The Connection Between Sleep and ADHD

Does your child struggle with staying focused and attentive? Does he or she also struggle with sleeping through the night?

Sleep is vital to daily life and crucial to health and well-being. Unfortunately, many children suffer from sleep issues, such as insomnia. But sleep is even more vital for children struggling with attention deficit hyperactivity disorder (ADHD). Sleep deprivation can trigger increased hyperactivity, impulsivity, and difficulty concentrating, making it hard to manage ADHD symptoms.

Hence, it is important to understand the correlation between ADHD and sleep to enhance well-being. During sleep, the brain consolidates memories, processes information, and regulates hormones and emotions. Sleep also affects the immune system, metabolism, and cardiovascular health. Sleep deprivation can impair cognitive functions, such as attention, memory, learning, and decision-making. It can also increase the risk of various physical and mental health problems, such as obesity, diabetes, heart disease, depression, and anxiety.

Let's look more closely at the connection between sleep and ADHD and explore common sleep disorders that affect people with ADHD, such as insomnia, restless leg syndrome, and sleep apnea, and how they can contribute to worsening symptoms of ADHD.

How Sleep and ADHD Are Related

ADHD is a mental health condition that causes hyperactivity, impulsivity, and difficulty focusing. According to scientists, a mix of genetic and environmental factors, including pollutants, neurotransmitter levels, and brain shape, contribute to ADHD. People with ADHD may have trouble regulating their emotions and behaviors, affecting their daily functioning and relationships.

Research suggests a bidirectional link between sleep and ADHD. This means sleep problems can worsen ADHD symptoms and vice versa. Some possible explanations for this link are:

• ADHD-related sleep problems may be a side effect of impaired arousal, alertness, and regulation circuits in the brain.
• ADHD-related sleep problems may be due to a delayed circadian rhythm with a later onset of melatonin production. Melatonin is a hormone that regulates the sleep-wake cycle and is increased by darkness, as when the sun sets.
• ADHD symptoms can make it difficult to settle down enough to fall asleep or stay asleep. For example, people with ADHD may have trouble relaxing their minds, ignoring distractions, or following a bedtime routine.
• Many ADHD medications are stimulants that can interfere with sleep quality or quantity if taken too late in the day.
• A lack of sleep can aggravate some ADHD symptoms or mimic them. For example, when children do not sleep enough, they may become more hyperactive. Adults who do not get enough sleep may feel more fatigued and lack energy.

Common Sleep Disorders That Affect People With ADHD

Sleep disorders are conditions that affect the quality or quantity of sleep. They can have various causes and symptoms. Some of the most common sleep disorders that affect people with ADHD are:

• Insomnia. This is the inability to fall asleep or stay asleep as long as desired. Insomnia can be acute (short-term) or chronic (long-term). Various factors can cause it, such as stress, anxiety, depression, medication side effects, medical conditions, or poor sleep hygiene. Insomnia can lead to daytime fatigue, irritability, mood swings, difficulty concentrating, and impaired performance.
• Sleep apnea. This disorder causes pauses in breathing or shallow breathing during sleep. These pauses can last from a few seconds to minutes and occur several times per hour. Sleep apnea can be obstructive (due to a blockage in the airway), central (due to a problem in the brain), or mixed (a combination of both). Sleep apnea can cause loud snoring, gasping for air, choking sounds, headaches, dry mouth, and sore throat, and can cause health problems if untreated.

Sleep Problems May Precede ADHD

Sleep problems may show up before an ADHD diagnosis. A study published in the Journal of Child Psychology and Psychiatry examined the relationship between sleep problems in early childhood and ADHD diagnosis in later childhood. The researchers analyzed data from a large cohort of children, who the researchers followed from birth to 10 years of age.

They assessed sleep problems at 18 months and five years of age using parent reports and actigraphy (a device that measures movement and sleep patterns). They also looked at ADHD symptoms and diagnosis at seven and 10 years of age using parent and teacher reports and standardized tests.

The results showed that sleep problems in early childhood were associated with an increased risk of ADHD diagnosis in later childhood. Specifically, children who had irregular sleep routines, short nighttime sleep duration, and frequent night awakenings at 18 months and five years of age were more likely to have ADHD symptoms and diagnosis at seven and ten years of age. These associations remained significant after controlling for other factors, such as gender, socioeconomic status, maternal mental health, and prenatal exposure to nicotine.

The researchers concluded that sleep problems in early childhood may be a risk factor for developing ADHD in later childhood. The study suggests that early identification and intervention for sleep problems may help prevent or reduce the negative consequences of ADHD on children's development and well-being.

Tips for Better Sleep With ADHD

Here are some guidelines for improving sleep quality with ADHD:

• Create a regular bedtime and wake-up routine for your child. Have him or her go to bed at a set time every night, and make sure he or she is out of bed or awake by a set time every morning. This helps regulate your child’s circadian rhythm and promote a consistent sleep pattern.
• Make sure your child gets enough exercise. Physical activity can help reduce stress, improve mood, and expend excess energy that may keep your child awake at night. Now that school will be out for the summer, schedule your child for at least 30 minutes of moderate exercise per day, preferably in the morning or evening.
• Leave hyper-focused activities for the day. Avoid your child engaging in tasks that require intense concentration or stimulation before bed, such as arts and crafts and video games. These activities can keep your child’s mind alert and make it harder for him or her to fall asleep.
• Avoid giving your child juice and heavy meals close to bedtime. These can interfere with your child’s sleep quality or quantity by stimulating his or her nervous system, disrupting your child’s sleep cycles, or causing indigestion. Try to avoid your child consuming them within four hours of bedtime.
• Consult your child’s pediatrician about your medication timing and dosage. Some ADHD medications are stimulants that can affect your child’s sleep if taken too late in the day. Talk to your child’s pediatrician or psychiatrist about the best time and dose for your child to take his or her medication without compromising his or her sleep.
• If your child is still struggling with poor sleep, consider having your child receive services from a therapist who can teach your child effective cognitive behavioral strategies to improve his or her sleep.

Sleep Essential Reads

6 Ways to Improve Your Sleep Without Medication

The Brain Benefits of Being a Night Owl (or a Drinker)

To find a therapist, visit the Psychology Today Therapy Directory.