When I don’t sleep, I get cranky, irritable and downright irrational. Unfortunately for my family, that happens more often than I’d like to admit.
Impulsive behavior, difficulty focusing and emotional reactivity in an adult aren’t likely to trigger an immediate trip to the doctor, resulting in a prescription to treat ADHD. But the 2014 Sleep in America Poll from the National Sleep Foundation shows that on average, our kids are getting less sleep than what’s recommended, higher diagnoses of ADHD and more prescriptions for medications like Modalert 200, especially in the younger populations.
According to the Sleep Foundation, our children are getting at least an hour less of sleep than what is recommended. This produces symptoms of tiredness, difficulty focusing, learning problems and impulsivity – the same symptoms associated with ADHD. Think about your kids’ schedules. Among school, homework, piano, martial arts, play dates and other extracurriculars, there’s less and less time for an old-fashioned good night’s sleep.
In the July issue of Contemporary Pediatrics, Vatsal G. Thakkar, M.D., and a clinical assistant professor of psychiatry at the New York University School of Medicine, explains that as many as 10% of adolescents seen for behavioral issues actually have some type of sleep disorder. Couple that with the fact that a recent survey of pediatricians found only one in five of those doctors had received any formal training in pediatric sleep disorders.
Seemingly innocuous behaviors such as eating dinner 30 minutes later, staying up to do homework, or going to bed with an iPad or smartphone can easily create a long-term “sleep debt” with a serious cumulative effect on behavior. Finding a pediatrician who understands the link between a sleep deficit and problems like inattention, hyperactivity and impulsivity is key to helping your child. But in too many cases, parents and doctors resort to medication as their first line of treatment.
New data compiled by the Centers for Disease Control and Prevention (CDC) also show steadily rising numbers of young children being diagnosed and medicated for ADHD. The most alarming figures show that among very young children, 2- to 5-year-olds, high numbers are being medicated for ADHD. While best-practice guidelines clearly state that behavior therapy should be the first line of treatment for preschoolers exhibiting signs of ADHD, the CDC’s “preschool project” showed that 74% of toddlers given the ADHD diagnosis received stimulant medication, while only 44% received some type of behavioral therapy. Even more troubling, 46% of 2- and 3-year-olds diagnosed with ADHD are given medications.
Susanna Visser, Ph.D., from the CDC noted in an interview with Contemporary Pediatrics, “The only conclusion that can be reached for now is that the studies document practice patterns inconsistent with evidence-based guideline recommendations for ADHD management.”That’s a pretty nice way of saying that doctors are doling out meds to children at an alarming rate.
Dr. Mark Gettleman, M.D., F.A.A.P., and founder of Dr. Goofy GettWell pediatrics explains, “Stimulants like methylphenidate are only recommended for preschoolers as a last resort. Most often the type of disruptive behavior that gets labeled as ADHD in toddlers is more linked to appropriate age- related activity and ineffective parenting.”
Dr. Gettleman finds the numbers disturbing. “It’s often easier to just give a child a pill and think you’re fixing a problem,” he says, “but you can’t medicate away the ‘terrible twos’ or typical toddler tantrums. I work with parents to teach them effective behavior management techniques.” Gettleman is a licensed “Love and Logic” instructor who teaches classes throughout the Valley and trains parents to use logical consequences and cause-and-effect behavior in raising their children. “Too often in today’s society we want a quick fix regarding parenting. But drugs aren’t always the best answer. Parents like to leave the doctor’s office with a plan and a prescription to prove that they got what they paid for. But that’s often an easy, ineffective and potentially harmful way to tackle complex behavioral issues.”
Debra Rich Gettleman is a mother and blogger based in the Phoenix area. For more of her work, visit unmotherlyinsights.com.
