Though it may seem like your little bundle of energy should crash into a deep sleep every night, ADHD is actually associated with sleep problems. “At the end of the day, bringing that motor down can be difficult,” Dr. Howie says.
Once they do conk out, they’re more likely to have trouble staying asleep, often due to nightmares, bedwetting, or other sleep disorders.
And poor sleep can exacerbate ADHD symptoms, according to the National Sleep Foundation. That’s why having an accurate diagnosis is key. Fatigue is associated with inattentiveness and restlessness, so sometimes a child will appear to have ADHD when they actually have a sleep disorder, Dr. Howie says.
Difficulty Reading Social Cues
When Sara’s daughter was in elementary school, she struggled to interact with the other kids, Sara says.
“She would repeat things over and over until others would react,” Sara remembers. “She couldn’t give up, and she couldn’t intuit how kids were reacting to her, and how annoying she was being. When I would volunteer in the classroom, I would gasp and think, ‘Stop doing that! That kid is so irritated.’ She didn’t see it.”
If a child struggles with this type of social interaction by the time they start school, it could be a sign of the uniquely impulsive behavior of ADHD, Dr. Howie says.
Other Complicating Factors
There are several other conditions that mimic ADHD, Dr. Howie cautions. Take a child who has anxiety and a phobia of thunderstorms. If his mind is obsessed with worry that it’s going to rain, he may appear inattentive.
Girls with ADHD often also have a mood disorder, Dr. Howie notes. And sometimes that disorder is recognized, but not the underlying ADHD.
There’s also a link to autism. Between 30% to 50% of children with autism-spectrum disorder also have ADHD, and that can make each diagnosis more challenging. It’s helpful to work with someone familiar with both disorders to get a complete diagnosis, ADDitude magazine notes.
What to Do Next
If you’re concerned about ADHD, your first step, as always, is to talk to your pediatrician. He or she will want to gather feedback not only from you and teachers, but also any counselors and coaches, says Dr. Howie. That input helps establish that symptoms are pervasive in multiple settings.
And once there is a diagnosis, it’s often a relief, she adds. “It gives parents a name for what’s going on and it opens up a whole world of services and behavior interventions,” she says. “And a child who can put a name to what’s going on is better equipped to work on it.”