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Attention Deficit Hyperactivity Disorder (ADHD)

What is adhd?

If you have a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) this means that you can struggle with paying attention, have high levels of energy and react quickly to things. This can get in the way of everyday life such as school, hobbies and making friends, although how much it affects someone can vary from person to person.

Tasks such as sitting still, concentrating and following instructions are much harder for people with ADHD as they often feel restless or fidgety, can be easily distracted and can talk a lot, which makes activities such as school lessons and doing homework even more difficult.

People with ADHD can sometimes find it harder in social situations such as making friends or playing games as they can find it hard to follow conversations, wait for things and take turns. Sometimes people with ADHD also have difficulties with getting to and staying asleep.

ADHD is a result of the brain being wired slightly differently to people who do not have ADHD. Although there is no cure for ADHD, the difficulties experienced, such as high energy levels, difficulties concentrating and reacting quickly, can be helped and managed in many ways including receiving extra support in school, learning techniques and strategies to help you cope and sometimes taking medication.

 

HELPFUL ADVICE

  1. The most important thing to know is that having ADHD is not your fault and is not a bad thing. People who have ADHD are just as talented as those without ADHD. In fact it is reported that some of the world’s most successful people have diagnoses of ADHD including; Justin Timberlake (singer), Jamie Oliver (chef), Will Smith (actor), Michael Phelps (Olympic swimmer), Emma Watson (actress) and Richard Branson (entrepreneur and owner of the Virgin brand) to name just a few!
  2. There are lots of strategies and techniques that you, your parents, carers and teachers can use to help you cope and manage with the things you find difficult. So it is important to make sure that those involved in teaching or supporting you are aware that you have ADHD. You can find suggestions of techniques and strategies that might help on the website link below. 
  3. As remembering, being organised and planning your day can be one of the hardest things to do and this often makes school difficult, it is a good idea to make notes or reminders and set alarms on your phone of important things that you need to remember. Try to be organised and plan ahead what you will need for each day. It may be helpful to let others help you with doing this. Having a familiar routine will also make it easier for you to remember what you have to do and what you might need with you.
  4. If you have been given a diagnosis and have been prescribed medication to help you there is a really useful website called YoungMinds which can give you lots of information and advice.

 

There are many sensory issues associated with sleep including:

  • Sensitivity to sound, touch, and visual stimuli which can be distracting and distressing and can affect the process of falling asleep.
  • Interoception difficulties, particularly recognising when hungry, full or thirsty or when the person is tired. 
  • Some children are more sensitive to foods like sugar, caffeine and additives which keep people awake.

Look at the bedroom environment to see what may be affecting their ability to go to sleep and stay asleep. Do their pyjamas and bedclothes feel comfortable, are they too hot or cold?  Is it too light or too dark, too noisy or too quiet? Perhaps it is too cluttered and stimulating. Think about your child’s diet. Are they eating too early or not having enough to eat? Are they eating food that can stimulate them close to bedtime. There can be added difficulties where children have restrictive diets but some simple adjustments of what is eaten and when can make a big difference. 

Click here for more information on sensory issues.
 

Sticking to the same routine helps your child to know what to expect at bedtime and helps them feel secure. It also helps to support your child’s internal body clock and keep it on track. The age related sleep advice and information on this website can help with establishing routines. Some children will benefit from using picture timetables, timers or social stories to help them understand their bed-time routine. More information about visual supports can be found on these websites

Visual Resources | Autism West Midlands 
Visual Supports | Autism Toolbox Autism Toolbox

Your child may be feeling overstimulated after a busy day and needs help to wind down, or their environment may be overstimulating with lots of toys, TVs and computers within reach. Avoiding TV and computers or hand-held devices an hour before bedtime can help your child to wind down. Activities that are good for the wind down period are jigsaws and colouring. Having a relaxing bath and milky drink can help some children, but for some children having a bath can over-excite them so they may need to have their bath earlier in the day.

Children who wake to use the toilet, wet the bed, or who wear nappies or pull-ups at night that need changing may have disturbed sleep. Eric, the children’s bowel and bladder charity are a good source of advice on this topic.

 

What might help 

Keeping a sleep diary 

A sleep diary can help you understand what may be causing difficulties with sleep. Fill it out every evening and record as much as you can. You can use it to spot patterns and make changes that may help. 

The Sleep Charity have templates you can download; one for teenagers and one for younger children. 

Seeking advice and help from sleep services 

There are organisations that can help you if you are having difficulties with your child’s sleep. There are many national organisations, including those who specialise in sleep for SEND families, and there are also community-based services in Shropshire, Telford and Wrekin. Click the link at the bottom of page to visit our support services page. 

Understanding sleep cycles 

The circadian sleep cycle is a 24-hour cycle that helps govern essential bodily functions especially the sleep-wake cycle. It plays a vital role in a person’s ability to sleep in one consolidated block of time at night and to stay awake during the day. As the sun sets in the evening, the brain begins producing melatonin, a hormone that induces sleepiness. Core body temperature also drops.

As melatonin and tryptophan (an amino acid which helps produce melatonin) are naturally produced in the body, there are things you can do to help their production.  Darkness helps to promote the production of melatonin which is why it is a good idea to put your child to sleep in a darkened room, and light emitting devices such as tablets and phones also can destroy melatonin so should not be used for at least an hour before bed. New research shows that limiting exposure to screens and increasing physical activity levels during the day has a positive effect on children's overall physical, mental health and wellbeing, including sleep.

Setting a waking time consistently even in holiday times, which is called ‘anchoring’ the wake time, can help to reset the body clock over time. This should be accompanied with exposure to lots of light on waking to support circadian rhythm. 

Melatonin and tryptophan occur naturally in some foods and drinks such as milky drinks and cereals which is why having a milky drink before bed can help settling to sleep. For more information visit Diet & Sleep - The Sleep Charity

Prescriptions of melatonin

Behavioural strategies and practical solutions are the best way to address sleep difficulties, but if they are having a significant impact on your child’s ability to function, a drug form of melatonin is sometimes prescribed for neurodivergent children. As the drug’s function is to re-set sleep and wake cycles, it works best combined with good sleep hygiene practices. It is important that is it taken under medical supervision and not purchased on-line so that it is closely monitored for dosage and side effects. It should be prescribed for the shortest period necessary as the long-term effects of the drug on children’s development are not yet known.

 In Shropshire, Telford and Wrekin the Community Paediatric Service and the CAMHS (BeeU) Service) can prescribe melatonin for children and young people who meet ALL of the following criteria.

  1. the child/young person must be open to and being treated by the service due to a neurodevelopmental/mental health need (diagnosis is not required but the child must be being seen by the service, not on a waiitng list)
  2. sleep issues are causing significant impact on the child/ young person, for example due to daytime sleeping or behavioural problems that are impacting daily functioning or educational attendance
  3. behavioural approaches have been tried and failed. These may have been offered by the service (where available) or by community sleep support services.

GPs are unable to prescribe melatonin although they sometimes issue repeat prescriptions when prescribing has been started by a specialist (such as a paediatrician or child psychiatrist). 

Further support 

Click on the link below to visit a page with information about

  • national websites and sleep organisations
  • local community services in Shropshire, Telford and Wrekin.