My Child With ADHD Can’t Wind Down at Night. What Can I Do?

By Ellen Braaten

My 11-year-old with ADHD doesn’t seem to be able to wind down at night so 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.

Ellen Braaten

Director, Learning and Emotional Assessment Program, Massachusetts General Hospital

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. Your child just may not be able to get to sleep as early as he should. That’s because his difficulty slowing down 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 his sleep problems, such as 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 son’s life. These might also make it hard for him to wind down. (If anxious thoughts are keeping him up at night, he could try keeping a journal next to his bed to write them down before he falls asleep in order to get them out of his head.)

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 is 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 helps 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 and see if she has ideas for what we can do.”
  • Help him get into the right mindset for sleep. Many kids with ADHD need help learning how to do this. Make sure your son only uses his bed for sleeping and quiet activities, like reading or listening to quiet music. Make sure his room is dark (a little night-light is fine, but much more than that can be a distraction) and that the temperature is one that is sleep-inducing. Colder rooms are better for sleeping than warm ones, but this can vary depending on your child.
  • Create clear transition rituals. Getting into the habit of doing relaxing things before bed can also help teach his brain to slow down. These might be a relaxing bath, bedtime stories or stretching. And eliminate things that get in the way of sleep: intense emotional conversations, TV, video games, big meals, caffeine.
  • Keep an open dialogue. Talk to your son about what’s going on in his 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 just sibling rivalry. Fixing the sources of stress—or at the very 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, discuss whether it may be keeping him from winding down, and what you can do about it. Would it help to change the timing of the medication or the dosage? 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. She will also offer support to you during what can be a trying time.
  • Change the routine. 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 him 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 his. And that makes it harder for him to wind down at night and get the sleep he needs.

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.

About the Author

Portrait of Ellen Braaten

Ellen Braaten is the director of the Learning and Emotional Assessment Program at Massachusetts General Hospital.

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