Herbie Murray
Sleep problems are common in people with ADHD, with an estimated 25% to 50% experiencing issues ranging from insomnia to secondary sleep conditions. Sleep problems in people with ADHD tend to increase with age, and medication can often make it worse. If your teenager is struggling to sleep, there are a few things you can try. Firstly, consider lifestyle changes such as improving sleep hygiene, sticking to a schedule, and avoiding caffeine and artificial ingredients. You could also try natural sleep aids such as melatonin, which is available over the counter, or weighted blankets. If these don't work, speak to your doctor about changing the dosage or type of medication, or ask about other sleep aids like sedatives.
| Characteristics | Values |
|---|---|
| ADHD medication | Stimulants, such as methylphenidate and amphetamine, are the most common and well-studied treatments for ADHD. |
| Side effects | Decreased appetite, weight loss, difficulty sleeping, rebound effect, and rarely, more severe or long-lasting effects. |
| Sleep medication | Melatonin is a natural hormone that can be taken as a supplement to aid sleep. It is considered safe for children, but should be taken under medical advice and supervision. |
| Lifestyle changes | Exercise, healthy eating, nutritional testing, a nightly routine, a calm and quiet environment, low lighting, and a weighted blanket can all help with sleep. |
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What You'll Learn
Melatonin supplements
Sleep-related difficulties are common in people with attention deficit hyperactivity disorder (ADHD), especially those who take stimulant medications. A growing body of evidence suggests that melatonin supplements are a safe and effective way to help people with ADHD fall asleep earlier. Melatonin is a hormone naturally produced by the pineal gland in the brain, which helps regulate the body's internal clock or circadian rhythm.
Several studies have found melatonin to be a safe and effective supplement to help people with ADHD fall asleep. One study found that sleep onset advanced by 27 to 48 minutes with melatonin, and sleep duration increased by as much as 62 minutes. Another study found that children with ADHD were able to sleep longer and fall asleep faster after taking melatonin daily with their ADHD medication over several weeks.
However, melatonin is a hormone and can cause side effects in some people. The National Center for Complementary and Integrative Health (NCCIH) warns that melatonin supplements may affect hormonal development, including puberty, menstruation, and prolactin production. While studies have not shown any danger with melatonin, including any risk of dependency, some patients may experience reactions, and the higher the dose, the more likely side effects are. The NCCIH reports that side effects in children are typically mild and include drowsiness, upset stomachs, vomiting, and headaches.
If you are considering melatonin supplements for your teenager, it is important to consult a healthcare professional for personalized advice and monitoring. Melatonin should not be given to a child except under direct medical advice and supervision. It is also important to note that melatonin supplements should be accompanied by behavioural interventions to address sleep problems.
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Non-stimulant medication
Non-stimulants currently used for ADHD treatment include atomoxetine, viloxazine, and alpha agonists. Atomoxetine is available in capsule and liquid form. It can take a few weeks to work properly, and it must be taken every day. Alpha agonists are less effective than stimulants in treating pediatric ADHD, but they are moderately effective for inattention, hyperactivity, impulsivity, and tics. A nighttime dose can help with sleep onset and may be higher than daytime doses.
Healthcare providers sometimes prescribe antidepressants alone or in combination with stimulants for ADHD treatment. However, the FDA has not specifically approved antidepressants for ADHD treatment.
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Behavioural changes
Exercise can be a great way to improve sleep, but it's important to ensure that any physical activity doesn't take place too close to bedtime, as this could have the opposite effect. A healthy diet is also important, and caffeine and artificial ingredients should be avoided, as these can promote hyperactivity.
It is also important to ensure your child's bedroom is optimised for sleep. Blackout curtains or a sleep mask can help to block out light, and electronics that emit blue light, such as computers, tablets, and phones, should be unplugged or covered, as this type of light can trick the brain into thinking it is time to be awake. White noise machines or earplugs can also be useful to block out distracting noises.
If your child is struggling with their sleep, it is important to discuss this with your doctor, who can advise on potential sleep medications and other strategies to help your child get a better night's rest.
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Sleep and lifestyle changes
Sleep problems are common in teenagers with ADHD. They can experience insomnia, shorter sleep time, and a heightened risk of developing a sleep disorder. Sleep problems can cause daytime fatigue, irritability, and restlessness, and can also negatively impact academic performance and relationships.
Before considering medication, it is recommended to try sleep and lifestyle changes to improve your teenager's sleep.
- Stick to a schedule: Decide on a bedtime routine with your teenager and ensure it is followed consistently. This should include the same wake-up time every day, including weekends. A consistent sleep schedule helps to regulate their body clock.
- Create a calming environment: Ensure the hour before bedtime is calm and quiet. Keep the lights low to signal to their body that it's time to prepare for sleep. Use blackout curtains or a sleep mask to block out any extra light. Unplug or cover any electronics that emit a glow.
- Avoid screens: The blue light from computers, tablets, and phones can trick the brain into thinking it's time to be awake. Avoid screens at least an hour before bedtime.
- Exercise: Ensure your teenager gets at least an hour of physical activity each day. However, be mindful that exercise can sometimes amp kids up, so avoid strenuous exercise too close to bedtime.
- Nutrition: Establish healthy eating habits by avoiding caffeine and artificial ingredients that may promote hyperactivity. Consider nutritional testing to check for any dietary issues that could exacerbate anxiety and sleep problems.
- Soothing activities: A warm bath before bed can help your teenager relax and feel sleepy as their body cools down afterward. Other calming activities include breathing exercises and guided imagery, which can help slow down racing thoughts and ease restlessness.
- Weighted blanket: A heavy, weighted blanket can provide deep pressure to muscles and joints, helping to calm an overactive central nervous system and improve sleep.
- White noise: Use a white-noise machine or earplugs to block out any distracting noises that could interrupt your teenager's sleep.
- Supplemental melatonin: Melatonin is a hormone that the brain releases to signal that it's time for sleep. If your teenager isn't producing enough melatonin naturally, ask your healthcare provider about supplemental melatonin. It is important to only give melatonin to your teenager under the advice and supervision of a doctor.
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Exercise
For teenagers with ADHD, exercise can help to improve attention, mood, executive function, and self-regulation. It can also reduce impulsivity and increase motivation for mental tasks, energy levels, and brainpower. Exercise acts on the brain in similar ways to ADHD medication, increasing the release of neurotransmitters such as dopamine, which aids attention and clear thinking.
To help your ADHD teenager sleep better, ensure they get at least an hour of physical activity each day. The exercise should be "moderately intense", causing an elevated heart rate, faster breathing, and muscle fatigue. Examples of suitable exercises include aerobic exercises such as walking, jogging, or martial arts, which create new pathways in the brain and flood it with attention-boosting chemicals.
To keep your teenager engaged, switch up the type of exercise regularly, and consider finding them a workout buddy. It is also beneficial to exercise in the morning, before taking any medication, to maximise the mood-boosting effects.
While exercise, sleep, and nutrition can positively impact ADHD symptoms, they usually do not replace medication or therapy in a treatment plan. However, they can be used as complementary treatments and may even reduce the need for medication or intensive counselling.
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Frequently asked questions
It is always best to consult a doctor before giving your teenager any medication or supplement to help them sleep. Melatonin is a hormone that is released by the brain to tell your body it is time to sleep. Melatonin can be purchased over the counter and may be suitable for your teenager, but you should always consult a doctor before giving your child any melatonin supplement.
It is important to establish a bedtime routine and stick to a schedule. Make sure the hour before bedtime is calm and quiet, with low lighting. A warm bath before bed may help your teenager feel sleepy as their body cools down afterward. You should also ensure their bedroom is dark and block out any extra noise that could distract them.
Exercise is important for children with ADHD, but it may be best to avoid having them exercise too close to bedtime as it may make it harder for them to fall asleep. Caffeine should also be avoided as it may make it harder for your teenager to fall asleep.
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