I need a glass of water.

Just one more story?

Mommy, I had a bad dream.

Every parent faces bedtime-stalling tactics and sleep problems from time to time. But if your child has attention deficit hyperactivity disorder (ADHD or ADD), settling down for sleep and getting a good nights rest may be a daily challenge with serious health consequences.

Many American families today struggle to get enough sleep. A poll by the National Sleep Foundation, for example, found that more than one-third of parents report that scheduled evening activities impede a good nights sleep for their child. Whats more, one in four parents report that homework made it more difficult for their child to get a good nights sleep at least once in the preceding seven days. Add in the artificial light and noise from media, available at all hours of the day and night, and its a wonder any of us get any sleep.

The symptoms of ADHD exacerbate all of the things that make sleep difficult and elusive for so many people. Children and teens with ADHD are hypersensitive to environmental stimuli and their bodies react more strongly, making it harder to turn off their brains and settle down for sleep.

In addition, poor sleep is a self-fulfilling prophecy. Just one night of bad sleep can make a childs inattention and opposition even worse the next day, in turn making it even more difficult to get ready and settled for sleep the next night. The pattern repeats indefinitely if not arrested.

Patients may experience a vicious cycle of poor sleep exacerbating ADHD symptoms, which in turn make sleep worse. Poor sleep can also negatively affect learning and memory. Several studies in the past decade have found that.1,2

The reality is that kids learn as much during sleep as they do when theyre awake. Sleep is when learning is actually consolidated.

Sleep is critical, and hard to come by we get it. But what can parents do to help their children and teens overcome ADHD sleep problems?

Parents working through ADHD-impacted sleep issues should begin by consulting their childs physician.

Some ADHD stimulants can make sleep worse, so its important to talk with your provider about the time your child is taking the medication, how long the stimulants are lasting, when they are wearing off, and how they are affecting the childs sleep. Some stimulants have actually been shown to improve sleep in patients with ADHD, so talking with your healthcare provider about this is very important.

Assuming a childs sleep issues are not being caused by stimulant medications, parents should adopt a behavioral perspective and focus on basic sleep hygiene for children.

Its important to put both time and space boundaries around sleep, making it a special action that we want our kids to learn to do. That means starting the bedtime routine early enough to ensure adequate sleep for the childs age.

For school-age children, for example, start the bedtime routine by 7:30 pm at the latest to ensure children get the recommended 10 to 12 hours of sleep their bodies require. Sticking to a regular and consistent bedtime routine perhaps ending with some kind of positive ritual that the child enjoys reading a book, singing a song, saying prayers, or talking about the best part of their day can also help create a positive association with bedtime.

We want the childs brain to learn that going to bed and sleeping are where something nice happens and it feels good, he says.

ADHD teen brains need 8 to 10 hours of sleep a night. Since most classes begin before 8 am, that means aiming for a 9 pm bedtime. Teens should avoid heavy meals and vigorous exercise, as well as electronic screen use, an hour before bedtime. This means no texting, social media, or video games after 8 pm, which will no doubt be controversial in most households. The blue light from electronic screens affects the bodys pineal gland and actually physiologically decreases our production of melatonin, the hormone that regulates the sleep-wake cycle. Popular blue-light glasses filter the light, which may decrease the effects of screens on that hormone production, they cant take away the stimulating effects of media itself.

Even if blue-light glasses solve one piece of the problem, they arent going to help the body and the brain really relax and get ready for the sleep cycle. Modeling this no-screens-after-8 policy can be one of the most effective ways that parents can make this rule stick. Its also important to make it clear that the child is not in trouble and putting away phones at 8 is not a punishment, but rather a strategy for getting healthy and functioning well tomorrow.

If working together with your child is not helping to solve sleep issues, or if they do appear to be getting enough sleep and are still showing symptoms of being sleepy, its time to consider a formal evaluation by a sleep specialist. This may indicate a more serious sleep disorder such as sleep apnea or restless legs syndrome. The good news is that, for nearly all sleep disorders, there are effective treatments to help children and teens get the rest they need.

The content for this article came from the webinar titled Sleep and the ADHD Brain: Why Its Critical and How To Get More.

1 Sandoval, M. , Leclerc, J. A. and Gmez, R. L. Words to Sleep On: Naps Facilitate Verb Generalization in Habitually and Nonhabitually Napping Preschoolers. Child Dev. (2017). doi:10.1111/cdev.12723

2 Axelsson, E. L., Swinton, J., Winiger, A. I., & Horst, J. S. Napping and toddlers memory for fast-mapped words. First Language (2018).https://doi.org/10.1177/0142723718785490

Updated on October 23, 2019

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Treating ADHD Sleep Problems in Children and Teens - ADDitude

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