How common are sleep problems in children with ADHD?
Up to seventy percent of children with ADHD suffer from problems with their sleep. Almost half the parents of a child with ADHD say that their child has moderate to serious sleep problems. Children with ADHD may have behavioural sleep problems or medically-based sleep problems.
What are some behavioural sleep problems experienced by children with ADHD?
Children with ADHD can find it hard to get to sleep at night. They may find it hard to stay asleep through the night as well. Behavioural sleep problems in children with ADHD are very much like those any other child might suffer from. Some examples include:
- Not being willing to go to bed — the child stalls or refuses to go to sleep at night-time.
- Being anxious at night — the child may be worrying about being alone in his or her bed. They may be scared of the dark. Or it might be that they worry about things that took place that day.
- Delayed Sleep Phase Syndrome — this is when a child goes to bed later at night. He or she then sleeps in later in the morning.
- Insomnia — the child cannot get as much sleep as wanted or needed. He or she may find it hard to get to sleep or stay asleep, or may get up too early in the morning.
- Sleep associations — the child may need the presence of a parent or an object, like a television, to feel able to fall asleep or stay asleep overnight.
What is the impact of behavioural sleep problems in children with ADHD?
Moderate to serious sleep problems in children with ADHD are linked with many other problems. For example their quality of life might not be as good, they might not function well during the day, or they might not go to school as much as they need to. This in turn can have an impact on whoever looks after them. A parent might miss work or suffer from stress because of their child’s sleep issues.
Why do children with ADHD have these behavioural sleep problems?
There can be many reasons. Medication may play a part. Stimulants are often used to treat ADHD and these can cause insomnia as a side effect. But even if children with ADHD are not on stimulants they may still suffer from sleep problems. This is because they are at greater risk of problems such as conduct difficulties, anxiety and depression, all of which can disturb sleep in themselves.
How can you treat these behavioural problems?
This can be done with the same methods used for any other child – see Sleep Problems and Sleep Disorders in School Aged Children. For some children, these methods may not work and there continue to be sleep problems. If so, melatonin may be of use and this should be discussed with the treating doctor (see Melatonin and Children).
My child just doesn’t seem to be able to switch off their mind at bedtime. What can I do to help?
Like any other child, a child with ADHD needs a calm and structured bedtime routine. This will help them get ready for sleep. Starting thirty to sixty minutes before bed, there are a number of things that your child should avoid e.g. computers, mobile phones, console games, television and other stimulating activities. Bedrooms should be free of TVs, phones etc. The aim is to help them to be relaxed for bed. Reading stories and/or some deep, slow breathing can help children to relax and settle at bedtime.
You also need to make sure that your child is going to bed at the right time (see Sleep Needs Across the Lifespan). Going to bed too early will make it hard for children to settle during the night. Going to bed too late can make them over tired and less cooperative.
What are some of the medically-based sleep problems experienced by children with ADHD?
Children with ADHD seem to have a higher risk of a variety of sleep disorders such as Obstructive Sleep Apnea, Restless Legs Syndrome and Periodic Limb Movements of Sleep (PMLS). Obstructive sleep apnoea is when the throat obstructs repeatedly during sleep, disrupting breathing and sleep. A child with restless legs syndrome feels discomfort in the legs which is accompanied by a strong desire to move them. This happens when trying to get to sleep and also during the night. Children with periodic limb movement disorder move their legs repeatedly during the night. They find it very hard to control this. If you have concerns about any of these, you should speak with a doctor.
I need more help with my child’s sleep, what should I do?
If you need help with your child’s sleep, you can get in touch with your general practitioner or a paediatrician. Some children may need a Sleep Specialists.