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ADHD in children and sleep problems

There is not one part of our body that does not benefit from sleep.  And it’s no surprise that importantly, our brain needs sleep to function correctly.  Lack of sleep not only impacts our physical but also our mental health…

I’m sure I’m not alone when I say I love my sleep.  But that’s probably because I rarely get a good night’s sleep.  Like a lot of parents, I am a light sleeper because I’m always listening out for a child who might need me in the night.  When one tiptoes in, after I’ve managed a couple of hours of sleep, my body thinks, oh that’s enough for you, you may as well stay awake now and my brain starts whirring about all the mum things I need to pack, buy, sort or fill in for the kids!  I hate being woken!  

Alas, it’s not just in the night either.  I know many parents lay next to their children trying to get them to sleep.  When you think you have succeeded and start to roll away, they ask you a question or are suddenly ravenous or thirsty, then inevitably need the toilet again and so the cycle begins again.

A bad night’s sleep is common for many parents with young children.  However, if you have a child with ADHD, there is a very high possibility that you get woken on a nightly basis.  In fact, about 70% of children with ADHD have sleep problems; either falling asleep or staying asleep.

Why do children with ADHD have sleep problems?

Sometimes it is simply due to their ADHD medication, as these are generally stimulants.  Their sleep may improve once your child becomes accustomed to them.  If it doesn’t get better, it’s worth speaking to your child’s specialist to alter when the last dose is given in the day. Sometimes a small tweak in their medication can resolve it

However, many children with ADHD who are not taking stimulant medication still have difficulties sleeping.  Research has shown that sleep problems in individuals with ADHD could be due to other ADHD comorbiditiesAnxiety and depression, for example, are also linked to sleeping difficulties. 

Research has shown that many of the same areas of the brain that control attention also regulate sleep.  We know our children have issues with attention, so it would make sense that this would also, therefore, affect their sleep.

As with many children, the child may simply not like the dark and being alone in their bedroom.  They may be worrying about something that has happened.  However, our children with ADHD feel things in much bigger more exaggerated ways than other children.  It’s just another part of ADHD, so they are more likely to be afraid and/or anxious at night.

Other research has shown that children with ADHD have a delayed circadian rhythm, our internal body clock, which also leads to lower production of melatonin, the hormone that is produced to make us sleepy at night.

Linked also to children with ADHD are Obstructive sleep apnea which affects the airways including snoring and Restless Legs Syndrome (RLS) where a tingling sensation in their legs can make it really difficult for them to fall asleep, and even harder to reach a deep sleep.

As appears to be the norm with ADHD, there is never one individual answer for why something occurs which is why it can be difficult to work out what’s causing their sleep problems.

Impact of Sleep deprivation

Anyone who has had a bad night’s sleep suffers the next day.  You feel groggy, snappy, lethargic, and often low mood, (sounds like I’m listing a bunch of seven dwarves!). My attention span is much shorter and my comprehension of events is skewed when I’m tired. 

With such a large percentage of our children having sleeping issues, this is a major problem.  Having sleep issues on top of ADHD exacerbates many issues including focus and attention.  Obviously, this is going to impact their academic day.  Already having shorter attention spans than a Neurotypical (NT) child, sleeping issues are going to create even shorter ones.

Or as is the case with insomnia, adrenalin goes into overdrive to keep you awake.  You may feel buzzed.  This in a child with ADHD is going to cause fidgeting and impulsivity, which are already key issues with ADHD.

And let’s not forget the tired parent.  You’ve had a full day as it is.  You are dreaming of sitting down and having some quiet adult time.  Maybe watch a film or even just a quick drama tv show, but no, your child needs you to help them settle.  You are already tired having been sleep deprived from the night before.  You’ve had no time to recharge your batteries.  You are more likely to have less patience than you would like.  More likely to have a shorter fuse.  And our children with ADHD will pick up on this being so sensitive.  A recipe for disaster.

Helping your child with ADHD to sleep

So, what can you do to help your child to sleep better?  As stated, if it’s not due to medication and you have waited for the medication to settle or be adjusted then the following are other ideas that can help.  These are obviously dependent on age.

  • Don’t put your child to bed too early if they won’t be tired enough to sleep.  I know, I know, we are all knackered and just want to relax and have some me-time.  Believe me, you will make it worse and last longer if your child is genuinely not tired.  You need to work out the right time for your child.  I was always put to bed before my older brother but after my younger brother.  I tried to apply this to my children.  However, my eldest (NT) loves his sleep and falls asleep with ease, whilst my youngest with ADHD has so much energy, there’s no point trying to make him lie down any earlier.

Not easy, but try to stick to the timings at weekends too or it will disrupt their circadian/internal body clock.

  • Try to start your bedtime routine about 30-60 minutes before bed.  Mine love to have a bath first.  This signifies that it’s nearing bedtime.  Whatever your routine might be stick to it so that your children learn what comes next.  And inevitably bed!
  • Limit screen time. If your child is anything like mine, this is their major go-to.  Try as I might suggest a game of Cluedo, they look at me like I’m mad.  If it’s not on a screen it’s not worth doing seems to be the latest opinion. 

If your child is younger, taking a screen and replacing it with storytime is a really nice thing to do.  A book is far more calming and less bright. Reading in their bed gets them warm and cosy and ready for the inevitable.

When your kids are a bit older, this becomes more challenging, especially when they have phones too!  My sons both like playing games and it’s hard being the tough parent at night when you are too exhausted for a fight to wrench them off their beloved electronics.  Especially when they are online playing with other kids from their class, ‘Mum why are you so mean?  Charlie doesn’t have to go to bed yet?’ I normally give them a 10-minute warning and if they don’t come off I will turn off the wifi and remove the electronics tomorrow.  Sometimes this is enough, sometimes I must get tough.

My daughter with ADHD likes to listen to things on her phone.  I do tell her though if I come in unexpectedly and see her still watching past a certain time, I will take it.  As of yet, I haven’t had to take it.

  • Make sure your child’s room is suitable for them.  I say suitable for them because one of my children insists on having their LED strip lights on all night, which absolutely goes against most parenting advice.  However, it works for him.  One of my children likes a warm room, the other the radiator is off and often the windows are open!  So, work out if your child likes light or dark; warm or cold; silence or low noise. 

If your child is young try to have the room as dark as they can bear, only so they can’t see their toys and want to jump out of bed to play with them, or put away temptations before bed.

  • Try to ensure your child with ADHD has had adequate exercise and daylight, during the day.  This will help them achieve a longer deep sleep.
  • Avoid heavy meals before bed.  Mine always get hungry right before bed, partly hunger partly delay tactic.  However, I know I can’t sleep if I’m hungry, so warm milk is an obvious choice.  Not too much though or you’ll get the, ‘I need to go to the toilet’ on replay.
  • Nice comfy pj’s and maybe socks to keep little feet warm helps.  I read a good point about not putting your child in flannel pj’s and having flannel sheets.  They stick together and make it difficult to turn over!  The thought made my toes curl!  If we are lucky enough to get a warm night, a fan can help, and the plus side is that the whirring noise can actually help and be quite calming.
  • Melatonin.  For me and my children, this works.  This is the hormone that helps us all sleep and appears to be low in many people, including our children with ADHD.  Both my children have been prescribed this.  They only need a very low dose but luckily once they’re asleep they seem to be ok.  My daughter does wake, and I won’t lie, tends to come into my room, but it’s made it easier for her to fall asleep.  I think her brain is so active when she goes to bed, it just helps to switch her off. 

I’m a rubbish sleeper and I have tried melatonin.  It’s very natural and helps me to ‘nod off’ and whilst it doesn’t keep me asleep all night (I really do have sleep issues) I don’t wake feeling groggy.  Always check with your doctor if this is appropriate for your child before taking it.

Sleep is so vital for everyone, yet so hard to achieve for many, and can greatly impact your and your child’s life.  I hope some of these suggestions can help.  It’s all about finding what works for you and your child with ADHD.  Keep trying because it is achievable, and you both deserve a good night’s sleep.

I have started a private support group on Facebook for parents and carers who need support with their child with ADHD. It’s a friendly place to chat with others. Please do click this link ADHDinchildren to join. And for anyone on Instagram, I’m there too ADHD Mum.

Vicki x

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