I've been repeatedly dxd. with bipolar, and, if it's true that I have it, I can tell you that some of the distinctions aren't always the case. I was always up early and down early to bed (except when anxiety was so bad it kept me up). I could never concentrate or keep my mind in one place due to racing thoughts, which probably looked like ADHD inattention, which I also may have. I can tell you that if I have co-morbid ADHD, I don't really care--it's the horrible moodswings that were debilitating, not the hyperness. The only way to rule in or out what a person has, if there are no blood tests, are medication trials and, later on, seeing moodswings for yourselves. If mood stabilizers work and stims make the child worse, it's a good guess that you aren't seeing ADHD. Kids with both bipolar and ADHD may have trouble sleeping because both taking stimulants and childhood mania can cause insomnia. Unfortunately, until there are blood tests, there is no way to know for sure why our kids are upset. It's trial and error. If something works, keep doing it, no matter what the diagnosis. is and if something doesn't work, keep looking. Bipolar is often misdiagnosed as ADHD, but the kids don't improve with ADHD interventions and medications.