If you or your child have ADHD and can’t sleep, you are not alone. Maybe its medication related, or maybe its just your mind racing and refusing to slow down, but if you have ADHD and you have insomnia, you aren’t alone.
There are many elements of sleep hygiene that may benefit you, but these are some areas that present the greatest challenges in people who suffer from ADHD and sleeplessness.
1) Get into a routine of regularly getting up and going to sleep at the same time every day. Setting an alarm will help, but you need to be sure you will not ignore it. Sometimes a spouse or parent can be helpful in reinforcing a routine.
2) Stay away from TV, video game, and computer (including smart phone) use for at least 1/2-1 hour prior to bedtime. The light from the screen can interfere with your body’s ability to sense day and night. Also, games and computer use can be so engaging that you may ignore your body’s normal signals of needing sleep.
3) Try stopping caffeine. Caffeine (or caffeine like substances in tea and chocolate) usually keeps people awake, but may have a calming effect in ADHD. If you normally use caffeine, you may want to take a break for a few weeks to see if you sleep better.
4) Exercise early during the day. Pick something you like to do, so you’ll want to do it again. It doesn’t have to be boring and repetitive. Try gardening, walking (try the mall or Walmart without your wallet if the weather is lousy), playing with your pet or your kids. Use a reward chart if you have trouble staying motivated.
Most commonly used medications for ADHD have insomnia listed as a side effect. The only exceptions are guanfacine and clonidine, which may cause drowsiness. If your medication is the problem, you may be able to improve the problem by taking the steps noted below:
1) Take your medication earlier in the day.
2) Take a lower dose of your medication, and add some natural methods to control your ADHD symptoms. An easy first step would be to add an omega 3 fatty acid supplement, such as fish oil.
3) Ask your doctor about a shorter acting form of your medication.
4) Consider adding or switching to guanfacine or clonidine.
Commonly used sleep medications
If all else fails, you may consider using medication to get yourself to sleep. Most prescription sleep medication carries significant risks, including addiction and a higher risk of death. Because ADHD by itself carries a higher than normal risk of addiction, usually prescription sleep medication isn’t worth the risk.
Melatonin is a naturally occuring hormone that causes sleepiness. It is typically taken at bedtime. In limited clinical studies, it has been shown to be effective for treating insomnia in children with ADHD. It is available over the counter, but this does not mean it is completely safe. Some physicians are under the impression that melatonin is without side effects, but this is untrue. Because it is a hormone, pregnant or infertile women trying to become pregnant may wish to consult their physicians prior to taking melatonin. Children who are neurologically disabled have been known to develop seizures when taking melatonin at 3 mg nightly or higher. We do not know what the long term effects of taking melatonin may be on the developing brain and body, so children should take melatonin at the lowest effective dose, for only the nights when sleep is a problem. Doses lower than 3 mg may be obtained via the internet.
Cummings, Carl, and Canadian Paediatrics Society. “Melatonin for the Management of Sleep Disorders in Children and Adolescents.” Paediatrics and Child Health 17.6 (2012): 331-36. Print.
Sheldon, S. “Pro-convulsant Effects of Oral Melatonin in Neurologically Disabled Children.”The Lancet 351.9111 (1998): 1254. Print.