Poor sleep due to ADHD or ADHD due to poor sleep?

Updated: May 4

By Barbara Howard, MD

The day wouldn’t be so bad if he would just go to sleep at night! How many times have you heard this plea from parents of your patients with ADHD? Sleep is important for everyone, but getting enough is both more important and more difficult for children with ADHD.

About three-quarters of children with ADHD have significant problems with sleep, most even before any medication treatment. And, inadequate sleep can exacerbate or even cause ADHD symptoms!

Solving sleep problems for children with ADHD is not always simple. The kinds of sleep issues that are more common in children (and adults) with ADHD, compared with typical children, include:

  • Behavioral bedtime resistance

  • Circadian Rhythm Sleep Disorder (CRSD)

  • Insomnia

  • Morning sleepiness

  • Night waking

  • Periodic Limb Movement Disorder (PLMD)

  • Restless Leg Syndrome (RLS)

  • Sleep Disordered Breathing (SDB)

Such a broad differential means a careful history and sometimes even lab studies may be needed.

Careful Histories, Assessments, and Studies

You will be helped at both initial and follow-up visits for ADHD by including:

  • A sleep history

  • A tool, e.g.

BEARS sleep screening tool

Children’s Sleep Habits Questionnaire

  • 2-week sleep diary (http://www.sleepfoundation.org/) to collect signs of:


Apnea (for SDB)

Limb movements or limb pain (for RLS or PLMD)

Mouth breathing

Night waking


  • You also need to ask about: