Bedtime & Sleep

Snoozefest: Tricks for An Easier Bedtime

Kids with ADHD are three times less likely to get enough shut-eye than their friends. Learn how a bedtime schedule, relaxation techniques, and keeping the bedroom dark can help them fall asleep easier.

Tired girl with ADHD sleeping while studying
Tired girl with ADHD sleeping while studying

Getting a good night’s sleep can be a big problem for children who have attention deficit hyperactivity disorder (ADHD). Research has shown that 20 percent of these children have difficulty falling or staying asleep. That’s three times the rate among children who don’t have the condition.

A study from England has found that sleep problems are also common among parents of kids with ADHD. In the study, which involved 100 parents of children five to 17 years of age, 57 percent of the parents slept six hours or less, with 27 percent getting less than five hours. More than half of the kids got up at least four times during the night. Forty-two percent of the kids woke up before 6:00 a.m.

It doesn’t take much to figure out what’s going on here: When children are awake, it’s hard for parents to get any shuteye.

Sleep deprivation affects adults the way it affects kids: It makes them irritable (and sometimes depressed), impatient, and less efficient at just about everything they do. Adults who haven’t gotten a good night’s sleep are more likely to miss work. And sleep-deprived parents aren’t very good at managing their children.

The Biology of Sleep

There’s a biological reason why children with ADHD tend to sleep less than kids without the condition: Many of the same regions of the brain regulate both attention and sleep. A child who has attention problems is likely to have sleep problems, as well.

You can’t change your child’s biology. But there are ADHD-friendly strategies to help kids overcome their sleep problems. Here’s what I tell parents:

Steer clear of sleeping pills.

Most sleep medications that work well for adults haven’t been adequately tested for their safety and effectiveness in children. That goes for the over-the-counter sleep aid melatonin, as well as prescription sleeping pills.

Doctors sometimes prescribe clonidine for children who have trouble falling asleep. The drug does make it easier to fall asleep, but its sedating effect lasts for only about six hours. Most kids who take it awaken around two o’clock in the morning.

Set a realistic bedtime.

Accept the fact that your child may need less sleep than other kids his age. If you put him to bed too early, there’s a chance that he’ll just lie there, wide awake, for an extended period of time. That will make him anxious — and will only increase the likelihood that he’ll climb out of bed and disturb your sleep.

Whatever bedtime you establish, enforce it consistently — on weekends as well as during the week. Letting your child stay up late on Friday and Saturday nights will disrupt his circadian clock; come Monday morning, he’ll wake up with something akin to jet lag.

The hour or so leading up to your child’s bedtime should be devoted to reading, listening to music, or some other calm, relaxing activity. Allow him to have a snack (he won’t be able to sleep if he’s hungry). Violent TV programs and video games should be strictly off-limits at this time. No roughhousing, either.

Keep the bedroom completely dark.

In addition to cueing your child that it’s time to go to sleep, darkness eliminates the visual distractions that keep him from falling asleep. If a child can’t see his toys, he’s less likely to get out of bed to play with them.

What if your child is afraid of the dark and needs a light on to fall asleep? Make sure that the light is dim, and that it goes off once he falls asleep (use a timer or shut it off yourself before you go to bed). Having a light on in the room after midnight will trigger the waking cycle.

Look into relaxation techniques.

Deep breathing or listening to soothing music can make it easier to fall asleep. Research shows that kids who do yoga are less hyperactive. (You can learn more about yoga’s calming effect on kids from Yoga Journal.)

When a child refuses to go to bed…

Some children with ADHD — especially those who also suffer from oppositional defiant disorder or an anxiety disorder — will do anything to avoid going to bed. If you do manage to get them to go to bed, odds are, they’ll be up and about a short time later.

If this describes your child, your best bet may be a behavioral approach: Give strict orders for your child to stay in bed between certain hours, and sit outside her bedroom door to make sure she stays in bed.

If your child gets up, calmly tuck her back into bed. Then, in a soft but firm voice, remind her that it’s time to go to sleep. Reassure her that you will be nearby in case she needs you. After a few nights of this routine, she will come to understand that resisting is futile — and you’ll no longer have to sit vigilantly outside her door.

Use caution with this approach; it can be stressful for parents, as well as children. Don’t attempt it unless you and your partner both feel confident that you have the resolve and the stamina to follow through. If you allow your child to break the rules, even once, you’re sunk. Deviating from the rules is permissible only in the case of illness or some other special situation.

Dealing with a child’s sleep problem isn’t easy, but it’s worth the effort. Given the consequences of chronic sleep problems-for the entire family — it’s best to take action sooner rather than later.

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