for him. The first night we put him in the bed I was terrified! I imagined that he’d be running out of the room continuously and I had a plan ready in case. To my amazement, he stayed in bed and continued to go to bed pretty much perfectly. A lot of parents aren’t so lucky, and I’ve certainly seen my fair share of that in my work! In the sleep seminar I gave a few weeks ago, one of the common problems that came up was “how do I get him to stay in bed once I say good night?” There are 3 components to this answer:
1. It’s so important to make sure kids are in bed at their optimal sleep time. Remember that sleep experts indicate the optimal bed time for young children is between 6-8 pm, with 8 pm being on the late side. (For more on this topic see my previous post on Feb. 17 called “sleep needs for children.” If your child is up past his or her optimal sleep time, you’re likely to see an overtired child pulling out all the stops and not going to sleep properly at bedtime. I can always tell with my son when it’s just a little past his sleep window as he asks for everything under the sun at bedtime “I need another cuddle,” “drink of water,” “just want to tell you something,” “I’m hungry”… When I get him to bed on time, he’s an angel and there’s not a peep.
2. Be prepared by the door and give as little attention to him or her as possible. Particularly if you are trying a new sleep routine or moving from a crib to a bed, be prepared to hang out outside your child’s bedroom until he or she stops coming out. As much as we like to blame our little rug rats for their behaviour, I’m sorry to say, but the majority of child bedtime problems are well-meaning parental attention maintained. So have a little camp out by your child’s door, with your book or laptop and a glass of wine (as necessary of course!), so that you can nip the fun out of their bud. With as little attention as possible, walk him back to bed, put him in therand leave the room, and close the door. If you need to say something, keep it simple – e.g., “it’s bedtime, I love you, good night.” The first time you may need to repeat this several times (or 65), but don’t worry, be consistent and it will pay off soon.
3. Did I mention be consistent? This is THE most important tool in your toolbox. Kids are smart little cookies and they know when mom and dad are going to give in and exactly which buttons to press. Don’t underestimate them! Stick to your guns. Don’t bring them to bed with you, read 12 more stories, allow 4 more glasses of water…. Have a set routine and stick to it and they will believeyou when you say “it’s bedtime, I love you, now go to sleep.”
Sleep needs for children February 17, 2012
Thanks to everyone who came out for the free seminar in honor of Psychology month on Wednesday “Getting your child to sleep and stay asleep.” It almost felt like a support group! Everyone had such common concerns, and I think most parents who have difficult sleepers probably do. I know it would have made me fee better when my son was a baby, to know there were so many other parents with similar experiences. For some reason, whenever I complained other parents would say to me “oh really? My baby has been sleeping through the night since she was 6 weeks old!” I have finally come to the conclusion that most of those parents were fibbing at least a little bit. Since I started telling people I’ve been investigating sleep and writing a “how-to” book for parents, people have been coming out of the woodworks with the same problems!
Probably the most important thing parents should know and learn to figure out in their own child is what the sleep needs are. Sleep experts indicate that on average (so some need more and some need less) children 3 and under need around 13 hours of sleep per day (including naps), and from 3-18 it’s around 9-10 hours. Further, optimal bedtimes are between 6-8 pm, with 8 being on the late side for young kids. Just by getting your kid to bed and to sleep at the right time can lengthen their sleep and reduce nightly wake ups. My kids are currently both in bed by 6 pm. It’s early, but they are ready, already getting cranky, my 3 year old is starting to misbehave, etc. and then they sleep a solid 13 hours. If my 3 year old goes to bed at 7, he’s just not quite himself the next day, wakes up at the same time in the am if not earlier, and only ends up with 11-12 hours. And then I pay for it all day. So if you can, take a look at getting your children to bed a little earlier, and all sleep a little easier for it.
I’m considering opening up another seminar in April if there is enough interest, so please send your requests through the contact page!
What to Remember for Sleeping After Illness February 12, 2012
It’s like a nightmare I remember only in my…well..dreams. My perfectly sleeping 7 month old daughter has a fever and barely slept a wink all night. Meaning my husband and I barely slept a wink last night. This is the girl who I normally can just waltz into her room, put her in the crib, and say “night night sweetie I love you,” leave the room and not even a peep. Last night I couldn’t put her down without her bursting into tears and crying for long periods of time. I would just rock her to sleep, slowly start to move her over the railing of the crib to put her down, and her eyes would pop open (like one of those dolls we had when we were kids) and she would start crying. So I spent much of the night sleeping off and on in the rocking chair holding her. It was like stepping back in time to when my son was a baby. He was the opposite of my perfectly sleeping 7 month old. He was the inspiration for my sleep training book, this blog, you get the picture. My husband and I spent many hours singing lullabies and doing strange rain dances through the night to get him to sleep. Anyways, I digress. But thinking back to that experience did lead to my train of thought to “here we go again, she’s never going to sleep again, I’m never going to sleep again…”
I had to start using some positive self-talk, and remind myself that I’ve been here before, I know what to do, and it will all be fine soon. I started planning for the worst case scenario. Anytime kids get sick we tend to do all the things we should and shouldn’t, to give them comfort, just to get ANY sleep, to watch over them. Once the kids are better this often leads to a need for some re-training – is it on our part or theirs? I dread that once my daughter is better that she won’t go back to being a perfect little sleeper. Maybe she will, and maybe she won’t. So I have to prepare myself that I will probably have to invest in some of the basics for sleep training. After her bedtime routine, I will put her down, tell her I love her and leave the room. I have to be prepared that some crying will be involved, and it will be okay. I can go and check on her if I need to, trying to provide as little attention as possible, and leave the room. She will get it. Now its just a matter of…how long is it going to be until then?