Many parents notice that their child with Attention-Deficit/Hyperactivity Disorder (ADHD) has trouble getting enough sleep, whether that's due to early waking or challenges in falling asleep. Can ADHD cause insomnia in children, and what can you do to help your child with ADHD sleep better?
Insomnia is a sleep disorder that is characterized by difficulty falling asleep, staying asleep, or waking up earlier than intended. Insomnia can range in severity, and it can have a serious impact on all areas of a person's health and life overall. It can affect people of all ages, and it is common.
General population statistics reveal that about 30% of adults will experience insomnia on a short-term basis, whereas 10% live with long-term, chronic insomnia. ADHD can further complicate and increase the likelihood of problems with sleep.
ADHD and Sleep
ADHD can make it hard to fall asleep, stay asleep, and get as much sleep as the body needs overall. The link between ADHD and sleep problems, including insomnia, is well-researched. One study, which looked at 252 adults who live with ADHD, found that 44.4% of the group had insomnia.
The prevalence was higher for those with combined presentation ADHD, who face insomnia at a rate of over 64%. It was also noted that various factors, such as the severity of ADHD symptoms and the diagnosis of other disorders in an individual (including anxiety disorders and mood disorders, both of which are common comorbidities seen in those with ADHD) can heighten the risk of trouble sleeping.
Another study on adults with ADHD found that inattention symptoms and hyperactivity symptoms are both affiliated with insomnia and impacted sleep duration.
However, the fact that trouble sleeping is common among those with ADHD doesn't mean that there aren't risks or consequences. Studies show that those with a combination of ADHD and insomnia are at an increased risk for lower productivity and quality of life, and we know that lack of sleep can raise the likelihood of serious negative health outcomes.
Negative health outcomes that are connected to lack of sleep include but aren't restricted to a heightened risk of daytime tiredness, getting into a car accident, having a stroke, heart disease, depression, and anxiety. It's also linked to lower performance at work and higher utilization of healthcare services.
Can ADHD Cause Difficulty Sleeping in Children?
It's clear that, for adults, ADHD and trouble sleeping are intertwined, but can ADHD cause difficulty sleeping in children? All signs point to "yes." It's not just adults who live with ADHD who face insomnia at a higher rate - the same is also very true for children.
In fact, it's said that somewhere from 55% to 74% of parents report problems with sleep in children with ADHD. If you notice symptoms of insomnia, or other sleep problems, in your child with ADHD, you most certainly aren't alone. It's also worth noting that kids with insomnia are likely to continue to struggle with insomnia as an adult.
The good news is that insomnia and other sleep-related health concerns are often highly treatable. So, as a parent, what can you do?
Helping Your Child with ADHD Sleep Better
Helping your child with ADHD sleep better is possible. Here are some things to try:
Set A Consistent Daily Routine
Look not just at what your child is doing before bed, but throughout the day, that could impact their sleep. Routines are incredibly important for children with ADHD. Consistent, supportive daily routines can set children up for success and aid healthy sleep patterns.
This can include waking up at around the same time each day, including on weekends, taking certain steps to get ready for the day every morning (taking medication early on, getting dressed for school, etc.), engaging in homework and chores at a certain time, getting adequate nutrition and hydration throughout the day, and so on.
Engage In Active Hobbies
Physical activity can support all areas of health, including sleep duration and quality. This is true for kids and adults alike. Kids with ADHD may have more energy than their peers do.
Accordingly, it may be crucial for a child to have an outlet for their energy, such as a sport, or other avenues for movement, such as playing outside. Physical activity also supports mood and focus, which may be an added bonus, especially when it comes to ADHD.
Research shows that even just 20 minutes worth of aerobic activity improves math and reading comprehension in children with ADHD as well as their counterparts who do not live with ADHD.
Use Calming Activities Before Bed
Adding activities that help your child wind down as a part of their bedtime routine can be highly beneficial, especially if your child is someone who finds it tough to relax in the evening, whether that's due to ADHD symptoms or something else. Calming activities may include but aren't limited to:
- Breathing exercises.
- Reading (depending on a child's age, you might read to your child, or they may read by themselves).
- Meditation or stretching (there are child-friendly meditations, yoga, and stretching activities you can try).
- Drinking caffeine-free tea.
- A warm, relaxing bath.
Once you find what works for your child, you can make it a consistent part of their nighttime routine.
Limit Technology Usage At Night
Blue light is linked to trouble sleeping due to the effects it has on the production of melatonin, a naturally occurring sleep hormone. Kids with ADHD are at a higher risk of gaming addiction, which may be worthwhile to note.
Experts generally say to put technology away at least one hour before bed, although some parents opt for two hours before bed to stay on the safe side.
Check On Sleep Hygiene Practices
Limiting technology usage is only one part of sleep hygiene. Other significant sleep hygiene practices can include but aren't necessarily restricted to making sure that the space your child sleeps in is cool in temperature, dark, and clean and limiting caffeine.
If your child has sensory issues or expresses potential sensory issues, it may be important to make sure that their bedding and pajamas are comfortable and do not exacerbate them.
Identify Triggers For Poor Sleep
Many things can impact sleep quality and a person's ability to fall asleep. Identifying specific triggers that make it more difficult for your unique child to fall asleep, or otherwise get the sleep they need, can be helpful.
For example, where some kids struggle with restlessness due to hyperactivity, for another, there could be a trigger, like feelings of anxiety or nervousness, which might be exacerbated by talking about certain topics (IE, once that show up in scary movies or books late in the day). This way, you can avoid or address these triggers.
If difficulty with sleep persists, or if it is severe, make sure to consult with your child's doctor. There are a number of treatments that can help, ranging from therapy (most often, this will be cognitive behavioral therapy for insomnia, which may be abbreviated to CBT-I), and medication to alternative interventions.
ADHD Medication and Sleep
Stimulant medications are frequently used and prescribed for ADHD. One of the most common possible side effects of stimulant medication prescribed for ADHD is trouble sleeping. This doesn't mean that ADHD medication isn't helpful; it most certainly is.
Stimulant medications work for 70-80% of people with ADHD. Instead, it's generally suggested that you look out for changes in sleep patterns that could be caused by medication.
For example, if your child's insomnia symptoms began or worsened when they started taking ADHD medication, it is something to discuss with their prescribing doctor. They may adjust the time that your child takes their medication (which can have an impact in some cases), or they may suggest other changes.
It can be dangerous to stop, start, or change medication regimens without the approval and guidance of a professional, so make sure to consult with a child's prescribing doctor before you make any changes.
Other Causes of Insomnia
Due to the fact that those with ADHD are very likely to live with a comorbid or co-occurring condition or concern, it may be relevant to look into other possible causes of insomnia.
There are many different possible causes and risk factors for insomnia. These can include but aren't limited to anxiety disorders, obsessive-compulsive disorder, trauma and post-traumatic stress disorder, substance use disorders, and various physical ailments or conditions.
A pediatrician should be able to diagnose these things or refer you to someone who can. Sometimes, other sleep disorders and related concerns, like restless leg syndrome, can impact the ability to fall asleep, stay asleep, and get quality sleep. Interestingly, restless leg syndrome, like insomnia, is seen at higher rates among those who live with ADHD. Once the cause of insomnia is determined, you can get adequate treatment and care for your child, which may include non-invasive, at-home remedies.
The conclusion? Sleep is vital for overall wellbeing, and if insomnia is a challenge for you or your child, there are answers. Don't hesitate to try different practices until you find what works best, and consult with a professional for individualized advice.