The Relationship between Sleep Issues and Children with ADHD

Sleep is crucial for everyone, but especially for children with ADHD.  Up to 70% of children with ADHD suffer from problems with their sleep and almost half of the parents of a child with ADHD say their child has moderate to severe sleep problems.  Children with sleep issues on top of ADHD have added day to day difficulties, including more severe ADHD symptoms (inattention, hyperactivity, or impulsivity).  This makes life harder for them as well as their families. 

There can be many reasons that your child is not getting a good night’s sleep.  Stimulant medication is often used to treat ADHD.  However, one of the most frequently reported side effects of stimulants is insomnia, as stimulants increase the activity of the central nervous system.  However, even children with ADHD that do not take stimulants can still suffer from sleep issues.  Children with ADHD are at a greater risk of issues such as restless leg syndrome, periodic limb movement disorder, anxiety, and depression, all of which can affect sleep.  

Sleep Problems Reported by Parents of ADHD Children

Difficulty getting child into bed:  The child may delay getting into bed, often making excuses, or coming up with things that they need to do before bed.  This can go on for what seems like hours as they become full of energy and come and go into the bedroom numerous times.

Worries and anxiety at bedtime:  The child might be worrying about school the next day, or they may be anxious about specific nighttime fears (such as being alone in the dark).

Insomnia:  Many children with ADHD have a difficult time falling asleep or find it hard to stay asleep through the night.  Children with insomnia often wake up early.  The sleep foundation states that serious sleep disturbances, including insomnia, have long been recognized as a common symptom of anxiety disorders.  Those who are plagued with worry often ruminate about their concerns in bed, and this anxiety at night can keep them from falling asleep.  

Delayed sleep phase:  This is when the sleep-wake cycle has changed, and the child isn’t sleepy until it is way past their bedtime.  ADHD children often have a delayed sleep phase.  Then they are difficult to wake up and the child wants to sleep in the next day, often leading to morning frustrations and a child being tardy to school or the parent being late to work.  

Sleep associations:  Often children (of all ages) feel the need of a particular item to fall asleep at night.  This could be anything from watching tv, having a particular item such as a stuffed animal or blanket, or needing someone to lay with them to fall asleep.      

As a parent with a child that has ADHD, you may notice that your child has problems falling asleep, staying asleep or sleeping through the night.  Often those with ADHD are difficult to wake up and are tired or grumpy in the morning.  With ADHD, if you’re tired, your symptoms can get worse, making it more challenging to get through the day and harder to sleep the next night.  This cycle can lead to frustration for the entire family as it becomes a daily struggle to wake your child, get them ready, and to school on time.    

Parents play an important role in helping to make sure their kids are getting adequate sleep each night.  There is a big difference between what a child or teenager “think” is enough sleep and what they actually “need” to function and perform at their best.  Let’s face it, if it was up to the kids, they wouldn’t have bedtimes.

Sleep Requirements for Children, School-age Kids & Teenagers:

• Children: Preschoolers (3-5 years) 10 to 13 hours
• School-age kids: (6-13 years) 9 to 11 hours
• Teenagers: (14-17 years) 8 to 10 hours

A National Sleep Foundation Sleep in America Poll found that over 45% of adolescents in the United States obtained inadequate sleep, with 73% percent of U.S. high school students getting less than the recommended 8-10 hours of sleep on school nights.  A consistent lack of sleep can have negative effects on physical and mental health along with reduced academic performance for kids of any age.  Whether your child is in grade school, middle school, or high school, it is important they are getting the necessary sleep to stay mentally and physically healthy, function and perform at their best.

How Can I Help My ADHD Child’s Sleep?

Children with ADHD that get consistent and adequate sleep are more likely to have improvement in attention, focus and energy.  There are numerous steps you can take to try to help your ADHD child get a better night’s sleep, without the use of medication.  It starts with the bedtime routine and a consistent sleep and wake schedule.  Brain training is another method to regulate your child’s brain and can help them fall asleep faster and sleep longer.  

The bedtime routine should start an hour or two before bed.  During this time, you want to start to dim the lights and create a calm and relaxing environment for your child.  Having a regular schedule with dim lights and a calm environment helps regulate your child’s circadian rhythm, which dictates when they feel sleepy or awake.

The Bedtime Routine

• Dinner 3-4 hours before bed – it generally takes about four hours for our body to digest a meal.  Small healthy snacks are ok a couple of hours before bed but stay clear of caffeine and sugar, such as chocolate and soda.
• Avoid screentime 1-2 hours before bed – this includes computers, phones, TV, tablets, and gaming.  Electronic devices emit blue light and stop the natural production of melatonin, the chemical that lets your child’s brain know it’s time to go to sleep.  If your child is accustomed to using screens right up until they go to sleep, try reducing the screentime in 15-minute increments each night.  For example, reduce their screen time 15 minutes before bedtime, then 30 minutes, and so on.  Switch out your child’s phone or tablet for a book or an audio book.  You will notice a significant difference in how much faster they will drift off to sleep.      
• Bath/Shower & brush teeth 1 hour before bed – a hot bath or shower will relax the muscles, soothe the mind, and indicate to the body its nearing sleep time (if done consistently).  Brushing teeth is not only good oral hygiene, but also helps your child realize that eating is done for the night.      
• Bedroom Environment – keep your child’s bedroom cool and dark (a dim nightlight is ok).  Kids with ADHD may have sensory issues and often have sensitive hearing, especially at bedtime.  Use white noise or sounds of nature to block household noise.  A fan in the background or an app that offers different sound options may do the trick.    

Establish a Consistent Sleep and Wake Schedule:  Setting times for your child to go to sleep and to wake up will make it easier to adhere to a regular sleep schedule. If possible, stick to the same schedule on the weekends.  To be sure your child is getting the necessary sleep for their age, it may be best to start with the time the child needs to wake and then work backwards to determine what time they need to go to sleep.  Be consistent!  If you send them to bed too early, it may take too long for them to fall asleep.  If you send them to bed too late, they will be tired.   

Improve Sleep and ADHD with Brain Training

Brain training, or EEG biofeedback, is a safe and natural approach that teaches the brain without chemicals and has been used successfully with young children, teenagers and adults that struggle with sleep issues such as trouble falling asleep, staying asleep and nightmares.  Many sleep issues including insomnia, problems falling asleep and trouble staying asleep, are a byproduct of brain over arousal, under arousal or brain instability.  EEG biofeedback, or Neurofeedback, trains your brain to regulate itself, which in turn helps one fall asleep faster, sleep longer, and wake up well rested.    

Emerald Coast NeuroFeedback, with offices located in Pensacola, Fl and Fort Walton Beach, Fl, have many clients that have reported dramatic improvements in their sleep after doing Neurofeedback.  The cutting-edge technology has demonstrated significant improvements in sleep and symptoms of ADD and ADHD in just 8-10 weeks.  This is accomplished by training abnormal brainwave patterns to produce normal organized patterns.  

Pamela Downey, MS, LMHC, of Emerald Coast NeuroFeedback has seen more requests from parents of children with sleep issues and ADHD then she can recall.  “We have taken more calls this year for sleep issues and ADHD than ever.  It’s always exciting to hear the feedback from clients that are surprised to be sleeping better after just a few sessions of brain training.  Most people don’t realize all the benefits of Neurofeedback.”  She went on to explain that many parents are interested in an alternative to medication to help with ADHD.

In 2013, The American Academy of Pediatrics gave it a Level 1 effectiveness rating in treating ADHD, which is the same as medication. Neurofeedback is a safe and effective treatment alternative for many conditions, and it is an option without the negative side effects of medication.  “When it comes to ADHD and our Neurofeedback system, 60% of clients reported improvement after just 5 sessions, and nearly 75% reported improvement after only 10 sessions.  The best part is, upon completion of Neurofeedback therapy, the effects are long lasting.”

Many parents are not aware of the relationship between sleep issues and children with ADHD.  If your child has ADHD, they are likely to struggle with some type of sleep issue.  It’s important to pay attention to the amount of sleep your child is getting, as a lack of sleep can lead to more severe symptoms of ADHD.   Common sleep issues for children with ADHD may include trouble getting your child into bed, worries or anxiety at bedtime, insomnia, delayed sleep phase, or sleep associations.  To help your child with ADHD get the adequate sleep they need, it is important that parents have a good bedtime routine and a consistent sleep and wake schedule.  A good bedtime routine, a consistent sleep and wake schedule along with brain training can help your child fall asleep faster, sleep longer, and wake more rested.