Why sleep is important for children and teenagers with ADHD

Getting enough quality sleep is essential for growth, development and learning in children and teenagers.

It can also help children and teenagers with attention deficit hyperactivity disorder (ADHD) to:

• concentrate at school
• manage their emotions
• feel less feel moody and irritable.

How does ADHD affect sleep?

Children and teenagers with ADHD often have trouble with things like falling asleep, staying asleep, and waking up earlier or later than they want to. ADHD affects sleep for several reasons.

Difficulty ‘switching off’

ADHD characteristics might make it difficult for children and teenagers to calm down and feel ready for sleep at bedtime.

For example, active or racing thoughts or hyperfocus might make it hard for your child’s brain to ‘switch off’. And unpredictable energy levels might mean your child has a surge of energy at night. As a result, your child might refuse to go to bed at bedtime, or they might go to bed but get up repeatedly.

Irregular body clocks

Children and teenagers with ADHD are more likely to have irregular body clocks or circadian rhythms.

For example, your child might have a late body clock, meaning they fall asleep later, wake up later or struggle to get out of bed in the morning. Or they might wake very early. Either way, they’re probably not getting enough sleep.

Other conditions

Some conditions that occur with ADHD can affect sleep.

For example, if your child has anxiety or worries at night, it might be hard for them to feel calm and ready for sleep. Or if your child snores or has obstructive sleep apnoea, they might wake a lot during the night. Or restless legs syndrome might mean your child finds it hard to get to sleep and stay asleep.

ADHD medicines

Some medicines that are used to treat ADHD can affect sleep. For example, some stimulant medicines for ADHD can wear off in the late afternoon or evening, which leaves children feeling energised and hyperactive at bedtime. This can make it harder for them to fall asleep.

Better sleep tips for children and teenagers

There are healthy habits that can help with school-age and pre-teen sleep and teenage sleep. They include:

• regular and appropriate nap times and bedtimes
• a consistent and positive bedtime routine
• a safe and comfortable sleep environment
• healthy eating, physical activity and natural light during the day
• no caffeine after 3 pm
• an hour of screen-free time before bed
• sleep relaxation strategies.

If your child with ADHD has sleep problems, you could look at whether changes in any of these areas might help with their sleep.

For more information and tips on helping your child go to bed, get to sleep, stay in bed and wake up on time, you can check out our 10 tips for better sleep, 20 sleep FAQs and illustrated guide to better sleep.

Strategies to help your child with ADHD get to sleep

Sometimes children and teenagers with ADHD need extra help to go to bed, get to sleep, stay in bed and wake up on time. The following strategies can help. You might have to try a few things to see what works best for your child.

Anxiety strategies

If your child is anxious or worried at night, try to find a time during the day to talk with them about their worries. Listening to and acknowledging your child’s feelings is key. Older children might find it helps to write their worries in a journal.

If worries about the next day make it hard for your child to relax for sleep, encourage them to prepare and get organised the night before. Routines can help with this.

Bedtime fading

Bedtime fading helps move your child’s body clock earlier.

This strategy starts with getting your child to bed at the time they’re naturally falling asleep. Every few days after that, you move your child’s bedtime earlier by 15 minutes. Keep your child’s wake time the same each morning, and make sure they get plenty of natural light during the day.

Bedtime pass

A bedtime pass can help your child with staying in bed.

This strategy involves giving your child a ‘pass’ that’s good for one acceptable request, like a drink of water. After your child uses the pass once, they must give it to you. If your child doesn’t use the pass, they can use it the next day or in exchange for a reward.

Bedtime passes work well alongside other strategies like bedtime fading and checking in.

Calming strategies

Calming their thoughts, muscles and breathing can help your child feel ready for sleep.

Breathing exercises, mindfulness exercises and muscle relaxation exercises can help your child with this. You and your child can do these exercises together, or you could help your child learn how to do them on their own. It’s good to make these activities part of your child’s bedtime routine.

Camping out

Camping out can help if your child has difficulty staying in their bedroom without you. This strategy involves sitting next to your child’s bed and slowly moving your chair further away from your child’s bed over a period of 7-14 nights.

Checking in

Checking in can help your child with staying in bed. This strategy involves checking on your child at set intervals until they fall asleep and then gradually extending the time between check-ins over a few days.

Rewards

If your child is trying to change their sleep habits, it’s good to praise and reward them for their efforts. Rewards can be things like choosing a movie for family movie night or having an extra trip to the park.

Falling asleep might be outside your child’s control, so it’s important to reward your child for trying rather than for falling asleep.

Snacks

Children with ADHD who take long-acting stimulant medicine might not eat much during the day and might be hungry or thirsty at bedtime or after bed. If your child takes this type of medicine, it might help to offer your child a snack before bed – for example, warm milk with honey and a piece of wholegrain toast.

If your child is older, it’s good to involve them in choosing and using sleep strategies. For example, you and your child could talk about what they think might work for them and what they can do to help sleep strategies go well.

When to get help with ADHD sleep problems

If your child with ADHD has sleep problems, it’s good to try healthy sleep habits, positive bedtime routines and sleep strategies first.

If your child’s sleep hasn’t started to improve after 2-4 weeks, it’s best to talk with your child’s GP. They can rule out medical or other problems. If necessary, they can also refer you to a paediatrician, a psychologist or another health professional experienced in treating children’s sleep problems.

Your child’s doctor might also prescribe melatonin supplements, which raise the level of melatonin in the body. This might help your child with falling asleep at night and maintaining their body clock from day to day.

If the way your child sleeps and settles is making things hard for you, it’s important to look after yourself by eating well, resting when you can, doing some physical activity and seeking support.