
Did you know that on average, humans spend about one-third of their lifetime, or 229,961 hours, sleeping? That’s a lot of hours! Sleep is an important part of our physiology and it’s no wonder we spend so much time sleeping. During sleep, our bodies essentially reset by carrying out important functions such as clearing waste and repairing damage to our cells. Sleep is also important for our brain development, especially during childhood. Sometimes, neurodevelopmental disorders in childhood can reduce sleep quality and lead to lasting consequences.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects children and adults worldwide. While ADHD is associated with issues such as inattention, hyperactivity, impulsivity, and irritability, many children with ADHD also experience sleep disturbances. These sleep disturbances can exacerbate ADHD symptoms leading to a challenging cycle that affects children’s well-being and daily functioning.
The Link Between ADHD and Sleep Disturbances
Research suggests that children with ADHD are more likely to experience a variety of sleep disturbances, including:

- Difficulty Getting into Bed/Falling Asleep: Many children with ADHD struggle to wind down at night and resist going to bed which can lead to prolonged sleep onset latency.
- Insomnia: Children with ADHD may experience trouble staying asleep and have early awakening.
- Frequent Nighttime Awakenings: These children may wake up multiple times during the night, disrupting their sleep continuity.
- Restless Sleep: Some children experience restless leg syndrome or other conditions that cause a restless night.
- Daytime Sleepiness: Due to poor sleep quality, children with ADHD may demonstrate daytime sleepiness, further impairing their attention and behavior.
- Anxiety: Children may experience increased feelings of anxiety at bedtime preventing onset of sleep and may affect sleep quality.
- Sleep associations: Some children with ADHD may need a certain thing or person present to fall asleep and then may have difficulty staying asleep if that factor is removed during the night.
Poor sleep can worsen symptoms of ADHD. This leads to a vicious cycle. Lack of sleep can lead to increased hyperactivity, reduced attention span, and irritability. This makes it harder for children to fall and stay asleep. As this cycle continues, this can have a negative impact on their academic performance, emotional regulation and quality of life.
Strategies to Improve Sleep Quality in Children with ADHD

- Establish a Consistent Bedtime Routine: A bedtime routine can help children prepare mentally for sleep. The routine should include steps that are predictable and calming. These activities may include taking a warm shower or bath, reading a book, and/or listening to soothing music.
- Create a Sleep-Friendly Environment: To limit distractions, parents should create a calm and quiet environment in their children’s bedroom. Ensure their bedroom is dark, cool, and free of electronic devices. Novel research has also shown that the use of a weighted blanket may also help children with ADHD sleep better.
- Limit Screen Time before Bedtime: Discontinue the use of electronic devices at least 2 hours before bedtime in order to help children wind down from the stimulation from their screens. Encourage non-screen activities prior to bed instead, such as reading a book.
- Physical Activity: Encourage regular psychical activity during the daytime in order to reduce hyperactivity at night and promote better sleep. Avoid vigorous activity at nighttime/before bedtime as this can be stimulating.
- Medication Management: Consult with your child’s pediatrician/healthcare provider on optimizing ADHD medication management and schedules to improve their sleep quality.
- Mindfulness and Relaxation Techniques: Helping children practice relaxation and mindfulness can help activate their parasympathetic nervous system and calm their minds before sleep.
- Reward Systems: Often, children respond well to rewards for good behavior. Create a token system in which they receive a token for every successful night of sleep and those tokens can be exchanged for a reward the following day.

Addressing sleep disturbances in children with ADHD is crucial for managing the disorder effectively. By implementing these strategies, parents and caregivers can help improve the quality of sleep for children with ADHD, leading to better overall health and well-being. As always, it’s important to work closely with your pediatrician and healthcare providers to tailor interventions to the individual needs of the child. If sleep disturbances persist despite these strategies, it may be beneficial to consult with a sleep specialist or consider a sleep study to rule out other underlying sleep disorders.
Written by:
Genesis Trejo
4th year medical student
Kirk Kerkorian School of Medicine at UNLV
Las Vegas, NV
At the Center for Psychiatry and Behavioral Medicine, Dr. Ann Childress and Dr. Randi Lampert conduct clinical studies to find the best treatments for ADHD.
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