In this article, we’ll explore:
- The importance of a good bedtime routine
- The 6 ways ADHD can impact sleep
- 10 top sleep tips to try - including relaxation strategies and keeping a sleep diary
- 7 strategies to help your child with ADHD get to sleep
Sleep and ADHD have a complex relationship but taking steps to improve sleep can also help to improve some of the symptoms of ADHD. Sleep plays a crucial role in supporting good mental health and helps us to regulate emotions. In turn, this supports better decision making.
It is thought that 1 in 20 people have a diagnosis of Attention Deficit Hyperactivity Disorder or ADHD as it is more commonly referred to. People with ADHD may be restless, have difficulty concentrating, act impulsively and often experience sleep problems.
In this article, we’ll take a look at some of the ways ADHD can impact sleep, along with 10 top sleep tips to try. If you’re a parent of a child who has ADHD, you’ll find 7 strategies to improve your child’s sleep routine.
ADHD and sleep problems
There can be a number of reasons that those diagnosed with ADHD have difficulty with sleep. Here are some common sleep problems:
Unable to switch off at bedtime
A common reported sleep difficulty is being unable to fall asleep due to having an overactive mind.
Feeling restless
Many people with ADHD report restlessness. There may be many reasons for this, including an underlying sleep disorder.
More likely to suffer from sleep disorders
Sleep disorders such as sleep apnoea and restless legs syndrome are more common in those with a diagnosis of ADHD.
Getting distracted easily
People with ADHD may get distracted. This can make it hard to stick to a sleep routine.
Medication affecting sleep
Certain medications can impact sleep. For instance, they can make it harder to fall asleep, or make you feel hungry during the night.
Difficulties starting the day
Many people who have ADHD report that they often don’t manage to fall asleep until late. When the alarm goes off in the morning, they can find it really hard to wake up.
How does ADHD cause restless sleep?
When individuals with ADHD have finally managed to nod off, many report restless sleep. Sleep may not be refreshing, due to moving frequently during the night.
This restlessness can be caused by a number of factors including underlying sleep disorders. It is important to try to work out what may be causing restless sleep and then to take appropriate action.
Here are some tips to try:
- Keep your bedroom cool - around 16-18 degrees is helpful
- Avoid caffeine after lunchtime
- Speak to a healthcare practitioner if you suspect a sleep disorder may be to blame
ADHD and sleep disorders
Sleep disorders tend to be more common in those with a diagnosis of ADHD. These sleep disorders can include sleep apnoea and restless legs syndrome.
ADHD and sleep apnoea
Research suggests around 3% of the population have sleep apnoea. However, 25% of those with ADHD have sleep apnoea or some other sleep disordered breathing difficulty.
ADHD and restless legs syndrome
Restless legs syndrome involves a strong urge to move your legs in the run up to bedtime. The sensation is often unpleasant and makes it difficult to sleep. Around 2% of the population will experience this, yet 44% of those with a diagnosis of ADHD have restless leg syndrome.
Speak to an expert
Always share concerns about your sleep with a healthcare professional. They can then refer you to the appropriate service for an assessment.
10 tips to improve ADHD sleep problems
Here are 10 top sleep tips to help improve ADHD sleep-related problems, help you fall asleep faster and get a better night’s sleep.
1. Stick to regular sleep and wake times
Many people with ADHD find that getting up to start the day can be an enormous challenge. Try to go to sleep and wake up at the same time every day of the week - even on weekends!
2. Keep to a set routine
People with ADHD can often get distracted easily. This can mean it’s challenging to stick to a routine. Even when a good routine is planned, it can soon go amiss without lots of cues and support to keep it on track.
Here are some tips to try:
- Start your bedtime routine one hour before you go to sleep
- Remove screens an hour before bedtime - they can be mentally stimulating and the blue light omitted from them can wake you up
3. Build relaxation strategies into your evening
An ADHD mind can be a busy mind and it can be incredibly difficult to switch it off at bedtime. For this reason, both children and adults can both benefit from having some relaxation strategies to help them to calm their minds at night time.
Here are some relaxation techniques to try:
- Try repeating a meaningless word such as ‘the’ over and over again
- Consider using an app such as Headspace
4. Avoid caffeine after midday
Caffeine can be very mentally stimulating and it can prevent you from falling asleep. Try to avoid caffeine - especially after midday - to ensure that it’s all out of your system by the time you go to bed.
5. Get plenty of natural light
It’s important to open the curtains and expose yourself to natural daylight when you wake up. This helps to suppress melatonin - a hormone that makes you feel sleepy.
In the dark winter months it can be hard to get exposure to enough natural light, so it might be worth investing in a light box. A light box is a device that emits a bright light that stimulates your brain in a similar way to natural light.
6. Keep a sleep diary
A sleep diary is a set of notes that some people keep to record how well they’re sleeping and their sleep habits. You could note down when you go to bed, what time you wake up, if you were restless in the night, whether you take any medication and so on.
You could keep a sleep diary and share it with practitioners involved in your care. They may be able to offer suggestions and support.
7. Talk with your doctor if you have any concerns about medication
Certain medications can affect sleep. For instance, stimulants are often prescribed to manage ADHD symptoms. If taken too late in the day these can have a knock-on effect, making it harder to fall asleep. Always talk to a healthcare professional if you have questions about medication affecting your sleep.
8. Have a supper time snack
Hunger can be an issue as stimulants may suppress the appetite. Add supper time into your routine to help keep hunger pangs at bay in the middle of the night.
9. Make your bedroom a relaxing place
Your bedroom should be a place you associate with sleep and relaxation. A calm environment will help you to drift off to sleep that little bit easier.
Here are some ideas:
- Remove any distractions, including your laptop
- Switch off your TV and put your phone on silent mode
- Add some fluffy pillows and a cosy blanket
10. Keep your bedroom cool
It can be difficult to get to sleep if it’s too warm, so having a cool bedroom around 16-18 degrees can help you fall asleep. Try opening the windows to keep your bedroom cool.
Do children with ADHD have trouble sleeping?
Children with ADHD can have specific difficulties with sleep.
They may:
- Find it harder to fall asleep
- Have trouble staying asleep
- Resist bedtime
If you have a child with ADHD, do try to put a routine in place. A recent research study carried out by the team at The Sleep Charity (in partnership with Sheffield Children’s Hospital and Sheffield Local Authority) found that behavioural intervention resulted in on average an additional 2.4 hours sleep per night.
How to get a child to sleep with ADHD
There are a number of strategies that you can try to help your child sleep better and encourage a good bedtime routine.
1. Gradually move bedtime forward
Children with ADHD may find it harder to fall asleep at the start of the night. If you put them to bed earlier, they may find it hard to nod off.
You could keep a sleep diary for 2 weeks and work out the average time they’re falling asleep - it may be much later than you would like.
You could use this as a guideline:
- Use the average time they fall asleep as a guide and aim to have them in bed for that time
- Once they fall asleep within 15 minutes, move bedtime 15 minutes earlier
- Repeat this process until they are falling asleep easily at a more appropriate time
2. Keep the bedroom calm
Children with ADHD often have sensory processing issues. Think about whether your child is particularly sensitive to noise or light and how this may impact their sleep.
Here are some strategies you can try:
- A white noise machine may help to mask background noise
- Blackout curtains may stop early wakings by blocking light entering the room
- Close the curtains in the run up to bedtime - this can help their body create melatonin, the sleep hormone
3. Plan a relaxing activity one hour before bedtime
It may be tempting to try to wear your children out before bed out but it can have the reverse effect. So, if you can, try to avoid physical activity leading up to sleep time. Instead, you could opt for more calming fine motor skill activities for them to do.
Example of fine motor skills activities include:
- Jigsaws
- Craft activities
- Colouring in
4. Add supper time into the bedtime routine
If your child takes medication for their ADHD, it may suppress their appetite. This can mean they wake due to hunger in the night. Adding in supper time to their bedtime routine may help. Slow-release carbohydrates such as porridge make a great bedtime snack.
5. Praise good behaviour!
Remember to praise your child during the routine and reinforce what they have done well. For example, you could say: “Well done for turning off your Xbox so calmly.”
Using positive language such as the ‘when – then’ rule can help. A good example of this is: “When you have tidied up your toys then you can play outside”. Try this instead of “You aren’t playing outside until you have tidied your toys”.
6. Try using a timetable
Bedtime resistance is a common issue in all children and particularly those who have an ADHD diagnosis. Some youngsters find using a visual timetable helps them to know what’s coming next and feel calmer during the routine.
7. Use a visual cue
Think about using a visual cue in the bedroom so that your child knows when it’s time to get up. A lamp on a timer switch works well. This teaches them that when the light is off it’s still sleep time and when the light is on they can get up.
When to get further help
Trying to get to sleep with ADHD symptoms can be tricky, but hopefully the advice suggested in this guide can help improve your sleep routine. If you’re looking for some more tips to get to sleep faster and the effects on sleep and mental health, why not check out our accompanying articles?
If you have any concerns about ADHD affecting your sleep, talk to your healthcare professional or GP. They will be able to provide specialist advice. Alternatively, the following charities can offer help and support:
