Poor sleep in teens can mimic the symptoms of ADHD, which is why sleep history should be considered before a diagnosis is reached, says Dr Alison Bentley, medical doctor at Restonic Ezintsha Sleep Clinic.
Dr Alison was speaking at a recent fireside chat hosted by Education Incorporated Private School and its principal, Gershom Aitchison, in partnership with Restonic, the largest bed manufacturer in southern Africa and a founding partner of the Restonic Ezintsha Sleep Clinic, the first facility of its kind in South Africa.
Adéle de la Reÿ, Group Marketing Manager at Sleep Group, explains that the clinic researches sleep and related health issues and provides training to medical professionals. “The fireside chat was a powerful conversation on the link between sleep, ADHD, and the mental health of teenagers,” she says. “The session brought together educators, parents and medical and mental health professionals to discuss the role of sleep in academic performance, emotional regulation, and correct diagnosis of behavioural challenges. One of the biggest takeaways for me was how important it is to address sleep in any health-related matter. It’s such a critical aspect of health, and yet it’s a factor that is often overlooked.”
Bringing sleep into the ADHD conversation
Dr Alison cautioned against the widespread tendency to overlook sleep problems in teens presenting with ADHD-like symptoms. “We have to ask whether a teenager is inattentive or simply sleep-deprived,” she said. “It’s not uncommon for teens to be medicated without a proper sleep history being taken.”
She explained that delayed sleep phase syndrome, which is a biological shift in teenagers’ internal clocks, causes adolescents to become naturally sleepy much later than expected, often leading to sleep deprivation when forced to wake early for school.
“These kids aren’t lazy or defiant – they’re on London time, not South African time,” noted Principal Gershom. “If we continue to ignore their biology, we’re setting them up for failure.”
Dr Alison echoed this sentiment. “Sleep is a passive activity that requires letting go – and that’s very difficult when you’re anxious or when your natural rhythm is out of sync with your schedule. We need to stop treating sleep as optional or secondary. The other two-thirds of your life depend on what happens in that one-third of sleep.”
Other factors affecting teens’ sleep
Teens’ sleep can also be compromised by caffeine abuse, overuse of screens, and the pressures of school performance. Amy Dewes-Goulborn, a psychologist working in a high school context, raised concern over the growing number of teenagers relying on energy drinks and late-night device use – behaviours that further disrupt sleep and can be misinterpreted as psychiatric conditions.
Practical insights were shared from the classroom, too. Gershom reflected on the success of school camps, where increased physical activity and structured routines reduced students’ reliance on sleep medication. “We also allow students to eat when they’re hungry at school,” he said. “Their digestive systems are on a delayed wake-up, just like their brains – so we listen to the body.”
Parental involvement
Throughout the session, Dr Alison emphasised the need for education, not just for teenagers, but for their parents and the healthcare system. “No child should be medicated for ADHD without a thorough conversation about their sleep. And parents need support to understand that setting boundaries around bedtime isn’t just discipline – it’s an act of care.”
She also highlighted the importance of giving teenagers agency. “Teens respond when we ask, ‘Does this make sense to you?’ or ‘Can you follow this plan?’ They need knowledge, and they need to feel seen. When we hand them some control, their anxiety drops – and so does the need for intervention.”
The speakers agreed that there is a need for more honest conversations, more informed medical referrals, and for sleep to be treated not as a luxury but as a cornerstone of well-being.
“We need to stop medicating away symptoms without asking why they’re there. If we get sleep right, we change everything – from mood and focus to health and academic success,” concluded Dr Alison.
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