Being a parent to a child diagnosed with ADHD can be both rewarding and challenging, especially when it comes to ensuring they get the rest they need. Sleep issues are common among children with ADHD, with around 70% experiencing difficulties falling asleep, staying asleep, or waking up feeling refreshed.
Sleep struggles can make ADHD symptoms even tougher to manage, impacting your child’s daily life and overall well-being. As someone with decades of experience in mental health, I’ve walked alongside countless families navigating these challenges. Whether through my work in the NHS or private practice, I’ve seen first-hand how small, consistent strategies can make a big difference.
With the new year just around the corner, it’s the perfect time to reset and find ways to support your child’s sleep. In this article, I’ll share practical tips and proven strategies that I’ve used with many families to help manage sleep issues, reduce stress, and create a smoother, more restful routine. Let’s tackle this together so you and your child can enjoy a new year with a little more calm and a lot more ease.
Recognising Signs:
Look for signs like:
- Difficulty waking up or not feeling refreshed.
- Sleepiness during the day, including dozing off in class. (It is always helpful to liaise with your child’s teacher to assess how they seem in class.)
- Increased irritability or grumpiness after poor sleep.
Check for conditions like snoring (possible sleep aponea) or restless leg syndrome. Children diagnosed with ADHD are more likely to have additional sleep conditions. Make an appointment with your GP for a review.
Assess Sleep Patterns
If you are worried about your child’s sleep. Step back and assess what the problems actually are. With teenagers, you can do this together.
- Use a sleep diary to track the child’s sleep patterns for 7–14 days, noting:
- Bedtime routine.
- Time taken to fall asleep.
- Nighttime awakenings.
- Wake-up time and feelings of restfulness.
- Include information about screen time, caffeine intake, and physical activity.
Identify Specific Sleep Issues
- Determine if the child struggles with:
- Falling asleep (sleep onset difficulties, bedtime resistance, or anxiety).
- Staying asleep (frequent awakenings).
- Restless sleep
- Waking too early or feeling unrested.
Healthy Sleep Practices: Laying the Foundation for Success
Before you start, it is always good to review your child’s sleep which include:
A Consistent Bedtime ( so important for children diagnosed with ADHD)
- Set a realistic bedtime tailored to your child’s wake-up time.
- Establish a fixed bedtime and wake-up time, even on weekends. Gradually adjust bedtime if the child’s natural sleep onset is late. (use bedtime fading).
Bedtime Fading: A Simple Sleep Solution for Children with ADHD
Bedtime fading is a behavioural sleep strategy designed to help children fall asleep more easily by aligning their bedtime with their natural sleep patterns. Instead of setting an arbitrary bedtime, parents work with their child’s current sleep tendencies and gradually adjust bedtime to an earlier time. This approach reduces frustration and bedtime battles, making the transition smoother for both parents and children.
Practical Steps for Parents to Implement Bedtime Fading:
Step 1: Track Your Child’s Sleep Patterns
- Over a few nights, observe and note:
- What time your child naturally falls asleep.
- Their wake-up time in the morning.
- For example, if your child consistently falls asleep at 11:00 PM, that is their “natural sleep time.”
Step 2: Set a Temporary Bedtime
- Set bedtime to match when they are naturally falling asleep. In this case, it would be 11:00 PM.
- This ensures they are tired enough to fall asleep quickly and associate bedtime with success, not frustration.
Step 3: Gradually Move Bedtime Earlier
- Every 3–4 or more nights, move bedtime earlier by 15 minutes.
- Example: After a few nights of going to bed at 11:00 PM and falling asleep easily, shift bedtime to 10:45 PM.
- Continue this process until you reach your desired bedtime (e.g., 9:00 PM).
Step 4: Keep the Morning Wake-Up Time Consistent
- Ensure your child wakes up at the same time every morning, even on weekends.
- Consistent wake-up times help regulate their internal body clock, making it easier to fall asleep earlier over time.
Consult Healthcare Professionals About Melatonin
Melatonin supplements can be beneficial for children with ADHD who have difficulty falling asleep. However, it’s crucial to consult with a healthcare provider to determine the appropriate dosage and to ensure it’s safe for your child.
Note on Melatonin:
It’s important to understand that melatonin supplements can help your child fall asleep more easily by supporting their body’s natural sleep-wake cycle. However, melatonin is not designed to address issues related to staying asleep throughout the night. If your child struggles with frequent awakenings or restless sleep, additional strategies or interventions may be needed.
Additional Suggestions for Establishing a Consistent Bedtime Routine:
- Establish simple sleep cues to signal bedtime, such as a warm bath with lavender, brushing your teeth, and reading a calming story or listening to music.
- Gentle activities like colouring or working on a jigsaw puzzle can also help your child relax and transition to sleep.
- Jigsaw puzzles require concentration and promote mindfulness, which can help calm the mind and reduce stress before bed. This relaxation may make it easier to transition to sleep, especially if your child finds puzzles enjoyable and not overly stimulating. Ensure the puzzle is not too complex. For sensory help, parents can also make a self-soothe box.
Relaxation techniques like deep breathing or guided imagery or a a meditation like one here https://bristolchildparentsupport.co.uk/you-are-loved-free-sleep-meditation/
- Screen Time: Gradually reduce screen use before bed. Start with small changes, like switching off screens 10 minutes before bedtime, and gradually extend this period.
- Bedroom Environment: Welcome the dark, black-out curtains and blinds help. Ensure it’s cool, comfortable, tidy (try and keep sleep and desks etc away from each other) and free of distractions. Invest in a good mattress.
- Consider the Use of Weighted Blankets:
- Weighted blankets provide deep pressure stimulation, which can promote relaxation and improve sleep quality in children with ADHD. It’s important to choose a blanket that is appropriate for your child’s weight and to consult with a healthcare professional before use.
- Diet & Exercise:
- Minimise caffeine, especially in the evening.
- Encourage regular physical activity. There is growing evidence that being in nature helps children with symptoms of ADHD, especially attention difficulties. So for the new year, focus on Green Time.
- Yoga poses, downward dog, etc are really good for children who are agitated at night.
- Avoid exciting games, intense conversations, or heavy meals close to bedtime.
Set Realistic Goals
- Start with small, manageable steps and progress gradually.
- If your child feels anxious at night and requires your presence to feel secure, begin with short intervals of support and slowly work toward greater independence.
- You can draw out a big ladder and collaborate on small steps.
Step 1: Manage Bedtime Resistance
Make a Bedtime Pass:
- This is particularly helpful for younger children, specifically those in primary school. The idea is to create a small pass together, for your child to place under their pillow.
- Your child will then receive a small reward the next morning if they only use the pass once. This pass gives them the opportunity to leave their bedroom and complete the one thing they really want to do before going to sleep. Allow one pass for a specific reason (e.g., bathroom break). Reward your child for using it responsibly or not at all.
Checking Method:
- Check on the child at set intervals (e.g., every 2 minutes initially).
- Gradually increase intervals as the child learns to stay in bed.
Step 2: Address Nighttime Anxiety
- Worry Time: Schedule 15 minutes earlier in the day to talk about worries. Use a worry journal or worry box to help externalise and set aside concerns.
- Visual Imagery: Guide your child to imagine a safe, relaxing place (e.g., a favourite beach or park) to help calm the mind. Let them draw it out. Go to my other article on Nighttime Fears for more ideas.
Relaxation Exercises:
- Deep Belly Breathing: Inhale for 4 counts, hold for 4 counts, and exhale for 6 counts.
- Progressive Muscle Relaxation: Encourage the child to tense and relax muscles starting from toes and working up to the head.
Step 3: Encourage Self-Soothing
Teach the child to lie quietly in bed and focus on calming techniques if they wake up night.
4. Helping Difficult Thoughts
- Step 1: Identify Negative Sleep Thoughts
- Examples include:
- “I’ll never fall asleep.”
- “Something bad will happen if I sleep.”
- “I’ll be tired tomorrow, and everything will go wrong.”
- Write down these thoughts and discuss them with your child.
- Examples include:
- Step 2: Challenge and Replace Negative Thoughts
- Replace unhelpful thoughts with positive, realistic ones:
- “Even if I don’t fall asleep right away, I’ll still get some rest.”
- “It’s safe for me to sleep; nothing bad will happen.”
- “If I’m tired tomorrow, I can handle it.”
- Step 3: Practice Positive Sleep Affirmations
- Help your child develop and repeat calming statements before bed, such as:
- “My bed is a safe and relaxing place.”
- “I will fall asleep when my body is ready.”
- Help your child develop and repeat calming statements before bed, such as:
Set Up A Reward System for Positive Behaviour
- Step 1: Use a Sleep Chart
- Track progress on specific sleep goals, such as:
- Going to bed on time.
- Staying in bed all night.
- Falling asleep within a reasonable time frame.
- Track progress on specific sleep goals, such as:
- Step 2: Offer Small, Consistent Rewards
- Daily rewards for meeting small goals:
- Sticker on a chart or pasta point jar.
- Choosing an extra bedtime story.
- Larger rewards for consistent progress (e.g., 5 stickers = a family movie night or choosing dinner).
- Daily rewards for meeting small goals:
- Step 3: Make Rewards Fun and Family-Oriented
- Avoid expensive or material rewards; focus on experiences that strengthen your connection.
Conclusion
Creating a healthy sleep routine for your child with ADHD may take time, patience, and persistence, but the rewards are well worth the effort. Better sleep not only helps your child feel more rested and focused but can also improve their mood, behaviour, and overall well-being. Remember, small, consistent steps lead to big changes over time.
If you’re feeling overwhelmed or unsure about where to start, you’re not alone. Contact your health provider as part of their ADHD management and I’m here for guidance and support tailored to your family’s unique needs. Together, we can create a plan that works for you and your child, ensuring restful nights and brighter days ahead. Don’t hesitate to contact me for a sleep consultation or for a private workshop on sleep, anxiety, ADHD, Positive Discipline and more.
This marks the final article in my 13-part series for 2024. I hope these insights have been valuable for you, your child, and your family. Thank you to all of you who have read my newsletter blogs, attended private workshops, and who are my clients. My work is nothing without you, and I am truly grateful.
I look forward to working and connecting with you in whatever form in 2025. From my heart to yours, wishing you a safe passage from 2024, I hope you find the key to open the door where every possibility awaits in 2025 .With love, Catherine.
If you enjoyed this blog post and found it helpful or inspiring, please share it with your friends on social media by clicking on the icons on the side. Thank you for visiting my website!
