Sleep and bedtime can be a difficult time for parents and children with ADHD. Children with ADHD are two to three times more likely to have difficulties falling asleep and staying asleep than children without ADHD. While the exact number of children with ADHD that have difficulty with sleep is unknown, we do have some estimates. A recent study of 239 children with ADHD found that about three-quarters of kids had sleep problems. Other studies have demonstrated that up to 50% of children with ADHD have some form of sleep disruption. Sleep problems commonly seen in children with ADHD include:
Refusing to go to bed
Difficulty falling asleep
Difficulty staying asleep/Frequent waking at nighttime
Fewer total hours of sleep
Restless Leg Syndrome/excessive nighttime movement
Over 50% of children with ADHD are described by their parents as tired upon waking.
Sleep is very important for development and day-to-day functioning. Children with disrupted sleep often exhibit difficulties in multiple domains. Some examples include:
Children with ADHD are more likely to be tired or sleepy during the day than children without ADHD.
Children with ADHD who have sleep problems have more severe ADHD symptoms, greater behavior difficulties, and poorer academic performance than children with ADHD without co-occurring sleep difficulties.
Sleep difficulties cause problems for parents of children with ADHD as well, as parents of children with sleep difficulties are likely to have decreased sleep themselves.
Causes of Sleep Problems
Much like with other difficulties in ADHD, there is no one cause that makes it difficult for children with ADHD to get a good nights sleep. However, there are some general reasons kids might have difficulty, including:
Children with ADHD often have a very hard time "settling down" at bedtime, and are more likely to resist going to bed and demonstrate behavioral problems at bedtime.
Children with ADHD often have more disrupted sleep patterns, which makes them more likely to move around at night, wake up in the middle of the night, and have difficulty sleeping.
Stimulant medication often contributes to sleep problems in ADHD; however, it is important to note that many children with ADHD have sleep disruptions even when they have not used stimulant medication.
Co-existing conditions with ADHD can cause difficulties with sleeping.
Addressing Problems with Sleep
The following suggestions are provided from the National Sleep Foundation. These tips will assist with children the transition to bedtime an improve the quality of their sleep:
Follow good sleep habits such as a regular bedtime schedule and a consistent bedtime routine.
Set an appropriate and realistic time for bed.
Establish a calming and age-appropriate nighttime routine.
Making sure children get plenty of exercise during the day, but reduce activity level before bedtime.
Be very active during the day, but not too close to bedtime.
Avoid eating large meals to close to bedtime, although a bedtime snack can be helpful
Be sure to monitor the time of medication administration, particularly if the child is taking stimulant medication. Many medications have side effects that interfere with sleep. A physician should be consulted about all medication administration times. If a child shows signs of physically disrupted sleep (i.e., sleep apnea, excessive physical activity during sleep, persistent sleepwalking or nighttime awakenings), it may be appropriate to refer the child for a sleep study to ensure that there is not an organic cause of their sleep disruption.