When their head won't switch off: ADHD and sleep

My eldest didn't sleep for more than about forty minutes at a time until he was four or five.

Not most nights. Every night. Forty minutes of sleep, and then he was awake. Settle him, forty minutes of sleep, and then awake again. For years.

And his naps were no different. Never more than forty minutes, which, if you've ever had a new baby, you'll know is the precious bit of the day when you get to eat, shower, or just sit down. Often settling him would take longer than the nap.

I didn't really question it. He hadn't slept in the womb either, so I wasn't surprised, and he was my first, so I had nothing to compare him with. I just assumed all babies were different and mine didn't sleep. I don't think I ever even mentioned it to a doctor. I used to call him my Duracell bunny.

When he was a baby, it never crossed my mind that it might be anything more than that. It wasn’t until he was around five or six that I started to wonder about ADHD, but I didn't want him to have a label, so I kept it to myself. Looking back, that was my own prejudice. I didn't yet understand how much a diagnosis could help, or that it's less a label than an explanation. It was only when he started asking me whether I thought he might have ADHD that I started raising it with his teachers. He was finally diagnosed at twelve.

And it wasn't a busy head, either. He was far too young to have the kind of racing thoughts older children describe. Whatever was keeping him awake was there before he had words for anything.

Then my youngest came along, and he was the polar opposite.

He needed sleep, and he thrived on it. It was as if he'd read the book. He'd be awake for exactly the amount of time the books said he should be at that age, then make a funny little noise that meant he was ready. I'd pop him in his cot, and he would go straight off. I had a video monitor, and neither my friends nor I could quite believe what we were watching.

Same parents. Same house. Same routine. Completely different child.

If I'd only ever had one, I would have spent years believing I was doing sleep wrong. Having the second one is how I know it was never about what I was doing.

I know now that we weren't unusual. I just didn't know it then.

Sleep problems often come first

Sleep difficulties are one of the most common things that go alongside ADHD. Somewhere between half and three quarters of children with ADHD have real trouble with sleep, and the most common problem is simply not being able to fall asleep.

What surprised me is how early it can show up. Studies that follow babies and toddlers over time have found that severe sleep problems in infancy are linked to a later ADHD diagnosis. In one, around one in four babies with severe sleep problems went on to be diagnosed with ADHD by the age of five and a half.

That doesn't mean every baby who won't sleep has ADHD. Most don't. And it works the other way too: plenty of children with ADHD sleep well. I've said it before and I'll say it again: no two ADHD children are the same, and sleep is no exception.

But if you are reading this with a child who has never slept well, and you have always quietly wondered whether it was something you did, it probably wasn't.

Their body clock can run late

One reason is the body clock itself.

Melatonin is the hormone that tells the body it's time to sleep. In many children with ADHD it switches on later in the evening than it does for other children. Research suggests by around three quarters of an hour on average, and in adults with ADHD it's later still.

So when you say "lights out" at the time that works for everyone else, their body may genuinely not be ready. They are not being difficult. They are lying in the dark, wide awake, being told to do something their body isn't set up to do yet.

That also explains the mornings. A child who fell asleep late is being woken before they've had enough, and then we wonder why getting out of the door is a battle.

And then the head gets busy

As they get older, a second thing often joins in: the busy head.

Everything that was held together all day comes out at night. The thing a friend said. The homework that isn't done. What if tomorrow goes wrong. Ideas, plans, a song on repeat. The moment the room goes quiet and there is nothing else to focus on, the brain turns up the volume.

This is why "just stop thinking about it" doesn't work. If they could, they would.

And here's the twist. My youngest, the one who slept exactly as the books said he should, now often finds it really hard to get to sleep. He's tired, he's ready for bed, and then the moment the light goes off, his brain goes into overdrive. Questions, plans, worries, whatever happened at school that day, all at once. It's one more reminder that sleep is about how a child is wired and where they are right now, not about something you're doing wrong.

Why it matters so much

This is the part that’s easy to miss: being short of sleep makes anyone more distracted, more impulsive and quicker to snap, which are exactly the things ADHD already makes harder. So a child with ADHD who hasn't slept well isn't just tired. Everything they already find hard gets even harder.

So a bad night doesn't just make for a grumpy morning. It can make the whole day harder, which makes the evening harder, which makes the next night harder.

It isn't screens, or not only screens. Phones, tablets and even the TV can make it worse, and they're worth thinking about. But plenty of children with ADHD are wide awake long after every screen in the house is off.

What actually helps

I'm a coach, not a doctor, so if sleep is a real problem, please talk to your GP. There are medical options, and they're for a professional to talk through with you. If your child takes ADHD medication, it's worth asking whether the timing is affecting their sleep. Some children might also be prescribed melatonin. It isn't a cure, and it won't work for everyone, but it can really help to regulate sleep, nudging that late body clock back towards a more workable bedtime. In the UK it's prescription only for children.

Alongside that, these are the things that tend to help most:

• Work with their clock, not against it. A later lights out that ends in sleep beats an early one that ends in an hour of lying awake.
• The same wind-down every night. The same few things, in the same order. Predictable is calming, and it takes the negotiating out of it.
• Light matters. Dimmer lights in the evening, and daylight in the morning, help nudge a late body clock earlier.
• Move earlier in the day. A body that's had a chance to run about settles more easily than one that's been still since three o'clock.
• Give the busy head somewhere to go. A notepad by the bed to "park" the thoughts until morning. An audiobook or a podcast they've heard before, so there's something to follow that asks nothing of them. Some of the grounding ideas can help here too.
• Try some background noise. Some children settle far better with sound around them than in silence: a fan, white noise, or the sound of outside.
• Don't make bed a battleground. If they're wide awake, lying there being told off about it only adds worry. Quiet and calm, even if not asleep, still counts.

With my eldest, I tried everything the books suggested. I read to him, rocked him, played music, and even tried leaving him to cry, which I hated and which only upset us both. Nothing worked, until eventually he just crashed out.

What did help was tiring him out. I genuinely thought of that as my job. Movement worked: a car journey would send him off, though never for long. Forty minutes, and he'd wake up refreshed and ready to go again. I walked round and round the park with the dog, who thought it was brilliant. He always settled better with noise around him than in silence, so being outside helped, and if he fell asleep in the pram he'd wake the second we came indoors. Quite often I'd leave him outside, because the wind in the trees seemed to calm him.

He's a teenager now, and he still sleeps with a little fan next to his bed, because the noise settles him.

If this sounds like your child

• Keep a simple sleep diary for a couple of weeks. What time they went to bed, roughly when they fell asleep, how often they woke, and what the next day was like. It shows you patterns that are hard to see when you're exhausted, and if you're thinking of seeking support, it's exactly what a GP or an assessment will want to see.
• Talk to your GP if it's affecting them, or you, day to day. Take the diary with you.
• Tell school, especially if they've noticed your child is tired. It shows them this isn't a case of letting them go to bed whenever they like: it's a real difficulty that you're working on. Raised as a real issue, schools tend to be far more understanding, and it gives them context for a hard morning or a flat afternoon.

And you

I'll be honest. I am really not good on little or no sleep. Five years of forty-minute stretches very nearly finished me off.

I had him at forty, and the sleep deprivation took its toll (and added many grey hairs). Even when he eventually learned to self-soothe, I would still hear him wake up, and lie in bed hoping he would manage to go back to sleep. Then, then when he started sleeping through, he was up at five, so that's when our day started. My friends' babies were all "sleeping through the night", and if I'm honest, I'm not sure I even believed them. There's a five-year gap between my boys, and I'm fairly sure that's why. I was just so exhausted.

When he was about three, we even paid for a highly recommended sleep consultant. She told me the problem was me: I was too soft on him, and he was ruling the house. She suggested bolting his bedroom door so he couldn't get out. I hated her.

If anyone has ever told you that your child's sleep is your fault, it wasn't mine, and it very probably isn't yours.

If you're parenting a child who doesn't sleep, you're not sleeping either. And everything I've said about what a tired brain does applies to you too. Shorter fuse, less patience, harder to stay calm when they can't. That's not a failure of parenting. That's what happens to anyone who's been awake for years.

So please don't leave yourself off the list. Take the naps you can get. Share the nights if there's anyone to share them with. Lower the bar on everything else for a while. You can't be the calm in the room if you're running on nothing.

It does get better. When he was small, friends used to warn me: "Just you wait until he's a teenager. You won't be able to get him out of bed." They were half right. He still genuinely needs less sleep than most people, and certainly less than me. But he can now sleep for ten hours straight.

With the fan on, of course.