My 11-year-old with ADHD doesn’t seem to be able to wind down at night. He’s up very late. I’m worried that he isn’t getting enough sleep, but I don’t know what to do about it.
You’re not alone — this is something I hear from parents often in my work as a psychologist. I totally understand your concern. Getting a good amount of sleep is important for all kids. But it might help to know that it’s quite common for kids (and adults) with ADHD to struggle with sleep. And there are things you can try to do that might help your child learn to wind down at night and be more ready for sleep.
These strategies may not always work, and that’s OK. Some kids with ADHD just may not be able to get to sleep as early as they should. Their difficulty slowing down at night is due to some of the brain differences that cause other ADHD symptoms.
Kids with ADHD have trouble regulating their brain’s centers of arousal and alertness. These are the areas that impact attention. But they also regulate sleep.
There are no quick fixes to eliminate sleep problems. But there are steps you can take, and changes you can make, to start making improvements.
The first thing to do is make sure there isn’t a medical reason (something other than ADHD) for your child’s sleep problems, like sleep apnea. Signs of that condition include loud snoring and pauses in breathing. Talk to your child’s doctor to rule this out.
Another important step is to take note of the amount of stress or anxiety in your child’s life. Stress or anxiety can make it hard for anyone to wind down at night. (If anxious thoughts are keeping kids up at night, try keeping a journal next to their bed so they can write down those thoughts and get them out of their head before they fall asleep.)
If it turns out there are no other obvious causes, here are some ways to help your child wind down at night and, hopefully, get more sleep.
Explain that there’s a problem. Kids don’t always realize that what they’re experiencing isn’t normal, or that there’s a reason for it. Naming the problem can help your child be a partner in fixing it. You can say something like, “You really seem to be struggling with falling asleep. Lots of kids with ADHD have trouble with this. Let’s talk to the doctor to get some ideas for what we can do.”
Help set the stage for sleep. Make sure the room is dark (a little night-light is fine, but much more than that can be a distraction) and that the room temperature helps your child fall asleep. Colder rooms tend to be better for sleeping than warmer ones, but this can vary from person to person.
Use relaxation rituals. Getting into the habit of doing relaxing things before bed can also help teach your child’s brain to slow down. These might be a relaxing bath, bedtime stories, or stretching. Make sure your child only uses the bed for sleeping and for quiet activities, like reading or listening to quiet music. And stop doing things close to bedtime that get in the way of sleep, like having intense emotional conversations, watching TV, playing video games, eating big meals, or drinking caffeine.
Keep an open dialogue. Talk to kids about what’s going on in their life. Stressful situations can affect sleep. These might include bullying, trouble adjusting to a new teacher, family problems at home, a death of a family member or a pet, or even sibling rivalry. Fixing the sources of stress — or at least acknowledging and talking about them — can have a positive impact on your child’s sleep.
Consult with your child’s doctor. If your child takes ADHD medication, talk to the doctor about whether it may be affecting sleep. Would changing the timing of the medication or the dosage help with winding down at night? Medication for sleep problems is usually a last resort. But there are some good options that are worth talking about with your doctor if other changes aren’t helping.
Consult a sleep expert. Sometimes sleep problems persist no matter what you do. At that point, you might want to talk with a doctor who specializes in treating sleep disorders. This specialist will have tips and resources to help you. The treatments include many of the suggestions mentioned above, but the doctor will help you tailor it to your child. The doctor will also offer support to you during what can be a trying time.
Change your daily routines. A few small changes to daily life can make a big difference in the quantity and quality of sleep your family gets. Regular exercise, outdoor time, and watching what and when you eat are just a few ideas.
Getting too little sleep can impact kids’ ability to perform at school, along with their health, mood, and judgment. So any success you have in helping your child wind down and get more sleep can have a positive impact. It will likely make it easier for your child to pay attention during the day. In fact, some studies have shown that treating sleep issues might be a key part of comprehensive treatment for ADHD.
At the same time, don’t stress out if the changes you and your child make aren’t always successful. Your stress may only increase your child’s. And that can make it harder for your child to wind down at night and get enough sleep.
Looking for more tips? Follow these steps to getting your grade-schooler or tween or teen on a healthy sleep schedule. If your child takes ADHD medication, take a look at signs it may need fine-tuning.
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About the author
About the author
Ellen Braaten, PhD is the director of LEAP at Massachusetts General Hospital.