Sleep and ADHD

Getting a full night of sleep is important for all children. It is especially important for children with diagnosed or suspected ADHD. When children do not get enough sleep, it can make problems worse. Sleep is related to ADHD in many different ways. This handout will give you an overview of the relationship between sleep and ADHD.

Sleep problems can look like ADHD:

• When children do not get enough sleep, they can develop problems. Sometimes these problems can look like ADHD. Sleep deprived children can have a hard time focusing and paying attention (a main symptoms of ADHD).
• Your child's doctor may ask about your child's sleep habits during an ADHD evaluation.
• You may be given steps to improve your child's sleep habits before a diagnosis of ADHD is made.
• In some cases, improving sleep habits can reduce problems that were thought to be ADHD.

Children with ADHD can have sleep problems:

• The symptoms of ADHD can make it hard for your child to fall asleep at night.
• Children with the hyperactive presentation of ADHD can have an especially hard time falling asleep. It may be hard for these children to slow down, relax and drift off to sleep.
• Children with ADHD may also have racing thoughts that make it hard to fall asleep at night.

Sleep problems can be a side effect of ADHD medication:

• Stimulant medications are widely used to treat ADHD. However, the "stimulating" effect can have a negative impact on sleep. Children taking stimulants may report not feeling tired when it is time to go to bed. When they try to fall asleep they may toss and turn. Ultimately, these children may not be able to get a full night of sleep.
• Sleep problems may suggest that children are taking stimulant medication too late in the day. Switching when you give the medication to the beginning of the day can improve sleep.
• For some children, however, stimulants can actually improve sleep.
• Talk to your child's doctor if you are concerned about sleep as a side effect of ADHD medication.

For children with ADHD, sleep problems can make symptoms of ADHD worse:

• Not getting enough sleep can make it even harder to focus for a child with ADHD.
• Sleep problems can get so bad that children are falling asleep at school. This can make school problems even worse.
• Poor sleep also increases irritability, which can make problems at school and home worse.

Make getting a good night's sleep a priority for your child! Most children need 8-12 hours of sleep per night. If your child is not getting enough sleep or has sleeping problems, use the sleep tips below to help your child get the sleep he/she needs.

Sleep tips:

• Have a set bedtime that is not too late. Stick to it every night.
• Have a bedtime routine. For younger children, this may be giving your child a bath and reading books before you tuck your child in bed. Older children can be more independent in their bedtime routine, but still need adult supervision. They may take a shower, read for 15 minutes in bed, then get a "good night" from mom and dad. A good bedtime routine is not too long or too short. It should involve 2-3 things. As a parent, you need to set limits during bedtime routine. Children may beg for you to read "just one more story," but really need parents to says "no more stories tonight, it's bedtime."
• Make sure your child feels safe and secure. If your child is scared at night, installing a nightlight may help.
• Be sure your child's bed is comfy and cozy. Have the number of blankets and pillows your child likes.
• Keep your child's room cool at night. Setting the thermostat between 65 and 70 degrees can help your child sleep.
• Have your child fall asleep on his/her own. If your child falls asleep with you patting his/her back, he/she will expect you to be there in the middle of the night to help in falling back to sleep. If your child wakes and is upset in the middle of the night, check in with him/her but encourage falling asleep alone.