ADHD and Tired

[Anonymous]

my 5yo DS has recently been diagnosed through psycheducational testing with adhd-combined. this comes as no surprise to us, but as i am researching it i do have a question that y'all with more experience might help me better understand. ds always complains of being tired. he falls asleep quickly at night and then usually comes into bed with me at varying times in the night. if i put him back in his room he will be up for the day. if i let him stay he stays asleep until 6:15 or so. after school he likes to crawl into my bed and watch tv until he has to go to speech or ot. on weekends he will easily fall asleep in the car if in it for longer than 15 minutes. everything i know about adhd combo kids is that they are perpetual motion with engines that are hard to slow down. he just isn't like that. at school when pressed with tasks that are too hard or challenging he can't sit still but at home he isnt like that. before we start medicating the adhd i'm trying to get a feel. is this tiredness common in adhd kids or could the tiredness be causing the adhd behavior we are seeing? thanks.

[Anonymous]

Have you discussed this with your ped? Ours talked about sleep issues as a contributing factor or sometimes complicating factor with ADHD combined. From what you describe - particularly the multiple wakings per night - there may be an issue here that is contributing to the ADHD behavior.

[Anonymous]

Maybe your son is simply worn out from the demands of his day? My son sounds a lot like yours and he is often also very tired on weeknights. On weekends he is on the go 24/7 because he doesn't have to conform to the rules and structure of school.

[Anonymous]

I think the constant movement is a stereotype but not an accurate descriptor of many ADHD kids. My child with ADHD combined is not in perpetual motion. He is wiggly/fidgety in some situations but not others. I know several kids with the same diagnosis and while they have their moments when it seems impossible to get them to turn their engine off, most of the time they are slouchy and slumpy. Most of the super active, on-the-go kids I know do not have ADHD.

When my son is stressed or bored he looks, and clearly feels, exhausted. When he has gone through bad stretches of anxiety I have often thought something was physically wrong with him because of how tired he was. Low energy, low muscle tone, exhausted all day. I am still not sure there is not an underlying medical issue but we have done tests and not found anything. Then when the anxiety gets better, so does his energy. In any case, if I were you, I would definitely look into medical causes both for the tiredness and the attention issues.

[Anonymous]

My son is similar. Has not been diagnosed with ADHD (has AS) but is fidgety, impulsive, and attention flags, esp. when things are too hard or too boring. Also a poor sleeper. Exercise might help give him energy (release nervous energy, create healthy energy) and I would make sure you are offering enough hydration. My son does not pay enough attention to body cues so I need to prompt him to drink more water. You can try rewards to motivate him to sleep better--but overall sleep is difficult. Someone at a healthfood store just gave me a talk about making sure I offer enough protein in the a.m. and throughout the day. These guys go through a lot of fuel so maybe make sure he's getting more than faster burning foods. No chocolate (except occasional treats) or other sources of caffeine of course.

[Anonymous]

Does he snore? Sleep apnea could be causing frequent night wakings, which could lead to insufficient sleep, which in turn could cause the problem behavior.

[Anonymous]

ADHD is a spectrum disorder so two kids with ADHD can have varying degrees in behavior, especially since there are three main types of ADHD - ADHD Inattentive, ADHD Hyperactive, and ADHD Combined (both inattentive and hyperactive).

My son and daughter are ADHD Inattentive. They do not have any sleep problems. They fall a sleep like clockwork and are such deep sleepers, I don't think the fire alarm in the house would wake them up. The one issue that they have in common that I don't see in my two children without ADHD is a lack of appetite. They had eating issues before medication (especially not wanting to eat breakfast). ADHD medication just makes eating even more challenging to them but we have worked our way around the problem with supplemental drinks such as Boost/Ensure as well as finding the right meds and dosage that the reaction isn't too bad. Our pediatrician is the prescribing doctor and he helped us with the recommendation for Boost/Ensure as well as regular med check appointments.

Before medicating for ADHD, I would go back to your pediatrician to discuss the sleep issues. Maybe your child should undergo a sleep study to find out how often he is really waking up at night (I would bet he is waking up more than you know - you only know of the times he wakes you up) as well as the root cause for his inability to sleep through the night. A treatment plan for the sleep issues then could be formulated to address that need and then you would know how that affects the ADHD symptoms. Any tired child would have difficulty concentrating. An ADHD child could have comorbid sleep issues. It would be hard to know what your son is dealing with without the further testing.

In the meanwhile, the ADHD symptoms should be addressed through some type of educational plan (If public - and IEP/504 plan). Special Education is just good teaching practices and often would help any child. Did the testing results given any recommendations for any instructional interventions or accommodations to help your child? I would implement these first before starting meds. You child may not need meds if he receives instructional interventions and accommodations. These may be enough to help with the ADHD. If you are shooting for an IEP or 504, the school also needs to see the problems and if a child is medicated the symptoms may not be as apparent. Meds should always be a last resort because they do have some bad side effects and can become less effective with time.

[Anonymous]

Talk to the doctor and try melatonin. I'm not an expert or a doctor, but I thought there was a documented connection between ADHD and lack of the hormones like melatonin that regulate the sleep-waking cycle. A lot of adults/kids with ADHD and ASD take melatonin.

Again, talk to the doctor first for sure to see if this supplement is okay for your child individually to try. Trader Joe's has a mint chewable form, you could give him half a tablet.

[Anonymous]

My daughter's doctor recommended Melatonin - we use Sundown, a liquid that tastes good enough that she does not object to a nightly dose. It has really helped her with the restlessness and multiple wakings during the night (both have disappeared). Lots of studies have been done that suggest kids who don't sleep well exhibit ADHD-like symptoms. The doctor also suggested as hot a bath as the child will tolerate to ready the body for sleep. It is still challenging to get her to go to sleep (we have a routine that still involves back rubbing at 6), but she sleeps through the night and is much less tired in the morning. ADHD often comes along with a good heaping of anxiety on the side - so reducing some of the anxiety may also help with maximizing the restful quality of your child's sleep (our local school which was language immersion was a bad fit for daughter; we changed schools and she's happier and less tired in general).

[Anonymous]

Op here- thanks so much for all the suggestions and insights. We are pursuing the sleep issues with doctors but I knew y’all would have some useful insight which I appreciate your time in responding.

For the poster concerned about iep in the school, our school has been 100% supportive of everything we have needed and I have zero complaints or concerns that his needs aren’t being met, but thanks for making sure i had that covered.

[Anonymous]

Anonymous wrote:My daughter's doctor recommended Melatonin - we use Sundown, a liquid that tastes good enough that she does not object to a nightly dose. It has really helped her with the restlessness and multiple wakings during the night (both have disappeared). Lots of studies have been done that suggest kids who don't sleep well exhibit ADHD-like symptoms. The doctor also suggested as hot a bath as the child will tolerate to ready the body for sleep. It is still challenging to get her to go to sleep (we have a routine that still involves back rubbing at 6), but she sleeps through the night and is much less tired in the morning. ADHD often comes along with a good heaping of anxiety on the side - so reducing some of the anxiety may also help with maximizing the restful quality of your child's sleep (our local school which was language immersion was a bad fit for daughter; we changed schools and she's happier and less tired in general).

I know you said you're happy with your son's school, but I wanted to emphasize this for anyone else reading. My child's first school was not a good fit, primarily bc its unstructured nature led to too many social demands, and we were shocked when dc suddenly had to go to sleep by 7 or even earlier. Now that dc is in a better school, she's sleeping better and doesnt need as much sleep.