Are restless nights a common occurrence for your child with ADHD (attention deficit hyperactivity disorder)? Understandably, this can be a challenging aspect of the condition. A poor ADHD sleep routine can lead to various sleep issues, from difficulty falling asleep and staying asleep, to morning wake-up struggles.
Further complicating things, lack of sleep can exacerbate ADHD symptoms, potentially making it harder for your child to focus, concentrate, and regulate their emotions.
Poor sleep can ultimately have a significant affect on your child’s mental health, too.
Yet, there’s hope. With the right tools and strategies, such as establishing a consistent ADHD sleep routine and practicing good “sleep hygiene”, you can help improve the quality of your child’s sleep.
Dive into this article to learn more about how you can support your child’s sleep health.
- Establishing a consistent sleep routine can be massively beneficial for children and teenagers with ADHD.
- Practicing good sleep hygiene will undoubtedly lead to a better night’s sleep for your ADHD child.
- Poor sleep exacerbates ADHD symptoms, making it even harder to focus, concentrate, and regulate emotions.
ADHD Symptoms and Sleep Issues
Nighttime can be a struggle. Falling asleep, staying asleep, waking up rested. These can seem elusive. The result? A worsening cycle of ADHD symptoms.
Inattention makes sleep tricky. Distractions, buzzing thoughts, overwhelming feelings – they create a whirlwind. Of course, for some children and teens there’s also hyperactivity and impulsivity. Winding down at night? Easier said than done.
Nights filled with wakefulness then often lead to groggy, irritable, unfocused days.
Applying a strategic game plan could be a game changer. This will involve one or more of the following:
- Physical activity
- Careful management of screen time and blue light
- Sleep-friendly bedroom environment
- A calming bedtime routine
- Cutting down on caffeine
In short, ADHD can mean sleep issues, but there are ways to help. I’ll show you what to do.
Factors Affecting Sleep in Children With ADHD
The following are some of the most important factors that will make a difference for children with ADHD when it comes to sleep. These can positively impact both the quality and quantity of your child’s sleep:
1. Physical Activity
Regular physical activity during the day can help children with ADHD sleep better at night. Exercise helps to reduce hyperactivity and improve mood, which can lead to better sleep quality. Encourage your child to engage in physical activities such as sports, dancing, or bike riding during the day, but avoid doing so too close to bedtime.
If your child is not “sporty”, don’t worry. Just try to encourage them to find a form of movement that works for them. It could be the climbing equipment in a park, or just dancing around the home or garden!
Physical exercise stimulates the release of endorphins, known as ‘feel-good’ hormones, that help in regulating mood and inducing a sense of calm. It also aids in reducing levels of the body’s stress hormones, such as adrenaline and cortisol. Physical activity encourages better sleep and helps regulate the body’s circadian rhythm, both essential for a child’s emotional regulation and overall well-being.
2. Blue Light and Screen Time
Exposure to blue light emitted by electronic devices can disrupt the production of melatonin, the sleep hormone, making it difficult for children to fall asleep at night. It’s worth noting that young children with ADHD may be more susceptible to the effects of blue light compared to their peers. To give your child the best chance of better sleep, it’s crucial to limit screen time before bedtime.
For parents of younger children, an extremely effective strategy is to establish a consistent evening routine that gradually winds down activities before bed. I used this strategy myself for many years with both of my children, including one with sleep difficulties. I believe it made a massive difference. In fact, I still encourage an evening wind-down routine now that they are older teens.
Encourage your child to engage in calming activities such as reading a book, listening to soft music, or playing with toys quietly. Create a technology-free zone in the bedroom by removing electronic devices or keeping them out of reach. This way, your child can gradually unwind and prepare for a restful night’s sleep.
If you have a teen, engage in open and supportive conversations about the impact of blue light on their sleep quality. Encourage your teen to become a proactive participant in managing their screen time. Set some boundaries together, such as a designated “tech-free” hour before bedtime. Explore alternative activities to replace screen time, such as relaxing hobbies, a warm bath, or a chat before bed.
Leading by example is powerful. As a parent, you can demonstrate healthy screen habits by managing your own technology use before bedtime. I know this is easier said that done! Go easy on yourself but keep trying to change those habits. Encourage your entire family to embrace a technology-free wind-down period, creating a tranquil environment that supports better sleep for everyone.
3. Sleep-Friendly Bedroom Environment
Creating a comfortable sleep environment is vital for children with ADHD. A bedroom that’s cool, dark, and quiet is optimal for promoting a deep, restful sleep. These conditions help signal to the body that it’s time to wind down and rest. The goal is to create an environment that supports the body’s natural circadian rhythm, encouraging children with ADHD to wind down when it’s time to sleep.
Five key elements are crucial in creating a sleep-friendly bedroom environment for these children: cool temperatures, darkness, quiet (or “neutralised” noise), minimalist environment and sensory regulation.
Maintaining a cool temperature in the bedroom is vital to encourage quality sleep. The reason behind this is biological: our body temperature naturally decreases as we prepare for sleep, and a cooler room can help mimic and support this physiological process.
For children with ADHD, who may already struggle to calm down, this effect can be particularly helpful. Aim to keep the room temperature between 15-19 degrees Celsius (60-67 degrees Fahrenheit) for the best results. Of course, you need to adjust for individual comfort, but it’s often better to lean towards a cooler room and provide adequate bedding for warmth. I find that I sleep much better when I have the window open, and will often have a fan on too, to circulate this fresh air.
Light can interfere with melatonin production, delaying the onset of sleepiness. This is particularly problematic for children with ADHD who may have difficulty falling asleep or staying asleep. For this reason, darkness plays a critical role in setting the mood for sleep. You can achieve this by using blackout curtains or blinds to keep out any external light.
I know this can be hard if your child is fearful of the dark. If they need a night light, or need the door to be open with the hall light on, it’s not the end of the world. But aim to gradually reduce any light your child needs at night, if you can.
TAKE THE QUIZ!
A quiet or distraction-free environment is another crucial aspect of a sleep-friendly bedroom. Children with ADHD can be especially alert to noises, which can further disrupt their sleep or prevent them getting to sleep in the first place. Try to keep the home as quiet as possible at night. Your child could also experiment with earplugs.
Neutralising any distracting or startling background sounds is often even more effective than a quiet or silent environment. White noise or nature sounds can be incredibly soothing. I listen to ocean sounds and I definitely think this helps me sleep more restfully.
Try to keep your child’s bedroom a space dedicated to sleep and relaxation. This means avoiding stimulating activities in the bedroom, like playing games or doing homework.
Ideally, if they have a desk or computer, these should be in a separate room. If this isn’t possible, keep it as far from the bed as you can and if possible, section it off with a screen.
Reduce clutter if you can. A cluttered bedroom can feel overwhelming and distracting and can impact sleep.
Other things you might consider include ensuring the bed and pillows are comfortable and supportive, and choosing bedding materials that are breathable to help maintain a cool temperature.
By creating a clear association between the bedroom and sleep, children with ADHD can begin to understand and respond better to their body’s sleep cues.
A well-regulated child will sleep better. Sensory regulation is important both at night and during the day. In short, what kind of sensory environment helps your child to feel calm and soothed?
A weighted blanket, for instance, can induce a feeling of security. It mimics the soothing effect of a gentle hug, helping your child to settle down for sleep. Although the research evidence in terms of the positive effects of weighted blankets on sleep are limited, many parents swear by them. I use a weighted blanket myself and I love it. Anecdotally, in my clinic many children with ADHD find them extremely helpful.
4. Calming and Regular Bedtime Routine
Routine and good “sleep hygiene” practices play a crucial role in managing sleep for children with ADHD. Sleep hygiene just means developing a calming and regular routine, and ensuring the bedroom environment is set up for the best night’s sleep.
Regular sleep schedules align with our body’s natural sleep-wake cycle (part of our circadian rhythm), encouraging smoother transitions between sleep and wakefulness.
Having a consistent bedtime routine can help your child’s body recognise when it’s time to sleep. I call these “sleep cues”. For example, having a shower before bed might become a sleep cue for your child. The brain recognises that night-time shower always comes before sleep, and starts producing melatonin to trigger sleepiness. This can help your child fall asleep faster and improve the quality of their sleep.
5. Cutting Down on Caffeine
It’s essential to limit your child’s intake of caffeine, especially in the afternoon and evening.
Caffeine is a central nervous system stimulant. It works by blocking the action of adenosine, a molecule that encourages sleep and relaxation in the brain. During the day, adenosine levels naturally build up, making us feel more tired and ready for sleep. However, when a child or teen consumes caffeine, it essentially competes with adenosine for the same receptors in the brain. This competition blocks adenosine from promoting sleepiness, leading to increased alertness and wakefulness.
On top of this, caffeine has a half-life of about 5 hours in children and teens, meaning that half of the consumed caffeine remains in the body after this time. However, the remaining caffeine can linger in the body for much longer. If a child or teen consumes caffeine in the afternoon or evening, it will still be in their system at bedtime, causing difficulties in falling asleep.
Improving sleep quality can significantly impact your child’s daytime functioning. A good night’s sleep helps them to be more alert, attentive, and focused during the day. The steps I have described above provide a practical roadmap towards achieving this.
But if you have some way to go before you can get all of this aligned for your child, take it step by step. Choose one area to focus on first, to avoid you and your child feeling overwhelmed. Bit by bit, you will put these strategies into place and you’ll see the positive results!
If your child is still struggling to sleep, talk to their doctor about other options. ADHD medications can sometimes interfere with sleep, so the doctor may need to adjust the dosage or timing of the medication to reduce this side effect.
Many people find that essential oils like lavender can be helpful for relaxation and sleep, though research evidence is limited. It’s important to talk to a healthcare professional before using any essential oils, as some can have side effects and interact with medications.
Melatonin is a commonly used medication in children with ADHD who have sleep issues. In many countries including the USA, you can buy it in pharmacies, whereas in the UK it has to be prescribed by your child’s paediatrician or psychiatrist. Melatonin medication is a synthetic version of the natural melatonin we produce in our bodies. It can be helpful for children who, for whatever reason, aren’t producing enough melatonin.
If sleep issues persist, your child may be referred to a sleep specialist.
Daytime Sleepiness and Its Impacts
Daytime sleepiness, one of the most overt manifestations of not enough sleep, poses particular challenges for children with ADHD. Sleep deprivation can cause a sense of exhaustion and grogginess throughout the day, compromising their ability to maintain focus, stay alert, and effectively manage ADHD symptoms.
The body responds to this exhaustion by producing an excess of cortisol and adrenaline – the stress and alertness hormones – in an attempt to keep the child awake. This reaction can cause a sensation of being “wired,” leading to increased hyperactivity and difficulty falling asleep when night comes. This cyclical pattern exacerbates sleep deprivation and ADHD symptoms, creating a vicious cycle.
The Caffeine Trap
The situation is further complicated as some older children and teenagers turn to energy drinks or other caffeine-laden substances to combat their daytime tiredness. As I have described above, this is a detrimental choice that will disrupt the sleep cycle. Caffeine is a stimulant that not only creates momentary alertness but also has a lingering effect, preventing your child from having restful sleep.
Caffeine sensitivity varies among individuals, making it challenging to prescribe a universal limit. However, as a rule of thumb, it’s advisable to completely avoid energy drinks given their high caffeine content. Caffeine sources such as coffee or cola drinks should be avoided after 2 pm. This allows the body enough time to metabolize and eliminate most of the caffeine, helping your child wind down in the evening.
Strategies for Combatting Daytime Sleepiness in Children & Teens With ADHD
Apart from managing caffeine consumption, it’s vital to introduce strategies that can help combat daytime sleepiness. Prioritise regular physical activity during the day, which can boost energy levels and lead to better sleep at night.
Consider implementing short, controlled daytime naps if they don’t cause trouble sleeping later on.
If daytime sleepiness continues to be a major issue despite these the strategies I have recommended, speak to your child’s doctor or see a paediatrician or sleep specialist. They can provide personalized advice, rule out other underlying sleep disorders, and suggest possible adjustments to ADHD stimulant medication.
Frequently Asked Questions
How to establish a bedtime routine for ADHD children?
Establishing a consistent bedtime routine is crucial for children with ADHD. Try to create a calming environment by dimming the lights, reducing noise, and avoiding stimulating activities such as playing video games or watching TV before bed. Encourage your child to engage in relaxing activities such as reading a book or taking a warm bath. Stick to a regular bedtime and wake-up time, even on weekends.
What are some strategies to manage bedtime battles with ADHD?
Bedtime battles can be challenging for parents of children with ADHD. Try to avoid power struggles by giving your child some control over their bedtime routine. Offer choices such as which pajamas to wear or which book to read. Use positive reinforcement to encourage good behaviour and avoid negative consequences. Consider using a visual schedule to help your child understand the bedtime routine.
How can I help my child with ADHD go to bed?
To help your child with ADHD go to bed, it is important to create a relaxing and predictable bedtime routine. Encourage your child to engage in calming activities such as reading or listening to soft music. Avoid stimulating activities such as playing video games or watching TV before bed. With older children, teach them the scientific reasons why sleep is so vital for their mental and physical health, happiness, learning and balanced mood.
What are some effective ways to overcome ADHD bedtime procrastination?
Bedtime procrastination can be a common problem for children with ADHD. To overcome bedtime procrastination, try to establish a consistent bedtime routine and stick to it. Use a very simple visual schedule to help your child move from one task to another. For example, first go upstairs, then find pyjamas and put them on, then brush teeth.
Is exercise before bed helpful for children with ADHD?
Exercise can be beneficial for children with ADHD, but it is important to avoid exercising too close to bedtime. Exercise can increase alertness and make it harder for your child to fall asleep. Encourage your child to engage in physical activity earlier in the day, such as before or after school or in the early evening before 7pm.
How can I improve my child’s morning routine with ADHD?
To improve your child’s morning routine with ADHD, establish a consistent wake-up time and morning routine. If possible, calm your child’s nervous system before you start the routine, for example with 3 minutes of slow, deep breathing. For best results use a simple visual schedule. Avoid rushing your child and give them plenty of time to get ready.
Dr Lucy Russell is a UK clinical psychologist who works with children and families. Her work involves both therapeutic support and autism assessments. She is the Clinical Director of Everlief Child Psychology, and also worked in the National Health Service for many years. In 2019 Lucy launched They Are The Future, a support website for parents of school-aged children.
Through TATF Lucy is passionate about giving practical, manageable strategies to parents and children who may otherwise struggle to find the support they need.
Lucy is a mum to two teenage children. She lives in Buckinghamshire with her husband, children, rescue dog and three rescue cats. She enjoys caravanning and outdoor living, singing and musical theatre.
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