With children back in school, that means parents are grappling with getting their children on a regular sleep routine. But for parents with children who have been diagnosed with ADHD, that’s no small task.
As many as 70% of children with ADHD experience problems with sleep. The issues include bedtime anxiety or resistance, insomnia and delayed sleep – meaning their sleep cycle has shifted and they aren’t tired at bedtime.
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Kristin Mock, MD, is a family practice physician at OSF HealthCare who specializes in ADHD and pediatric sleep issues. She sees patients whose behaviors are often linked to ADHD; but they could also be a result of a lack of sleep.
Unlike adults who have excessive sleepiness and fatigue, Dr. Mock says children with ADHD tend to have more behavioral issues such as acting out or temper tantrums. They have difficulties with behavior and focus and concentration, and they tend to get fidgety.
So that begs the question – is the issue ADHD or a sleep problem or a combination of both?
“If your child has ADHD, there is a high likelihood they have comorbid sleep dysfunction and mental health dysfunction,” says Dr. Mock. “We need to treat the whole of the child and make sure that we've looked at all of those reasons that people can have concentration deficits and treat all of that to give them the best potential.”
Dr. Mock adds that not getting enough sleep can cause or make ADHD symptoms worse. And that means improving a child’s sleep issues can help reduce symptoms.
“So, when the brain is tired, it tries to find ways to get it to stay awake. It will go from one task to the next. It will jump from here to there. It will stutter and sometimes forget things,” she says. “Children will get very fidgety to keep their brain awake. So, while your brain is trying to just get through to the next time it gets to sleep, it makes you not as effective.”
Dr. Mock says the most common referral to her clinic comes from teachers who inform parents that their child lacks focus in the classroom. “Then it's our job to figure out why,” she says. “What’s really going on? Are they tired or are they just a little differently wired?”
Mock says parents can help by discouraging any use of electronics once your child has gone to bed. That means there is no iPhone, iPad or TV in their bedroom and no texting, social media or video games, which will not go over well with many teens.
She also recommends encouraging children to go to bed and wake up at the same time every day. Most children require seven to nine hours of sleep every day and teens with ADHD need about eight to 10 hours. Dr. Mock adds children need two weeks to gradually get back into a good sleep routine now that school has started.
It's also important to get a handle on your child’s medication. Some ADHD stimulants can make sleep worse so talk to your child’s care team about how they are affecting your child’s sleep. And if your child is snoring, Dr. Mock says their doctor should make a detailed sleep history or a make a referral to a sleep specialist.
“Parents need to pay attention to their children's sleep,” Dr. Mock says. “Physicians are often worried about finding the big diagnosis, and they may not realize that the child is not sleeping well. And so, parents need to be able to tell their doctor. Hey, I'm concerned about the way my child is sleeping, or my child is snoring. Can we do more?”
