How Does Sleep Affect Children with ADHD?

What you need to know

• Children with ADHD commonly experience sleep problems that can worsen attention, behavior and learning
• Sleep issues include trouble falling asleep, resisting bedtime, night wakings, and daytime sleepiness
• Behavioral interventions and good sleep habits can help improve sleep in children with ADHD

The Sleep-ADHD Connection

Picture this: It’s bedtime, and while other kids are drifting off to sleep, your child with ADHD is still wide awake - tossing, turning, and struggling to settle down. If this sounds familiar, you’re not alone. Sleep problems affect many children with ADHD, creating a frustrating cycle where poor sleep worsens ADHD symptoms, and ADHD symptoms make it harder to sleep well.

A comprehensive review of over 148 studies, involving more than 42,000 children, reveals just how common and impactful these sleep challenges can be. But there’s good news too - understanding the connection between sleep and ADHD can help parents and healthcare providers better support these children.

Common Sleep Challenges

Children with ADHD often face several sleep-related hurdles. They may strongly resist bedtime, take longer to fall asleep, wake up frequently during the night, and feel excessively sleepy during the day. Parents report their children with ADHD often need more support around bedtime, like having a parent stay with them until they fall asleep or keeping lights on.

The problems aren’t just behavioral - researchers have found differences in sleep patterns and brain activity during sleep in children with ADHD compared to their peers. These children often get less total sleep time and experience more restless sleep with frequent movements and disruptions.

Impact on Daily Life

Poor sleep doesn’t just make kids tired - it can significantly affect their daily functioning. When children with ADHD don’t sleep well, they often have:

• More difficulty paying attention and controlling impulses
• Increased emotional reactions and behavioral problems
• Poorer memory and academic performance
• Greater challenges in social situations

Research shows that improving sleep can help reduce ADHD symptoms and improve overall functioning. It’s a two-way street - better sleep helps manage ADHD symptoms, and better managed ADHD symptoms often lead to improved sleep.

The Role of Daily Rhythms

Our bodies have natural daily (circadian) rhythms that help regulate sleep and wake patterns. Some studies suggest these rhythms may work differently in children with ADHD. They might release sleep hormones like melatonin at different times, or have variations in their natural body clock that make it harder to maintain consistent sleep schedules.

This can explain why many children with ADHD seem to get a “second wind” at bedtime or have trouble waking up in the morning. Understanding these biological differences helps explain why standard bedtime advice may not always work for children with ADHD.

What Helps Improve Sleep

Research has identified several strategies that can help improve sleep in children with ADHD:

1. Consistent bedtime routines that help signal it’s time to wind down
2. Regular sleep and wake times, even on weekends
3. A calm, dark, and quiet sleep environment
4. Limited screen time before bed
5. Physical activity during the day (but not too close to bedtime)
6. Behavioral therapy focused on sleep habits

Some children may also benefit from medication adjustments or additional treatments like melatonin supplements, but these should always be discussed with healthcare providers.

What This Means for You

If you’re parenting a child with ADHD who struggles with sleep, know that you’re dealing with a real and common challenge. The research shows that sleep problems aren’t just a behavioral issue - they’re often tied to the underlying neurobiology of ADHD.

Working with your child’s healthcare providers to address sleep challenges can be as important as managing other ADHD symptoms. Don’t hesitate to bring up sleep concerns during medical visits, as improving sleep could have wide-ranging benefits for your child’s daily functioning and quality of life.

Conclusions

• Sleep problems are a core challenge for many children with ADHD, not just a side effect
• Poor sleep can worsen ADHD symptoms while good sleep can help improve them
• Consistent sleep routines and good sleep habits can make a significant difference
• Working with healthcare providers to address sleep issues should be part of ADHD management