It’s 11 pm and you’ve gone into your child’s room for the 5th time. You stay calm, you rub his back AGAIN, tell him to look at the stars painted on the ceiling, and just try to sleep. After nights of yelling, punishing, bribing, and begging you realize in your frustration that he is not trying to defy you, he’s not just trying to make you crazy, HE JUST CAN’T FALL ASLEEP!
What’s up with that? Well, for kids who have ADHD, sleep disorders are not uncommon. In fact, studies have shown that between 25 % and 50 % of children and adolescents diagnosed with the ADHD have clinically reported sleep problems. This can include difficulty falling asleep, staying asleep, and waking up from sleep.
If your child is among those who suffer from sleep difficulties, there is no doubt you are aware of the problems such suffering can create. Too little sleep may profoundly exacerbate ADHD symptoms. Being chronically tired can make one irritable and less able to face the stressors and expectations of their day. Compound this with their inherent difficulty regulating their emotions and it makes for a troublesome situation. The continual stress it places on the parents and caretakers trying to help the child manage sleep can negatively impact family relationships across the board.
What causes the problem?
Children’s reluctance or inability to settle into sleep at a designated time may be due to many different factors. One issue may be biological. There is evidence that the circadian rhythm (our internal clock related to light-dark cycles) may be delayed in some people with ADHD. A second issue may be related to ADHD medication side effects, although approximately one-third of medication-free children who have ADHD have difficulty falling asleep. A third consideration may be related to a lack of or inconsistent nighttime routine for winding down and getting to bed at a regular time. [see https://www.sleepadvisor.org/adhd-and-sleep/ for additional factors] But by and large, it seems that much of the difficulty in regulating sleep may be due to the ADHD itself. Many children and adults with ADHD report that it is often easier for them to concentrate in the evening when they are less interrupted by the people and environmental stimuli of the day. Some report that the opposite is true, that in the quiet of the evening their mind is full of a bombardment of thought and they get all revved up. And many remain awake stimulated by hyper-focusing on reading, surfing the net, or computer gaming.
What to do to encourage sleep
Your best resource to figure how what to do is your child. As with any area of concern, start with a nonjudgmental inquiry as to what their insights might be as to what is making falling asleep or waking up so difficult. A conversation during the day, far away from the bedtime hours, that starts off with a simple “I notice that you often have a hard time falling asleep. What’s up?” They may not be aware themselves, but the important message here is that you are not looking to punish or control, rather to understand and help.
Here are some other practical things that you can consider doing:
- Get a sleep study at a qualified center to rule out any medical issues.
- Speak to your Psychiatrist about adjusting the medication schedule. Perhaps adjusting the medications themselves if depression or anxiety are co-existing conditions with the ADHD.
- With your doctor’s okay, give your child Melatonin. Melatonin is a hormone released by the brain in response to the setting of the sun that has some function in setting the circadian clock. It is available as a supplement that can be purchased without a prescription at most pharmacies and health food stores.
- Develop a consistent routine for winding down and ending the day.
- Dim the lights 30 minutes before bed.
- Shut off electronics 1 hour before bed. Computer games, especially ones with active moving objects where the images are likely to repeat in your child’s head long after the computer is off, can be too stimulating. Talk about a substitute method for winding down.
- Avoid scary shows or books in the evening that may induce too many anxious thoughts.
- Experiment with soft music or a white noise machine.
- Stay away from chocolate and other caffeinated products for several hours before bedtime.
- Let your child take a warm bath in the evening.
- Lie down with your child to help them transition to a calm, sleepy state.
- If sleep is occurring way too late on a regular basis, adjust the schedule by no more than 20 minutes earlier every few days to bring to a more appropriate time.
Difficulty Waking Up
Sleep difficulties as I mentioned at the beginning of this blog are not restricted to issues related to falling asleep. For some families, that’s only half the battle. READ MORE about Difficulty Waking up. Rest easy!
Clocky: A fun and crazy alarm clock on wheels. It jumps from a 3-foot high nightstand, and then off it runs in different directions every day, bumping into objects, changing direction again, and beeping until you wake up, get out of bed and turn him off.
Sonic Bomb Alarm Clock: can be set super loud, has lights that flash, and has a vibrating disk to shake the bed.
Phillips Wake-Up Light: as a light that goes on gradually 30 minutes prior to the time the alarm goes off.
Written by Cindy Goldrich, Ed.M., ACAC Certified ADHD Parent Coach Originally published in SOS Research, http://sos-research-blog.com/11/sleep-difficult-kids- with-adhd © 2010, SOS Research. All rights reserved. Articles may be reproduced or electronically distributed as long as attribution to SOS Research is maintained.