Trouble falling asleep, staying asleep and waking up are common complaints for both children and adults diagnosed with ADHD. The verdict within the scientific community is still out as to whether problems with sleep are symptoms of ADHD, or another disorder altogether. For the purpose of your question, let’s assume the trouble your child is experiencing is associated with ADHD, and not a co-existing condition, for which you would need to seek a diagnosis and additional treatment.
Here are a few tips to help your child fall asleep, stay asleep and wake up on time:
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Establish a homework routine: Homework should be done early, before supper. Backpacks should be checked, loaded and next to the front door after homework time. This will prevent many a panic attack at bedtime for those times when your child suddenly remembers the diorama is due the next day, or the spelling test is a day earlier because of the holiday (A side-note about homework: The amount of time spent on homework should be age-appropriate. In other words, if your third grader is spending 2-3 hours each evening trying to complete assignments, it is time to talk with the teacher. They are often unaware of your nightly battles and will work with you and your child to modify his or her workload.)
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Establish a bedtime routine: Routines are particularly important for children with ADHD, and often difficult to maintain, but the extra effort establishing and continuing a bedtime routine will definitely pay off.
- Establishing the setting and routine:
- About an hour before “lights-out,” turn off the TV/computer. No more horseplay, telephone calls, games, computers, etc.
- Some children will need to be reminded earlier in the evening to get their last drink before the bedtime routine begins, to help prevent middle-of-the-night bathroom visits. A bedtime snack is individualized.
- Their bedrooms should be dark and cool (nightlights are fine)
- Decide the order for the rest of the routine. (Compliance increases if your child has some input in developing the routine):
- Bathe/shower
- Change into pajamas
- Brush teeth
- Interact with your child – read a book
- Listen to relaxing music
- Complete any other personal tasks
- Post the routine and stick to it faithfully!
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Medication:
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At night to fall asleep: Thomas Brown, Ph.D., Yale University and international expert on ADD/ADHD, suggests that a low dose of an antihistamine about an hour before bedtime may help to fall asleep.
- Some children are so restless at bedtime that they require a small dose of stimulant medication to relax enough to fall asleep. Ask your child’s doctor if this might be appropriate.
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In the morning to wake-up: If your child is having trouble waking up and cooperating during the morning routine, talk with your child’s doctor about a low dose/short acting stimulant medication an hour before your child needs to be out of bed. They should take their regular daytime medication before leaving for school.
Remember, always speak with your child’s doctor before making any changes in medications.
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Alarm clocks: As children approach middle school age, you may want to start the use of an alarm clock. Depending on the difficulty your child has with waking up, there are several clocks that are perfect for those with ADHD who love punching the snooze button.
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ADDitude has reviewed of some of the alarm clocks on the market designed for people who have ADHD.
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ADD Consultants sells a wide variety of unique alarm clocks for people with ADHD.
If after you try these tips and your child is still struggling to fall asleep, stay asleep or wake-up, consult your child’s pediatrician about an evaluation for a sleep disorder.