How Can You Help Your Child with ADHD Sleep Better?

 
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There are many challenges to parenting children with ADHD. I often characterize living with ADHD as being similar to learning to drive a race car- it can perform well when given the best conditions (open track with no limits), but it can really struggle when stuck in stop-and-go traffic with slow speed limits. One of the basic factors that can contribute to regulating well during the day is the ability to sleep well at night. Here are a few simple changes that can really help:

Get them in the dark. We need to be in a period of darkness to allow for melatonin production, and the darkness needs to be sustained throughout the sleep period. This is true across the lifespan, and even simple devices like nightlights or lights left on in the hallway can suppress overall drive for sleep. Encourage your child to have some strategies for feeling safe at night that don’t involve light, such as a favorite stuffed animal or a reassuring scent.

Weigh them down. Our proprioceptive system needs to feel that we will be secure in our sleep environment, and this can be even more impactful for kids with ADHD. Firm touch, much like swaddling an infant, creates this feedback. Some kids can really like the sensation of a weighted blanket, but I often find that they can make kids a little too hot. I like some of the sensory sheets that have been developed that create a tight sensation in the bed without the sense of heat. In our house, we use a massive stuffed animal (could also be a body pillow) to create the sensation of being pressed down.

Have a consistent bedtime routine. A bedtime routine prepares our brain for its next important task: sleep! Across the lifespan, we see increased consistency in sleep and decreased time to fall asleep when there is a very consistent bedtime routine. This is a good opportunity to spend a few minutes debriefing about the day, and working through any worries or stressors that your child may have. For adolescents, this can be an independent process, but it can be good to make it a stable time to connect, even for just a hug.

Avoid devices in the bedtime routine. An American Academy of Pediatrics study demonstrated significant sleep issues in adolescents when they were exposed to devices near bedtime. A good rule for school-age children is not to watch TV or be on devices after dinner, whereas tweens and adolescents need to put away their devices at least an hour before bed. In some households, it can make sense to have a Wi-Fi curfew to aid in this process- there is less of a fight when the shutdown happens automatically.

Keep the same schedule 7 days per week. I know that this seems like an impossible proposition with adolescents in particular, but sleeping well is related to consistency with your brain’s clock system (circadian rhythm). If they stay up later on the weekend, you can let them compensate by napping rather than having them sleep in. This will reinforce their normal wake time so that they can focus on Monday mornings.

Avoid caffeine. Some parents are told that caffeine can be a good replacement when stimulant medications are not an option or have worn off, but this is not really a good choice when it comes to sleep. It can take up to 12 hours for caffeine to metabolize, so an afternoon pick-me-up can end up wrecking sleep. A study by the National Sleep Foundation demonstrated that caffeine consumption in children reduced sleep by 15 minutes, along with the 45 minutes that were suppressed with exposure to devices. Yes, the impact seems minor, but studies consistently demonstrate an inverse relationship between caffeine consumption and hours slept.

Regular meals. If your child takes medication for ADHD, it is possible that medication suppresses their appetite during the day, and skipping meals can affect ability to sleep well at night. Try to get them to eat breakfast before they take their medication and talk with them about what foods could be desirable during the day, even if they might not feel hungry. Try not to have too much of their eating happen at or near bedtime, as this can delay sleep onset and affect sleep continuity.

Managing ADHD is complex, and needs change as the brain develops, but sustaining sleep will help make sure that the race car starts each day with a relatively full attentional tank. 

Excerpts of this blog were originally posted on www.psychbytes.com.

Kristin Daley, Ph.D.