Good sleep and good health are like night and day—you can’t have one without the other. Unfortunately, a lot of us have lost the ability to pass out in bed on a whim.
45 million Americans fit the official definition of insomnia: having trouble falling asleep, staying asleep, or waking up too early, at least three times a month for more than one month. Another 60 million have those same symptoms, but less often.
Millions of us also have a sleep disorder, like sleep apnea (interrupted breathing during sleep) or restless legs syndrome (unpleasant sensations in the legs when lying down to sleep, and the urge to move).
Scientific studies link insomnia and sleep disorders to a wide variety of health problems, including anxiety, burnout, chronic pain, depression, diabetes, fibromyalgia, heartburn, heart disease, high blood pressure, memory loss, menopausal problems and overweight.
Well, you can add another health problem to that long list caused by poor sleep and sleep disorders: ADHD.
Sleeping and ADHD
ADHD isn’t just an attention-deficit disorder. It’s also a nutritional-deficit disorder, with low levels of magnesium, zinc, omega-3s and other nutrients causing or contributing to symptoms.
And—as just about every ADHD parent knows—it’s a sleep-deficit disorder, too.
According to a study published in the journal Sleep Medicine, an estimated 55% of ADHD children have a sleep problem, like not getting enough sleep, waking up repeatedly during the night, and daytime sleepiness because of poor sleep.1
My experience treating ADHD patients for over 30 years tells me the percentage of ADHD children with sleep issues is much closer to 100.
I’ve rarely encountered a patient who didn’t have some type of difficulty with sleep. Dozens of other scientific studies on ADHD and sleep have added more items to that catalog of nighttime woes: resisting going to sleep, anxiety about sleeping, difficulty falling asleep (the most common sleep problem among ADHD children), and difficulty waking up in the morning.
A host of other studies show that many ADHD children have a sleep disorder. The most common type of sleep disorder is sleep-disordered breathing (SDB): chronic mouth breathing, snoring or sleep apnea.
Some ADHD kids have a sleep movement disorder, usually restless legs syndrome. And some have a parasomnia—they sleepwalk, have frequent nightmares (frightening dreams that wake a child up) or frequent sleep terrors (extreme nightmares, with the child crying or screaming when he wakes up).
Studies Connecting Sleep Issues and ADHD
One recent study on sleep-disordered breathing provided a dramatic demonstration of the link between sleep disorders and ADHD.2 The researchers evaluated more than 9,000 children, from when they were six-months-old to when they were 7-years-old.
By the age of 7, the children who had sleep-disordered breathing sometime during their childhood were:
- 85% more likely to be hyperactive
- 60% more likely to have conduct problems
- 37% more likely to have difficulties with their peers
- 65% more likely to have emotional difficulties.
The leader of the study, Karen Bonuck, PhD, even told the New York Times:3
“Lack of sleep is an insult to a child’s developing body and mind that can have a huge impact,”
A study in the Journal of Attention Disorders summed up the link between sleep issues and ADHD with a set of startling statistics.5
Compared to non-ADHD children, ADHD children were:
- 41% more likely to resist going to bed
- 49% more likely to have anxiety about sleeping
- 36% more likely to have trouble falling asleep
- 36% more likely to wake up during the night
- 57% more likely to sleep less
- 88% more likely to have daytime sleepiness
- 89% more likely to have sleep-disordered breathing
Does my ADHD Child Have Sleep Problems?
The first thing I’d like you to know is that the amount of sleep your ADHD child gets shouldn’t be your sole focus: a lot of ADHD kids seem to do better when they get a little less sleep than their non-ADHD peers.
How much less?
Many ADHD children do fine with an hour or so less than the recommended sleep durations from the American Academy of Sleep Medicine (recommendations endorsed by the American Academy of Pediatrics): 10 to 13 hours for preschoolers (3- to 5-years-old); 9 to 12 hours for children 6- to 12-years-old; and 8 to 10 hours for teenagers.6
Rather than concentrating on the quantity of your child’s sleep, concentrate on the quality and ask yourself these questions:
- Does my child resist going to bed?
- Is he anxious about falling asleep?
- Does she have difficulty falling asleep? (Almost a given.)
- Does he regularly wake one or more times throughout the night?
- Does she have difficulty waking up in the morning?
- Does he have daytime fatigue, perhaps falling asleep at his desk during class?
If you answered yes to any of these questions, it’s important to treat your child’s sleep problem.
Left untreated, a seemingly small-scale sleep problem can develop over many years into chronic insomnia, with your child sleeping only five to six hours a night. No child can feel good or function well with so little sleep.
Fortunately, there are many ways to treat sleeping problems and disorders in children. From simple supplements like magnesium and melatonin, to sleeping aid medicine and even surgery in some cases. I discuss the why’s and how’s of all of these methods in my award-winning book, Finally Focused. Don’t let something like sleep issues continually affect your ADHD child!
Yours in health,
James M. Greenblatt, MD
Founder, Medical Director, Psychiatry Redefined
Did you know the ADHD brain processes sugar differently than other people?
References
- Efron D, et al. Use of sleep medication in children with ADHD. Sleep Medicine, 2014 Apr;15(4):472-5.
- Bonuck K, et al. Sleep-disordered breathing in a population-based cohort: behavioral outcomes at 4 and 7 years. Pediatrics, 2012 Apr;129(4):e857-65.
- Murphy, K. Attention problems may be sleep-related. The New York Times. 2012 Apr 16. Available from www.well.blogs.nytimes.com/2012/04/16/attention-problems-may-be-sleep-related.
- Chervin RD, et al. Sleep-disordered breathing, behavior, and cognition in children before and after adenotonsillectomy. Pediatrics, 2006 Apr;117(4):e769-78.
- Li S, et al. Sleep problems in chinese school-aged children with a parent-reported history of ADHD. Journal of Attention Disorders, 2009 Jul;13(1):18-26.
- Paruthi S, et al. Recommended Amount of Sleep for Pediatric Populations: A Statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine, 2016 Jun 15;12(6):785-6.