Sleep Problems in Teens with ADHD: Causes and Solutions

Sleep Problems in Teens with ADHD: Causes and Solutions

Sleep problems commonly plague individuals with ADHD — particularly during the teen years, when sleep hygiene and patterns go haywire in even the most neurotypical brains and households. Studies estimate that up to 70 percent of children and adolescents with ADHD have problems with sleep that stem from reasons ranging from racing thoughts to coexisting conditions and even environmental factors that can impact sleep patterns.

No matter the underlying causes, persistent sleep problems can impact functioning and impair quality of life over time. Thoughtful interventions and practices, however, can significantly improve sleep quality — especially when implemented during the childhood and adolescent years. Sleeping Problems in Teens with ADHD: Causes and Outcomes

Common sleep problems in teens with ADHD include: Insomnia , or difficulty falling asleep even when going to bed later. This often comes with early awakenings and an inability to fall back asleep.

Sleep onset association , or when falling asleep is linked to an object or an event (like turning on the TV for “background noise” to sleep).

Bedtime resistance , or refusing to go to bed or adhere to bedtime limits.

Anxiety , which may be sleep related (feeling worried about darkness or other things in the sleep environment), or related to worries and stressors experienced throughout the day.

Delayed sleep phase , which refers to falling asleep late and waking up late in a strong deviation from what would be expected of a typical circadian or developmental pattern. This is a common issue, as teens have to rise early for school on weekdays but delay their sleep drastically on weekends.

Some factors predict sleep problems in teens with ADHD: Biology – similar neurological pathways appear to be involved in the regulation of attention, arousal, and sleep.

Comorbidities – internalizing (anxiety, mood disorders) and externalizing (aggression, oppositionality) comorbidities are strong predictors of sleep problems.

Medication – all stimulants can produce sleep problems, with sleep onset latency (how long it takes to fall asleep) as the main disturbance. But these disturbances generally resolve and subside after some time on medication 1 . Furthermore, unmedicated children with ADHD will still have elevated sleep problems compared to children without ADHD. Sleep should be monitored for teens initiating or changing ADHD medication doses.

Environmental factors like parental mental health, family and social dynamics, and difficulties with schoolwork or homework can contribute to sleep problems.

For some children and teens, these sleep problems will resolve on their own or through some intervention. But for a sizable subset, they will persist. Teens with ADHD, for example, are more likely than their neurotypical peers to get insufficient sleep on school nights, and more likely to report doing “ all-nighters .” 2 They also […]

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