ADHD AND SLEEP IN CHILDREN

Updated: Aug 23

Children with ADHD often have problems getting to sleep or staying asleep, but is it the ADHD symptoms that cause the lack of sleep, or is it the lack of sleep, potentially caused by undiagnosed airway issues, that is causing the ADHD symptoms?

ADHD and sleep in children

It is estimated that up to 70% of children diagnosed with ADHD have issues falling and staying asleep. If children aren't able to obtain quality sleep, then their bodies aren't able to repair and grow properly, which can lead to long-term health issues down the road.


WHY DO CHILDREN WITH ADHD HAVE SLEEP ISSUES?


Studies have found that there is a biological reason why children with ADHD tend to have sleep issues. Many of the same regions of the brain regulate that regulate attention also regulate sleep. This is why a child with ADHD is likely to have sleep problems, as well.


Kids with sleep disorders have trouble falling asleep or staying asleep throughout the night. Some kids with sleep disorders experience anxiety, including night terrors. Others have airway issues like sleep apnea or asthma, which gets in the way of their breathing and make it hard to stay asleep.


IS IT ADHD OR AN AIRWAY DISORDER?


Children with airway issues often suffer from sleep-disordered breathing (SDB) or sleep apnea. Kids with breathing issues who are unable to obtain a restful night's sleep are often irritable and have trouble paying attention in class. Their continued lack of sleep makes children more likely to act out or throw a tantrum.


There are several signs that may indicate that a child is suffering from sleep-disordered breathing or sleep apnea:


  • Abnormal breathing when sleeping --- patterns where breathing stops and restarts or your child experiences labored breathing

  • Snoring or wheezing while sleeping

  • Grinding of the teeth

  • Recurring episodes of waking up or being restless all night

  • Frequent reports of nightmares

  • Increased crying or bedwetting episodes at night

  • Difficulty waking up

  • Frequent reports of dry mouth or headaches when waking up

  • Excessive daytime sleepiness

  • Chronic anxiety and allergies

  • Daytime mouth breathing


ADHD can look quite similar, which is why it's often misdiagnosed in children with airway dysfunction. Children with ADHD have a hard time staying focused. They’re easily distracted and don’t follow directions all the time. They act out or throw tantrums when they are frustrated.


Children with both ADHD and sleep difficulties often display more pronounced or severe ADHD symptoms, experience a poorer quality of life, and grapple with increased mental health difficulties.


Because symptoms can look so similar, it’s important for medical professionals to rule out an airway dysfunction before diagnosing ADHD.



HOW TO HELP CHILDREN SLEEP BETTER


According to a 2014 study, behavioral insomnia is the most common cause of children not being able to fall asleep. Behavioral insomnia is caused by bedtime habits and behavior, rather than an underlying medical condition, such as sleep-disordered breathing or ADHD. Behavioral insomnia may cause children to resist sleep, wake up frequently, or need more help from caregivers to fall asleep.


Creating good sleep hygiene and a nightly routine will help your child overcome behavioral insomnia. A few ways to help foster good sleep hygiene for your child include:

  • Make sure they've had enough to eat before bed, but avoid foods with caffeine or stimulants

  • Place a fresh cup of water by their bed

  • Take them to the bathroom right before bed and install a nightlight in the hallway and bathroom so they can reach the bathroom safely in the middle of the night if they need to

  • Reduce anxiety by giving them comfort objects (like a stuffed toy or blanket) and talk with them about their worries during the day (not right before bed)

  • Create a healthy sleep environment by removing distractions, turning off all electronics at least one hour before bedtime, and move objects that may cause scary dark shadows

  • Let your child pick out their own pajamas and read them a book to help them calm down and settle in for the evening

Once you've established a routine, consistency is key to creating good sleep health for your child.


WHY IS GOOD SLEEP HEALTH IMPORTANT FOR KIDS?

Establishing and maintaining good sleep health for your child is a matter of life or death as a consistent lack of restful sleep can cause long-term physical and mental health issues.


Hopkins Children's and many other studies have shown that kids who consistently get an adequate amount of sleep have better attention, behavior, learning, memory, and overall mental and physical health. Transversely, sleep deprivation can cause high blood pressure, obesity, and even depression.

We know how much sleep children need, but it has to be the right kind of restful sleep. In order for this to occur and for sleep to be restorative, children need to breathe well while they sleep. Thus the urgency of identifying sleep-disordered breathing in a child as earlier as possible.


HOW CAN I TELL IF MY CHILD HAS AN AIRWAY DISORDER?


There are several signs and symptoms to look for that will help to identify if your child might have an airway disorder. Ask yourself the following:


  • Does your child sleep through the night?

  • How many times does your child chew each bite or mouthful before swallowing?

  • Does your child almost always have a stuffy nose?

  • Does your child have a "worried" expression when swallowing?

  • Does your child sleep with an open mouth?

These are just a few of the questions that can help you identify if your child might be dealing with a sleep-breathing or other airway disorder.


As with any medical condition, consult your child's pediatrician should you see any of these symptoms in your child or if you suspect your child is suffering from an airway disorder.