A good night’s sleep is important for the health and wellbeing of your child, but it can also be essential for managing ADD/ADHD symptoms in children. A restful night of sleep is vital for children’s mood and brain functions and some studies have shown that a lack of sleep can worsen ADD/ADHD symptoms in children and affect their working memory. However, transitioning from a busy, active day to settling in for sleep can be particularly difficult for youngsters with ADHD.

To help manage ADD/ADHD symptoms in children and provide your child with a full night’s sleep, here are several tips to help settle down at bedtime:

  • Have a consistent routine.
    • As much as possible, keep bedtime at the same time every night.
    • For the last half hour before bedtime, keep the nightly routine the same. This can include a bath, story time, reading time, quiet play, drawing, or whatever works best in your home with your child.
    • Anticipate procrastination! Make sure the bedtime routine includes time for children to go to the bathroom, brush their teeth, and have a small drink of water.
    • Avoid stimulating activities in the last half hour of the day. This includes video games, horseplay, and most TV programs.
    • Turn down the lights for the last half hour before bedtime. Dim the overhead lights or turn off the room light and turn on a lamp. The lower level of illumination helps the brain get ready for sleep.
    • Consider a system to reward the child in the morning if he or she is quiet in bed until they fall asleep.
    • Not close to bedtime, but earlier in the day, make sure your child has plenty of exercise. An active day will help your child sleep better at night. For the cold, rainy days of an Oregon winter, consider aerobic video games (such as Wii).
    • Set up the bedroom to promote sleep.
      • For several reasons, it is best that the child not have a TV in his bedroom.
      • If possible, an ADHD child should be in his or her own bedroom.
      • The choice of a night-light or not, door open or closed, depends on the child’s individual needs.
      • Try to minimize noise coming from the rest of the house as the child is trying to fall asleep. It is particularly important that a TV in another part of the house does not disturb the child.
      • Keep the bedroom a little on the cool side. We generally sleep better in a cool room, with appropriate blankets.

In addition to these tips, many ADHD children have trouble slowing down their brain enough to fall asleep. Here are some helpful suggestions to encourage them to settle down around bedtime:

  • Turn on music. A CD player is better than a radio, which attempts to make itself interesting and engaging to attract listeners. Quiet instrumental music is oftentimes the best option for children, but sometimes they surprise us! It doesn’t matter what they’re listening to, as long as it helps them settle enough to fall asleep.
  • “White noise” is another option. An electric fan works well – if it’s too cool, have the air blow against a wall.
  • Books on tape can be helpful for some children. They are likely to listen to the story on the first night – so choose a night when they do not have school the next day for the first listen. After that, keep playing the same book. Many children find the familiar story and voice soothing and relaxing and you can change out the book every few weekends.

If all else fails, consider medication. Nobody likes the idea of having to give extra medication to a child to get them to sleep; however, consider the alternative. Sleep deprivation can aggravate ADHD symptoms and make the situation worse. Try everything else first, but if it still doesn’t work, medication is a viable option to discuss.

  • Before you get to real medicine, try a bedtime drinkof:
    • 1 c. warm milk
    • 1 tsp. honey
    • 1 tsp. real vanilla (not artificial)
    • Another option is a low dose of caffeine. This doesn’t work for everyone, but some children settle down with a low dose, much like they do for their stimulant medication. Options include a cup of tea or a half cup of coffee. Added milk and some sweetener will make it acceptable to a child’s palate. Stevia, a natural non-sugar sweetener is the best option and artificial sweeteners are OK, while sugar should be the last choice. Avoid soda or “pop” as these drinks contain too much sugar.
    • Melatonin is a natural sleep hormone that can be purchased without a prescription. The usual dose is 3 mgs.
    • Benadryl is an over-the-counter antihistamine that is pretty sedating for most children. The recommended dose is 25 mgs for children from 30-50 lbs., and 25-50 mgs for larger children.
    • There are a variety of prescription medications often used for sleep; we can discuss these options if needed.

Even though we say stimulant medication will interfere with sleep, there are many ADHD children who need some of their stimulant close to bedtime in order to settle down enough to fall asleep. The trouble that some children have with sleep may be due to the rebound as the medication leaves their system, and not due to the stimulant effect of the medication. If you think this might be the case with your child, contact the Woodburn Pediatric Team to discuss medication and scheduling options for your child.