Sleep, Interrupted: The ADHD-Insomnia Link in Children (2023)

Jessica is a handful by daylight, and most observers outside her home heave a sigh for her parents that the day will eventually be done with, and night and sleep will be on the way. Ahhh! Sleep and quiet. But in reality, many parents of children with ADHD say that the night is filled with agitation, restlessness and sleeplessness, and the calm after the storm isn’t as tranquil as outsiders would like to believe.

In other words, the biology that helps define a child with ADHD doesn’t shut down at the stroke of 9 p.m. In fact, psychiatrists and sleep researchers are trying to understand whether the common ADHD sleep issues among children are cut from the biology of the behavioral disorder or a result of the mix of medicines these children have to take to calm their symptoms. In fact, there are researchers who are studying the possibility that the irritability, hyperactivity and inattentiveness of ADHD may, for some, be due to a lack of sleep.

Unfortunately, the jury is still out.

“Children with ADHD are so wound up that it takes them a long time to turn their motor off,” said Dr. Gabrielle Carlson, director of child and adolescent psychiatry at the State University of New York at Stony Brook. “It might seem that their energy level is there all the time.”

But what Carlson and others who work ’round-the-clock with severe ADHD, see is that children on Stony Brook’s inpatient unit sleep, well, like babies. They have no problems falling asleep — or staying asleep. “With structure, a lot of the sleep problems disappear.”

[Your Free Essential Guide: Sound Sleep Solutions for Kids with ADHD]

Canadian psychologist Rosemary Tannock and her research colleague, Penny Corkum, recently documented this in Tannock’s laboratory at the Hospital for Sick Children in Toronto. “We couldn’t find evidence that sleep was an integral part of the ADHD picture,” she said. The real culprits: the separation anxiety that many kids with ADHD share; stimulants; and a lack of a consistent bedtime routine.

Corkum added that the children with ADHD didn’t look different from those children with anxiety and other symptoms of mental illness. But Corkum, who is now at Mount St. Vincent University in Halifax, Nova Scotia, also said that shorter sleep times are generally related to more attention problems. “If your mind is racing, it is difficult to go to sleep.”

She believes that medicines could play an important role in keeping some children up and helping others to settle down. “If a child is suffering at night, you might want to look at an alternate dosing schedule.”

In the study, the scientists recruited 30 children with ADHD, and this was a special group of children whose parents said had severe sleep problems. An equal number of kids without ADHD were brought in to compare sleep patterns during a 7-day study. The children slept in their own beds and wore a wrist device, much like a watch, that records virtually every body move the child makes. The children and parents also kept sleep diaries throughout the week. Children with ADHD had no more movements than the kids without.

[Read: End the ‘I Can’t Sleep’ Cycle of Exhaustion]

The researchers also looked for evidence of restless leg syndrome, the symptom de jour these days, and it was not a problem in the kids with ADHD who were studied. People who have restless leg syndrome describe it as an uncomfortable sensation — crawling, tingling, pulling or twitching feeling — that begins right before they fall asleep and forces them to move their leg. Some investigators believe there is a link between RLS and ADHD and one theory is that both share a lack of the brain chemical dopamine. Dopamine regulates movement as well as behavior and mood.

But these children clearly took longer getting to sleep, and had greater difficulty getting up in the morning. In fact, the kids with ADHD slept longer than the other children, suggesting that they need more sleep to integrate and store a brain system that Tannock says is “overloaded” during the day.

She has seen parents pull their hair out (figuratively, of course) trying to get their child to sleep. They use more requests, and there is far more follow-through. Over and over again. “Kids with ADHD are difficult to organize and the symptoms make it difficult to do things in a timely matter,” she explains.

Tannock and her colleagues can’t rule out the possibility that different medicine regimens in the United States may color another sleep picture for American children. Ritalin and other ADHD medicines are often used three times a day whereas in Canada it is given twice a day. What she is hoping to study is whether the high anxiety in these children — one third of them constantly worry about being alone — can be treated to overcome nighttime problems. Addressing the anxiety should be separate from treating the ADHD attention and hyperactivity problems, experts agree. Many now teach coping strategies so children can recognize “worry” symptoms — the racing heart, the agitation — and use mental exercises to help them go away.

Anyone who has ever lost a lot of sleep knows that concentration falls, memory slips and a bit of crankiness is justified. Isn’t that why we don’t want our kids staying up until all hours at a sleepover?

Researchers in Sydney, Australia are taking a different research road to understand ADHD and sleep problems. Dr. Arthur Teng and his colleague, Grant Betts, are studying 50 children in the sleep medicine unit at Sydney Children’s Hospital. Their theory is that these children are overly restless, cranky and uncontrollable simply because an underlying sleep problem is depriving them of a healthy sleep.

The researchers are testing children diagnosed with mild ADHD before and after they receive treatment for sleep disorders to see whether behavioral symptoms improve. The common sleep problems among these children: snoring and apnea, which is disrupted breathing. They believe enlarged tonsils and adenoids may cause sleep apnea, the periodic missed breaths during the night.

The Australian researchers have already completed the first part of testing on a few dozen children, and that includes memory and attention tests prior to treatment for their sleep disorders. They also obtain extensive parent and teacher ratings on behavioral and attention issues. Four months after the treatment, the children will be retested to see whether their ADHD problems have lessened.

This is just one theory — and needs proper testing before anyone makes the great leap to sleep treatment to rule out ADHD. In fact, John Harsh at the University of Southern Massachusetts is also testing whether children with ADHD are sleepier in the daytime than children without ADHD. During a recent meeting of the Associated Professional Sleep Societies, held in Chicago, Dr. William Orr, an Oklahoma City sleep specialist, said that he also believes that treating sleep disorders improves daytime behavior in children.

“ADHD seems to be a 24-hour condition, disrupting daytime and sleep,” says Lynne Lamberg, co-author of The Body Clock Guide to Better Health. Most people, she adds, “think about behavioral treatments but not the basic physiology and how that contributes to the symptoms.” During the recent sleep meeting, she listened to French researchers describe how giving Ritalin and similar medicines in the evening paradoxically decreases activity during sleep.

Dr. Ronald Chervin is acting director of the University of Michigan’s Sleep Disorders Center and a leading expert in ADHD and sleep. Chervin says that scientists are testing the idea that a child with ADHD has a biological clock, the body’s internal ticker that tells us when to fall asleep, that may be slightly off. A recent study by Reut Gruber of the federal National Institute of Mental Health in Bethesda reported that children with ADHD have a more varied sleep schedule than children without the behavioral disorder. Gruber found that children without ADHD fell asleep at roughly the same time during a five-day study period, within 40 minutes of lights out. But the children with ADHD had a very erratic ‘falling to sleep’ schedule, two to three times longer than the children without. The study was published in the April issue of the American Academy of Child and Adolescent Psychiatry.

The bottom line in all of these studies is this: Parents should tell their child’s doctor about sleep patterns, and ask if there is anything they can do to better help their child fall asleep at night.

Children need anywhere from 9 to 11 hours of sleep nightly, and it doesn’t take a scientist to tell you that the nation’s sleep debt is great. Last February, the federal government embarked on an educational campaign to promote healthy sleeping habits in children. (See the American Academy of Child and Adolescent Psychiatry‘s signs of sleep deprivation, below.)

No one knows why humans require sleep for at least a third of their day. There is strong evidence that sleep is restorative, the body needs quiet time each day to process the activities of the day. Scientists have discovered that dreams, which take place during a period of sleep called Rapid Eye Movement or REM, are important for learning and memory.

Rosemary Tannock advises parents that the best way to avoid sleep problems is to secure a set bedtime and make it pleasurable. “The child should know that at a specific time every night they can expect to be alone,” she says. “Give a 10-minute warning and then share a pleasant activity with your child. And make sure they have water before they can ask for it. Make it a relaxing routine.”

Signs of Sleep Deprivation

  1. Frequent awakening during the night
  2. Talking during sleep
  3. Difficulty falling asleep
  4. Waking up crying
  5. Daytime sleepiness
  6. Nightmares or bedwetting
  7. Teeth grinding or clenching

Source: American Academy of Child and Adolescent Psychiatry

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Is insomnia a symptom of ADHD in children? ›

Most studies on the subject suggest that ADHD can cause difficulty sleeping. For example, the research from 2014 suggests that 50–95% of children with neurodevelopmental disorders, including ADHD, have trouble sleeping. Behavioral insomnia is the most common cause, according to this research.

What is the relationship between sleep problems and ADHD in children? ›

How common are sleep problems in children with ADHD? Up to 70% of children with ADHD suffer from problems with their sleep. Almost half the parents of a child with ADHD say that their child has moderate to serious sleep problems. Children with ADHD may have behavioural sleep problems or medically-based sleep problems.

Is there a link between ADHD and insomnia? ›

Conclusion: Insomnia disorder is highly prevalent in adult ADHD and is related to higher ADHD severity and more psychiatric and medical comorbidities. Some stimulants and stable pharmacological ADHD treatment are associated with better outcomes of insomnia disorder.

Why are people with ADHD prone to insomnia? ›

Along with medications and trouble sticking to a schedule, there are other reasons people with ADHD are at risk for insomnia. You may get a burst of energy at night, along with racing thoughts that make it hard to get to sleep.

What helps kids with ADHD fall asleep? ›

8 Sleep Tips for Kids with ADHD and Asperger Syndrome (ASD)
  • Exercise daily and avoid trigger foods. ...
  • Stick to a schedule. ...
  • Set a bedtime alarm. ...
  • Use white noise and blackout curtains. ...
  • Try aroma therapy. ...
  • Reduce anxiety. ...
  • Sleep with a weighted blanket. ...
  • Consider melatonin.

What sleep disorder is associated with ADHD? ›

ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian-rhythm sleep disorders).

Is melatonin good for ADHD? ›

According to one study, children with ADHD were able to sleep longer and fall asleep faster after taking melatonin daily combined with their ADHD medication over several weeks. Additionally, I have young patients who take melatonin on a daily basis, and I've also worked with kids and teenagers who take it regularly.

Do ADHD kids wake up early? ›

For instance, as many as 70% of children with ADHD struggle to fall asleep at night. Children with ADHD might also wake up early in the morning, which can throw everyone in the family off of their routine.

Does caffeine help ADHD? ›

Some studies have found that caffeine can boost concentration for people with ADHD. Since it's a stimulant drug, it mimics some of the effects of stronger stimulants used to treat ADHD, such as amphetamine medications. However, caffeine alone is less effective than prescription medications.

How much melatonin should someone with ADHD take? ›

The ADHD nervous system doesn't [understand] time.”He recommends taking a melatonin dose of 1 mg or less. And you need to remember to take it every night, which can be hard for people with ADHD, he warns.

Which ADHD med is best for insomnia? ›

We find the Daytrana patch helpful for those with stimulant-induced insomnia, because it's the only medication that can be shut off early (by removing the patch). In other cases, we find that treating the sleep problem directly is a better long-term solution than eliminating the stimulant.

Does melatonin help ADHD kids sleep? ›

Conclusion. In children with ADHD with sleep problems after receiving MPH treatment, melatonin may be an effective and safe treatment, irrespective of gender, age and comorbidities.

What can I give my child instead of melatonin? ›

Don't want to use melatonin to help your lil' bub fall asleep? No problem. There are a bunch of melatonin-free sleep aids that'll have your kiddo counting sheep in no time. Essential oils like lavender and chamomile are well-known for their calming scents that lull adults and children alike into a deep sleep.

What does Benadryl do to someone with ADHD? ›

In short, antihistamines interfere with the metabolism of the stimulant medication. As a result, cognitive performance may be below what the person experienced when their ADHD was untreated. Thus, when taken together, antihistamines and stimulants can make symptoms worse.

What helps people with ADHD sleep? ›

ADHD-Friendly Bedtime Activities

A simple, consistent, relaxing routine before bed helps prepare your body for sleep. Your bedtime routine might include activities like these. Drinking a warm cup of tea: Many people find that a cup of warm chamomile or “sweet dreams” tea helps promote a good night's sleep.

What is the best vitamin for ADHD? ›

Finally, supplementing vitamins B and C can also help alleviate ADD and ADHD symptoms. Vitamin C, like zinc, iron, and magnesium, is used to produce neurotransmitters like dopamine. Additionally, vitamin B deficiency is linked to irritability and fatigue in children.

What foods to avoid with ADHD? ›

Some of the common foods that can cause ADHD reactions include milk, chocolate, soy, wheat, eggs, beans, corn, tomatoes, grapes, and oranges. If you suspect a food sensitivity may be contributing to your child's ADHD symptoms, talk to your ADHD dietitian or doctor about trying an elimination diet.

Does B12 help with ADHD? ›

CONCLUSION: Vitamin B12 and iron support may be useful in treatment of childhood ADHD, especially for learning problems, besides medication.

When Does ADHD peak in children? ›

The symptoms may peak in severity when the child is seven to eight years of age, after which they often begin to decline. By the adolescent years, the hyperactive symptoms may be less noticeable, although ADHD can continue to be present.

Are weighted blankets good for ADHD? ›

Weighted blankets are a tool occupational therapists (OTs) often recommend for kids with ADHD, SPD, and autism spectrum disorders to help with calming. The weight is intended to provide proprioceptive input to the brain, which has a calming and organizing effect on the central nervous system.

How many hours do kids with ADHD sleep? ›

Switch Off All Devices. ADHD teen brains need 8 to 10 hours of sleep a night. Since most classes begin before 8 am, that means aiming for a 9 pm bedtime. Teens should avoid heavy meals and vigorous exercise, as well as electronic screen use, an hour before bedtime.

Is melatonin safe for kids with ADHD? ›

In children with ADHD with sleep problems after receiving MPH treatment, melatonin may be an effective and safe treatment, irrespective of gender, age and comorbidities.

What are the signs of insomnia in a child? ›

Your child might have insomnia if they:
  • struggle to wake or refuse to get out of bed in the morning.
  • nap for long periods during the day or fall asleep at school.
  • sleep at different times from day to day.
  • lack energy or constantly feel tired in the day.
  • struggle to concentrate or remember information.
Jul 1, 2022

What are the signs of ADHD in a child? ›

Hyperactivity and impulsiveness
  • being unable to sit still, especially in calm or quiet surroundings.
  • constantly fidgeting.
  • being unable to concentrate on tasks.
  • excessive physical movement.
  • excessive talking.
  • being unable to wait their turn.
  • acting without thinking.
  • interrupting conversations.

Why can't my 6 year old fall asleep? ›

For many children, their difficulties falling or staying asleep stem from their daytime habits or how they spend their time right before bed. Eating too much sugary food during the day, for example, or watching TV right before bed could be enough to disrupt your child's sleep.

Why is melatonin not recommended for kids? ›

For example, there are concerns about how it might affect a child's growth and development, particularly during puberty. Studies have also found that morning sleepiness, drowsiness, and possible increased urination at night are the most common side effects that occur while taking melatonin.

Can I give my child melatonin every night? ›

Some experts recommend against giving melatonin gummies to children and teens on a regular basis because melatonin is a hormone and may have an impact on development or puberty.

What causes severe insomnia in children? ›

anxiety or stress. a medical, mental health or developmental condition such as asthma, depression, attention-deficit/hyperactivity disorder (ADHD) or autism. certain medications, such as steroids or antidepressants. caffeine, found in many types of soda and energy drinks.

What are the 2 most common sleeping problems for children? ›

Common sleep disorders in children include sleep apnea and insomnia, as well as parasomnias, which are disruptive sleep-related behaviors such as sleepwalking and night terrors. Sleep disorders in children, especially parasomnias, are not likely to persist past adolescence.

Do children outgrow insomnia? ›

The findings show that 43 percent of children who had insomnia symptoms continued to have them throughout the study. Around 27 percent of children with insomnia symptoms did have remission in adolescence, though. However, 19 percent had a “waxing and waning” insomnia pattern by the time they reached adulthood.

Is ADHD inherited from mother or father? ›

You can inherit genes that boost risk for ADHD from your mother, from your father or from both parents. In a recent Norwegian study, inherited risk was somewhat higher when a child's mother had ADHD compared to their father, but researchers weren't certain why that would be.

What triggers ADHD in children? ›

Risk factors

Blood relatives, such as a parent or sibling, with ADHD or another mental health disorder. Exposure to environmental toxins — such as lead, found mainly in paint and pipes in older buildings. Maternal drug use, alcohol use or smoking during pregnancy. Premature birth.

What not to give a child with ADHD? ›

Foods to Avoid With ADHD
  • Candy.
  • Corn syrup.
  • Honey.
  • Sugar.
  • Products made from white flour.
  • White rice.
  • Potatoes without the skins.
Jun 14, 2021

What are the bad side effects of melatonin? ›

The most common melatonin side effects include: Headache. Dizziness. Nausea.
Other, less common melatonin side effects might include:
  • Vivid dreams or nightmares.
  • Short-term feelings of depression.
  • Irritability.
  • Stomach cramps.
  • Diarrhea.
  • Constipation.
  • Decreased appetite.
  • Urinary incontinence at night.

How do you test a child for insomnia? ›

No tests should be needed to diagnose child insomnia. The child's history of going to sleep and waking is normally enough to pinpoint this disorder. Actigraphy could be used in extreme cases.

What happens if a 7 year old doesn't get enough sleep? ›

Insufficient sleep means not getting enough sleep at night, which can cause several problems including decreased brain development, learning problems and more frequent negative emotions. It can also contribute to weight management problems, growth issues and increased frequency of illnesses.


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