Sleep Challenges in Children With ADHD


Chris Iliades, MD

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Talking With Your Doctor About ADHD Treatment

As soon as you learn that your child has attention deficit hyperactivity disorder (ADHD), start talking to the doctor about treatment. 
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Sleep problems are common in children with attention deficit hyperactivity disorder (ADHD). Up to half of all parents with a child who has ADHD say their child has trouble with sleep. Most often they have trouble getting to sleep and staying asleep.

The reasons for this vary. Children with ADHD might have sleep problems because of their symptoms or the stimulant medications they take to treat ADHD. Sometimes, other medical problems interfere with their sleep.

You can help your child overcome sleep challenges. This starts by understanding what might be getting in the way of a good night's sleep for your child. It also requires working closely with the child's doctor to deal with the issues.

Sleep Challenges and Stimulant Drugs

Stimulant drugs are the most common, safest, and most effective way to treat ADHD in children. Doctors have been prescribing them for a long time. They help about 85% of the children who take them.

These drugs affect a child’s brain like a cup of coffee affects an adult’s brain. It’s no surprise, then, that problems with sleep are a common side effect. However, you and the doctor can manage this side effect by:

  • Giving the child the drug earlier in the day
  • Trying a shorter-acting drug that wears off before nighttime
  • Using a low dose of a short-acting stimulant at night to help the child get organized for bed
  • Using a mild sleep-aid medication if the doctor agrees. Do not try any over-the-counter sleep aids without first checking with the doctor.

Medical Conditions That Disrupt Sleep

Medical conditions that lots of children have can make sleep a challenge for children with ADHD. These include allergies, asthma, and sleep apnea. Any of these can make it hard for a child to breathe at night. Make sure the doctor knows if you notice that your child has trouble breathing when in bed. Treating these conditions can help make sleep easier.

Sleep apnea can be a special problem. It's a condition that causes loud breathing at night. The child goes through periods when breathing stops for a few seconds. This can happen many times a night. The result is poor sleep and often tiredness during the day. Sleep apnea also can make ADHD symptoms worse. Doctors can test for this condition, so be sure to talk to the child's doctor if you notice any signs that might mean sleep apnea.

At Your Appointment

Questions to Ask Your Doctor About ADHD

Sleep Management for ADHD

ADHD symptoms like hyperactivity and difficulty focusing can make bedtime a challenge on their own, even without stimulant side effects or other health problems. That makes good bedtime habits very important for all children with ADHD.

Ways to improve sleep for children with ADHD include:

  • Have a routine: Going through the same bedtime rituals every night helps children know it's time for sleep.
  • Create a sleep sanctuary: Make sure the child’s bedroom is quiet, comfortable, cool and dark. Keep toys, games and TVs out of the bedroom. Make the bedroom a place for sleeping only.
  • Avoid bad bedtime habits: Don’t hold your child until he or she falls asleep. Also, don't let your child leave the bedroom at night. Provide a gentle reminder to use the bathroom before bed.
  • Be consistent: Keep a strict time for both going to sleep and waking up. Keep this routine all 7 days of the week.
  • Avoid caffeine: Offer your child drinks without caffeine instead of sodas, tea or cocoa. Do this especially starting in the afternoon.
  • Reward success: Offer praise and reward your child for a successful bedtime routine and a full night of sleep.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 19, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

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Medical References

  1. ADHD and Coexisting Conditions: ADHD, Sleep and Sleep Disorders. National Resource Center on ADHD, 2007. Accessed Feb 18, 2014.
  2. What Can I Do When My Child Has Problems With Sleep? American Academy of Pediatrics, 2002. Accessed Feb 18, 2014.
  3. ADHD Parents Medication Guide (pages 17-19). American Academy of Child & Adolescent Psychiatry, Jul 2013. Accessed Feb 18, 2014.
  4. ADHD Medications. An Overview, Children and Adults with Attention-Deficit/Hyperactivity Disorder, 2006. Accessed Feb 18, 2014.

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