We’re talking today about a serious issue — ADHD, and its relationship to sleep. Now, since ADHD isn’t usually diagnosed until the preschool or early school years, you may be thinking, “What does this have to do with me and my baby? Why should I read this?”
Don’t skip this article just yet, though. This might not impact you now, but the odds suggest it definitely could. Rates of ADHD diagnoses are on the rise. The percentage of American children diagnosed with the disorder has risen 66% in the last 10 years. That is significant, readers! There’s also evidence to suggest that the sleep issues your baby or toddler might have now could lead to a greater risk for ADHD.
And of course, some of you reading this have experienced ADHD personally. Perhaps one of your children has it, or a niece or nephew has it. Maybe you have it. Adults suffer from ADHD, too, after all.
We’re not going to attempt to tackle every facet of ADHD in this article. We’d fast run out of room if we tried! Rather, we’re going to focus on one particular sub-set of the ADHD diagnosis. We’re going to examine ADHD and sleep disorders, and how the two are connected.
ADHD and Sleep Disorders: A Major Correlation
You don’t have to search very far to come up with plenty of evidence indicating that ADHD and sleep disorders are connected. It’s estimated that anywhere from one quarter to one half of children with an ADHD diagnosis also suffer from one or more sleep disorders. That’s a significantly higher rate than we would find in a group of children without ADHD.
So what kinds of sleep disorders do children with ADHD diagnoses suffer from? The list includes:
- Bruxism (teeth grinding)
- Sleep apnea (loud snoring, long pauses between breathing during sleep)
- Restless Leg Syndrome (an overwhelming desire to move and kick legs during sleep)
- Frequent night waking
- Sensory processing issues (heightened sensitivity to the feel of the blankets or sheets, to light or sound, etc.)
- Difficulty relaxing and falling asleep at bedtime
Here’s the really, really hard part — sleep disorders and ADHD symptoms tend to work in tandem. Sleep disorders cause a child to get less sleep than she needs. This lack of sleep makes her ADHD symptoms (hyperactivity, an inability to calm down and focus, etc.) worse. And her worsening ADHD symptoms make it even harder for her to sleep, which makes her ADHD symptoms even more severe… It’s a discouraging, heartbreaking cycle for many families.
This works in much the same way that overtiredness works in babies — if your baby doesn’t get enough sleep one night, it makes him overly exhausted the next day. And that overtiredness makes it even harder for him to fall sleep the next night, which makes him even more overtired…
Peggy Dolane shared her own experience with us. Here’s what she had to say about the connection between her daughter’s ADHD and sleep:
Three years ago, my seven year old daughter was diagnosed with ADHD. Looking back on it, difficulty falling sleep was one of the significant symptoms of her ADHD. From day one, even as a baby, sleep didn’t come as easily as for her older brother. She would lie in her crib, clearly tired, singing to herself for up to an hour every night. Often, you’d find her sitting up in her crib asleep!
Once we moved her to a big-girl bed, sleep became a major issue. She just couldn’t seem to let go at the end of the day. The more tired she was, the harder it was for her to go to sleep. Exhausted, she would have major tantrums at night.
Could Sleep Disorders Actually Cause ADHD?
Experts agree that there’s a strong connection between ADHD and sleep, but in the last decade or so, some researchers have found evidence to suggest that sleep disorders might actually be the cause of many cases of ADHD.
The article highlighted a study presented in March 2012, which found that children who suffered from sleep apnea as infants and toddlers were significantly more likely to be diagnosed with ADHD when they reached their preschool and early school years.
The article goes on to cite other studies that indicate that children who have ADHD and sleep apnea benefit greatly from having their adenoids and tonsils removed (since enlarged adenoids and tonsils are a huge cause of sleep apnea). In fact, many of the children who had surgery improved so much, they no longer fit the criteria for an ADHD diagnosis!
Dr. Merill Wise, a pediatric neurologist, and sleep medicine specialist summarizes the findings this way:
“No one is saying that ADHD does not exist, but there’s a strong feeling now that we need to rule out sleep issues first.”
ADHD and Sleep Disorders: What Parents Can Do To Help
It’s almost a chicken-and-egg scenario, isn’t it? Which came first — the ADHD or the sleep disorder? Researchers haven’t come to an agreement on that question yet. One fact remains clear. It’s vital that a child with ADHD get the sleep he needs. Research suggests that being well-rested will help alleviate some (or maybe even all) of his ADHD symptoms.
So what can we do as parents to help our children with ADHD sleep well? Consider some of the following steps:
- Talk to your doctor. If you suspect your child has a sleep disorder like sleep apnea or Restless Leg Syndrome, seek out appropriate medical treatment. Surgery to remove tonsils and adenoids can help with apnea, and there are several types of medications that can alleviate RLS.
- Consider vitamin supplements (under doctor supervision, of course!) Low levels of magnesium and iron impact sleep. Some parents have found that offering magnesium and iron supplements has really helped their children get the sleep they need.
- Talk with your pediatrician about a melatonin supplement. We wrote a bit about this in our article on Autism and Sleep. Turns out that children with autism and ADHD tend to have lower-than-normal levels of melatonin, the hormone responsible for setting our sleep-wake cycles. We advise that you always speak to your doctor before giving your child any supplements. We also recommend looking at sleep associations and reviewing your child’s schedule as the first steps in trying to remedy a sleep problem before thinking about giving your child supplements. With that in mind, melatonin supplements have worked well for some families. Peggy Dolane shares this about how melatonin has helped her daughter:
At our next visit, our psychiatrist affirmed that many of his patients took Melatonin daily to sleep. So with mixed emotions, we tried it. The very first night we saw a dramatic improvement. The child that regularly took an hour or more to fall asleep immediately lay down and slept. Quietly. With no fuss. Within three weeks she was sleeping 11 hours a night instead of 10 and her evening tantrums had dramatically decreased. I started being able to enjoy being around my child at bedtime.
- Establish boundaries and routines, and stay consistent. We all know that when it comes to bedtime and sleep, our children need to have firm boundaries in place, and to know that mom and dad are consistent in enforcing those boundaries. The same goes for children with ADHD. It may be difficult (extremely difficult!) to get your child with ADHD to get in bed, stay in bed, and fall asleep at a reasonable time. Do your best to establish a good bedtime routine and then stick to it. Prioritizing her sleep will pay off in the long run.